FITZGERALD FNP Exit Exam-style practice
exam Questions and Answers with Rationales
Latest Version Top Rated
Question 1
A 58-year-old man with type 2 diabetes presents for follow-up. His A1C
is 8.9% despite taking metformin 1,000 mg twice daily. He has
established atherosclerotic cardiovascular disease and an eGFR of 75
mL/min/1.73 m².
Which medication should be added next?
A. Glyburide
B. Pioglitazone
C. Empagliflozin
D. Sitagliptin
Correct Answer: C. Empagliflozin
Rationale
Current diabetes guidelines recommend adding an SGLT2 inhibitor or
GLP-1 receptor agonist with proven cardiovascular benefit in patients
with established ASCVD.
• A. Glyburide increases hypoglycemia risk.
• B. Pioglitazone may worsen heart failure.
• C. Empagliflozin reduces cardiovascular mortality and slows
kidney disease progression.
• D. Sitagliptin has neutral cardiovascular outcomes.
,Clinical Pearl: Cardiovascular disease drives medication selection more
than A1C alone.
Question 2
A 24-year-old woman complains of dysuria and urinary frequency for
two days. She denies fever, flank pain, and vaginal discharge.
The best initial treatment is:
A. Ciprofloxacin for 10 days
B. Nitrofurantoin for 5 days
C. Amoxicillin for 3 days
D. No antibiotics until urine culture returns
Correct Answer: B. Nitrofurantoin
Rationale
This patient has uncomplicated cystitis.
Recommended first-line therapy includes:
• Nitrofurantoin
• TMP-SMX (if resistance is low)
• Fosfomycin
Fluoroquinolones should be reserved for complicated infections.
Question 3
,A patient presents with crushing substernal chest pain lasting 45
minutes. ECG shows ST elevation in leads II, III, and aVF.
Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
Correct Answer: C. Right coronary artery
Rationale
Inferior myocardial infarctions involve:
• Leads II
• III
• aVF
Most are caused by right coronary artery occlusion.
Remember:
• LAD → anterior MI
• RCA → inferior MI
• LCX → lateral MI
Question 4
A 67-year-old smoker has progressive dyspnea and chronic productive
cough for several years.
Spirometry shows:
, FEV1/FVC = 0.60 after bronchodilator.
Diagnosis?
A. Asthma
B. COPD
C. Restrictive lung disease
D. Pulmonary fibrosis
Correct Answer: B. COPD
Rationale
Persistent airflow obstruction after bronchodilator confirms COPD.
Diagnostic criterion:
Post-bronchodilator FEV1/FVC <0.70
Smoking is the strongest risk factor.
Question 5
Which thyroid laboratory profile is most consistent with primary
hypothyroidism?
A. High TSH, low Free T4
B. Low TSH, high Free T4
C. Low TSH, low Free T4
D. Normal TSH, elevated T4
exam Questions and Answers with Rationales
Latest Version Top Rated
Question 1
A 58-year-old man with type 2 diabetes presents for follow-up. His A1C
is 8.9% despite taking metformin 1,000 mg twice daily. He has
established atherosclerotic cardiovascular disease and an eGFR of 75
mL/min/1.73 m².
Which medication should be added next?
A. Glyburide
B. Pioglitazone
C. Empagliflozin
D. Sitagliptin
Correct Answer: C. Empagliflozin
Rationale
Current diabetes guidelines recommend adding an SGLT2 inhibitor or
GLP-1 receptor agonist with proven cardiovascular benefit in patients
with established ASCVD.
• A. Glyburide increases hypoglycemia risk.
• B. Pioglitazone may worsen heart failure.
• C. Empagliflozin reduces cardiovascular mortality and slows
kidney disease progression.
• D. Sitagliptin has neutral cardiovascular outcomes.
,Clinical Pearl: Cardiovascular disease drives medication selection more
than A1C alone.
Question 2
A 24-year-old woman complains of dysuria and urinary frequency for
two days. She denies fever, flank pain, and vaginal discharge.
The best initial treatment is:
A. Ciprofloxacin for 10 days
B. Nitrofurantoin for 5 days
C. Amoxicillin for 3 days
D. No antibiotics until urine culture returns
Correct Answer: B. Nitrofurantoin
Rationale
This patient has uncomplicated cystitis.
Recommended first-line therapy includes:
• Nitrofurantoin
• TMP-SMX (if resistance is low)
• Fosfomycin
Fluoroquinolones should be reserved for complicated infections.
Question 3
,A patient presents with crushing substernal chest pain lasting 45
minutes. ECG shows ST elevation in leads II, III, and aVF.
Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
Correct Answer: C. Right coronary artery
Rationale
Inferior myocardial infarctions involve:
• Leads II
• III
• aVF
Most are caused by right coronary artery occlusion.
Remember:
• LAD → anterior MI
• RCA → inferior MI
• LCX → lateral MI
Question 4
A 67-year-old smoker has progressive dyspnea and chronic productive
cough for several years.
Spirometry shows:
, FEV1/FVC = 0.60 after bronchodilator.
Diagnosis?
A. Asthma
B. COPD
C. Restrictive lung disease
D. Pulmonary fibrosis
Correct Answer: B. COPD
Rationale
Persistent airflow obstruction after bronchodilator confirms COPD.
Diagnostic criterion:
Post-bronchodilator FEV1/FVC <0.70
Smoking is the strongest risk factor.
Question 5
Which thyroid laboratory profile is most consistent with primary
hypothyroidism?
A. High TSH, low Free T4
B. Low TSH, high Free T4
C. Low TSH, low Free T4
D. Normal TSH, elevated T4
