FITZ Exit Exam | 2026/2027
Verified Questions and 100% Correct Answers |
A+ Graded
Nurse Practitioner Board Review
Section 1: Primary Care – Adult/Gerontology
Q1: A 55-year-old African American male presents for a routine exam. His blood pressure is
148/96 mm Hg on three separate occasions. He has no history of diabetes or CKD. According to
ACC/AHA guidelines, what is the most appropriate initial pharmacologic treatment?
A. Hydrochlorothiazide
B. Amlodipine
C. Lisinopril
D. Metoprolol
Correct Answer: A [CORRECT]
Rationale: According to ACC/AHA guidelines, for the general non-black population, initial
agents include thiazides, CCBs, or ACEIs/ARBs. However, for African American patients,
thiazides or CCBs are preferred first-line due to better efficacy and lower risk of angioedema
with ACEIs. Hydrochlorothiazide is the best answer among the choices for this demographic.
Q2: A 65-year-old female with Type 2 Diabetes Mellitus has an HbA1c of 8.5% on Metformin
1000mg BID. She has a history of ASCVD. What is the best addition to her regimen?
A. Sulfonylurea
B. DPP-4 inhibitor
C. GLP-1 receptor agonist or SGLT2 inhibitor
D. Basal insulin
Correct Answer: C [CORRECT]
,Rationale: Current ADA standards recommend GLP-1 RAs or SGLT2 inhibitors for patients
with T2DM and established ASCVD, as these agents have proven cardiovascular benefit.
Sulfonylureas and insulin increase hypoglycemia risk and weight gain.
Q3: A 72-year-old male presents with knee pain that worsens with activity and improves with
rest. Examination reveals crepitus and bony enlargement. There is no effusion. What is the most
likely diagnosis?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Septic arthritis
Correct Answer: B [CORRECT]
Rationale: Osteoarthritis is characterized by joint pain with use, relieved by rest, along with
crepitus and bony enlargement (Heberden's and Bouchard's nodes). RA typically involves
morning stiffness and symmetrical small joint swelling. Gout is acute, inflammatory, and
monoarticular.
Q4: A 60-year-old patient with COPD is prescribed a tiotropium inhaler. What instruction is
essential?
A. "Rinse your mouth after use to prevent thrush."
B. "This is a rescue inhaler; use it every 4 hours."
C. "Use it once daily at the same time."
D. "Do not use it if you are allergic to peanuts."
Correct Answer: C [CORRECT]
Rationale: Tiotropium is a long-acting muscarinic antagonist (LAMA) taken once daily. It is a
maintenance medication, not a rescue inhaler. While inhalers containing lactose (like some
ICS/LABA combos) caution about peanut allergy, tiotropium is generally the focus of dosing
instruction.
Q5: A 45-year-old female reports feelings of hopelessness, weight loss, and insomnia for the past
3 weeks. She scores 18 on the PHQ-9. What is the most appropriate initial treatment?
,A. Hospitalization
B. SSRI (e.g., Sertraline) and psychotherapy
C. Benzodiazepine
D. Antipsychotic
Correct Answer: B [CORRECT]
Rationale: Moderate depression (PHQ-9 10-19) is typically treated with first-line
pharmacotherapy (SSRIs) and/or psychotherapy (CBT). Hospitalization is for suicidal ideation.
Benzodiazepines are not first-line for depression due to dependence risk.
Q6: A 58-year-old male presents with exertional chest pain that resolves with rest. His ECG is
normal. What is the next step in diagnosis?
A. Stress test
B. CT Angiogram
C. Cardiac catheterization
D. Holter monitor
Correct Answer: A [CORRECT]
Rationale: Stable angina in a patient with an intermediate pre-test probability of CAD is best
evaluated with functional testing, such as a stress test (exercise or pharmacological).
Catheterization is reserved for high-risk or unstable patients.
Q7: Which screening test for colorectal cancer is recommended every 10 years for average-risk
adults aged 45-75?
A. Flexible sigmoidoscopy
B. Colonoscopy
C. FIT (Fecal Immunochemical Test)
D. CT Colonography
Correct Answer: B [CORRECT]
Rationale: Colonoscopy is recommended every 10 years for average-risk adults. FIT is done
annually, and flexible sigmoidoscopy every 5 years (with FIT every 3 years). CT colonography
every 5 years.
, Q8: A 50-year-old female has a BMI of 32, hypertension, and hyperlipidemia. Her labs show
fasting glucose 110 mg/dL. She is at high risk for:
A. Type 1 Diabetes
B. Metabolic Syndrome
C. Hypothyroidism
D. Cushing's syndrome
Correct Answer: B [CORRECT]
Rationale: Metabolic syndrome is diagnosed by 3 of 5: increased waist circumference, elevated
triglycerides, reduced HDL, elevated blood pressure, and elevated fasting glucose. This patient
meets the criteria.
Q9: A patient with atrial fibrillation and a CHA2DS2-VASc score of 3 is prescribed warfarin.
What is the target INR?
A. 1.5 - 2.0
B. 2.0 - 3.0
C. 3.0 - 4.0
D. 2.5 - 3.5
Correct Answer: B [CORRECT]
Rationale: The therapeutic INR range for atrial fibrillation in patients taking warfarin is 2.0 to
3.0.
Q10: An 80-year-old patient is hospitalized with pneumonia. On discharge, what vaccine is
indicated if they have never received it?
