1
NURS 5433 FNP II Final Exam Actual Exam
2026/2027 | University of Texas at Arlington | Family
Nurse Practitioner II Questions with Complete
Solutions | Pass Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (15 Questions)
Case Study 1: Hypertension with Comorbidities
Scenario: A 62-year-old African American male with hypertension, type 2 diabetes, and CKD
stage 3 presents for follow-up. Current BP 148/90 mmHg on lisinopril 20 mg daily. Labs: Cr 1.8,
eGFR 45, K+ 5.1.
Q1: According to ACC/AHA guidelines, what is the BP target for this patient?
A. <140/90
B. <135/85
C. <130/80
D. <120/80
Correct Answer: C [CORRECT]
Rationale: ACC/AHA guidelines recommend BP target <130/80 for patients with diabetes and
CKD due to increased cardiovascular risk. This is a more aggressive target than for
uncomplicated hypertension.
Q2: What is the most appropriate next step in management given his current BP of 148/90?
A. Increase lisinopril to 40 mg daily
B. Add a thiazide diuretic
C. Add amlodipine 5 mg daily
D. Discontinue lisinopril due to renal impairment
Correct Answer: C [CORRECT]
Rationale: Current BP is above goal on ACE inhibitor monotherapy. Adding a calcium channel
blocker (amlodipine) is appropriate for African American patients and those with CKD. ACE
inhibitors remain indicated for renal protection despite reduced eGFR.
,2
Q3: Given his potassium of 5.1 on lisinopril, which medication would be most appropriate to
add for better BP control?
A. Spironolactone
B. Amlodipine
C. Losartan
D. Hydrochlorothiazide
Correct Answer: B [CORRECT]
Rationale: With potassium already elevated (5.1) on ACE inhibitor, adding another agent
affecting potassium (ARB, spironolactone) risks hyperkalemia. Amlodipine (CCB) is a safe,
effective add-on with no effect on potassium.
Q4: A 58-year-old female with no history of cardiovascular disease has a total cholesterol of 240
mg/dL, HDL 45 mg/dL, LDL 160 mg/dL, and triglycerides 180 mg/dL. Her 10-year ASCVD risk
is calculated at 8.5%. According to ACC/AHA guidelines, what is the appropriate statin
intensity?
A. No statin therapy needed
B. Low-intensity statin
C. Moderate-intensity statin
D. High-intensity statin
Correct Answer: C [CORRECT]
Rationale: For adults aged 40-75 with LDL 160-189 mg/dL and 10-year ASCVD risk ≥7.5%,
moderate-intensity statin therapy is recommended to reduce ASCVD risk by approximately 30%
or more.
Q5: A 45-year-old male presents with chest pain described as pressure-like, radiating to the left
arm, occurring with exertion and relieved by rest. ECG shows no acute changes, troponins
negative. What is the most appropriate next diagnostic step?
A. Immediate coronary angiography
B. Stress testing (exercise or pharmacologic)
C. Cardiac MRI
D. CT coronary angiography
Correct Answer: B [CORRECT]
Rationale: This presentation is consistent with stable angina. In patients with intermediate pre-
, 3
test probability and no high-risk features, stress testing is the appropriate initial non-invasive
evaluation to assess for ischemia and guide further management.
Q6: A 70-year-old male with HFrEF (EF 35%) is on lisinopril 20 mg, metoprolol succinate 50
mg, and furosemide 40 mg daily. He remains symptomatic with NYHA Class II-III symptoms.
According to GDMT guidelines, what medication should be added next?
A. Digoxin
B. Sacubitril/valsartan (ARNI)
C. Diltiazem
D. Hydralazine/isosorbide dinitrate
Correct Answer: B [CORRECT]
Rationale: For HFrEF patients remaining symptomatic on ACE inhibitor and beta-blocker,
switching to sacubitril/valsartan (ARNI) is recommended (PARADIGM-HF trial) to reduce
cardiovascular death and heart failure hospitalization. ARNIs are preferred over ACE inhibitors
in eligible patients.
Q7: A 68-year-old female with atrial fibrillation (CHA₂DS₂-VASc score 4) is being considered
for anticoagulation. She has well-controlled hypertension and no history of bleeding. What is the
most appropriate recommendation?
A. Aspirin 81 mg daily
B. Warfarin with INR goal 2.0-3.0
C. Apixaban 5 mg twice daily
D. No anticoagulation needed
Correct Answer: C [CORRECT]
Rationale: With CHA₂DS₂-VASc score ≥2 in females (≥1 in males), oral anticoagulation is
indicated. DOACs like apixaban are preferred over warfarin for non-valvular AF due to reduced
bleeding risk, no monitoring requirements, and fewer drug-food interactions.
Q8: Which patients should receive high-intensity statin therapy according to ACC/AHA
guidelines? Select all that apply.
