NP 235 CORE EXAM 2026 TEST QUESTIONS AND
SOLUTIONS GRADED A+
✔✔AST levels - ✔✔0 to 35
Elevation occurs with hepatitis or cirrhosis
✔✔Troponin - ✔✔Proteins found in the cardiac and skeletal muscles
Doctors measure troponin levels to detect whether or not someone is experiencing a
heart attack.
✔✔Troponin proteins are split into three subunits: - ✔✔troponin C (TnC)
troponin T (TnT)
troponin I (TnI)
✔✔Normal levels of Troponin - ✔✔If a patient is experiencing chest pain, but these
levels are still low 12 hours after the chest pain started, the possibility of a heart attack
is unlikely.
High levels of this are an immediate red flag.
measured in nanograms per milliliter. Normal levels fall below the 99th percentile in the
blood test. If the results are above this level, it may be an indication of heart damage or
heart attack.
✔✔C-Reactive Protein - ✔✔CRP test can check for inflammation, which can indicate
infection or a chronic inflammatory disease, such as rheumatoid arthritis or lupus, as
well as risk of heart disease.
✔✔Creatinine Kinase (CK-MB) - ✔✔measures the amount of an isoenzyme of
creatinine kinase (CK) in your blood.
Because many tissues contain CK, high levels of CK can be a sign of a variety of
problems. Higher CK-MB may point more directly to heart damage.
✔✔B-type Natriuretic Peptide (BNP) - ✔✔measures the levels of the BNP
hormone.BNP and another heart hormone, called atrial natriuretic peptide (ANP), work
together to keep veins and arteries widened, or dilated.
✔✔The doctor may order a BNP blood test if - ✔✔the patient has symptoms of heart
failure, including:
Trouble breathing (dyspnea)
Feeling exhausted or weak for no apparent reason
Rapid weight gain without a change in diet or activity
Inability to concentrate or remain alert
Abnormally high or irregular heart rate
, Coughing a lot, and producing white or pink phlegm
Nausea or having no appetite
✔✔Thyroid Stimulating Hormone (TSH) - ✔✔controls production of the thyroid
hormones, thyroxine and triiodothyronine, by the thyroid gland by binding to receptors
located on cells in the thyroid gland. Thyroxine and triiodothyronine are essential to
maintaining the body's metabolic rate, heart, and digestive functions, muscle control,
brain development and maintenance of bones.
✔✔How is thyroid stimulating hormone controlled? - ✔✔When thyroid stimulating
hormone binds to the receptor on the thyroid cells, this causes these cells to produce
thyroxine and triiodothyronine and release them into the bloodstream. These hormones
have a negative effect on the pituitary gland and stop the production of thyroid
stimulating hormone if the levels of thyroxine and triiodothyronine are too high.
✔✔Thyroxine (T4) - ✔✔This hormone plays a role in growth and metabolism. Some of
the T4 exists as free T4. This means that it hasn't bonded to protein in the blood.
✔✔there are two kinds of T4 tests: - ✔✔A total T4 test measures the T4 that has
bonded to protein along with any free T4.
A free T4 test measures only the free T4 in the blood. Because free T4 is what's
available to the body for use, a free T4 test is often preferred over a total T4 test.
✔✔Why Perform a T4 Test? - ✔✔if a thyroid-stimulating hormone (TSH) test has come
back with abnormal results.
Some disorders that affect thyroid function include:
hyperthyroidism, or overactive thyroid
hypothyroidism, or underactive thyroid
hypopituitarism, or underactive pituitary gland
✔✔Symptoms of Abnormal T4 Levels - ✔✔eye issues, like dryness, irritation, puffiness,
and bulging
skin dryness or skin puffiness
hair loss
hand tremors
changes in heart rate
changes in blood pressure
The patient may also experience more general symptoms such as:
weight changes
difficulty sleeping or insomnia
anxiety
fatigue and weakness
intolerance to cold
sensitivity to light
SOLUTIONS GRADED A+
✔✔AST levels - ✔✔0 to 35
Elevation occurs with hepatitis or cirrhosis
✔✔Troponin - ✔✔Proteins found in the cardiac and skeletal muscles
Doctors measure troponin levels to detect whether or not someone is experiencing a
heart attack.
