FNP TEST (620 QUESTIONS WITH 100% CORRECT ANSWERS) 2024-2025 UPDATED LATEST GRADED 100% PA, Exams of Nursing

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FNP TEST (620 QUESTIONS WITH 100%

CORRECT ANSWERS) 2024-

UPDATED LATEST GRADED 100% PASS

(ACTUAL EXAM).

What is the first-line treatment for asthma? A. Inhaled corticosteroids B. Long-acting beta2-agonists C. Leukotriene inhibitors D. Short-acting beta2-agonists - Solution A. Inhaled corticosteroids A young adult patient comes in with diffused generalized abdominal pain. Which of the following signs would support a diagnosis of appendicitis? Select all that apply: A. Murphy's sign B. Obturator sign C. Turner's sign D. Blumberg sign E. Rovsing sign - Solution B. Obturator sign D. Blumberg sign E. Rovsing sign An adolescent male patient presents to the office with diffused hives and pruritus that began suddenly this morning. His mother brings him into the clinic as it appears to be getting worse. What would be the next most appropriate action by the nurse practitioner? A. Administer Epinephrine IM in the office B. Prescribe Benadryl 50 mg PO BID until symptoms resolve C. Educate the patient about avoiding triggers in the future D. Assess the patient further - Solution D. Assess the patient further A 13 year old female patient was recently diagnosed at an outside facility with pharyngitis and prescribe amoxicillin. A week after starting the

antibiotics, the patient develops an erythematous maculopapular rash with healthy skin intervening throughout. What should you educate the mother about? A. This is likely scarlatina and we need to start Keflex instead B. This is a typical side effect of taking amoxicillin, and it will result with use of OTC steroids C. Sometimes this rash occurs when patients are given antibiotics for viral etiologies of strep throat. It will resolve on its own D. This rash is known as scarlatina so I am going to refer you to the ED for further treatment - Solution C. Sometimes this rash occurs when patients are given antibiotics for viral etiologies of strep throat. It will resolve on its own When does scarlatina occur? - Solution If strep throat is caused by Group A Streptococcus and it goes untreated, we have to worry about scarlet fever and dust, scarlatina rash. Scarlatina rash is sandpapery and bright red. A middle-aged adult male smoker with COPD presents to the clinic complaining of several days of fever, loss of appetite, coughing, and chest pain. The cough is productive of purulent sputum. Physical examination reveals a temperature of 102.0ºF (39.0ºC), pulse of 88, and respiratory rate of 24. The lung exam reveals crackles on the lower right lobe and wheezing on the upper airways. Which of the following bacteria is more likely to be the infectious agent? A. Streptococcus pneumoniae and Mycoplasma pneumoniae B. Staphylococcus aureus and Mycoplasma pneumoniae C. Haemophilus influenzae and Streptococcus pneumoniae D. Legionella pneumophilia and Haemophilus influenzae - Solution C. Haemophilus influenzae and Streptococcus pneumoniae What is the preferred treatment for the above patient's condition? A. Amoxicillin B. Doxycycline C. Amoxicillin-clavulanate plus a macrolide

D. Azithromycin plus a fluoroquinolone - Solution C. Amoxicillin-clavulanate plus a macrolide Isoniazid therapy is associated with some possible adverse events. Which of the following events can be minimized or prevented with simultaneous intake of pyridoxin? A. Hepatic toxicity B. Peripheral neuropathy C. Urticaria D. Nausea and vomiting - Solution B. Peripheral neuropathy Which of the following is a major risk factor for fatal asthma? A. Exercising in cold weather B. Smoking and vaping C. Hospital admission in past year D. Allergy to pet dander and dust mites - Solution C. Hospital admission in past year What is the preferred reliever medication for asthmatics according to the Global Initiative for Asthma (GINA, 2020) treatment guidelines? A. Low-dose ICS with formoterol B. SABA C. LABA D. Leukotriene receptor agonists - Solution A. Low-dose ICS with formoterol What type of electrolyte should an individual with primary hypertension increase in their diet? A. Calcium B. Chloride C. Potassium D. Sodium - Solution C. Potassium After anti-hypertensive therapy is initiated, when should a patient's blood pressure be rechecked?