A. Patient with clinical ASCVD (prior MI, stroke)
B. Patient with LDL ≥190 mg/dL
C. Patient with diabetes aged 40-75 with 10-year risk ≥7.5%
D. Patient aged 20-39 with family history of premature ASCVD
NURS 5433 FNP II Final Exam Actual Exam
2026/2027 | University of Texas at Arlington | Family
Nurse Practitioner II Questions with Complete
Solutions | Pass Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (15 Questions)
Case Study 1: Hypertension with Comorbidities
Scenario: A 62-year-old African American male with hypertension, type 2 diabetes, and CKD
stage 3 presents for follow-up. Current BP 148/90 mmHg on lisinopril 20 mg daily. Labs: Cr 1.8,
eGFR 45, K+ 5.1.
Q1: According to ACC/AHA guidelines, what is the BP target for this patient?
A. <140/90
B. <135/85
C. <130/80
D. <120/80
Correct Answer: C [CORRECT]
Rationale: ACC/AHA guidelines recommend BP target <130/80 for patients with diabetes and
CKD due to increased cardiovascular risk. This is a more aggressive target than for
uncomplicated hypertension.
Q2: What is the most appropriate next step in management given his current BP of 148/90?
A. Increase lisinopril to 40 mg daily
B. Add a thiazide diuretic
C. Add amlodipine 5 mg daily
D. Discontinue lisinopril due to renal impairment
Correct Answer: C [CORRECT]
Rationale: Current BP is above goal on ACE inhibitor monotherapy. Adding a calcium channel
blocker (amlodipine) is appropriate for African American patients and those with CKD. ACE
inhibitors remain indicated for renal protection despite reduced eGFR.
,2
Q3: Given his potassium of 5.1 on lisinopril, which medication would be most appropriate to
add for better BP control?
A. Spironolactone
B. Amlodipine
C. Losartan
D. Hydrochlorothiazide
Correct Answer: B [CORRECT]
Rationale: With potassium already elevated (5.1) on ACE inhibitor, adding another agent
affecting potassium (ARB, spironolactone) risks hyperkalemia. Amlodipine (CCB) is a safe,
effective add-on with no effect on potassium.
Q4: A 58-year-old female with no history of cardiovascular disease has a total cholesterol of 240
mg/dL, HDL 45 mg/dL, LDL 160 mg/dL, and triglycerides 180 mg/dL. Her 10-year ASCVD risk
is calculated at 8.5%. According to ACC/AHA guidelines, what is the appropriate statin
intensity?
A. No statin therapy needed
B. Low-intensity statin
C. Moderate-intensity statin
D. High-intensity statin
Correct Answer: C [CORRECT]
Rationale: For adults aged 40-75 with LDL 160-189 mg/dL and 10-year ASCVD risk ≥7.5%,
moderate-intensity statin therapy is recommended to reduce ASCVD risk by approximately 30%
or more.
Q5: A 45-year-old male presents with chest pain described as pressure-like, radiating to the left
arm, occurring with exertion and relieved by rest. ECG shows no acute changes, troponins
negative. What is the most appropriate next diagnostic step?
A. Immediate coronary angiography
B. Stress testing (exercise or pharmacologic)
C. Cardiac MRI
D. CT coronary angiography
Correct Answer: B [CORRECT]
Rationale: This presentation is consistent with stable angina. In patients with intermediate pre-
, 3
test probability and no high-risk features, stress testing is the appropriate initial non-invasive
evaluation to assess for ischemia and guide further management.
Q6: A 70-year-old male with HFrEF (EF 35%) is on lisinopril 20 mg, metoprolol succinate 50
mg, and furosemide 40 mg daily. He remains symptomatic with NYHA Class II-III symptoms.
According to GDMT guidelines, what medication should be added next?
A. Digoxin
B. Sacubitril/valsartan (ARNI)
C. Diltiazem
D. Hydralazine/isosorbide dinitrate
Correct Answer: B [CORRECT]
Rationale: For HFrEF patients remaining symptomatic on ACE inhibitor and beta-blocker,
switching to sacubitril/valsartan (ARNI) is recommended (PARADIGM-HF trial) to reduce
cardiovascular death and heart failure hospitalization. ARNIs are preferred over ACE inhibitors
in eligible patients.
Q7: A 68-year-old female with atrial fibrillation (CHA₂DS₂-VASc score 4) is being considered
for anticoagulation. She has well-controlled hypertension and no history of bleeding. What is the
most appropriate recommendation?
A. Aspirin 81 mg daily
B. Warfarin with INR goal 2.0-3.0
C. Apixaban 5 mg twice daily
D. No anticoagulation needed
Correct Answer: C [CORRECT]
Rationale: With CHA₂DS₂-VASc score ≥2 in females (≥1 in males), oral anticoagulation is
indicated. DOACs like apixaban are preferred over warfarin for non-valvular AF due to reduced
bleeding risk, no monitoring requirements, and fewer drug-food interactions.
Q8: Which patients should receive high-intensity statin therapy according to ACC/AHA
guidelines? Select all that apply.
A. Patient with clinical ASCVD (prior MI, stroke)
B. Patient with LDL ≥190 mg/dL
C. Patient with diabetes aged 40-75 with 10-year risk ≥7.5%
D. Patient aged 20-39 with family history of premature ASCVD
