,UTA NURS 5433 Final Exam | Family II (FNP II) (2026)
Q&A
1. Which of the following best describes the primary mechanism of action of statins in
managing dyslipidemia?
A) Inhibiting HMG-CoA reductase to reduce cholesterol synthesis
B) Blocking cholesterol absorption in the small intestine
C) Increasing HDL cholesterol production
D) Inhibiting platelet aggregation
Correct Answer: Inhibiting HMG-CoA reductase to reduce cholesterol synthesis
Rationale: Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in hepatic
cholesterol synthesis, leading to upregulation of LDL receptors and decreased LDL
cholesterol. They do not primarily block intestinal absorption, increase HDL production, or
inhibit platelet aggregation. Ezetimibe blocks absorption, and niacin increases HDL.
2. What is the primary purpose of the CHA2DS2-VASc score in atrial fibrillation?
A) To assess the risk of bleeding from anticoagulation
B) To estimate the risk of stroke and guide anticoagulation decisions
C) To determine the need for cardioversion
D) To evaluate left ventricular function
Correct Answer: To estimate the risk of stroke and guide anticoagulation decisions
Rationale: The CHA2DS2-VASc score estimates stroke risk in patients with nonvalvular
atrial fibrillation and guides decisions about anticoagulation. The HAS-BLED score assesses
bleeding risk. Cardioversion decisions are based on hemodynamic stability and symptom
duration, and echocardiography evaluates ventricular function.
,3. In the context of heart failure with reduced ejection fraction, what is the primary mortality
benefit of sacubitril-valsartan?
A) It reduces preload by acting as a diuretic
B) It increases cardiac contractility
C) It combines neprilysin inhibition with angiotensin receptor blockade
D) It slows heart rate through beta-blockade
Correct Answer: It combines neprilysin inhibition with angiotensin receptor blockade
Rationale: Sacubitril-valsartan combines a neprilysin inhibitor with an angiotensin receptor
blocker, leading to vasodilation, natriuresis, and reduced mortality in heart failure with
reduced ejection fraction. It does not act as a primary diuretic, increase contractility, or slow
heart rate through beta-blockade.
4. A researcher is studying the pathophysiology of aortic stenosis. Which of the following
best describes the primary consequence of this condition?
A) Backward flow of blood into the left atrium
B) Increased afterload leading to left ventricular hypertrophy
C) Dilation of the aortic root
D) Reduced systemic vascular resistance
Correct Answer: Increased afterload leading to left ventricular hypertrophy
Rationale: Aortic stenosis obstructs blood flow from the left ventricle to the aorta, increasing
afterload. The left ventricle compensates by undergoing hypertrophy, which may eventually
lead to heart failure. Backward flow into the left atrium occurs in mitral regurgitation. Aortic
root dilation occurs in aortic regurgitation or aneurysm.
, 5. What is the primary mechanism by which spironolactone reduces mortality in heart
failure?
A) It blocks aldosterone receptors, reducing sodium retention and myocardial fibrosis
B) It increases cardiac contractility
C) It reduces heart rate
D) It dilates coronary arteries
Correct Answer: It blocks aldosterone receptors, reducing sodium retention and myocardial
fibrosis
Rationale: Spironolactone is a mineralocorticoid receptor antagonist that blocks aldosterone,
reducing sodium and water retention and inhibiting myocardial fibrosis. It does not directly
increase contractility, reduce heart rate, or dilate coronary arteries. These effects are mediated
by other drug classes.
6. According to the JNC 8 guidelines, what is the recommended initial treatment for
hypertension in a Black adult without comorbidities?
A) Angiotensin-converting enzyme inhibitor
B) Thiazide diuretic or calcium channel blocker
C) Beta-blocker alone
D) Alpha-blocker alone
Correct Answer: Thiazide diuretic or calcium channel blocker
Rationale: JNC 8 recommends initiating treatment with a thiazide diuretic or calcium
channel blocker for Black adults without comorbidities. Angiotensin-converting enzyme
inhibitors are less effective as monotherapy in this population due to lower renin levels. Beta-
blockers and alpha-blockers are not first-line agents.
