APRN EXAM NEWEST 2026 ACTUAL EXAM TEST
BANK| COMPLETE 600 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+| ADVANCED PRACTICE
REGISTERED NURSE EXAM PREP 2026/2027 (MOST
RECENT!!)
1. A 55-year-old male presents with a 3-month history of
progressive weakness in his right hand. On exam, you note
thenar wasting, fasciculations, and hyperreflexia in the right arm
with a Babinski sign. Sensation is intact. What is the most likely
diagnosis?
a) Carpal tunnel syndrome
b) Cervical radiculopathy
c) Amyotrophic lateral sclerosis (ALS)
d) Multiple sclerosis
1
,Correct Answer: c
Rationale: ALS presents with both upper motor neuron signs
(hyperreflexia, Babinski) and lower motor neuron signs (wasting,
fasciculations) without sensory loss. Carpal tunnel and
radiculopathy typically have sensory changes and lack UMN
findings.
2. A 68-year-old female with hypertension and type 2 diabetes
presents with a blood pressure of 162/94 mmHg in the clinic.
She reports taking lisinopril 20 mg daily but admits missing doses
"sometimes." Her home readings average 150/90 mmHg. What
is the most appropriate next step?
a) Add amlodipine 5 mg daily
b) Increase lisinopril to 40 mg daily
c) Counsel on medication adherence and recheck in 4 weeks
d) Order renal artery duplex ultrasound
2
,Correct Answer: c
Rationale: Medication non-adherence is the most likely cause of
uncontrolled hypertension. First, address adherence before
escalating therapy or pursuing expensive testing. Home readings
confirm true elevation but below threshold for immediate
escalation.
3. A 28-year-old pregnant woman at 32 weeks gestation
presents with a blood pressure of 155/100 mmHg and 2+
proteinuria on dipstick. She denies headache or visual changes.
What is the most appropriate next step?
a) Outpatient labetalol and repeat BP in 1 week
b) Admit for magnesium sulfate and delivery planning
c) Admit for blood pressure control and fetal monitoring
d) Start methyldopa and follow as outpatient
Correct Answer: c
3
, Rationale: This is preeclampsia without severe features (BP
≥140/90 with proteinuria after 20 weeks). Admission for
monitoring and BP control is indicated. Magnesium sulfate is for
severe features or eclampsia; delivery at 32 weeks requires
steroids and is not immediate unless severe.
4. A 45-year-old male presents with a painful, red, swollen right
great toe that began overnight. He denies trauma. He has a
history of hypertension (HCTZ) and drinks 4-5 beers daily.
Synovial fluid analysis is not available. What is the most
appropriate initial treatment?
a) Allopurinol 300 mg daily
b) Colchicine 0.6 mg BID
c) Prednisone 40 mg daily with taper
d) Indomethacin 50 mg TID
Correct Answer: d
4
BANK| COMPLETE 600 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+| ADVANCED PRACTICE
REGISTERED NURSE EXAM PREP 2026/2027 (MOST
RECENT!!)
1. A 55-year-old male presents with a 3-month history of
progressive weakness in his right hand. On exam, you note
thenar wasting, fasciculations, and hyperreflexia in the right arm
with a Babinski sign. Sensation is intact. What is the most likely
diagnosis?
a) Carpal tunnel syndrome
b) Cervical radiculopathy
c) Amyotrophic lateral sclerosis (ALS)
d) Multiple sclerosis
1
,Correct Answer: c
Rationale: ALS presents with both upper motor neuron signs
(hyperreflexia, Babinski) and lower motor neuron signs (wasting,
fasciculations) without sensory loss. Carpal tunnel and
radiculopathy typically have sensory changes and lack UMN
findings.
2. A 68-year-old female with hypertension and type 2 diabetes
presents with a blood pressure of 162/94 mmHg in the clinic.
She reports taking lisinopril 20 mg daily but admits missing doses
"sometimes." Her home readings average 150/90 mmHg. What
is the most appropriate next step?
a) Add amlodipine 5 mg daily
b) Increase lisinopril to 40 mg daily
c) Counsel on medication adherence and recheck in 4 weeks
d) Order renal artery duplex ultrasound
2
,Correct Answer: c
Rationale: Medication non-adherence is the most likely cause of
uncontrolled hypertension. First, address adherence before
escalating therapy or pursuing expensive testing. Home readings
confirm true elevation but below threshold for immediate
escalation.
3. A 28-year-old pregnant woman at 32 weeks gestation
presents with a blood pressure of 155/100 mmHg and 2+
proteinuria on dipstick. She denies headache or visual changes.
What is the most appropriate next step?
a) Outpatient labetalol and repeat BP in 1 week
b) Admit for magnesium sulfate and delivery planning
c) Admit for blood pressure control and fetal monitoring
d) Start methyldopa and follow as outpatient
Correct Answer: c
3
, Rationale: This is preeclampsia without severe features (BP
≥140/90 with proteinuria after 20 weeks). Admission for
monitoring and BP control is indicated. Magnesium sulfate is for
severe features or eclampsia; delivery at 32 weeks requires
steroids and is not immediate unless severe.
4. A 45-year-old male presents with a painful, red, swollen right
great toe that began overnight. He denies trauma. He has a
history of hypertension (HCTZ) and drinks 4-5 beers daily.
Synovial fluid analysis is not available. What is the most
appropriate initial treatment?
a) Allopurinol 300 mg daily
b) Colchicine 0.6 mg BID
c) Prednisone 40 mg daily with taper
d) Indomethacin 50 mg TID
Correct Answer: d
4
