Family Nurse Practitioner (FNP) Barkley Post-Test
Fall 2025 Comprehensive Final Exam with Verified
Rationales Practice Questions and Answers 2026
with complete solution
Q1.
A 58-year-old patient with type 2 diabetes and established ASCVD has an
A1C of 8.4% on metformin. Which medication provides both glycemic
control and cardiovascular benefit?
A. Glyburide
B. Pioglitazone
C. GLP-1 receptor agonist
D. Acarbose
Correct Answer: C
Big Rationale:
GLP-1 receptor agonists (e.g., semaglutide, liraglutide) reduce A1C,
promote weight loss, and significantly reduce major adverse
cardiovascular events. Sulfonylureas increase hypoglycemia risk and do
not offer CV protection.
Q2.
Which finding best differentiates Bell’s palsy from stroke?
,A. Sudden onset
B. Facial droop
C. Forehead involvement
D. Slurred speech
Correct Answer: C
Big Rationale:
Bell’s palsy affects the entire side of the face, including the forehead.
Stroke typically spares the forehead due to bilateral cortical innervation.
Q3.
First-line treatment for uncomplicated acute cystitis in a healthy, non-
pregnant woman is:
A. Ciprofloxacin
B. TMP-SMX (3 days)
C. Nitrofurantoin
D. Amoxicillin
Correct Answer: C
Big Rationale:
Nitrofurantoin is first-line due to low resistance, safety, and targeted
urinary activity. Fluoroquinolones are avoided due to adverse effects.
Q4.
Which blood pressure meets criteria for Stage 2 hypertension?
,A. 128/78
B. 134/86
C. 142/92
D. 138/88
Correct Answer: C
Big Rationale:
Stage 2 hypertension = ≥140 systolic OR ≥90 diastolic.
Q5.
A patient with asthma has symptoms daily and nighttime symptoms
weekly. Classification?
A. Intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent
Correct Answer: C
Big Rationale:
Daily symptoms + weekly nighttime awakenings = moderate persistent
asthma, requiring daily inhaled corticosteroid + LABA.
Q6.
Which medication is contraindicated in pregnancy?
A. Labetalol
B. Methyldopa
, C. ACE inhibitors
D. Nifedipine
Correct Answer: C
Big Rationale:
ACE inhibitors cause fetal renal failure, oligohydramnios, and death and
are absolutely contraindicated.
Q7.
A patient presents with weight loss, tremor, and heat intolerance.
Expected labs?
A. Elevated TSH
B. Low T4
C. High free T4
D. Elevated cortisol
Correct Answer: C
Big Rationale:
Hyperthyroidism = high T4, suppressed TSH.
Q8.
Which screening is recommended for colorectal cancer in average-risk
adults?
A. FOBT yearly only
B. Colonoscopy every 5 years
Fall 2025 Comprehensive Final Exam with Verified
Rationales Practice Questions and Answers 2026
with complete solution
Q1.
A 58-year-old patient with type 2 diabetes and established ASCVD has an
A1C of 8.4% on metformin. Which medication provides both glycemic
control and cardiovascular benefit?
A. Glyburide
B. Pioglitazone
C. GLP-1 receptor agonist
D. Acarbose
Correct Answer: C
Big Rationale:
GLP-1 receptor agonists (e.g., semaglutide, liraglutide) reduce A1C,
promote weight loss, and significantly reduce major adverse
cardiovascular events. Sulfonylureas increase hypoglycemia risk and do
not offer CV protection.
Q2.
Which finding best differentiates Bell’s palsy from stroke?
,A. Sudden onset
B. Facial droop
C. Forehead involvement
D. Slurred speech
Correct Answer: C
Big Rationale:
Bell’s palsy affects the entire side of the face, including the forehead.
Stroke typically spares the forehead due to bilateral cortical innervation.
Q3.
First-line treatment for uncomplicated acute cystitis in a healthy, non-
pregnant woman is:
A. Ciprofloxacin
B. TMP-SMX (3 days)
C. Nitrofurantoin
D. Amoxicillin
Correct Answer: C
Big Rationale:
Nitrofurantoin is first-line due to low resistance, safety, and targeted
urinary activity. Fluoroquinolones are avoided due to adverse effects.
Q4.
Which blood pressure meets criteria for Stage 2 hypertension?
,A. 128/78
B. 134/86
C. 142/92
D. 138/88
Correct Answer: C
Big Rationale:
Stage 2 hypertension = ≥140 systolic OR ≥90 diastolic.
Q5.
A patient with asthma has symptoms daily and nighttime symptoms
weekly. Classification?
A. Intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent
Correct Answer: C
Big Rationale:
Daily symptoms + weekly nighttime awakenings = moderate persistent
asthma, requiring daily inhaled corticosteroid + LABA.
Q6.
Which medication is contraindicated in pregnancy?
A. Labetalol
B. Methyldopa
, C. ACE inhibitors
D. Nifedipine
Correct Answer: C
Big Rationale:
ACE inhibitors cause fetal renal failure, oligohydramnios, and death and
are absolutely contraindicated.
Q7.
A patient presents with weight loss, tremor, and heat intolerance.
Expected labs?
A. Elevated TSH
B. Low T4
C. High free T4
D. Elevated cortisol
Correct Answer: C
Big Rationale:
Hyperthyroidism = high T4, suppressed TSH.
Q8.
Which screening is recommended for colorectal cancer in average-risk
adults?
A. FOBT yearly only
B. Colonoscopy every 5 years
