FNP MSN 560 EXAM PRACTICE QUESTIONS PLUS
RATIONALES 2026 |INSTANT DOWNOAD PDF
1. A 45-year-old male presents with sudden onset chest pain
radiating to the left arm. Which is the most appropriate initial
action?
A. Order a chest X-ray
B. Administer nitroglycerin and aspirin immediately
C. Schedule an outpatient cardiology referral
D. Obtain a fasting lipid panel
Correct answer: B. Administer nitroglycerin and aspirin
immediately
Rationale: Sudden chest pain radiating to the left arm is
suggestive of acute myocardial infarction. Immediate
administration of aspirin and nitroglycerin (if not
contraindicated) is life-saving and follows ACLS guidelines.
2. Which of the following vaccines is recommended annually
for adults?
A. Tdap
B. Influenza
C. MMR
D. Hepatitis B
,Correct answer: B. Influenza
Rationale: The influenza vaccine is recommended annually for
all adults to reduce morbidity and mortality from seasonal flu.
3. A 60-year-old female presents with a blood pressure of
150/95 mmHg. What is the first-line pharmacologic
treatment?
A. Beta-blockers
B. ACE inhibitors or thiazide diuretics
C. Calcium supplements
D. Statins
Correct answer: B. ACE inhibitors or thiazide diuretics
Rationale: According to JNC 8 guidelines, ACE inhibitors or
thiazide diuretics are first-line therapy for primary hypertension,
particularly in adults without contraindications.
4. Which lab test is the most sensitive marker for acute kidney
injury?
A. Serum creatinine
B. Blood urea nitrogen (BUN)
C. Urinalysis
D. Serum potassium
Correct answer: A. Serum creatinine
Rationale: Serum creatinine is the most commonly used marker
,for kidney function and acute kidney injury because it rises
when glomerular filtration rate declines.
5. A patient with Type 2 Diabetes has an HbA1c of 8.5%. What
is the most appropriate next step?
A. Maintain current lifestyle plan
B. Intensify pharmacologic therapy
C. Discontinue all medications
D. Recommend fasting only
Correct answer: B. Intensify pharmacologic therapy
Rationale: An HbA1c above 7% indicates inadequate glycemic
control. Adjusting pharmacologic therapy (adding or increasing
medications) alongside lifestyle interventions is recommended.
6. Which of the following is a classic sign of hypothyroidism?
A. Weight loss and palpitations
B. Cold intolerance and fatigue
C. Hyperactivity and diarrhea
D. Tremor and anxiety
Correct answer: B. Cold intolerance and fatigue
Rationale: Hypothyroidism slows metabolism, causing fatigue,
cold intolerance, weight gain, and bradycardia.
, 7. Which antibiotic is first-line for uncomplicated urinary tract
infections in women?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin-clavulanate
D. Vancomycin
Correct answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is first-line therapy for uncomplicated
UTIs in women due to its efficacy and low resistance profile.
8. A 55-year-old male presents with shortness of breath,
orthopnea, and lower extremity edema. Which condition is
most likely?
A. COPD
B. Heart failure
C. Pulmonary embolism
D. Pneumonia
Correct answer: B. Heart failure
Rationale: Symptoms of dyspnea, orthopnea, and peripheral
edema suggest fluid overload, which is characteristic of heart
failure.
9. Which lipid-lowering medication is most effective at
reducing LDL cholesterol?
A. Statins
RATIONALES 2026 |INSTANT DOWNOAD PDF
1. A 45-year-old male presents with sudden onset chest pain
radiating to the left arm. Which is the most appropriate initial
action?
A. Order a chest X-ray
B. Administer nitroglycerin and aspirin immediately
C. Schedule an outpatient cardiology referral
D. Obtain a fasting lipid panel
Correct answer: B. Administer nitroglycerin and aspirin
immediately
Rationale: Sudden chest pain radiating to the left arm is
suggestive of acute myocardial infarction. Immediate
administration of aspirin and nitroglycerin (if not
contraindicated) is life-saving and follows ACLS guidelines.
2. Which of the following vaccines is recommended annually
for adults?
A. Tdap
B. Influenza
C. MMR
D. Hepatitis B
,Correct answer: B. Influenza
Rationale: The influenza vaccine is recommended annually for
all adults to reduce morbidity and mortality from seasonal flu.
3. A 60-year-old female presents with a blood pressure of
150/95 mmHg. What is the first-line pharmacologic
treatment?
A. Beta-blockers
B. ACE inhibitors or thiazide diuretics
C. Calcium supplements
D. Statins
Correct answer: B. ACE inhibitors or thiazide diuretics
Rationale: According to JNC 8 guidelines, ACE inhibitors or
thiazide diuretics are first-line therapy for primary hypertension,
particularly in adults without contraindications.
4. Which lab test is the most sensitive marker for acute kidney
injury?
A. Serum creatinine
B. Blood urea nitrogen (BUN)
C. Urinalysis
D. Serum potassium
Correct answer: A. Serum creatinine
Rationale: Serum creatinine is the most commonly used marker
,for kidney function and acute kidney injury because it rises
when glomerular filtration rate declines.
5. A patient with Type 2 Diabetes has an HbA1c of 8.5%. What
is the most appropriate next step?
A. Maintain current lifestyle plan
B. Intensify pharmacologic therapy
C. Discontinue all medications
D. Recommend fasting only
Correct answer: B. Intensify pharmacologic therapy
Rationale: An HbA1c above 7% indicates inadequate glycemic
control. Adjusting pharmacologic therapy (adding or increasing
medications) alongside lifestyle interventions is recommended.
6. Which of the following is a classic sign of hypothyroidism?
A. Weight loss and palpitations
B. Cold intolerance and fatigue
C. Hyperactivity and diarrhea
D. Tremor and anxiety
Correct answer: B. Cold intolerance and fatigue
Rationale: Hypothyroidism slows metabolism, causing fatigue,
cold intolerance, weight gain, and bradycardia.
, 7. Which antibiotic is first-line for uncomplicated urinary tract
infections in women?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin-clavulanate
D. Vancomycin
Correct answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is first-line therapy for uncomplicated
UTIs in women due to its efficacy and low resistance profile.
8. A 55-year-old male presents with shortness of breath,
orthopnea, and lower extremity edema. Which condition is
most likely?
A. COPD
B. Heart failure
C. Pulmonary embolism
D. Pneumonia
Correct answer: B. Heart failure
Rationale: Symptoms of dyspnea, orthopnea, and peripheral
edema suggest fluid overload, which is characteristic of heart
failure.
9. Which lipid-lowering medication is most effective at
reducing LDL cholesterol?
A. Statins
