Pharmacology, and Clinical Management –
Integration of Evidence-Based Science in Advanced
Practice Nursing 2025-2026
1. A 45-year-old male presents with sudden onset chest pain
radiating to the left arm and jaw. Which of the following is
the most likely diagnosis?
A. Gastroesophageal reflux
B. Acute myocardial infarction
C. Pulmonary embolism
D. Panic attack
Rationale: Chest pain radiating to the jaw or arm,
especially sudden onset, is classic for acute myocardial
infarction.
2. Which heart sound is commonly associated with
congestive heart failure?
A. S1
B. S2
C. S3
D. S4
Rationale: S3 (ventricular gallop) is often heard in volume
overload states like CHF.
3. A patient presents with polyuria, polydipsia, and weight
loss. The most likely endocrine disorder is:
, A. Hypothyroidism
B. Diabetes mellitus
C. Cushing’s syndrome
D. Addison’s disease
Rationale: These are hallmark signs of hyperglycemia and
uncontrolled diabetes.
4. Which of the following lung sounds is high-pitched,
musical, and often heard on expiration?
A. Crackles
B. Rhonchi
C. Wheezing
D. Stridor
Rationale: Wheezing is due to narrowed airways and is
typically expiratory.
5. The most appropriate initial imaging for suspected
appendicitis in adults is:
A. MRI
B. CT abdomen/pelvis with contrast
C. X-ray
D. Ultrasound
Rationale: CT scan is the gold standard for diagnosing
appendicitis in adults due to high sensitivity and specificity.
6. Which symptom is most suggestive of a hyperthyroid
state?
A. Weight gain
B. Cold intolerance
, C. Bradycardia
D. Heat intolerance
Rationale: Hyperthyroidism increases metabolic rate,
causing heat intolerance and sweating.
7. A 60-year-old female has unilateral leg swelling, redness,
and warmth. The most likely diagnosis is:
A. Cellulitis
B. Deep vein thrombosis (DVT)
C. Lymphedema
D. Peripheral artery disease
Rationale: Unilateral leg swelling, redness, and warmth
raise high suspicion for DVT.
8. Which of the following is the best screening test for type 2
diabetes?
A. Fasting lipid panel
B. Fasting plasma glucose
C. Serum insulin
D. Hemoglobin electrophoresis
Rationale: Fasting plasma glucose is a widely used
screening test for diabetes.
9. A patient presents with fever, cough, and rust-colored
sputum. The most likely pathogen is:
A. Haemophilus influenzae
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Legionella pneumophila
, Rationale: Rust-colored sputum is classically associated
with pneumococcal pneumonia.
10. A bruit heard over the carotid artery indicates:
A. Normal finding
B. Turbulent blood flow, suggestive of stenosis
C. Low cardiac output
D. Heart failure
Rationale: A bruit suggests turbulent flow often caused by
atherosclerotic narrowing.
11. Which condition is associated with a “butterfly” rash
on the face?
A. Rosacea
B. Acne vulgaris
C. Systemic lupus erythematosus (SLE)
D. Psoriasis
Rationale: The malar rash across the cheeks and nose is
classic for SLE.
12. The most sensitive test for early detection of chronic
kidney disease is:
A. Serum creatinine
B. Urine albumin-to-creatinine ratio
C. BUN
D. Urinalysis
Rationale: Microalbuminuria is an early marker of kidney
damage.