NR667 APEA Review: MSN FNP Program
.
Capstone Practicum & Intensive (2025/2026)
— Verified Content (180 Questions &
Answers | Chamberlain University | FNP
Certification Readiness)
1. A 45-year-old patient presents with fatigue, pallor, and spoon-shaped nails. Lab tests
reveal microcytic anemia. What is the most likely cause?
A) Vitamin B12 deficiency
B) Iron deficiency
C) Folate deficiency
D) Hemolytic anemia
Answer: B) Iron deficiency
Rationale: Microcytic anemia with pallor and spoon-shaped nails is classic for iron deficiency
anemia. B12 and folate deficiencies cause macrocytic anemia, and hemolytic anemia usually
presents with normocytic anemia and jaundice.
2. Which of the following vaccines is recommended annually for adults with chronic
medical conditions?
A) Tdap
B) MMR
C) Influenza
D) Varicella
Answer: C) Influenza
Rationale: Annual influenza vaccination is recommended for all adults, especially those with
chronic medical conditions. Tdap is once every 10 years, MMR and Varicella are given as part
of childhood vaccination or catch-up schedule.
,3. A patient with type 2 diabetes has a fasting blood glucose of 140 mg/dL and HbA1c of
7.8%. What is the most appropriate next step?
A) Initiate insulin therapy immediately
B) Reinforce lifestyle modification and oral therapy
C) No intervention required
D) Prescribe only dietary supplements
Answer: B) Reinforce lifestyle modification and oral therapy
Rationale: HbA1c <8% and moderate fasting glucose can be managed by optimizing oral
agents and lifestyle interventions before considering insulin therapy.
4. Which heart sound is most indicative of left ventricular failure?
A) S1
B) S2
C) S3
D) S4
Answer: C) S3
Rationale: An S3 gallop is associated with volume overload and left ventricular failure. S4 is
more indicative of stiff, hypertrophic ventricles.
5. A 60-year-old patient presents with polyuria, polydipsia, and weight loss. Random
blood glucose is 320 mg/dL. Which test confirms diabetes diagnosis?
A) Fasting glucose
B) HbA1c
C) Oral glucose tolerance test (OGTT)
D) Any of the above
Answer: D) Any of the above
Rationale: Diabetes can be diagnosed with fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, or
2-hour OGTT ≥200 mg/dL. Random glucose ≥200 mg/dL with symptoms also confirms
diagnosis.
6. Which antihypertensive class is preferred in a patient with chronic kidney disease?
A) Thiazide diuretics
B) ACE inhibitors
, C) Beta-blockers
D) Calcium channel blockers
Answer: B) ACE inhibitors
Rationale: ACE inhibitors slow progression of CKD and provide renal protection, especially in
patients with proteinuria.
7. A patient presents with acute onset right-sided facial droop, drooling, and inability to
close the eye. The forehead is involved. Most likely diagnosis?
A) Stroke
B) Bell’s palsy
C) Trigeminal neuralgia
D) Myasthenia gravis
Answer: B) Bell’s palsy
Rationale: Bell’s palsy affects the entire side of the face including the forehead. Stroke typically
spares the forehead due to bilateral cortical innervation.
8. What is the first-line therapy for newly diagnosed essential hypertension in an adult
without comorbidities?
A) ACE inhibitor
B) Thiazide diuretic
C) Beta-blocker
D) Calcium channel blocker
Answer: B) Thiazide diuretic
Rationale: For uncomplicated hypertension, thiazide diuretics are first-line according to JNC 8
guidelines. ACE inhibitors or calcium channel blockers may also be used based on patient
profile.
9. Which lab finding is most indicative of hyperthyroidism?
A) Elevated TSH, low T4
B) Low TSH, high T4
C) Low TSH, low T4
D) High TSH, high T4
.
Capstone Practicum & Intensive (2025/2026)
— Verified Content (180 Questions &
Answers | Chamberlain University | FNP
Certification Readiness)
1. A 45-year-old patient presents with fatigue, pallor, and spoon-shaped nails. Lab tests
reveal microcytic anemia. What is the most likely cause?
A) Vitamin B12 deficiency
B) Iron deficiency
C) Folate deficiency
D) Hemolytic anemia
Answer: B) Iron deficiency
Rationale: Microcytic anemia with pallor and spoon-shaped nails is classic for iron deficiency
anemia. B12 and folate deficiencies cause macrocytic anemia, and hemolytic anemia usually
presents with normocytic anemia and jaundice.
2. Which of the following vaccines is recommended annually for adults with chronic
medical conditions?
A) Tdap
B) MMR
C) Influenza
D) Varicella
Answer: C) Influenza
Rationale: Annual influenza vaccination is recommended for all adults, especially those with
chronic medical conditions. Tdap is once every 10 years, MMR and Varicella are given as part
of childhood vaccination or catch-up schedule.
,3. A patient with type 2 diabetes has a fasting blood glucose of 140 mg/dL and HbA1c of
7.8%. What is the most appropriate next step?
A) Initiate insulin therapy immediately
B) Reinforce lifestyle modification and oral therapy
C) No intervention required
D) Prescribe only dietary supplements
Answer: B) Reinforce lifestyle modification and oral therapy
Rationale: HbA1c <8% and moderate fasting glucose can be managed by optimizing oral
agents and lifestyle interventions before considering insulin therapy.
4. Which heart sound is most indicative of left ventricular failure?
A) S1
B) S2
C) S3
D) S4
Answer: C) S3
Rationale: An S3 gallop is associated with volume overload and left ventricular failure. S4 is
more indicative of stiff, hypertrophic ventricles.
5. A 60-year-old patient presents with polyuria, polydipsia, and weight loss. Random
blood glucose is 320 mg/dL. Which test confirms diabetes diagnosis?
A) Fasting glucose
B) HbA1c
C) Oral glucose tolerance test (OGTT)
D) Any of the above
Answer: D) Any of the above
Rationale: Diabetes can be diagnosed with fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, or
2-hour OGTT ≥200 mg/dL. Random glucose ≥200 mg/dL with symptoms also confirms
diagnosis.
6. Which antihypertensive class is preferred in a patient with chronic kidney disease?
A) Thiazide diuretics
B) ACE inhibitors
, C) Beta-blockers
D) Calcium channel blockers
Answer: B) ACE inhibitors
Rationale: ACE inhibitors slow progression of CKD and provide renal protection, especially in
patients with proteinuria.
7. A patient presents with acute onset right-sided facial droop, drooling, and inability to
close the eye. The forehead is involved. Most likely diagnosis?
A) Stroke
B) Bell’s palsy
C) Trigeminal neuralgia
D) Myasthenia gravis
Answer: B) Bell’s palsy
Rationale: Bell’s palsy affects the entire side of the face including the forehead. Stroke typically
spares the forehead due to bilateral cortical innervation.
8. What is the first-line therapy for newly diagnosed essential hypertension in an adult
without comorbidities?
A) ACE inhibitor
B) Thiazide diuretic
C) Beta-blocker
D) Calcium channel blocker
Answer: B) Thiazide diuretic
Rationale: For uncomplicated hypertension, thiazide diuretics are first-line according to JNC 8
guidelines. ACE inhibitors or calcium channel blockers may also be used based on patient
profile.
9. Which lab finding is most indicative of hyperthyroidism?
A) Elevated TSH, low T4
B) Low TSH, high T4
C) Low TSH, low T4
D) High TSH, high T4
