Description

1. Question: Your patient presents with a blowing systolic murur rated 3/6 that is heard best over the left chest at the 5th intercostal space, left midclavicular space, radiating to the left axilla. This likely represents which cardiac finding?
2. Question: While working in a fast-track clinic as a NP in an emergency department, your patient complains of shortness of breath with activity and near syncope with changing position from seated to standing on multiple recent episodes. You examine them and notice a harsh systolic murmur heard best at the right sternal border at the 2nd intercostal space rated 3/6, which has a bruit radiating to the right carotid artery. Of the following examinations, which is most appropriate for you to order next to evaluate this murmur?
3. Question: The most important diagnostic factor in evaluating angina pectoris is the patient’s:
4. Question: A 65-year-old woman presents for a follow-up examination. She is a smoker, and her hypertension is now adequately controlled with medication. Her mother died at age 40 from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200. In addition to starting therapeutic lifestyle changes, what medication should the nurse practitioner start?
5. Question: As a follow-up from a hospitalization, an adult patient presents with ankle edema. Which medication is the most likely cause?
6. Question: An older adult with diabetes mellitus presents with leg cramps that worsen with walking and improve with rest. The nurse practitioner knows this patient needs a workup for what condition?
7. Question: An otherwise healthy patient reports episodes of palpitations lasting less than 5 minutes with sudden onset and termination. Holter monitoring would most likely document what rhythm?
8. Question: A patient presenting with hypotension, narrowed pulse pressure, muffled heart tones, and jugular venous distention is most likely experiencing which life-threatening condition?
9. Question: An adult patient must maintain an INR between 2.0 and 3.0. The patient’s INR is 1.4. Which dietary item would likely decrease the effects of warfarin?
10. Question: An example of secondary prevention for coronary artery disease includes which intervention?
11. Question: A 50-year-old man presents with fatigue, muscle weakness, hyperpigmentation, hyponatremia, hyperkalemia, and low cortisol. What is the most likely diagnosis?
12. Question: Patients on levothyroxine should be monitored for signs of which complication?
13. Question: A patient has a 2 cm pituitary adenoma. Deficiency of which pituitary hormone can cause immediate hemodynamic instability and risk of death?
14. Question: After confirming hypercortisolism, what is the next critical diagnostic step?
15. Question: A 33-year-old woman presents with irregular menses, hirsutism, obesity, and elevated testosterone. What is the most appropriate initial treatment?
16. Question: A patient with low TSH, elevated free T4, and positive TSI antibodies should be counseled regarding which diagnosis?
17. Question: A woman presents with headaches, galactorrhea, and amenorrhea with MRI showing pituitary adenoma. What is the most appropriate initial treatment?
18. Question: An adult patient on levothyroxine presents with tachycardia and nervousness. What dose adjustment is anticipated?
19. Question: An adult female has low TSH and a tender thyroid gland. Which labs should be ordered next?
20. Question: All of the following are risk factors for type II diabetes EXCEPT which?
21. Question: A 90-year-old woman with poor hygiene, bruising, and financial neglect is suspected of abuse. What is the nurse practitioner legally obligated to do?
22. Question: A frail elderly patient presents with constipation. Which age-related physiologic change is the most likely cause?
23. Question: Which finding triggers a full fall-risk assessment in an elderly patient?
24. Question: How should effectiveness of palliative care be evaluated?
25. Question: Management of COPD in the elderly is best guided by what factor?
26. Question: Where can Crohn’s disease be located in the GI tract and how does it present?
27. Question: A patient with localized colon cancer should be prepared for which primary treatment?
28. Question: Which physical exam finding confirms ascites?
29. Question: A patient presents with flank pain radiating to the groin, nausea, and vomiting. What is the most likely diagnosis?
30. Question: If biliary tract obstruction is suspected, what is the preferred initial imaging modality?
31. Question: RUQ pain, fever, gallstones, gallbladder wall thickening, and edema are most consistent with what diagnosis?
32. Question: A patient with nocturnal heartburn relieved by baking soda most likely has what diagnosis?
33. Question: Oral clindamycin is contraindicated in which GI condition?
34. Question: A patient with C. difficile infection who cannot afford vancomycin should be treated with what medication?
35. Question: A patient with mild uncomplicated diverticulitis should receive which treatment?
36. Question: What ethical principle refers to not intentionally harming a patient?
37. Question: Multimodal analgesia aims to reduce reliance on which medication class?
38. Question: A patient threatening harm verbally is exhibiting which behavior?
39. Question: A competent elderly patient refuses chemotherapy despite family wishes. What is the nurse practitioner’s best action?
40. Question: Which 1996 act protects patient health information?
41. Question: Hyphema after trauma is commonly treated with which medication?
42. Question: An adult with acute eye pain and decreased vision suspected of glaucoma should receive what immediate action?