A. 1 month B. 2 months C. 3 months D. 4 months - Solution A. 1 month A 73-year-old male who is a smoker has a BMI of 28 and his newly diagnosed with primary hypertension. He has a history of emphysema and second-degree AV block. His blood pressure from the previous visit is 145/80 mmHg. During the current visit, his blood pressure is 155/80 mmHg. What is the next step? A. Start patient on atenolol 50 mg once a day and reassess in three months B. Start patient on felodipine 2.5 mg once a day and reassess in two months C. Start patient on chlorthalidone 12.5 mg daily and reassess in one month D. No medication is needed at this time - Solution C. Start patient on chlorthalidone 12.5 mg daily and reassess in one month All of the following ethnic groups are at higher risk for heart disease, except: A. Mexican Americans B. African-Americans C. East Asians D. Europeans - Solution D. Europeans What is the most common cause of death for people with DM? A. Unintentional injuries or accidents B. Pancreatic cancer C. Heart disease D. Hypoglycemia - Solution C. Heart disease The best screening test for both hyperthyroidism and hypothyroidism is: A. Free T4 (thyroxine) B. Thyroid stimulating hormone C. Thyroid profile D. Palpation of the thyroid gland - Solution B. Thyroid stimulating hormone

A male patient has type two diabetes mellitus and a " sensitive stomach". Which medication is least likely to cause him gastrointestinal distress? A. Naproxen sodium B. Aspirin C. Erythromycin D. Sucralfate - Solution D. Sucralfate An obese Asian patient with a BMI of 33 complaints of fatigue and excessive thirst and hunger. You suspect type two diabetes mellitus. Initial testing to confirm diagnosis can include: A. Fasting plasma glucose level B. Glycated hemoglobin level (A1C) C. Oral glucose tolerance testing D. All of the above - Solution D. All of the above Which one of the following findings is associated with diabetic retinopathy? A. AV nicking B. Copper wire arterioles C. Flame shaped hemorrhages D. Microaneurysms - Solution D. Microaneurysms A 30 year old woman with type two diabetes uses regular and intermediate acting insulin in the morning and evening. She denies changes in her diet or any illness, but she recently started attending aerobic classes in the afternoon. Our fasting blood glucose level before breakfast is now elevated. Which of the following is best described? A. Somogyi phenomenon B. Dawn phenomenon C. Raynaud's phenomenon D. Insulin resistance - Solution A. Somogyi phenomenon Which of the following best describes Cullen's sign? A. Cessation of inspiration upon deep palpation of the RUQ of the abdomen B. Bruising around the periumbilical area of the abdomen

C. Deep palpation of the LLQ of the abdomen that causes pain to radiate to the RLQ D. Blue-black discoloration that is located on the right flank of the trunk - Solution B. Bruising around the periumbilical area of the abdomen Which of the following is the screening test for hepatitis C virus (HCV)? A. Anti-HCV B. HBsAg C. Anti-HAV D. HCV RNA polymerase chain reaction (PCR) - Solution A. Anti-HCV Which of the following is indicative of gallbladder Inflammation? A. Rovsing's maneuver B. Rebound tenderness C. Murphy's maneuver D. McMurrays maneuver - Solution C. Murphy's maneuver A 45 year old female with a BMI of 28 complaints of intermittent burning epigastric pain over the past few months. It is worse at night, especially after a heavy or spicy meal. She goes to sleep about two hours after eating. The pain is partially relieved by antacids or not at all. She's not a smoker and denies radiation of pain to neck, arms, or jaw; diaphoresis; and dyspnea. What is the next step? A. Order a 12 lead EKG B. Prescribe a proton pump inhibitor C. Recommend to stop eating four hours and avoid spicy or heavy meals before bedtime, as well as lose weight D. Schedule a fasting lipid profile, including cholesterol, low density lipoprotein, high density lipoprotein, and triglycerides - Solution C. Recommend to stop eating four hours and avoid spicy or heavy meals before bedtime, as well as lose weight A 13 year old middle school student reports that he does not feel like eating and that his stomach has bothered him for the past 24 hours. He states that last night, the middle of his stomach around the umbilicus hurt and then the pain moved to the right lower side of his abdomen. His temperature is 100.8°F, Pulse is 90 bpm, respiratory rate is 20 breaths per minute, and

