FITZGERALD FNP Exit Exam-style
practice exam 3 Questions and
Answers with Rationales Latest
Version Top Rated
Question 1
A 67-year-old man with hypertension and type 2 diabetes presents with
crushing substernal chest pain radiating to his jaw that began 30 minutes
ago. ECG demonstrates ST-segment elevation in leads V2–V5.
What is the priority intervention?
A. Schedule an exercise stress test
B. Activate the STEMI reperfusion pathway immediately
C. Begin oral prednisone
D. Obtain an outpatient echocardiogram
Correct Answer: B. Activate the STEMI reperfusion pathway
immediately
Rationale
This patient has an acute anterior STEMI.
Priority management includes:
• Immediate reperfusion (primary PCI when available)
• Aspirin unless contraindicated
• Guideline-directed STEMI therapy
• Continuous cardiac monitoring
• A: Delays treatment.
, • B: Correct.
• C: Not indicated.
• D: Echocardiography should not delay reperfusion.
Clinical Pearl: Door-to-balloon time should be minimized because
rapid reperfusion improves survival.
Question 2
A 59-year-old woman with type 2 diabetes has:
• A1C: 8.8%
• eGFR: 68 mL/min/1.73 m²
• Established heart failure with reduced ejection fraction
She is taking metformin.
Which medication should be added?
A. Pioglitazone
B. SGLT2 inhibitor
C. Glyburide
D. Acarbose
Correct Answer: B. SGLT2 inhibitor
Rationale
SGLT2 inhibitors provide:
• Cardiovascular benefit
• Reduced heart failure hospitalization
• Renal protection
, • Glucose lowering
Examples include:
• Empagliflozin
• Dapagliflozin
• A: Can worsen fluid retention.
• B: Correct.
• C: Increased hypoglycemia risk.
• D: Less beneficial in this setting.
Clinical Pearl: Consider cardiovascular and renal comorbidities—not
just A1C—when selecting diabetes medications.
Question 3
A 24-year-old woman presents with dysuria, urinary urgency, and
frequency. Urinalysis shows positive leukocyte esterase and nitrites. She
is afebrile with no flank pain.
What is the diagnosis?
A. Acute pyelonephritis
B. Acute uncomplicated cystitis
C. Interstitial cystitis
D. Nephrolithiasis
Correct Answer: B. Acute uncomplicated cystitis
Rationale
Typical findings include:
, • Dysuria
• Frequency
• Urgency
• Positive nitrites and leukocyte esterase
• No systemic symptoms
• A: Usually includes fever and flank pain.
• B: Correct.
• C: Chronic pain syndrome.
• D: Causes colicky flank pain.
Clinical Pearl: Obtain urine cultures in complicated infections,
recurrent UTIs, pregnancy, or suspected pyelonephritis.
Question 4
A 75-year-old man complains of resting tremor, bradykinesia, rigidity,
and shuffling gait.
Which diagnosis is most likely?
A. Essential tremor
B. Parkinson disease
C. Huntington disease
D. Multiple sclerosis
Correct Answer: B. Parkinson disease
Rationale
Parkinson disease is characterized by:
• Bradykinesia
• Resting tremor
practice exam 3 Questions and
Answers with Rationales Latest
Version Top Rated
Question 1
A 67-year-old man with hypertension and type 2 diabetes presents with
crushing substernal chest pain radiating to his jaw that began 30 minutes
ago. ECG demonstrates ST-segment elevation in leads V2–V5.
What is the priority intervention?
A. Schedule an exercise stress test
B. Activate the STEMI reperfusion pathway immediately
C. Begin oral prednisone
D. Obtain an outpatient echocardiogram
Correct Answer: B. Activate the STEMI reperfusion pathway
immediately
Rationale
This patient has an acute anterior STEMI.
Priority management includes:
• Immediate reperfusion (primary PCI when available)
• Aspirin unless contraindicated
• Guideline-directed STEMI therapy
• Continuous cardiac monitoring
• A: Delays treatment.
, • B: Correct.
• C: Not indicated.
• D: Echocardiography should not delay reperfusion.
Clinical Pearl: Door-to-balloon time should be minimized because
rapid reperfusion improves survival.
Question 2
A 59-year-old woman with type 2 diabetes has:
• A1C: 8.8%
• eGFR: 68 mL/min/1.73 m²
• Established heart failure with reduced ejection fraction
She is taking metformin.
Which medication should be added?
A. Pioglitazone
B. SGLT2 inhibitor
C. Glyburide
D. Acarbose
Correct Answer: B. SGLT2 inhibitor
Rationale
SGLT2 inhibitors provide:
• Cardiovascular benefit
• Reduced heart failure hospitalization
• Renal protection
, • Glucose lowering
Examples include:
• Empagliflozin
• Dapagliflozin
• A: Can worsen fluid retention.
• B: Correct.
• C: Increased hypoglycemia risk.
• D: Less beneficial in this setting.
Clinical Pearl: Consider cardiovascular and renal comorbidities—not
just A1C—when selecting diabetes medications.
Question 3
A 24-year-old woman presents with dysuria, urinary urgency, and
frequency. Urinalysis shows positive leukocyte esterase and nitrites. She
is afebrile with no flank pain.
What is the diagnosis?
A. Acute pyelonephritis
B. Acute uncomplicated cystitis
C. Interstitial cystitis
D. Nephrolithiasis
Correct Answer: B. Acute uncomplicated cystitis
Rationale
Typical findings include:
, • Dysuria
• Frequency
• Urgency
• Positive nitrites and leukocyte esterase
• No systemic symptoms
• A: Usually includes fever and flank pain.
• B: Correct.
• C: Chronic pain syndrome.
• D: Causes colicky flank pain.
Clinical Pearl: Obtain urine cultures in complicated infections,
recurrent UTIs, pregnancy, or suspected pyelonephritis.
Question 4
A 75-year-old man complains of resting tremor, bradykinesia, rigidity,
and shuffling gait.
Which diagnosis is most likely?
A. Essential tremor
B. Parkinson disease
C. Huntington disease
D. Multiple sclerosis
Correct Answer: B. Parkinson disease
Rationale
Parkinson disease is characterized by:
• Bradykinesia
• Resting tremor