Q&A
1. Which of the following best describes the primary mechanism of action of statins in
managing dyslipidemia?
A) Inhibiting HMG-CoA reductase to reduce cholesterol synthesis
B) Blocking cholesterol absorption in the small intestine
C) Increasing HDL cholesterol production
D) Inhibiting platelet aggregation
Correct Answer: Inhibiting HMG-CoA reductase to reduce cholesterol synthesis
Rationale: Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in hepatic
cholesterol synthesis, leading to upregulation of LDL receptors and decreased LDL
cholesterol. They do not primarily block intestinal absorption, increase HDL production, or
inhibit platelet aggregation. Ezetimibe blocks absorption, and niacin increases HDL.
2. What is the primary purpose of the CHA2DS2-VASc score in atrial fibrillation?
A) To assess the risk of bleeding from anticoagulation
B) To estimate the risk of stroke and guide anticoagulation decisions
C) To determine the need for cardioversion
D) To evaluate left ventricular function
Correct Answer: To estimate the risk of stroke and guide anticoagulation decisions
Rationale: The CHA2DS2-VASc score estimates stroke risk in patients with nonvalvular
atrial fibrillation and guides decisions about anticoagulation. The HAS-BLED score assesses
bleeding risk. Cardioversion decisions are based on hemodynamic stability and symptom
duration, and echocardiography evaluates ventricular function.
,3. In the context of heart failure with reduced ejection fraction, what is the primary mortality
benefit of sacubitril-valsartan?
A) It reduces preload by acting as a diuretic
B) It increases cardiac contractility
C) It combines neprilysin inhibition with angiotensin receptor blockade
D) It slows heart rate through beta-blockade
Correct Answer: It combines neprilysin inhibition with angiotensin receptor blockade
Rationale: Sacubitril-valsartan combines a neprilysin inhibitor with an angiotensin receptor
blocker, leading to vasodilation, natriuresis, and reduced mortality in heart failure with
reduced ejection fraction. It does not act as a primary diuretic, increase contractility, or slow
heart rate through beta-blockade.
4. A researcher is studying the pathophysiology of aortic stenosis. Which of the following
best describes the primary consequence of this condition?
A) Backward flow of blood into the left atrium
B) Increased afterload leading to left ventricular hypertrophy
C) Dilation of the aortic root
D) Reduced systemic vascular resistance
Correct Answer: Increased afterload leading to left ventricular hypertrophy
Rationale: Aortic stenosis obstructs blood flow from the left ventricle to the aorta, increasing
afterload. The left ventricle compensates by undergoing hypertrophy, which may eventually
lead to heart failure. Backward flow into the left atrium occurs in mitral regurgitation. Aortic
root dilation occurs in aortic regurgitation or aneurysm.
, 5. What is the primary mechanism by which spironolactone reduces mortality in heart
failure?
A) It blocks aldosterone receptors, reducing sodium retention and myocardial fibrosis
B) It increases cardiac contractility
C) It reduces heart rate
D) It dilates coronary arteries
Correct Answer: It blocks aldosterone receptors, reducing sodium retention and myocardial
fibrosis
Rationale: Spironolactone is a mineralocorticoid receptor antagonist that blocks aldosterone,
reducing sodium and water retention and inhibiting myocardial fibrosis. It does not directly
increase contractility, reduce heart rate, or dilate coronary arteries. These effects are mediated
by other drug classes.
6. According to the JNC 8 guidelines, what is the recommended initial treatment for
hypertension in a Black adult without comorbidities?
A) Angiotensin-converting enzyme inhibitor
B) Thiazide diuretic or calcium channel blocker
C) Beta-blocker alone
D) Alpha-blocker alone
Correct Answer: Thiazide diuretic or calcium channel blocker
Rationale: JNC 8 recommends initiating treatment with a thiazide diuretic or calcium
channel blocker for Black adults without comorbidities. Angiotensin-converting enzyme
inhibitors are less effective as monotherapy in this population due to lower renin levels. Beta-
blockers and alpha-blockers are not first-line agents.
