FITZGERALD FNP Exit Exam-Style
Practice Exam 4 Questions and
Answers with Rationales Latest
Version Top Rated
Question 1
A 67-year-old man with type 2 diabetes, hypertension, and hyperlipidemia presents
for routine follow-up. His blood pressure is 152/92 mm Hg despite taking lisinopril
20 mg daily. Home blood pressure readings average 150–155/90–94 mm Hg.
What is the most appropriate next step?
A. Continue the current regimen and recheck in 12 months
B. Add a second first-line antihypertensive agent while reinforcing lifestyle
modifications
C. Stop lisinopril and begin a beta-blocker alone
D. Discontinue all medications and focus only on diet
Correct Answer: B. Add a second first-line antihypertensive agent while
reinforcing lifestyle modifications
Rationale
Patients with persistent hypertension despite appropriate monotherapy often
require combination therapy.
Appropriate first-line drug classes include:
• ACE inhibitors or ARBs
• Thiazide-type diuretics
• Calcium channel blockers
Lifestyle modifications should continue alongside medication adjustments.
,Clinical Pearl: Many patients ultimately require two or more antihypertensive
medications to achieve target blood pressure.
Question 2
A 24-year-old woman presents with fatigue, palpitations, and heavy menstrual
bleeding. Laboratory studies reveal:
• Hemoglobin: 9.2 g/dL
• MCV: 70 fL
• Ferritin: Low
Which diagnosis is most likely?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Aplastic anemia
D. Hemolytic anemia
Correct Answer: B. Iron deficiency anemia
Rationale
Iron deficiency anemia typically presents with:
• Microcytic anemia
• Low ferritin
• Fatigue
• Pallor
• Heavy menstrual bleeding or chronic blood loss
Treatment includes iron replacement and evaluation for the source of blood loss.
Question 3
,A 72-year-old smoker presents with chronic cough, progressive dyspnea, and
unintended weight loss. Chest radiograph reveals a right upper lobe mass.
What is the most appropriate next step?
A. Prescribe antibiotics
B. Repeat chest radiograph in one year
C. Obtain a chest CT and tissue diagnosis
D. Begin inhaled corticosteroids
Correct Answer: C. Obtain a chest CT and tissue diagnosis
Rationale
A suspicious pulmonary mass requires prompt evaluation with:
• Chest CT
• Tissue diagnosis (biopsy)
• Appropriate staging if malignancy is confirmed
Smoking remains the leading risk factor for lung cancer.
Question 4
A 58-year-old woman presents with fatigue, weight gain, constipation, and dry
skin. Laboratory results show:
• TSH: Elevated
• Free T4: Low
Which medication is indicated?
A. Methimazole
B. Levothyroxine
C. Prednisone
, D. Propranolol
Correct Answer: B. Levothyroxine
Rationale
Primary hypothyroidism is treated with levothyroxine.
TSH should generally be reassessed about 6–8 weeks after starting therapy or
adjusting the dose.
Question 5
A 5-year-old child presents with barking cough, inspiratory stridor, and hoarseness
that worsens at night. The child is alert without drooling.
What is the most likely diagnosis?
A. Epiglottitis
B. Croup (viral laryngotracheitis)
C. Bronchiolitis
D. Bacterial tracheitis
Correct Answer: B. Croup (viral laryngotracheitis)
Rationale
Typical features of croup include:
• Barking cough
• Hoarseness
• Inspiratory stridor
• Viral prodrome
Mild cases may be treated with corticosteroids; moderate to severe cases may also
require nebulized epinephrine.
Practice Exam 4 Questions and
Answers with Rationales Latest
Version Top Rated
Question 1
A 67-year-old man with type 2 diabetes, hypertension, and hyperlipidemia presents
for routine follow-up. His blood pressure is 152/92 mm Hg despite taking lisinopril
20 mg daily. Home blood pressure readings average 150–155/90–94 mm Hg.
What is the most appropriate next step?
A. Continue the current regimen and recheck in 12 months
B. Add a second first-line antihypertensive agent while reinforcing lifestyle
modifications
C. Stop lisinopril and begin a beta-blocker alone
D. Discontinue all medications and focus only on diet
Correct Answer: B. Add a second first-line antihypertensive agent while
reinforcing lifestyle modifications
Rationale
Patients with persistent hypertension despite appropriate monotherapy often
require combination therapy.
Appropriate first-line drug classes include:
• ACE inhibitors or ARBs
• Thiazide-type diuretics
• Calcium channel blockers
Lifestyle modifications should continue alongside medication adjustments.
,Clinical Pearl: Many patients ultimately require two or more antihypertensive
medications to achieve target blood pressure.
Question 2
A 24-year-old woman presents with fatigue, palpitations, and heavy menstrual
bleeding. Laboratory studies reveal:
• Hemoglobin: 9.2 g/dL
• MCV: 70 fL
• Ferritin: Low
Which diagnosis is most likely?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Aplastic anemia
D. Hemolytic anemia
Correct Answer: B. Iron deficiency anemia
Rationale
Iron deficiency anemia typically presents with:
• Microcytic anemia
• Low ferritin
• Fatigue
• Pallor
• Heavy menstrual bleeding or chronic blood loss
Treatment includes iron replacement and evaluation for the source of blood loss.
Question 3
,A 72-year-old smoker presents with chronic cough, progressive dyspnea, and
unintended weight loss. Chest radiograph reveals a right upper lobe mass.
What is the most appropriate next step?
A. Prescribe antibiotics
B. Repeat chest radiograph in one year
C. Obtain a chest CT and tissue diagnosis
D. Begin inhaled corticosteroids
Correct Answer: C. Obtain a chest CT and tissue diagnosis
Rationale
A suspicious pulmonary mass requires prompt evaluation with:
• Chest CT
• Tissue diagnosis (biopsy)
• Appropriate staging if malignancy is confirmed
Smoking remains the leading risk factor for lung cancer.
Question 4
A 58-year-old woman presents with fatigue, weight gain, constipation, and dry
skin. Laboratory results show:
• TSH: Elevated
• Free T4: Low
Which medication is indicated?
A. Methimazole
B. Levothyroxine
C. Prednisone
, D. Propranolol
Correct Answer: B. Levothyroxine
Rationale
Primary hypothyroidism is treated with levothyroxine.
TSH should generally be reassessed about 6–8 weeks after starting therapy or
adjusting the dose.
Question 5
A 5-year-old child presents with barking cough, inspiratory stridor, and hoarseness
that worsens at night. The child is alert without drooling.
What is the most likely diagnosis?
A. Epiglottitis
B. Croup (viral laryngotracheitis)
C. Bronchiolitis
D. Bacterial tracheitis
Correct Answer: B. Croup (viral laryngotracheitis)
Rationale
Typical features of croup include:
• Barking cough
• Hoarseness
• Inspiratory stridor
• Viral prodrome
Mild cases may be treated with corticosteroids; moderate to severe cases may also
require nebulized epinephrine.
