and 100% Correct Answers | A+ Graded Nurse Practitioner
Board Review
Q1. A 15-year-old male presents with a 1-day history of sore throat, swollen
glands, low-grade fever, rash, and post-cervical and post-auricular
lymphadenopathy. The pharynx is erythematous. What is the most likely
diagnosis?
A. Roseola
B. Rubeola (Measles)
C. Rubella (German Measles)
D. Scarlet Fever
Answer: C. Rubella
Rationale: Rubella is characterized by a maculopapular rash, low-grade fever, and
posterior auricular/suboccipital lymphadenopathy. The rash typically begins on the face
and spreads downward.
Q2. A 22-year-old of Asian descent with no complaints has a blood count showing:
HGB-low, HCT-low, RBC-high, MCV normal, RDW normal. This is most consistent
with which anemia?
A. Iron Deficiency Anemia
B. Anemia of Chronic Disease
,C. Alpha Thalassemia Minor
D. Sickle Cell Trait
Answer: C. Alpha Thalassemia Minor
Rationale: Alpha thalassemia trait is common in Asian populations and presents with
mild anemia, low MCV, and a high RBC count. The elevated RBC count helps distinguish
it from iron deficiency anemia.
Q3. A 57-year-old woman with Rheumatoid Arthritis on DMARDs has the
following blood count: HGB-low, HCT-low, RBC-low, MCV normal, MCHC normal,
RDW normal. What is the most likely diagnosis?
A. Iron Deficiency Anemia
B. Anemia of Chronic Disease
C. Vitamin B12 Deficiency
D. Thalassemia Minor
Answer: B. Anemia of Chronic Disease
Rationale: Anemia of chronic disease is a normocytic, normochromic anemia commonly
seen in chronic inflammatory conditions like RA. The normal RDW helps differentiate it
from iron deficiency anemia.
Q4. An 18-year-old presents with a 3-day headache, fever, and positive Kernig's
and Brudzinski's signs. What is the most likely diagnosis?
A. Migraine
B. Bacterial Meningitis
C. Viral Encephalitis
D. Sinusitis
Answer: B. Bacterial Meningitis
Rationale: Kernig's and Brudzinski's signs are classic meningeal irritation signs. The acute
presentation with fever and headache suggests bacterial meningitis until proven
otherwise.
,Q5. A 24-year-old woman presents with a 1-week history of thin, yellow-green
vaginal discharge with itching, cervical hemorrhage, and numerous WBCs with
motile organisms on wet mount. What is the most likely diagnosis?
A. Bacterial Vaginosis
B. Candidiasis
C. Trichomoniasis
D. Chlamydia
Answer: C. Trichomoniasis
Rationale: Trichomoniasis presents with a thin, frothy, yellow-green discharge, pruritus,
and "strawberry cervix" with punctate hemorrhages. Motile organisms on wet mount are
diagnostic.
Q6. A patient with ulcerative colitis is at increased risk for which complication?
A. Peptic Ulcer Disease
B. Colon Cancer
C. Pancreatitis
D. Gastritis
Answer: B. Colon Cancer
Rationale: Chronic inflammation in ulcerative colitis increases the risk of colorectal
carcinoma, particularly in patients with long-standing disease.
Q7. A 45-year-old woman presents with tremor, tachycardia, and weight loss. TSH
is low, and free T4 is high. What is the most likely diagnosis?
A. Graves' Disease
B. Hashimoto's Thyroiditis
C. Subacute Thyroiditis
D. Pituitary Adenoma
, Answer: A. Graves' Disease
Rationale: Low TSH with high free T4 indicates primary hyperthyroidism, most
commonly caused by Graves' disease. Other signs may include ophthalmopathy and
goiter.
Q8. Which ECG change is expected in a patient with a history of acute transmural
MI from 6 months ago?
A. ST-segment elevation
B. Deep Q waves
C. T-wave inversion only
D. Prolonged PR interval
Answer: B. Deep Q waves
Rationale: Deep Q waves represent irreversible myocardial damage and are a permanent
finding following a transmural MI. They reflect the absence of electrical activity in the
scarred area.
Q9. A 70-year-old smoker presents with painless hematuria. What should be the
primary concern?
A. Kidney Stones
B. Benign Prostatic Hyperplasia
C. Bladder Cancer
D. Glomerulonephritis
Answer: C. Bladder Cancer
Rationale: Painless hematuria in an older smoker is bladder cancer until proven
otherwise. Gross, painless hematuria is the most common presenting sign of bladder
cancer.
Q10. What is the most common sign of bladder cancer?