ACUTE CARE NP EXIT EXAM V-1 LATEST UPDATED
2026-2027 ACTUAL FINAL EXAM WITH ALL POSSIBLE
150 PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS FULLY SOLVED WITH RELIABLE
RATIONALES PLUS ANSWER KEY ALREADY A+
GRADED MOST RECENT!!!
1. A 68-year-old male with a history of hypertension
and COPD presents with acute worsening of
dyspnea, cough with purulent sputum, and fever.
Chest X-ray shows a right lower lobe infiltrate.
Which of the following is the most appropriate
initial antibiotic regimen?
,A) Amoxicillin-clavulanate
B) Levofloxacin
C) Azithromycin
D) Vancomycin
Correct Answer: B) Levofloxacin
Rationale: This patient has community-acquired
pneumonia with risk factors (COPD, age >65). A
respiratory fluoroquinolone like levofloxacin covers
typical and atypical pathogens and is
recommended as monotherapy for CAP in patients
with comorbidities.
2. A 55-year-old female presents with acute onset of
severe chest pain radiating to the back, associated
with diaphoresis and a blood pressure of 160/95
mmHg in the right arm and 110/70 mmHg in the left
arm. Which diagnostic test is most urgent?
A) ECG
B) Chest X-ray
C) CT angiography of the aorta
D) D-dimer
,Correct Answer: C) CT angiography of the aorta
Rationale: The differential blood pressure and
severe tearing chest pain suggest aortic dissection.
CT angiography is the gold standard for diagnosis
and should be obtained emergently.
3. A 72-year-old male with chronic kidney disease
(eGFR 30 mL/min) is started on enoxaparin for acute
DVT. What adjustment is required?
A) No adjustment needed
B) Reduce dose by 50%
C) Avoid enoxaparin; use unfractionated heparin
D) Increase dose by 25%
Correct Answer: C) Avoid enoxaparin; use
unfractionated heparin
Rationale: Enoxaparin is renally excreted and
accumulates in CKD. For eGFR <30 mL/min,
unfractionated heparin is preferred, or enoxaparin
dose must be reduced (but the safer choice is
UFH).
, 4. A patient with septic shock requires vasopressor
support. Which vasopressor is first-line?
A) Dopamine
B) Epinephrine
C) Norepinephrine
D) Phenylephrine
Correct Answer: C) Norepinephrine
Rationale: Norepinephrine is the first-line
vasopressor for septic shock due to its alpha-
adrenergic effects and favorable mortality profile
compared to dopamine.
5. A 45-year-old male with acute pancreatitis
develops persistent fever and leukocytosis on day 5.
Contrast-enhanced CT shows a peripancreatic fluid
collection with gas bubbles. What is the next best
step?
A) Continue supportive care
B) Start empiric antibiotics
C) Percutaneous drainage
D) Surgical necrosectomy
2026-2027 ACTUAL FINAL EXAM WITH ALL POSSIBLE
150 PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS FULLY SOLVED WITH RELIABLE
RATIONALES PLUS ANSWER KEY ALREADY A+
GRADED MOST RECENT!!!
1. A 68-year-old male with a history of hypertension
and COPD presents with acute worsening of
dyspnea, cough with purulent sputum, and fever.
Chest X-ray shows a right lower lobe infiltrate.
Which of the following is the most appropriate
initial antibiotic regimen?
,A) Amoxicillin-clavulanate
B) Levofloxacin
C) Azithromycin
D) Vancomycin
Correct Answer: B) Levofloxacin
Rationale: This patient has community-acquired
pneumonia with risk factors (COPD, age >65). A
respiratory fluoroquinolone like levofloxacin covers
typical and atypical pathogens and is
recommended as monotherapy for CAP in patients
with comorbidities.
2. A 55-year-old female presents with acute onset of
severe chest pain radiating to the back, associated
with diaphoresis and a blood pressure of 160/95
mmHg in the right arm and 110/70 mmHg in the left
arm. Which diagnostic test is most urgent?
A) ECG
B) Chest X-ray
C) CT angiography of the aorta
D) D-dimer
,Correct Answer: C) CT angiography of the aorta
Rationale: The differential blood pressure and
severe tearing chest pain suggest aortic dissection.
CT angiography is the gold standard for diagnosis
and should be obtained emergently.
3. A 72-year-old male with chronic kidney disease
(eGFR 30 mL/min) is started on enoxaparin for acute
DVT. What adjustment is required?
A) No adjustment needed
B) Reduce dose by 50%
C) Avoid enoxaparin; use unfractionated heparin
D) Increase dose by 25%
Correct Answer: C) Avoid enoxaparin; use
unfractionated heparin
Rationale: Enoxaparin is renally excreted and
accumulates in CKD. For eGFR <30 mL/min,
unfractionated heparin is preferred, or enoxaparin
dose must be reduced (but the safer choice is
UFH).
, 4. A patient with septic shock requires vasopressor
support. Which vasopressor is first-line?
A) Dopamine
B) Epinephrine
C) Norepinephrine
D) Phenylephrine
Correct Answer: C) Norepinephrine
Rationale: Norepinephrine is the first-line
vasopressor for septic shock due to its alpha-
adrenergic effects and favorable mortality profile
compared to dopamine.
5. A 45-year-old male with acute pancreatitis
develops persistent fever and leukocytosis on day 5.
Contrast-enhanced CT shows a peripancreatic fluid
collection with gas bubbles. What is the next best
step?
A) Continue supportive care
B) Start empiric antibiotics
C) Percutaneous drainage
D) Surgical necrosectomy