blood pressure is 110/60 4 mmHg. During abdominal exam, the patient has RLQ abdominal tenderness without rebound. Rovsing's sign is negative. Which of the following is the most helpful clue in the patient's diagnosis? A. The manner in which the pain involved B. The patient's vital signs C. The patient poor appetite D. The abdominal exam - Solution A. The manner in which the pain involved The best test of cure after treating a patient with Helicobacter pylori infection is: A. CBC with white blood cell differential B. Stool for occult blood x 3 specimens C. H. pylori IgM and IgG serology D. Urea breath test - Solution D. Urea breath test An adult with a seizure disorder is experiencing gingival hypertrophy, coarse facial features, and increased hair growth. These are potential side effects of which medication? A. Carbamazepine B. Valproic acid C. Phenytoin D. Venlafaxin - Solution C. Phenytoin Among patients with nephrolithiasis, which is the most common type of kidney stone? A. Struvite B. Cystine C. Calcium oxalate D. Uric acid - Solution C. Calcium oxalate A 55-year-old female patient presents with symptoms of urinary tract infection. A clean catch midstream urine specimen is obtained and sent to the laboratory for culture and sensitivity testing. Which of the following results is indicative of an uncomplicated urinary tract infection?

A. 10^5 CFU/mL of one organism B. 10^5 CFU/mL of one or more organism C. 10^3 CFU/mL of Enterobacteriacae D. 10^3 CFU/mL of gram-negative Enterobacteriacae - Solution A. 10^ CFU/mL of one organism All of the following groups are considered complicated urinary tract infection, except: A. Males B. Infants C. Pregnant women D. Middle-aged women - Solution D. Middle-aged women All of the following increase the risk of urinary tract infection in women, except: A. Frequent sexual intercourse B. Pregnancy C. Vaginal douching D. Spermicide used with diaphragms - Solution C. Vaginal douching A new patient, who is a 54 year old athlete with a history of hyperlipidemia, is seen for new onset of generalized myalgia, muscle weakness, oliguria, and tea-colored urine for the past 24 hours. He recently completed running a marathon. He's on a statin and reports taking ibuprofen several times to treat the muscle pain. Which diagnosis is most likely? A. Hyperthyroidism B. Rhabdomyolysis C. Pyelonephritis D. Viral influenza - Solution B. Rhabdomyolysis A 23 year old woman is seen in the office by the nurse practitioner for a complaint of weakness, poor balance, and problems with walking. She states, "I am so clumsy. Sometimes I fall when I walk." She reports new onset vision loss and bladder incontinence. Each episode lasts a few days; she has had several in the past six months. When she bends her head forward to tie her shoes, she reports a sharp shooting sensation from the

opera to lower back. She's anxious and crying at the office. What is the most likely diagnosis for this patient? A. Vitamin B 12 deficiency B. Tertiary syphilis C. Multiple sclerosis D. Lou Gehrig's disease - Solution C. Multiple sclerosis The nurse practitioner is instructing the patient to flex both wrists at 90° for one minute. This test is associated with: A. Median nerve inflammation B. Navicular fracture C. Colle's fracture D. Scaphoid bone fracture - Solution A. Median nerve inflammation Which of the following is a contra indication for prescribing the "triptan" drug class? A. Peptic ulcer disease B. Heart disease C. Kidney infection D. Psoriasis - Solution B. Heart disease Which cranial nerve is responsible for tongue movement? A. CN VIII B. CN IX & CN X C. CN XI D. CN XII - Solution D. CN XII A 54 year old woman complains of "being stressed out" at her new job. She complains about daily headaches for several months and takes acetaminophen to self-treat twice a day. She describes the headache as being band-like and dull accompanied by tight neck muscles bilaterally. She denies nausea, vomiting, visual changes, and photophobia. Which of the following is appropriate management of this patient? A. Stop the acetaminophen and start her on ketorolac

B. Discontinue the acetaminophen and encourage stress reduction measures as exercise and yoga C. Advised patient to start taking ibuprofen 1 to 2 tablets daily D. Start patient on butalbital and discontinue acetaminophen - Solution B. Discontinue the acetaminophen and encourage stress reduction measures as exercise and yoga Which of the following is the recommended treatment for hereditary hemochromatosis? A. Genetic counseling B. Ferrous sulfate supplementation C. Phlebotomy D. Dialysis - Solution C. Phlebotomy What is the most common type of hemophilia in the United States? A. Hemophilia B B. Hemophilia C C. Von Willebrand disease D. Factor VIII deficiency (Hemophilia A) - Solution D. Factor VIII deficiency An elderly male visits the nurse practitioner in November for an annual physical exam and laboratory tests. The CBC results are hemoglobin of 12 g/dL, Hematocrit of 36%, and MCV of 76 fL. The patient has a history of benign prostatic hyperplasia, hypertension, hyperlipidemia. Which off the following laboratory tests is the next step in this patient's evaluation? A. TIBC, ferritin level, iron B. Homocysteine, folate level C. Vitamin B12 level, folate level D. Hemoglobin electrophoresis - Solution A. TIBC, ferritin level, iron During the early stages of iron deficiency anemia, the red blood cells are: A. Microcytic B. Normocytic C. Macrocytic D. Hyperchromic - Solution B. Normocytic

