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1. Question: Which of the following people groups represent the least risk of cardiac disease?
2. Question: Although men less than 55 have an increased risk of cardiac events compared to women, both men and women start to have equivalent cardiac risks by age 60. This is primarily due to which following mechanism?
3. Question: The suggested International Normalized Ratio (INR) range in a patient being treated for atrial fibrillation is:
4. Question: A 55-year-old female patient with no previous cardiac history and no family history of hyperlipidemia with an acute myocardial infarction treated with a drug-eluting stent—what lipid-lowering agent is most likely started at discharge?
5. Question: A patient with crushing chest pain converts from sinus rhythm to sinus bradycardia with ST elevation in leads II, III, and aVF. What intervention is the priority?
6. Question: The use of sublingual nitrates for chest pain is relatively or absolutely contraindicated in all the following scenarios except:
7. Question: Which medication is not part of optimal medical therapy for heart failure with reduced ejection fraction (EF 30%) and normal renal function?
8. Question: A patient presents with palpitations and is found to have atrial fibrillation with a heart rate of 122 bpm. What is the next order?
9. Question: A 60-year-old man with hypertension and diabetes presents with headache, visual changes, and BP 200/110 mmHg. What is the most appropriate management?
10. Question: A blowing systolic murmur best heard at the left 5th intercostal space radiating to the axilla represents which cardiac finding?
11. Question: Patients on levothyroxine should be monitored for signs of which condition?
12. Question: A 33-year-old woman with palpitations, anxiety, heat intolerance, low TSH, and high free T4 most likely has which diagnosis?
13. Question: After ruling out diabetes mellitus, which initial laboratory tests are appropriate when diabetes insipidus is suspected?
14. Question: Which statement is true regarding hyperosmolar hyperglycemic state (HHS)?
15. Question: A 3 cm pituitary mass is noted on CT. What is the next step in evaluation?
16. Question: A patient with fatigue, muscle weakness, hyperpigmentation, hyponatremia, hyperkalemia, and low cortisol most likely has which condition?
17. Question: After treatment for DKA, a patient develops recurrent acidosis. What is the most likely cause?
18. Question: A patient with type 2 diabetes and A1c of 10.4% despite oral agents and basal insulin—what regimen should be recommended?
19. Question: Classic findings in pheochromocytoma include which feature?
20. Question: A patient on levothyroxine presents with tachycardia and nervousness. What medication adjustment is anticipated?
21. Question: Which factor would trigger a complete fall risk assessment in an elderly patient?
22. Question: An end-stage lung cancer patient refuses meals except ice cream. What is the most appropriate NP response?
23. Question: How should a nurse practitioner evaluate if palliative care is effective?
24. Question: Which test is best to assess fall risk in an 88-year-old adult?
25. Question: A 90-year-old woman with bruising, poor hygiene, and financial neglect—what is the NP obligated to do next?
26. Question: Which physical exam finding confirms the presence of ascites?
27. Question: A patient with abdominal pain, jaundice, and unintentional weight loss is most likely to have which malignancy?
28. Question: What is the primary management for localized colon cancer?
29. Question: Oral clindamycin is contraindicated in which condition?
30. Question: A patient with severe flank pain radiating to the groin most likely has which diagnosis?
31. Question: If biliary tract obstruction is suspected, what is the preferred initial imaging modality?
32. Question: What questions are important to differentiate causes of a lower GI bleed?
33. Question: A patient with refractory GERD and risk factors should undergo which diagnostic study?
34. Question: An elderly patient with anemia and guaiac-positive stool should receive which diagnostic test?
35. Question: Persistent nocturnal cough in an adolescent with asthma is most likely caused by which condition?
36. Question: Which medical ethics principle refers to intentionally avoiding harm?
37. Question: A patient threatens to kill a provider after discharge. This represents which legal concept?
38. Question: Which scenario is an example of implied consent?
39. Question: What term refers to the primary access point of care that improves continuity and reduces cost?
40. Question: Which 1996 act protects patient health information from disclosure?
41. Question: A patient with epiglottitis and worsening stridor—what intervention should be prepared?
42. Question: What is the most likely source of Streptococcus viridans endocarditis?
43. Question: A patient with allergic rhinitis unresponsive to antihistamines—what is the next step?
44. Question: Which bacteria is most commonly associated with pharyngitis?
45. Question: Why should globe rupture be treated with immediate surgery?
46. Question: Which factor is most commonly associated with premature gum decay?
47. Question: A patient with sore throat and dysphagia—what life-threatening illness must be ruled out?
48. Question: Which technique assists in removing a caustic substance from the eye?
49. Question: Treatment of hyphema commonly includes which medication?
50. Question: A patient with mild upper respiratory symptoms and no fever—what is the most appropriate initial intervention?
