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1. Question: An older adult with diabetes mellitus presents with leg cramps that worsen with walking and improve with rest. What condition does this presentation require workup for?
2. Question: A patient presents with bradycardia, severe nausea, and substernal pain, and an EKG shows STEMI. Which region of the heart is most likely involved?
3. Question: What is the recommended frequency for lipid screening in adolescents with type 1 diabetes mellitus?
4. Question: An 80-year-old man with atrial fibrillation presents with sudden-onset unilateral leg pain and pallor. What is the most likely diagnosis?
5. Question: A patient on an ACE inhibitor develops a persistent dry cough with no respiratory findings. What is the most appropriate intervention?
6. Question: A 65-year-old alcoholic patient presents with new-onset palpitations and an irregularly irregular rhythm lasting more than 48 hours. What evaluation should be performed first?
7. Question: A 70-year-old man with atrial fibrillation presents with sudden left-sided weakness and slurred speech. What is the most likely diagnosis?
8. Question: What is the key long-term benefit of carvedilol use in patients with coronary artery disease and heart failure with reduced ejection fraction?
9. Question: A low-pitched, diastolic rumbling murmur at the apex heard best in the left lateral decubitus position indicates which valvular disorder?
10. Question: Which cardiac chamber directly pumps blood into the ascending aorta?
11. Question: Which physical findings support a diagnosis of hypothyroidism?
12. Question: A patient with type 1 diabetes develops persistent metabolic acidosis after transitioning off an insulin drip. What is the most likely cause?
13. Question: Which symptom pattern is characteristic of pheochromocytoma?
14. Question: What is the best diagnostic test for pheochromocytoma?
15. Question: Excessive use of levothyroxine may cause or worsen which condition?
16. Question: According to ADA guidelines, how often should a well-controlled patient with type 2 diabetes be followed?
17. Question: Patients on levothyroxine should be monitored for which adverse effects?
18. Question: Which individual is at highest risk for developing type 2 diabetes mellitus?
19. Question: A patient started on levothyroxine has persistently elevated TSH after 8 weeks. What is the most appropriate next step?
20. Question: A patient has a 3 cm pituitary mass on CT. What is the next step in evaluation?
21. Question: How should a nurse practitioner respond to family concerns about nutrition in a terminal cancer patient refusing meals?
22. Question: An elderly patient with gradual cognitive decline following prior CVA most likely has which diagnosis?
23. Question: Which age-related physiologic change most commonly contributes to constipation in the elderly?
24. Question: Management of COPD in the elderly is best guided by which factor?
25. Question: Which test is best to assess fall risk in an 88-year-old patient?
26. Question: What physical exam finding is most specific for ascites?
27. Question: A patient on methotrexate and NSAIDs presents with abdominal pain and dark stools. What is the most likely diagnosis?
28. Question: Which gastrointestinal change is associated with normal aging?
29. Question: Where can Crohn’s disease occur, and how does it present?
30. Question: A patient with refractory GERD and risk factors requires which diagnostic study?
31. Question: What is the most common side effect of oral ribavirin therapy?
32. Question: What is the treatment of choice for uncomplicated diverticulitis in a patient without allergies?
33. Question: Which factor most strongly predicts progression of hepatitis C to liver failure?
34. Question: Anorexia nervosa most commonly occurs in which population?
35. Question: Which laboratory tests help further evaluate suspected inflammatory bowel disease?
36. Question: In a terminally ill ICU patient with stated wishes against aggressive care, which consult would be inappropriate?
37. Question: What risk of urgent care use may lead to missed subtle changes in patient condition over time?
38. Question: A patient threatens harm after discharge. This statement represents which legal concept?
39. Question: When a competent elderly patient refuses further chemotherapy, what is the nurse practitioner’s most appropriate action?
40. Question: What is the best initial recommendation to reduce osteoporosis risk in an older sedentary male smoker?
41. Question: A patient awakens with painless bright-red blood in the sclera and normal vision. What is the appropriate management?
42. Question: Postmenopausal nasal congestion with clear discharge is most consistent with which diagnosis?
43. Question: A patient with exudative pharyngitis, fatigue, and left upper quadrant tenderness most likely has which condition?
44. Question: What intervention should be anticipated next in a patient with epiglottitis and stridor?
45. Question: Why is immediate surgery indicated in patients with globe rupture?
46. Question: What is the most appropriate initial management of viral upper respiratory symptoms without systemic illness?
