FNP 654 Family Care Primary 2: The Ultimate Final Exam Success Guide

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FNP 654/FNP 654 FAMILY CARE PRIMARY 2 Final
Exam Newest Exam Preparation With Complete
Questions And Correct Answers With Rationales |
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Question 1
A 45-year-old male with a history of hypertension presents with a blood
pressure of 150/92 mmHg on two separate occasions. He has no target
organ damage or comorbidities. According to the JNC 8 guidelines,
what is the most appropriate initial pharmacologic treatment?
A) Hydrochlorothiazide
B) Lisinopril
C) Amlodipine
D) No pharmacologic treatment, continue lifestyle modifications


Correct Answer: D
Explanation: JNC 8 recommends initiating pharmacologic treatment for
patients under 60 years old with a blood pressure of 140/90 mmHg or
higher. However, for patients with no comorbidities or target organ
damage, lifestyle modifications are recommended as initial therapy for
3-6 months before starting medication. This patient meets criteria for
stage 1 hypertension but lacks other risk factors.

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Question 2
A 60-year-old female with type 2 diabetes mellitus and
microalbuminuria presents for follow-up. Her blood pressure is 138/86
mmHg. Which antihypertensive class provides the most benefit for
renal protection in this patient?
A) Beta-blockers
B) Calcium channel blockers
C) ACE inhibitors
D) Alpha-blockers


Correct Answer: C
Explanation: ACE inhibitors (and ARBs) are first-line agents in diabetic
patients with microalbuminuria due to their reno-protective effects.
They reduce intraglomerular pressure by dilating the efferent arteriole,
thereby decreasing proteinuria and slowing progression of diabetic
nephropathy.


Question 3
A 55-year-old male presents with complaints of chest pain that occurs
with exertion and is relieved by rest. The pain is described as pressure-
like and radiates to the left arm. An EKG shows ST-segment depression.
What is the most likely diagnosis?
A) Stable angina
B) Unstable angina

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C) Myocardial infarction
D) Pericarditis


Correct Answer: A
Explanation: Stable angina is characterized by chest pain that is
predictable, occurs with exertion or stress, and is relieved by rest or
nitroglycerin. The EKG findings of ST-segment depression without
elevation suggest ischemia. The pattern is consistent with stable angina
pectoris.


Question 4
A 70-year-old female with a history of heart failure presents with
worsening dyspnea, orthopnea, and peripheral edema. Her ejection
fraction is 35%. Which medication has been shown to reduce mortality
in heart failure with reduced ejection fraction?
A) Digoxin
B) Hydralazine
C) Carvedilol
D) Verapamil


Correct Answer: C
Explanation: Beta-blockers such as carvedilol, bisoprolol, and
metoprolol succinate have been shown to reduce mortality and
hospitalizations in patients with HFrEF (ejection fraction ≤ 40%). These

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agents work by reducing sympathetic nervous system overactivity,
which is detrimental in heart failure.


Question 5
A 35-year-old female presents with fatigue, weight gain, cold
intolerance, and constipation. Thyroid function tests reveal an elevated
TSH and low free T4. What is the most likely diagnosis?
A) Graves' disease
B) Hashimoto's thyroiditis
C) Subclinical hypothyroidism
D) Euthyroid sick syndrome


Correct Answer: B
Explanation: Elevated TSH with low free T4 indicates primary
hypothyroidism. The most common cause of primary hypothyroidism in
the United States is Hashimoto's thyroiditis, an autoimmune disorder.
Graves' disease causes hyperthyroidism, and subclinical hypothyroidism
would show elevated TSH with normal T4.


Question 6
A 28-year-old female presents with palpitations, heat intolerance,
weight loss, and a fine tremor. Physical exam reveals a diffusely
enlarged, non-tender thyroid gland and tachycardia. What is the most
likely diagnosis?
A) Toxic multinodular goiter