51. Question: What is the most appropriate initial management of a sickle cell pain crisis?
52. Question: What laboratory test best distinguishes iron deficiency anemia from other anemias?
53. Question: A patient on warfarin has an INR of 5.5. What is the appropriate management?
54. Question: Progression to acute myelogenous leukemia is a risk of which condition?
55. Question: A patient with intrinsic factor autoantibodies is at risk for which deficiency?
56. Question: Proper treatment of iron deficiency anemia typically resolves anemia within what time frame?
57. Question: An asymptomatic patient with ANC 1.4—what is the most appropriate intervention?
58. Question: What parameter should be monitored long-term in patients with sickle cell disease?
59. Question: A patient with microcytic hypochromic anemia most likely has which diagnosis?
60. Question: Overactivation of coagulation and fibrinolysis with thrombosis and hemorrhage describes which condition?
61. Question: Progressive leg weakness, coordination loss, and bladder dysfunction over two months suggests which disease?
62. Question: Patients with Stevens-Johnson syndrome should be managed similarly to which group?
63. Question: Painful blistering after sulfamethoxazole use raises concern for which condition?
64. Question: Patients with herpes zoster are at risk of shedding which virus?
65. Question: Which treatment is not recommended for newly diagnosed rheumatoid arthritis?
66. Question: A vesicular rash in a dermatomal pattern with prior hypersensitivity suggests which illness?
67. Question: What is the first-line chronic treatment for mild systemic lupus erythematosus?
68. Question: A patient with fatigue, joint pain, and malar rash—what is the most appropriate initial management?
69. Question: Which medication category is not part of standard HIV therapy?
70. Question: Which symptom best describes classic systemic lupus erythematosus?
71. Question: What is the most common form of skin cancer?
72. Question: Which diagnostic procedure confirms pinworm infestation?
73. Question: What is the treatment of choice for scabies?
74. Question: Herpes zoster is later identified by which characteristic finding?
75. Question: A patient with severe cellulitis, hypotension, fever, and systemic symptoms—what is the appropriate next step?
76. Question: An 18-year-old presents with acne. He notes that he washes his face with a mild skin cleanser 3 to 4 times daily, however the acne persists and has worsened. The nurse practitioner explains that:
77. Question: During an appointment history and physical, you examine your patient and find a new multicolored mole measuring 9 mm with irregular borders. What is the most likely diagnosis?
78. Question: Your patient presents with a red, well-differentiated, raised circular lesion on their nose which has a bloody-appearing central appearance. Which type of lesion does this likely represent?
79. Question: A 27-year-old male patient who works as a janitor presents with a 6-month history of an intermittent rash on his hands. What is the most likely diagnosis?
80. Question: What is the etiology of verruca?
81. Question: An 86-year-old patient is experiencing radiculopathy-associated lower back pain that has not improved over the past 4 weeks. What is the best type of imaging study for evaluating this patient?
82. Question: A 25-year-old athlete presents with shoulder pain and difficulty with overhead activities. Physical examination suggests impingement syndrome. What is the most appropriate initial treatment?
83. Question: An adolescent athlete presents with shoulder pain and inability to raise the arm above the shoulder. What is the most likely diagnosis?
84. Question: A high school football player presents after sustaining a lateral leg injury. Which test should be performed to assess for medial or lateral meniscus injury?
85. Question: Which of the following are not items assessed for compartment syndrome?
86. Question: An 84-year-old patient presents with diffuse bilateral lower back pain worsened by standing and relieved by forward flexion. What is the most likely diagnosis?
87. Question: Which of the following treatments is most successful for patients with chronic fatigue syndrome?
88. Question: Patients involved in a multi-car pileup should be evaluated for which element of the secondary trauma survey?
89. Question: Your patient has presented with an acute GI bleed. Which scenario is most probable as the cause?
90. Question: An adult female with leg and buttock pain relieved by leaning forward is suspected of having which diagnosis?
91. Question: Patients presenting with hematuria and RBC casts in urine should be considered for which diagnosis?
92. Question: A 45-year-old man with worsening urinary symptoms due to BPH presents to clinic. What is the most appropriate initial pharmacologic treatment?
93. Question: An older adult with chronic renal disease has declining GFR. Which antihypertensive medications are most appropriate?
94. Question: What is the most appropriate screening recommendation for prostate cancer in a 50-year-old man?
95. Question: Elevated creatinine after contrast administration from angiography represents which classification of renal dysfunction?