✔✔Troponin proteins are split into three subunits: - ✔✔troponin C (TnC)
troponin T (TnT)
troponin I (TnI)
✔✔Normal levels of Troponin - ✔✔If a patient is experiencing chest pain, but these
levels are still low 12 hours after the chest pain started, the possibility of a heart attack
is unlikely.
High levels of this are an immediate red flag.
measured in nanograms per milliliter. Normal levels fall below the 99th percentile in the
blood test. If the results are above this level, it may be an indication of heart damage or
heart attack.
✔✔C-Reactive Protein - ✔✔CRP test can check for inflammation, which can indicate
infection or a chronic inflammatory disease, such as rheumatoid arthritis or lupus, as
well as risk of heart disease.
✔✔Creatinine Kinase (CK-MB) - ✔✔measures the amount of an isoenzyme of
creatinine kinase (CK) in your blood.
Because many tissues contain CK, high levels of CK can be a sign of a variety of
problems. Higher CK-MB may point more directly to heart damage.
✔✔B-type Natriuretic Peptide (BNP) - ✔✔measures the levels of the BNP
hormone.BNP and another heart hormone, called atrial natriuretic peptide (ANP), work
together to keep veins and arteries widened, or dilated.
✔✔The doctor may order a BNP blood test if - ✔✔the patient has symptoms of heart
failure, including:
Trouble breathing (dyspnea)
Feeling exhausted or weak for no apparent reason
Rapid weight gain without a change in diet or activity
Inability to concentrate or remain alert
Abnormally high or irregular heart rate
, Coughing a lot, and producing white or pink phlegm
Nausea or having no appetite
✔✔Thyroid Stimulating Hormone (TSH) - ✔✔controls production of the thyroid
hormones, thyroxine and triiodothyronine, by the thyroid gland by binding to receptors
located on cells in the thyroid gland. Thyroxine and triiodothyronine are essential to
maintaining the body's metabolic rate, heart, and digestive functions, muscle control,
brain development and maintenance of bones.
✔✔How is thyroid stimulating hormone controlled? - ✔✔When thyroid stimulating
hormone binds to the receptor on the thyroid cells, this causes these cells to produce
thyroxine and triiodothyronine and release them into the bloodstream. These hormones
have a negative effect on the pituitary gland and stop the production of thyroid
stimulating hormone if the levels of thyroxine and triiodothyronine are too high.
✔✔Thyroxine (T4) - ✔✔This hormone plays a role in growth and metabolism. Some of
the T4 exists as free T4. This means that it hasn't bonded to protein in the blood.
✔✔there are two kinds of T4 tests: - ✔✔A total T4 test measures the T4 that has
bonded to protein along with any free T4.
A free T4 test measures only the free T4 in the blood. Because free T4 is what's
available to the body for use, a free T4 test is often preferred over a total T4 test.
✔✔Why Perform a T4 Test? - ✔✔if a thyroid-stimulating hormone (TSH) test has come
back with abnormal results.
Some disorders that affect thyroid function include:
hyperthyroidism, or overactive thyroid
hypothyroidism, or underactive thyroid
hypopituitarism, or underactive pituitary gland
✔✔Symptoms of Abnormal T4 Levels - ✔✔eye issues, like dryness, irritation, puffiness,
and bulging
skin dryness or skin puffiness
hair loss
hand tremors
changes in heart rate
changes in blood pressure
The patient may also experience more general symptoms such as:
weight changes
difficulty sleeping or insomnia
anxiety
fatigue and weakness
intolerance to cold
sensitivity to light