43. Question: Blood covering the lower half of the iris indicates which diagnosis?
44. Question: Severe sinus symptoms with fever, periorbital swelling, and proptosis require what action?
45. Question: Postmenopausal clear rhinorrhea without abnormalities suggests what diagnosis?
46. Question: Retropharyngeal abscess should be treated with which antibiotic?
47. Question: Which option is NOT one of the four Ds of epiglottitis?
48. Question: Workup for cardiac embolic stroke should include which exam?
49. Question: Which bacteria is most commonly associated with pharyngitis?
50. Question: Acute eye pain with halos, cloudy cornea, and fixed pupil requires what immediate action?
51. Question: Which lab indices suggest iron deficiency anemia?
52. Question: A patient with microcytic hypochromic anemia most likely has what diagnosis?
53. Question: Intrinsic factor autoantibodies place patients at risk for which condition?
54. Question: Which thrombocytopenic scenario does NOT require immediate action?
55. Question: Treatment for symptomatic aplastic anemia includes all EXCEPT which?
56. Question: A patient with chronic liver disease and bleeding symptoms likely has what condition?
57. Question: Which symptoms indicate severe GI bleed requiring transfusion?
58. Question: Pancytopenia with dysplasia after chemotherapy requires what further workup?
59. Question: A patient on warfarin has an INR of 5.5. What is the appropriate management?
60. Question: In which patient is PRBC transfusion recommended?
61. Question: A patient with butterfly rash, joint pain, and fatigue should receive what initial management?
62. Question: What treatment strategy is most likely for stage IV Hodgkin’s lymphoma?
63. Question: Progressive weakness, coordination loss, and bladder dysfunction suggest which disease?
64. Question: Patients with bradykinin-mediated angioedema should avoid which medication?
65. Question: What diagnostic intervention confirms suspected lymphoma?
66. Question: Which patient statement raises suspicion for angioedema?
67. Question: What is first-line chronic therapy for mild systemic lupus erythematosus?
68. Question: Painful blistering after sulfa use raises concern for which condition?
69. Question: Progressive ascending weakness requires what priority intervention?
70. Question: Anaphylaxis represents which hypersensitivity reaction type?
71. Question: What is the treatment of choice for scabies?
72. Question: Chronic hand rash in a janitor is most consistent with which diagnosis?
73. Question: Which test is commonly used to identify fungal skin infections?
74. Question: Recurrent vesicular finger lesions in a nail biter most likely indicate what diagnosis?
75. Question: Worsening cystic skin lesions despite cephalexin require what next step?
76. Question: Which diagnostic procedure confirms pinworm infestation?
77. Question: How should a nurse practitioner respond to anxiety caused by a benign seborrheic keratosis?
78. Question: What is the most likely technique used for melanoma removal?
79. Question: A new multicolored mole with irregular borders most likely represents what diagnosis?
80. Question: Which option is NOT effective treatment for verruca?
81. Question: An acute ankle injury with inability to bear weight requires evaluation for which conditions?
82. Question: Decreased lumbar joint space on X-ray indicates which chronic disease?
83. Question: Positive anterior drawer test indicates injury to which structure?
84. Question: Which supplement may reduce osteoarthritis pain and joint narrowing?
85. Question: Forward-flexed posture with back pain suggests which diagnosis?
86. Question: Which antidepressant also benefits osteoarthritis pain?
87. Question: Which scenario is most likely to cause an acute GI bleed?
88. Question: What is the most specific diagnostic test for gout?
89. Question: Which component is evaluated in the trauma secondary survey?
90. Question: Elevated calcium levels may suggest which condition?
91. Question: What is standard treatment for uncomplicated UTI in areas with >20% resistance?
92. Question: Which dialysis modality allows home therapy without being connected during treatment?
93. Question: Which labs best assess CKD progression?
94. Question: Which finding suggests glomerulonephritis?
95. Question: Hypotension-induced renal injury represents which type of acute renal dysfunction?
96. Question: Chronic urinary urgency with negative workup suggests what treatment?
97. Question: Contrast-induced nephropathy represents which renal dysfunction type?
98. Question: Inability to reach the bathroom before urinating indicates which incontinence type?
99. Question: What is first-line antibiotic therapy for uncomplicated UTI in women with no allergies?
100. Question: Diabetes, hypertension, COPD, and osteoarthritis most commonly lead to CKD due to which condition?
101. Question: Which drug class is used for migraine prevention?
102. Question: Progressive headache with focal neurologic deficit requires what action?
103. Question: Hypotension after Parkinson’s treatment is most likely caused by which medication?
104. Question: Acute confusion with hyponatremia indicates what diagnosis?
105. Question: Acute vertigo without hearing loss should be managed how?
106. Question: What best describes amaurosis fugax?
107. Question: When should disease-modifying therapy be started in multiple sclerosis?
108. Question: Which comorbidity contraindicates ergot and triptan use?
109. Question: Which headache symptom requires immediate neuroimaging?
110. Question: Which medication is appropriate for migraine prophylaxis?
111. Question: Sore throat, fever, and sandpaper rash in a child indicate what diagnosis?
112. Question: Exercise-induced syncope with murmur increasing on standing suggests what condition?
113. Question: Inconsolable crying in an infant with normal exam warrants which test?
114. Question: Loud holosystolic murmur at left lower sternal border indicates which diagnosis?
115. Question: Which HPV vaccine statement requires further education?
116. Question: At what age should a child sit unsupported?
117. Question: How is asthma classified with symptoms >2 days/week and nighttime awakening?
118. Question: What is best post-exposure therapy for unvaccinated child exposed to hepatitis A?
119. Question: Recurrent strep after erythromycin should be treated with what?
120. Question: Fluctuating hypomania and mild depression over years indicates which diagnosis?
121. Question: No improvement after SSRI dose increase at 2 weeks requires what action?
122. Question: Which medication is NOT associated with serotonin syndrome when combined with SSRIs?
123. Question: How should hallucinations be addressed by the clinician?
124. Question: PTSD care should focus on which key element?
125. Question: Before increasing SSRI dose for postpartum depression, which lab must be checked?