A black adult male presents with new onset of jaundice, dark urine, fatigue, and anorexia. He was seen a few days previously and treated for a possible urinary tract infection. He is on the third day of nitrofurantoin 100 mg PO BID 7 days. The hemoglobin is 11 g/dL, and hematocrit is 34%. The MCV is 84 fL. The serum indirect bilirubin is elevated. Which of the following conditions is most likely? A. G6PD anemia B. Sickle cell anemia C. Iron deficiency anemia D. Pernicious anemia - Solution A. G6PD anemia An 18 year old woman is complaining of right ankle pain. She reports twisting her ankle while jogging the previous day. She states that she "rolled inward" on her ankle. During the physical exam, the nurse practitioner finds a markedly swollen ankle with several areas of ecchymosis. There is tenderness on the tip of the lateral malleolus. The joint is tender on palpation. The patient has problems with weight-bearing and walking. What type of sprain does this patient have? A. Grade I B. Grade II C. Grade III D. Grade IV - Solution C. Grade III A 37-year-old male high school teacher complains of an acute onset of pain and tenderness of his left wrist. He denies trauma to the wrist. He reports that the condition occurred on the same wrist before. The symptoms started that morning after he went to a birthday party the previous evening. He reports that he drank a few glasses of white wine. During the physical exam, the left wrist is red, swollen, and tender to palpation. The skin is intact but feels warm to touch. What is the most likely diagnosis? A. Wrist sprain B. Gout C. Osteoarthritis D. Septic joint - Solution B. Gout Regarding the previous case, all of the following can be used to treat his condition, except:

A. Oral glucocorticoids B. Topical glucocorticoids C. NSAIDs D. Colchicine - Solution B. Topical glucocorticoids An adolescent athlete reports a sudden onset of posterior right thigh pain. The injury occurred while she was running during a soccer game. She denies falling. She is limping and walking slowly. On physical examination, the middle portion of the right hamstring muscle is tender to palpation with some bruising noted. Which of the following conditions is most likely in this patient? A. Hamstring muscle strain B. Baker's cyst C. Quadriceps muscle strain D. Piriformis syndrome - Solution A. Hamstring muscle strain Which organ system is not affected by chronic NSAID use? A. Cardiovascular system B. Renal system C. Immune system D. Gastrointestinal system - Solution C. Immune system An older adult male with alcohol use disorder is scheduled for a physical exam and laboratory testing. The patient's laboratory blood test results may show: A. Increase serum creatinine levels and eGFR B. Decreased number of platelets and increased MCV C. Increased serum potassium and increased triglycerides D. Decreased AST and ALT levels - Solution B. Decreased number of platelets and increased MCV The female athlete triad includes all of the following, except: A. Menstrual dysfunction B. Premature osteoporosis C. Disordered eating

D. Insulin resistance - Solution D. Insulin resistance Which of the following individuals is at the highest risk for suicide? A. Obese teenager who fails an exam in high school B. Black middle-aged female who is newly diagnosed with type 2 diabetes C. Elderly white male whose wife of 40 years recently died D. Asian adult who is mother has a chronic illness - Solution C. Elderly white male whose wife of 40 years recently died An elderly diabetic female with peripheral neuropathy and corner artery disease is recently diagnosed with major depression. The patient refuses psychotherapy and wants medication. She denies suicidal and homicidal ideation. Which of the following pharmacologic agents is the best choice for this patient? A. Quetiapine (Seroquel) B. Duloxetine (Cymbalta) C. Escitalopram (Lexapro) D. Amitriptyline (Elavil) - Solution B. Duloxetine (Cymbalta) A 13 year old male patient is brought to an outpatient clinic by his father with a complaint of a sudden onset of severe left testicular pain. The patient is very nauseous and has already vomited a few times. Physical exam reveals a red, swollen, and tender left scrotum. There is no cremasteric reflex. The abdomen is soft, with no rebound or localized tenderness. Ball sounds are positive. Which of the following is recommended for this patient? A. Recommend increase fluid intake and BRAT diet (bananas, rice, applesauce, and dry toast) B. Order an ultrasound of the left scrotum C. Refer the patient with urologist; give the patient's father the contact information D. Refer the patient to the ED as soon as possible - Solution D. Refer the patient to the ED as soon as possible Which of the following conditions is a possible effect of the mumps virus, which can affect male fertility?