96. Question: Which antihypertensive medication should not be considered in a patient with acute kidney injury?
97. Question: Which lab tests are most important to assess progression of chronic kidney disease?
98. Question: Which bacteria are commonly associated with pyelonephritis?
99. Question: A male adult presents with sudden onset painful hematuria. What is the most likely diagnosis?
100. Question: Hypotension for two hours prior to fluid resuscitation represents which type of acute renal dysfunction?
101. Question: Medication-overuse (analgesic rebound) headaches occur at what frequency in patients with chronic daily headaches?
102. Question: A 78-year-old male presents with paroxysmal dizziness and nausea. What is the next diagnostic procedure?
103. Question: What value represents an abnormal intracranial pressure?
104. Question: Which tool is most easily administered in practice to assess cognitive decline?
105. Question: What risk is associated with abrupt discontinuation of chronic anti-seizure medications?
106. Question: Progressive muscular weakness over 15 months allows reasonable exclusion of which diagnosis?
107. Question: A 70-year-old man presents with acute stroke symptoms that began 2 hours ago. What is the most appropriate initial intervention?
108. Question: A patient presents with worsening headache, papilledema, and aphasia. What is the best course of action?
109. Question: A college freshman with academic difficulty suspects a learning disorder. How should the nurse practitioner respond?
110. Question: GABA-agonist drugs have what effect on seizure threshold?
111. Question: At what age should a child typically sit without support?
112. Question: A patient presents with unilateral eye pain, halos, cloudy cornea, and a nonreactive pupil. What should be done immediately?
113. Question: A toddler with otitis media is found to have a systolic murmur. What is the most appropriate next step?
114. Question: Which diagnostic procedure confirms pinworm infestation in a child?
115. Question: A child presents with fever, cough, lymphadenopathy, and a spreading rash beginning on the face. What is the most likely diagnosis?
116. Question: A 4-year-old child presents with chronic cough, wheezing, and nocturnal symptoms. What is the most likely diagnosis?
117. Question: A newborn with worsening hyperbilirubinemia despite increased feeding should receive what intervention?
118. Question: A healthy unvaccinated child exposed to hepatitis A should receive what treatment?
119. Question: A positive Auspitz sign in psoriasis is characterized by what finding?
120. Question: A febrile child refusing to bear weight with a swollen knee most likely has which diagnosis?
121. Question: What must be assessed to determine a patient’s risk of harm to self or others?
122. Question: Which medication is not associated with serotonin syndrome when combined with SSRIs?
123. Question: Patients treated with haloperidol should be aware of which potential side effect?
124. Question: Altered mental status should be evaluated for all causes except which?
125. Question: A patient reports no improvement after 2 weeks on increased escitalopram dose. What is the best course of action?
126. Question: How should a provider respond to a patient experiencing visual hallucinations?
127. Question: What is the first-line treatment for generalized anxiety disorder?
128. Question: Altered mental status should be evaluated for all causes except which?
129. Question: A patient wishes to stop venlafaxine after 14 months of remission. What should be recommended?
130. Question: A patient presents with FINISH symptoms. What question should the nurse practitioner ask?
131. Question: A pregnant patient with chlamydia infection places her newborn at risk for which complication?
132. Question: Which factor most likely causes intrauterine growth restriction?
133. Question: A pregnant smoker with respiratory infection and penicillin allergy should receive which antibiotic?
134. Question: A Pap smear reveals high-grade squamous intraepithelial lesion. What is the next step?
135. Question: A patient has a hard breast mass despite a negative mammogram. What is the appropriate action?
136. Question: A soft, mobile, tender breast mass with negative mammogram should be evaluated with what next?
137. Question: A pregnant woman with nausea and vomiting in first trimester should receive what initial management?
138. Question: A woman with irregular menses, obesity, hirsutism, and elevated testosterone most likely has which condition?
139. Question: A patient with galactorrhea on multiple medications should discontinue or change which drug?
140. Question: Which finding is not associated with abruptio placentae?
141. Question: A patient with COPD exacerbation presents with wheezing and dyspnea. What is the most appropriate initial treatment?
142. Question: Which assessment is most useful in evaluating COPD?
143. Question: A smoker with hemoptysis and a lung nodule on X-ray should undergo what next diagnostic step?
144. Question: Chest X-ray findings obscure the left cardiac border. What is the most likely lobe involved?
145. Question: What is the most common cause of community-acquired pneumonia?
146. Question: A geriatric patient with burning dermatomal pain should be treated with which medication?
147. Question: A patient misusing asthma inhalers should be instructed to do what?
148. Question: Acute hyperventilation places a patient at risk for which acid–base disorder?
149. Question: A lung apex mass with weight loss requires what next diagnostic step?
150. Question: Which agent is a common bacterial cause of pneumonia?