A. PCV20 alone or PCV15 followed by PPSV23 one year later.
B. PCV13 only.
C. PPSV23 only.
D. Zostavax
Correct Answer: A [CORRECT]
Verified Questions and 100% Correct Answers |
A+ Graded
Nurse Practitioner Board Review
Section 1: Primary Care – Adult/Gerontology
Q1: A 55-year-old African American male presents for a routine exam. His blood pressure is
148/96 mm Hg on three separate occasions. He has no history of diabetes or CKD. According to
ACC/AHA guidelines, what is the most appropriate initial pharmacologic treatment?
A. Hydrochlorothiazide
B. Amlodipine
C. Lisinopril
D. Metoprolol
Correct Answer: A [CORRECT]
Rationale: According to ACC/AHA guidelines, for the general non-black population, initial
agents include thiazides, CCBs, or ACEIs/ARBs. However, for African American patients,
thiazides or CCBs are preferred first-line due to better efficacy and lower risk of angioedema
with ACEIs. Hydrochlorothiazide is the best answer among the choices for this demographic.
Q2: A 65-year-old female with Type 2 Diabetes Mellitus has an HbA1c of 8.5% on Metformin
1000mg BID. She has a history of ASCVD. What is the best addition to her regimen?
A. Sulfonylurea
B. DPP-4 inhibitor
C. GLP-1 receptor agonist or SGLT2 inhibitor
D. Basal insulin
Correct Answer: C [CORRECT]
,Rationale: Current ADA standards recommend GLP-1 RAs or SGLT2 inhibitors for patients
with T2DM and established ASCVD, as these agents have proven cardiovascular benefit.
Sulfonylureas and insulin increase hypoglycemia risk and weight gain.
Q3: A 72-year-old male presents with knee pain that worsens with activity and improves with
rest. Examination reveals crepitus and bony enlargement. There is no effusion. What is the most
likely diagnosis?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Septic arthritis
Correct Answer: B [CORRECT]
Rationale: Osteoarthritis is characterized by joint pain with use, relieved by rest, along with
crepitus and bony enlargement (Heberden's and Bouchard's nodes). RA typically involves
morning stiffness and symmetrical small joint swelling. Gout is acute, inflammatory, and
monoarticular.
Q4: A 60-year-old patient with COPD is prescribed a tiotropium inhaler. What instruction is
essential?
A. "Rinse your mouth after use to prevent thrush."
B. "This is a rescue inhaler; use it every 4 hours."
C. "Use it once daily at the same time."
D. "Do not use it if you are allergic to peanuts."
Correct Answer: C [CORRECT]
Rationale: Tiotropium is a long-acting muscarinic antagonist (LAMA) taken once daily. It is a
maintenance medication, not a rescue inhaler. While inhalers containing lactose (like some
ICS/LABA combos) caution about peanut allergy, tiotropium is generally the focus of dosing
instruction.
Q5: A 45-year-old female reports feelings of hopelessness, weight loss, and insomnia for the past
3 weeks. She scores 18 on the PHQ-9. What is the most appropriate initial treatment?
,A. Hospitalization
B. SSRI (e.g., Sertraline) and psychotherapy
C. Benzodiazepine
D. Antipsychotic
Correct Answer: B [CORRECT]
Rationale: Moderate depression (PHQ-9 10-19) is typically treated with first-line
pharmacotherapy (SSRIs) and/or psychotherapy (CBT). Hospitalization is for suicidal ideation.
Benzodiazepines are not first-line for depression due to dependence risk.
Q6: A 58-year-old male presents with exertional chest pain that resolves with rest. His ECG is
normal. What is the next step in diagnosis?
A. Stress test
B. CT Angiogram
C. Cardiac catheterization
D. Holter monitor
Correct Answer: A [CORRECT]
Rationale: Stable angina in a patient with an intermediate pre-test probability of CAD is best
evaluated with functional testing, such as a stress test (exercise or pharmacological).
Catheterization is reserved for high-risk or unstable patients.
Q7: Which screening test for colorectal cancer is recommended every 10 years for average-risk
adults aged 45-75?
A. Flexible sigmoidoscopy
B. Colonoscopy
C. FIT (Fecal Immunochemical Test)
D. CT Colonography
Correct Answer: B [CORRECT]
Rationale: Colonoscopy is recommended every 10 years for average-risk adults. FIT is done
annually, and flexible sigmoidoscopy every 5 years (with FIT every 3 years). CT colonography
every 5 years.
, Q8: A 50-year-old female has a BMI of 32, hypertension, and hyperlipidemia. Her labs show
fasting glucose 110 mg/dL. She is at high risk for:
A. Type 1 Diabetes
B. Metabolic Syndrome
C. Hypothyroidism
D. Cushing's syndrome
Correct Answer: B [CORRECT]
Rationale: Metabolic syndrome is diagnosed by 3 of 5: increased waist circumference, elevated
triglycerides, reduced HDL, elevated blood pressure, and elevated fasting glucose. This patient
meets the criteria.
Q9: A patient with atrial fibrillation and a CHA2DS2-VASc score of 3 is prescribed warfarin.
What is the target INR?
A. 1.5 - 2.0
B. 2.0 - 3.0
C. 3.0 - 4.0
D. 2.5 - 3.5
Correct Answer: B [CORRECT]
Rationale: The therapeutic INR range for atrial fibrillation in patients taking warfarin is 2.0 to
3.0.
Q10: An 80-year-old patient is hospitalized with pneumonia. On discharge, what vaccine is
indicated if they have never received it?
A. PCV20 alone or PCV15 followed by PPSV23 one year later.
B. PCV13 only.
C. PPSV23 only.
D. Zostavax
Correct Answer: A [CORRECT]