A. Salivary gland inflammation B. Cryptorchidism C. Orchitis D. Prostatitis - Solution C. Orchitis What is the most common cause of balanitis? A. Pseudomonas B. Candida albicans C. Bacteria D. Virus - Solution B. Candida albicans 37 year old adult male complains of swelling on the right scrotum that is mildly tender for a few weeks. There is a pressure-like sensation. The right scrotum is larger than the left scrotum. Which of the following tests is appropriate for this patient? A. Transillumination B. CBC with differential C. Ultrasound of the scrotum D. Urinalysis - Solution A. Transillumination Which of the following medication increases the risk of erectile dysfunction? A. Amoxicillin B. Paroxetine C. Levothyroxine D. Aspirin - Solution B. Paroxetine What is the most common cause of secondary amenorrhea? A. Turner syndrome B. Polycystic ovary syndrome C. Pregnancy D. Anorexia nervosa - Solution C. Pregnancy Which of the following factors will not increase a woman's risk of developing breast cancer? A. Moderate to high intake of alcohol

B. Onset of menstruation at 10 years of age C. First pregnancy at age 30 years or older D. Body mass index of 23 - Solution D. Body mass index of 23 A 25 year old woman with hirsutism, obesity, and oligomenorrhea is diagnosed with PCOS. A woman with PCOS is at higher risk for all of the following except? A. Cervical cancer and atrophic vaginitis B. Endometrial cancer and infertility C. Type two diabetes and heart disease D. Obesity and nonalcoholic fatty liver disease - Solution A. Cervical cancer and atrophic vaginitis A 35 year old woman smokes approximately 10 cigarettes per day. She started smoking at the age of 18 years. She has a new male sexual partner and is interested in contraception. She was recently treated for gonorrhea and chlamydia. She is using condoms in consistently. The urine pregnancy test is negative. She denies a history of hypertension, blood clots, liver disease, heart disease, and diabetes. Her last menstrual period was five days ago. Which of the following contraceptive methods is recommended? A. Oral contraceptive pills B. Copper IUD C. Etonogestrel implant (Nexplanon) D. Vaginal ring (NuvaRing) - Solution C. Etonogestrel implant (Nexplanon) A 22-year-old presents for her annual gynecology goal exam and testing. The Pap smear results shows ASC - US. Which of the following is the best management for this patient? A. Check for high-risk HPV B. Repeat Pap in 12 months C. Refer patient to colposcopy D. Refer patient for endometrial biopsy - Solution B. Repeat Pap in 12 months Hegar's sign is considered a: A. Positive sign of pregnancy

B. Probable sign of pregnancy C. Presumptive sign of pregnancy D. Problem in pregnancy - Solution B. Probable sign of pregnancy Which of the following statements is true regarding a threatened abortion? A. Vaginal bleeding and cramping are present, but the cervix remains closed B. Vaginal bleeding and cramping are present along with a dilated cervix C. The fetus and placenta are both expelled D. The products of conception and the placenta remain inside the uterus along with a dilated cervix - Solution A. Vaginal bleeding and cramping are present, but the cervix remains closed A multigravitable who is at 28 weeks gestation has a funnel height of 29 cm. Which of the following is the best recommendation for this patient? A. Advise mother that her pregnancy is progressing well B. Order an ultrasound of the uterus C. Refer her to an obstetrician for an amniocentesis D. Recommend bed rest with bathroom privileges - Solution A. Advise mother that her pregnancy is progressing well Do notice the following results on a routine urinalysis of a 37-year-old primagravida who is at 30 weeks gestation: Leukocytes = trace, nitrite = negative, protein = 2+, blood = negative. Her weight has increased by 5 pounds during the past week. Which of the following is most likely? A. HELLP syndrome B. Pregnancy induced hypertension (preeclampsia) C. Eclampsia of pregnancy D. Primary hypertension - Solution B. Pregnancy induced hypertension (preeclampsia) A 28 year old multipara who is at 32 weeks gestation presents to your office complaining of a sudden onset of small amount of bright red vaginal bleeding. She has had several episodes and appears anxious. On exam, her uterus is soft about patient. Which of the following is most likely? A. Placenta abruptio