47. Question: Which antibiotic is indicated for retropharyngeal abscess?
48. Question: An elderly patient with eye pain, photophobia, and redness around the iris likely has which diagnosis?
49. Question: Which diagnostic aid helps evaluate suspected corneal abrasion?
50. Question: A patient presents with signs of acute angle-closure glaucoma. What is the immediate action?
51. Question: What is the most appropriate initial management for acute sickle cell pain crisis?
52. Question: Which disorder is characterized by simultaneous thrombosis and hemorrhage?
53. Question: Which mechanism does NOT cause neutropenia?
54. Question: What additional workup is indicated for suspected myelodysplastic syndrome?
55. Question: Which symptoms indicate a severe gastrointestinal bleed requiring urgent transfusion?
56. Question: What is the appropriate long-term treatment for vitamin B12 deficiency after gastric bypass?
57. Question: Which condition carries a risk of progression to acute myelogenous leukemia?
58. Question: How should asymptomatic neutropenia be managed in a patient with rheumatoid arthritis?
59. Question: Which red blood cell indices are consistent with iron deficiency anemia?
60. Question: What is the best laboratory test to distinguish iron deficiency anemia from other anemias?
61. Question: Which therapy benefits patients with primary progressive multiple sclerosis?
62. Question: What is the first-line chronic treatment for mild systemic lupus erythematosus?
63. Question: Patients with bradykinin-mediated angioedema should avoid which medication class?
64. Question: Which treatment is NOT recommended for a new diagnosis of rheumatoid arthritis?
65. Question: Anaphylaxis represents which type of hypersensitivity reaction?
66. Question: A patient with ascending weakness involving the abdomen requires what priority intervention?
67. Question: Which immunoglobulin provides long-term passive immunity from mother to fetus?
68. Question: When should disease-modifying therapy be initiated in multiple sclerosis?
69. Question: Which clinical finding is most characteristic of systemic lupus erythematosus?
70. Question: Which medication class is NOT part of standard HIV therapy?
71. Question: What is the treatment of choice for acute poison ivy dermatitis?
72. Question: What is the most appropriate initial antibiotic for uncomplicated cellulitis?
73. Question: What is the most effective removal method for seborrheic keratosis?
74. Question: Round, pruritic plaques with vesicles on the legs suggest which diagnosis?
75. Question: How should a provider respond to patient anxiety caused by a benign seborrheic keratosis?
76. Question: An adult female with a diagnosis of eczema presents with worsening itching, vesicles, papules, and a linear burrow between the fingers after treatment with topical hydrocortisone. What is the most appropriate treatment?
77. Question: An adult daycare worker presents with severe itching of the arms and wrists, excoriations, and microscopic confirmation of scabies. What is the treatment of choice?
78. Question: What is the etiology of squamous cell carcinoma?
79. Question: A patient with a draining sebaceous cyst and ascending cellulitic streaking from the abscess site should receive which treatment?
80. Question: A patient treated with disease-modifying antirheumatic drugs for plaque-like lesions on extensor surfaces most likely has which condition?
81. Question: A geriatric patient with gout experiences worsening pain after restarting allopurinol during an acute flare. What is the nurse practitioner’s best management?
82. Question: A patient with moderate osteoarthritis asks about supplements to reduce pain and joint space narrowing. Which supplement is recommended?
83. Question: A football player presents with knee pain after lateral trauma. Which test should be performed to assess meniscal injury?
84. Question: An adolescent athlete with shoulder pain and inability to raise the arm above shoulder level most likely has which diagnosis?
85. Question: Which behavior is most likely to precipitate rhabdomyolysis?
86. Question: Which medication lowers uric acid levels and may be used in the management of gout?
87. Question: An adult female with neurogenic claudication relieved by forward flexion most likely has which diagnosis?
88. Question: Which element is assessed during the secondary trauma survey?
89. Question: Decreased joint space of lumbar vertebrae on X-ray suggests which chronic condition?
90. Question: Elevated serum calcium levels may suggest which diagnosis?
91. Question: Which finding is most suggestive of glomerulonephritis?
92. Question: Which nationality is four times more likely than Caucasians to develop kidney disease?
93. Question: Which laboratory tests are most important to assess progression of chronic kidney disease?
94. Question: Patients with hematuria and RBC casts on urinalysis should be evaluated for which diagnosis?
95. Question: Which diagnostic finding differentiates pyelonephritis from cystitis?
96. Question: Hypotension leading to acute kidney injury represents which type of renal dysfunction?
97. Question: What is the standard treatment for uncomplicated urinary tract infection in women in areas with high resistance?
