CMN 577 CERTIFICATION EVALUATION
2026 FULL QUESTIONS AND SOLUTIONS
◉ 1. A 72-year-old female complains of shortness of breath,
nonproductive cough, weight gain in the last 2 weeks, and dyspnea
with exertion. On auscultation, you hear fine crackles and no
wheezes. She most likely has:
Answer: Chronic Bronchitis
B. R sided heart failure
C. L sided heart failure*
D. Atrial Fibrillation
Rationale: The most common symptoms of Left heart failure are
shortness of breath, dyspnea with exertion, and nonproductive
cough. Crackles represent fluid collection in the alveoli. Fluid
retention causes rapid weight gain. Symptoms of R sided heart
failure include edema, ascites, hepatic congestion, decreased
appetite and nausea.
◉ 2. Which of the following signs of pregnancy are typically present
at 12 weeks gestation?
Answer: Goodell's sign (cervical softening) and palpation of the
uterine fundus at the umbilicus
B. breast tenderness and fetal heart tone on doppler
,C. fetal heart tone on doppler and Chadwick's sign (cyanosis of
vagina and cervix)*
D. quickening (perception of fetal movement) abd Chadwick's sign
Rationale: Goodell's sign, Chadwick's sign, palpation of the uterine
fundus, and fetal heart tone are all signs of pregnancy; however, the
fundus is not palpable at the umbilicus until 20-22 weeks gestation.
Quickening, which usually occurs around 18 weeks, and breast
tenderness are considered symptoms of pregnancy, not signs.
◉ 3. A 32-year-old primagravida comes to the office for her 38 week
check-up. She has protein in her urine, mild swelling in her ankles, a
BP of 168/110, and a 'bad headache.' The nurse practitioner seeing
the patient decides the best course of action is to?
Answer: start the patient on low-dose aspirin and labetalol to
prevent complications
B. have the patient admitted to the hospital for close monitoring and
management*
C. schedule the patient for a cesarean section within the next 48 hrs
D. explain to the patient that her signs and symptoms are common
toward the end of pregnancy and are not cause for concern
Rationale: The patient has preeclampsia with severe features. Signs
and symptoms of severe features may include headache, vision
changes, BP greater than or equal to 160/110, thrombocytopenia,
proteinuria, edema, epigastric pain, and elevated liver enzymes. The
patient requires hospitalization for close monitoring of both mother
and fetus, serial lab work, and eventually administration of
,magnesium sulfate and delivery. Though delivery is ultimately the
only cure, preeclampsia, even with severe features, is not an
indication for cesarean section. Low-dose aspirin may be started
between 12-28 weeks gestation for those at increased risk for
preeclampsia.
◉ 4. A 52-year-old female who has been taking pravastatin 20 mg
nightly for the past 6 months, comes into the clinic complaining of
extreme fatigue, dark urine, and muscle pain for the past 3 weeks.
Which of the following is the best treatment plan for the NP to
follow?
Answer: Continue the pravastatin but at half the dose
B. Recommend increasing fluid intake and rest.
C. Discontinue the pravastatin and order a liver function panel *
D. Switch to Simvastatin 40 mg nightly
Rationale: Side effects of statins include fatigue, elevated liver
enzymes and muscle pain. When patients present with these
symptoms, the drug should be discontinued, and liver enzymes
should be checked to assess the effects on the liver. Simvastatin is
associated with the highest risk of muscle injury and pain.
◉ 5. A 45-year-old male patient comes to clinic after an episode of
chest pain in his substernal area that occurred while he was running.
He says that the pain was relieved immediately when he stopped
running. Which of the following should the NP recommend to this
patient?
, Answer: See a cardiologist for further evaluation. *
B. Take 600 mg ibuprofen every 6 hours as needed for pain.
C. Begin an exercise program that includes walking instead of
running.
D. Consult a gastroenterologist to rule out gastroesophageal reflux
disease.
Rationale: Because the chest pain was brought on by physical
exertion and immediately relieved with rest, the pain is consistent
with stable angina pectoris. The patient should see a cardiologist to
rule out any potential cardiac problems and to ensure that physical
exercise is safe.
◉ 6. A 23-year-old male patient presents to the clinic with
complaints of fever, irritative voiding symptoms, and
perineal/suprapubic pain for 2 days. On exam, the CBC shows
leukocytosis and a left shift. UA is positive for pyuria and bacteriuria.
There is no CVA tenderness or painful scrotal enlargement. The NP
suspects the patient has which of the following diagnosis?