B. Placenta previa C. Acute cervicitis D. Molar pregnancy (hydatidiform mole) - Solution B. Placenta previa Which of the following antigens is a component of the HIV 1/2 combination antibody/antigen testing? A. p B. p C. p D. p14 - Solution A. p A sexually active 16 year old which cervicitis is tested for gonorrhea and chlamydia. The NAAT test results shows that the patient is positive for gonorrhea. Which of the following is appropriate treatment for this patient? A. Cephalosporin B. Cephalosporin and macrolide C. Tetracycline D. Tetracycline and sulfonamide - Solution B. Cephalosporin and macrolide The Jarisch-Herxheimer reaction is a response to treatment of which of the following organisms? A. Neisseria gonorrhoeae B. Chlamydia trachomatis C. Treponema pallidum D. Rickettsia rickettsii - Solution C. Treponema pallidum Coco All of the following have been classified as nationally notifiable diseases by the Centers for Disease Control and Prevention, except: A. Herpes simplex infections B. Pertussis C. Anthrax D. Lyme disease - Solution A. Herpes simplex infections A 30 year old male with a history of HIV infection has been an anti-retroviral therapy (ART) since diagnosis at age 28 years. Which of the following indicates that the patient immune system is responding to ART?

A. The HIV viral load is higher compared with the previous test B. The CD4 count is higher than the previous test C. The CBC shows an increase in the leukocyte count D. HIV genetic testing of the patient's HIV strain shows that it is sensitive to current HIV regimen - Solution B. The CD4 count is higher than the previous test Which HPV strains are uncle Janic and cause the majority of cervical cancer cases? A. HPV 6 and HPV 11 B. HPV 16 and HPV 18 C. HPV 2 and HPV 4 D. HPV 40 and HPV 51 - Solution An adolescent high school athlete who is on the wrestling team complains of multiple bumps on his lower left arm. The patient denies pruritus, pain, or discomfort from the lesions. During the skin exam, the nurse practitioner notices multiple smooth domed papules that are 2 to 5 mm in diameter with central umbilication. Which diagnosis is most likely? A. Molluscum contagiosum B. Acne vulgaris C. Verruca vulgaris D. Basal cell carcinoma - Solution A. Molluscum contagiosum And adult blackmail presents with blood under the nail of the grade to that involves approximately 50% of the nail area. He reports dropping a hammer accidentally on his toe about five hours ago. Which of the following is the recommended treatment? A. Biopsy to rule out melanoma B. No treatment is needed C. Trephination D. Nail removal - Solution C. Trephination All of the following pharmacologic agents are indicated for the treatment of plaque psoriasis, except:

A. Topical corticosteroids B. Vitamin D analogs C. Ultraviolet light therapy D. Oral antibiotics - Solution D. Oral antibiotics Which of the following is considered as a precursor lesion of squamous cell skin cancer? A. Atopic dermatitis B. Actinic keratosis C. Seborrheic keratosis D. Nevi - Solution B. Actinic keratosis Molluscum contagiosum is caused by: A. Herpesvirus B. Poxvirus C. Staphylococcus aureus D. Haemophilus influenzae - Solution B. Poxvirus A middle-aged adult presents as a "walk-in" patient. He is anxious and wants to be seen today. He complains that when he woke up and got out of bed that morning, he had severe dizziness and almost fell on the floor because "the room was spinning so much." His gait is unstable with some swaying noted. He reports that if he moves his head quickly, he gets very dizzy and has problems with balance. He denies trauma, hypertension, tinnitus, hearing loss, and fever. The Romberg test is positive. Which of the following conditions is most likely? A. BPPV (Benign proximal positional vertigo) B. Ménière's disease C. Acoustic neuroma D. Cerebrovascular accident (CVA) - Solution A. BPPV (Benign proximal positional vertigo) Regarding the previous case, which of the following tests will help diagnose this patient? A. Lachman B. Dix-Hallpike