98. Question: Which antihypertensive medication class is most appropriate for patients with chronic kidney disease and declining GFR?
99. Question: A woman with dysuria, urgency, chronic pelvic pain relieved by voiding, and normal urinalysis most likely has which diagnosis?
100. Question: A woman with dysuria, urgency, pyuria, and bacteriuria most likely has which diagnosis?
101. Question: Which medication is most appropriate for migraine prophylaxis?
102. Question: A patient with acute ischemic stroke symptoms should receive tPA within what time frame?
103. Question: A college student struggling academically with a history suggestive of attention or learning disorder should be managed how?
104. Question: Which antibiotic is appropriate initial therapy for acute bacterial sinusitis?
105. Question: Which clinical exam is most appropriate to evaluate acute stroke?
106. Question: Which constellation of symptoms lasting more than three months is most consistent with fibromyalgia?
107. Question: An elderly patient on gabapentin develops dizziness when standing. What is the best management?
108. Question: A patient with confusion, agitation, hallucinations, and hyponatremia most likely has which diagnosis?
109. Question: When should disease-modifying therapy be initiated in multiple sclerosis?
110. Question: Abrupt discontinuation of antiseizure medications increases the risk of what outcome?
111. Question: A newborn with purulent conjunctivitis after vaginal delivery most likely has infection caused by which organism?
112. Question: At what age should an infant typically sit without support?
113. Question: An inconsolable 8-week-old infant with a normal exam should undergo which diagnostic test?
114. Question: Which finding in an infant suspected of colic warrants further evaluation?
115. Question: A teen with asthma symptoms more than twice weekly and nighttime awakenings once weekly is classified as having which severity?
116. Question: An infant with retinal hemorrhages and abnormal posturing should undergo which imaging study?
117. Question: A newborn with rising bilirubin levels despite increased feeding should receive which intervention?
118. Question: A child diagnosed with Fifth disease should receive which management?
119. Question: A child with dark urine, facial edema, and recent streptococcal infection most likely has which condition?
120. Question: After treating otitis media in a toddler with a systolic murmur, what is the next appropriate step?
121. Question: Which symptom is NOT part of antidepressant discontinuation syndrome?
122. Question: What is an appropriate treatment strategy for extrapyramidal symptoms?
123. Question: A patient with agitation, hyperthermia, rigidity, and diarrhea should be evaluated for which condition?
124. Question: Which condition is NOT a cause of altered mental status?
125. Question: Which physical finding is most common in bulimia nervosa?
126. Question: Which medication is used to treat beta-blocker overdose?
127. Question: Which symptom would raise concern for serotonin syndrome?
128. Question: What is the most common cause of hallucinations?
129. Question: A patient with no improvement two weeks after increasing escitalopram should be managed how?
130. Question: A patient with urinary retention and dry mouth after starting amitriptyline should receive which intervention?
131. Question: What screening test should be performed at 24–28 weeks of pregnancy?
132. Question: Painless vaginal bleeding in the second trimester suggests which diagnosis?
133. Question: Lower abdominal pain, fever, purulent discharge, and cervical motion tenderness suggest which diagnosis?
134. Question: What emergency contraception is appropriate within 120 hours of sexual assault?
135. Question: Unilateral spontaneous serous nipple discharge from a single duct is most often caused by what condition?
136. Question: Which supplement is highest priority for a woman planning pregnancy?
137. Question: A postmenopausal woman with breast skin dimpling and thickening should undergo which evaluation?
138. Question: Mid-cycle spotting during the first month of oral contraceptive use should be managed how?
139. Question: What is the most appropriate initial management of nausea and vomiting in early pregnancy?
140. Question: A pregnant patient with penicillin allergy and respiratory infection should receive which antibiotic?
141. Question: What is the optimal treatment for latent tuberculosis?
142. Question: A focal lung consolidation obscured by the cardiac silhouette on lateral X-ray is most likely located where?
143. Question: What is a typical symptom of asthma in adults?
144. Question: Which test is most useful in diagnosing COPD?
145. Question: Patients with bullous lung disease are NOT at risk for which barotrauma complication?
146. Question: What is the most common cause of community-acquired pneumonia?
147. Question: Which statement indicates correct understanding of inhaled corticosteroid therapy in asthma?
148. Question: What is the first-line treatment for Clostridioides difficile infection?
149. Question: A smoker with chronic productive cough and dyspnea most likely has which diagnosis?
150. Question: Which medication class is added for daily management of advanced COPD?