Answer: Acute Bacterial Prostatitis *
B. Chronic Bacterial Prostatitis
C. Acute Epididymitis
D. Prostatodynia
Rationale: Acute Bacterial Prostatitis presents with fever, irritative
voiding symptoms, perineal and/or suprapelvic pain, and a positive
UA. Chronic bacterial prostatitis does not present with fever or a
2026 FULL QUESTIONS AND SOLUTIONS
◉ 1. A 72-year-old female complains of shortness of breath,
nonproductive cough, weight gain in the last 2 weeks, and dyspnea
with exertion. On auscultation, you hear fine crackles and no
wheezes. She most likely has:
Answer: Chronic Bronchitis
B. R sided heart failure
C. L sided heart failure*
D. Atrial Fibrillation
Rationale: The most common symptoms of Left heart failure are
shortness of breath, dyspnea with exertion, and nonproductive
cough. Crackles represent fluid collection in the alveoli. Fluid
retention causes rapid weight gain. Symptoms of R sided heart
failure include edema, ascites, hepatic congestion, decreased
appetite and nausea.
◉ 2. Which of the following signs of pregnancy are typically present
at 12 weeks gestation?
Answer: Goodell's sign (cervical softening) and palpation of the
uterine fundus at the umbilicus
B. breast tenderness and fetal heart tone on doppler
,C. fetal heart tone on doppler and Chadwick's sign (cyanosis of
vagina and cervix)*
D. quickening (perception of fetal movement) abd Chadwick's sign
Rationale: Goodell's sign, Chadwick's sign, palpation of the uterine
fundus, and fetal heart tone are all signs of pregnancy; however, the
fundus is not palpable at the umbilicus until 20-22 weeks gestation.
Quickening, which usually occurs around 18 weeks, and breast
tenderness are considered symptoms of pregnancy, not signs.
◉ 3. A 32-year-old primagravida comes to the office for her 38 week
check-up. She has protein in her urine, mild swelling in her ankles, a
BP of 168/110, and a 'bad headache.' The nurse practitioner seeing
the patient decides the best course of action is to?
Answer: start the patient on low-dose aspirin and labetalol to
prevent complications
B. have the patient admitted to the hospital for close monitoring and
management*
C. schedule the patient for a cesarean section within the next 48 hrs
D. explain to the patient that her signs and symptoms are common
toward the end of pregnancy and are not cause for concern
Rationale: The patient has preeclampsia with severe features. Signs
and symptoms of severe features may include headache, vision
changes, BP greater than or equal to 160/110, thrombocytopenia,
proteinuria, edema, epigastric pain, and elevated liver enzymes. The
patient requires hospitalization for close monitoring of both mother
and fetus, serial lab work, and eventually administration of
,magnesium sulfate and delivery. Though delivery is ultimately the
only cure, preeclampsia, even with severe features, is not an
indication for cesarean section. Low-dose aspirin may be started
between 12-28 weeks gestation for those at increased risk for
preeclampsia.
◉ 4. A 52-year-old female who has been taking pravastatin 20 mg
nightly for the past 6 months, comes into the clinic complaining of
extreme fatigue, dark urine, and muscle pain for the past 3 weeks.
Which of the following is the best treatment plan for the NP to
follow?
Answer: Continue the pravastatin but at half the dose
B. Recommend increasing fluid intake and rest.
C. Discontinue the pravastatin and order a liver function panel *
D. Switch to Simvastatin 40 mg nightly
Rationale: Side effects of statins include fatigue, elevated liver
enzymes and muscle pain. When patients present with these
symptoms, the drug should be discontinued, and liver enzymes
should be checked to assess the effects on the liver. Simvastatin is
associated with the highest risk of muscle injury and pain.
◉ 5. A 45-year-old male patient comes to clinic after an episode of
chest pain in his substernal area that occurred while he was running.
He says that the pain was relieved immediately when he stopped
running. Which of the following should the NP recommend to this
patient?
, Answer: See a cardiologist for further evaluation. *
B. Take 600 mg ibuprofen every 6 hours as needed for pain.
C. Begin an exercise program that includes walking instead of
running.
D. Consult a gastroenterologist to rule out gastroesophageal reflux
disease.
Rationale: Because the chest pain was brought on by physical
exertion and immediately relieved with rest, the pain is consistent
with stable angina pectoris. The patient should see a cardiologist to
rule out any potential cardiac problems and to ensure that physical
exercise is safe.
◉ 6. A 23-year-old male patient presents to the clinic with
complaints of fever, irritative voiding symptoms, and
perineal/suprapubic pain for 2 days. On exam, the CBC shows
leukocytosis and a left shift. UA is positive for pyuria and bacteriuria.
There is no CVA tenderness or painful scrotal enlargement. The NP
suspects the patient has which of the following diagnosis?
Answer: Acute Bacterial Prostatitis *
B. Chronic Bacterial Prostatitis
C. Acute Epididymitis
D. Prostatodynia
Rationale: Acute Bacterial Prostatitis presents with fever, irritative
voiding symptoms, perineal and/or suprapelvic pain, and a positive
UA. Chronic bacterial prostatitis does not present with fever or a