C. Obturator D. Finklestein - Solution B. Dix-Hallpike Where is Kiesselbach's plexus located? A. The posterior area of the pharynx B. The superior lateral area of the maxillary sinus C. The anterior inferior area of the nasal septum D. The submandibular area of the mouth - Solution C. The anterior inferior area of the nasal septum What is the first line treatment for allergic rhinitis? A. Saline nasal spray B. Oral antihistamine C. Topical nasal decongestant spray D. Topical nasal steroid spray - Solution D. Topical nasal steroid spray Which of the following conditions is classified as sensory neuro hearing loss? A. Presbycusis B. Otitis media C. Ceruminosis D. Otitis externa - Solution A. Presbycusis 40-year-old male who is building a house presents with a two day history of foreign body sensation and excessive tearing of the right eye. What type of exam is recommended initially? A. Cardiac exam B. Visual exam C. Neurologic exam D. Cerebellar exam - Solution B. Visual exam An 80-year-old female with a history of hypertension, atrial fibrillation, and type 2 diabetes presents to the clinic with a complaint of painless bright-red blood on the right eye that she noticed on awakening. She denies falling, visual changes, visual loss, eye pain, headache, coryza, and fever. The visual exam is normal, and both pupils are equal and reactive to light and

accommodation. The funduscopic exam does not show bleeding. Which of the following conditions is most likely? A. Hyphema B. Subconjunctival hemorrhage C. Ectropion D. Blepharitis - Solution B. Subconjunctival hemorrhage A 16 year old male athlete has recently been diagnosed with infectious mononucleosis. During the abdominal exam, the nurse practitioner identifies an enlarged spleen. Abdominal ultrasound confirms this findings. The patient wants to know when he can go back to playing football. Which of the following responses by the nurse practitioner is the most appropriate? A. You may return to play contact sports when your sore throat is gone B. You should avoid all sports and exercise for the next 2 weeks C. You may not play contact sports for 4 to 6 months D. You may return to exercise and sports in 4 to 6 weeks after a follow-up visit to confirm that your splenomegaly has resolved - Solution D. You may return to exercise and sports in 4 to 6 weeks after a follow-up visit to confirm that your splenomegaly has resolved A 36-year-old female patient today comes in requesting birth control as she is recently divorced and started dating again. She has no known past medical history and has used the birth control pill Loestrin [norethindrone acetate/ethinyl estradiol) in the past. She is requesting to be placed back on Loestrin. Her vital signs at today's visit are: temp 98.7, heart rate 85, blood pressure 152/89, and O2 sat 99%. How should you respond to this patient? A. We will start you on the Loestrin today. Be sure to follow up if you have any new side effects. B. I can start you on birth control today, but I prefer to either start to an a progesterone only method or a non-hormonal method due to your elevated BP. C. I cannot start you on any birth control methods until your blood pressure has been evaluated. D. Loestrin is no longer FDA approved. I could start you on another combined oral contraceptive method such as Ortho-Tricycl - Solution B. I

can start you on birth control today, but I prefer to either start to an a progesterone only method or a non-hormonal method due to your elevated BP. A 55-year-old male patient presents to the clinic with a history of hypertension and diabetes. You draw a fasting lipid profile and note the following labs: LDL 191, triglycerides 142, HDL 439, and total cholesterol

276. What medication do you anticipate starting him on? A. Fenofibrate B. Rosuvastatin C. Lovastatin D. Niacin - Solution B. Rosuvastatin This same patient comes back into the clinic 4 weeks later with increasing fatigue and muscle weakness. He complains that his urine has become tea colored. What is your priority action as the NP? A. Order LFTs B. Order a CK level C. Educate the patient that this is an expected findings after starting rosuvastatin D. Order a urinalysis - Solution B. Order a CK level Your patient comes in complaining of unilateral muffled hearing. When you do the weber test, the test lateral lyses to the bad ear. Which of the following could be a potential cause of the patient's muffled hearing? A. Cerumen impaction B. Age C. Ménière's disease D. Head trauma - Solution A. Cerumen impaction Your patient comes in to see you after being prescribed ciprofloxacin for a recent uncomplicated UTI. Which complaint requires the most immediate follow up? A. Patient complains of an intermittent headache this morning B. Patient states that they were nauseous the last two days since starting the antibiotic

C. Patient complains of vaginal itching/new clumpy discharge D. Patient complains of right heel pain when walking up her stairs this morning - Solution D. Patient complains of right heel pain when walking up her stairs this morning Your patient reports to you that over the last several months they have had a crampy leg pain while walking around the neighborhood. They state that there is a park bench they frequently sit on as sitting relieves their pain. There is no edema of the bilateral lower extremities. There only past medical history includes smoking one pack per day over the last 20 years. What should your next step be? A. Order a d-dimer B. Order an ABI C. Order a Venus Doppler D. Obtain a more thorough history - Solution B. Order an ABI An adolescent male who runs cross country comes into your office as he is having intermittent knee pain during races that is getting progressively worse. He complains of a bump right below his knee. On exam, there is pain over the tendon insertion site. What guidance should we give the patient and his parents about his new condition? A. We are going to refer you to an orthopedist for further evaluation and possible bracing B. This is going to be a lifelong issue that we will need to monitor closely C. This is common during growth spurts and can be managed supportively with ice and NSAIDs D. We will refer you to physical therapy starting next week in order to get this under control - Solution C. This is common during growth spurts and can be managed supportively with ice and NSAIDs. (Osgood-Schlatter) A patient comes into the office after having dental work completed two days before. She's complaining of severe and burning mouth pain. She is finding it difficult to both eat and drink currently. On exam, you note a shallow ulcer on the inside of her cheek that is erythematous and tender. How should you treat this patient? A. Prescribed valacyclovir and prescribe extra in case this issue reoccurs in the future

B. Instruct the patient that this is viral and will go away on its own C. Prescribe the patient "magic mouthwash" for symptom relief D. Educate the patient about proper oral hygiene before and after dental procedures - Solution C. Prescribe the patient "magic mouthwash" for symptom relief (aphthous stomatitis) A 42 year old obese female patient comes in with RUQ pain after eating fried chicken last night from a local restaurant. She states that pain started about an hour after eating and radiated between her shoulder blades. What should you order for the patient? A. EGD B. HIDA scan C. Abdominal ultrasound D. Baseline CMP - Solution C. Abdominal ultrasound Do you have a woman who is 30 weeks pregnant that presents in the office for an ultrasound today. Which of the following vaccines would be appropriate for her to receive during today's visit? A. Flumist B. Hepatitis B C. Varicella D. MMR - Solution B. Hepatitis B Your patient is complaining of incontinence and some burning with urination over the last week. You perform a urinalysis to rule out UTI. Which of the following findings on the urinalysis warrants an immediate referral? A. Leukocytes B. Nitrates C. RBC casts D. Trace amount of blood - Solution C. RBC casts A first time mother comes into the office frantic as she is worried her baby is not receiving enough breastmilk. What education and guidance should be provided to the mother?

A. If there is a notable clicking sound when the baby is breast-feeding, then we know the infant has a good latch and is adequately breast-feeding. B. If your baby has 6 to 8 wet diapers a day and is gaining weight appropriately, then we know they are receiving enough breastmilk. C. The baby should only need to eat up to four times per day, so if they eat at all for times we know they are receiving enough. D. There is no need to worry about your baby not breast-feeding enough, they have gained a pound in their first month of life. - Solution B. If your baby has 6 to 8 wet diapers a day and he's gaining weight appropriately, then we know they are receiving enough breastmilk. A middle-aged man with a past medical history of diabetes, hyperlipidemia, hypertension and smoking comes into your office stating he is having new blurred vision and trouble seeing. What should the NP do next? A. Write the patient a referral for an ophthalmologist as he is at a high risk of diabetic retinopathy B. Assess the patient's eyes using tonometry and fluorescein staining C. Assess the patient's visual acuity using the Snellen chart D. Assure the patient that this is a normal finding as he is Hgb A1c is 9% and his diabetes is uncontrolled - Solution C. Assess the patient's visual acuity using the Snellen chart You recently saw a 57 year old woman two months ago for treatment of a sinus infection. Today, she is complaining of a cough, fever and chills over the last three days. On exam, you note audible expiratory wheezes on auscultation and there is increased tactile fremitus. What should you prescribe for this patient? A. Ciprofloxacin B. High dose amoxicillin C. Doxycycline D. Levofloxacin - Solution D. Levofloxacin A 45-year-old female patient with no significant past medical history patient over the last several months. You decide to order diagnostic lab work because of your patient symptoms. Which of the following would be inappropriate to order for this patient? Select all that apply: A. CBC