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Update 2026/2027
Question: A 15 years old high school student with a mild sore throat and low-grade fever that has persisted for
about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The NP suspects mononucleosis.
Which of the following is the LEAST appropriate intervention? Palpate the lymph nodes and spleen Examine the
posterior oropharynx for petechiae Obtain a CBC, throat culture, and heterophil antibody test. Obtain an
urinalyses and serum for LFTs and amylase
Answer: Obtain an urinalyses and serum for LFTs and amylase Explanation: mononucleosis is a symptomatic
infection caused by the Epstein-Bar virus. Common is people 15-24 years of age. Common signs and symptoms
following incubation period (1-2 months) include fatigue, chills, malaise, anorexia, white tonsillar exudates and
lymphadenopathy or posterior cervical region. Splenomegaly can be present. A maculopapular or occasionally
a petechial rash occurs in less than 15% of patients. A diagnosis is usually made using the Monospot. In
addition, neutropenia and lymphocytosis are usually detected in the CBC
Question: A 32 years old male patient complaint of urinary frequency and burning on urination for 3 days.
Urinalyses reveals bacteriuria and positive nitrites. He denies any past hx. Of urinary tract infections. The initial
treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10
day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose
Answer: . trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day Explanation:
trimethoprim-sulfamethoxazole (TMPS) is usually n appropriate medication to treat urinary tract infections in
most patients. In the case of community resistance to TMPS >20%^, another medication should be
substituted. In men, the appropriate length of time is 7 10 days. Women may be treated for 3 days for
uncomplicated UTI
Question: Which agent is most effective for the treatment of nodulocystic acne? Benzoyl peroxide (Benzac)
Retinoic acid (Retin A) Topical tetracycline Isotretinoin
Answer: Isotretinoin Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment with
severe inflammatory acne. Guidelines for its use must be clearly understood by the patient. A woman of
childbearing age must use an effective method of contraception because isotretinoin is 1 There are many
restrictions in prescribing this medication because of the teratogenic effects is given during pregnancy.
Therefore, it is a pregnancy category X.
Question: An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be instructed to use
a backup method for the prevention of pregnancy
a. Throughout the week of placebo pills
If prescribed topiramate (Topamax) for the treatment of migraines. If prescribed amoxicillin/clavulanate
(Augmentin) for a sinus infection if she forgets to take a single dose of the contraceptive
Answer: If prescribed topiramate (Topamax) for the treatment of migraines. Explanation: Anticonvulsant
including phenytoin (Dilantin), carbamazepine (Tegretol), primidone (Mysoline), topiramate (Topamax) and
oxcarbazepine (Trileptal) reduce the effectiveness of contraceptives. Depo-medroxyprogesterone acetate
injections or levonorgestrel-releasing intrauterine devices would be a better method of contraceptive for
patients taking anticonvulsants. Most commonly used antibiotics have not been proven to reduce the
effectiveness of contraceptives. Rifampin is an exception, and additional .... Be used by women taking this drug
and using oral contraceptives, transdermal, or vaginal ring preparations. Additional backup contraception
should be used if taking antifungal agents. No additional protection is needed thought the week of placebo
pills. Missing one single dose of contraceptive does not require additional protection, missing more than one
doses does.
, Question: A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl (6.5 mmol/L),
LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and triglycerides= 344 mg/dL (8.94 mmol/L).
What agent have the greatest effect on improving her lipid profile and reducing morbidity and mortality
associates with dyslipidemia? Atorvastatin Niacin (Niaspan) Omega 3 fatty acids Fenofibrates
Answer: Atorvastatin Explanation: First and foremost, it is essential to educate individuals on a heart-healthy
lifestyle. LDL-C is one of the major culprits in the development of atherosclerotic heart disease. The target level
of LDL-C is between 50 to 70mg/dl to prevent plaque formation in the blood vessels. Guidelines strongly
recommend statin therapy because they primarily lower LDL-C levels, but they also have the secondary effects
of lowering triglyceride and increasing HDL-C levels.
Question: A 30 years old female comes into a clinic with classic signs and symptoms of appendicitis. The NP
fails to refer the patient to a surgeon. The appendix ruptures and the woman die. This is an example of Failure
of diligence Professional liability Negligence Malpractice
Answer: Malpractice Explanation: malpractice, a negligence tort, occurs when a health care professional's
actions fall bellow the appropriate standard of care and hurts the patient. In this case the patient came with
sings and symptoms indicating appendicitis and the NP failed to refer the patient.
Question: A NP has recently been hired to work in a fast track facility. The NP employer asked if she has "a
problem prescribing medications for emergency contraception." The NP replies affirmatively. This is: a.
Grounds for dismissal An ethical dilemma for the NP Illegal according to the standards of nursing Patient
abandonment.
Answer: An ethical dilemma for the NP Explanation: in this instance, the NP has a difference of opinion with her
employer based on her religious or moral belief about providing emergency contraception. This situation is an
example of an ethical dilemma. Failure to participate in the provision of care to the patient based on the NP's
beliefs is neither against the law nor a violation of the standards of practice
Question: A patient presents with pruritic lesions on both knees. There are visible silver scales. How Should this
condition be managed? . Topical antifungal cream or ointment Oral antibiotics Topical corticosteroids cream .
Topical anti-fungal/ steroid cream
Answer: Topical corticosteroids cream Explanation: Psoriasis is characterized by erythematous papules, as well
as itchy, red, precisely defined plaques with silvery scales. Auspitz sings is another common finding. Topical
agents containing tar and salicylic acid may be used. Topical steroids, such as betamethasone, may also be
ordered.
Question: Antidepressant discontinuation syndrome is less likely if the patient Is male Is less than 35 y/o Has
taken an SSRI with a short half life Gradually tapers SSRI use
Answer: Gradually tapers SSRI use Explanation: Antidepressant discontinuation syndrome is most often seen in
the primary care office in association with SSRI discontinuation, because SSRIs are the most commonly
prescribed class of antidepressant medications. Interruption of treatment with an anti-depressant medication is
sometimes associated with an antidepressant discontinuation syndrome; in early reports it was referred to as a
"withdrawal reaction. Symptoms of antidepressant discontinuation syndrome can include flu-like symptoms,
insomnia, nausea, imbalance, sensory disturbances, and hyperarousal. Tapering is recommended by experts.
Question: Patient with benign prostatic hyperplasia (BPH) should be taught to avoid which one of the following
drug classes? . Alpha adrenergic antagonist Anti-androgen agents Tricyclic antidepressant (TCA) Sulfonamides
Answer: Tricyclic antidepressant (TCA) Explanation: tricyclic antidepressant should not be used by men with
benign prostatic hyperplasia because of the increased risk of urinary retention secondary to the anticholigergic
effects of TCAs.
Update 2026/2027
Question: A 15 years old high school student with a mild sore throat and low-grade fever that has persisted for
about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The NP suspects mononucleosis.
Which of the following is the LEAST appropriate intervention? Palpate the lymph nodes and spleen Examine the
posterior oropharynx for petechiae Obtain a CBC, throat culture, and heterophil antibody test. Obtain an
urinalyses and serum for LFTs and amylase
Answer: Obtain an urinalyses and serum for LFTs and amylase Explanation: mononucleosis is a symptomatic
infection caused by the Epstein-Bar virus. Common is people 15-24 years of age. Common signs and symptoms
following incubation period (1-2 months) include fatigue, chills, malaise, anorexia, white tonsillar exudates and
lymphadenopathy or posterior cervical region. Splenomegaly can be present. A maculopapular or occasionally
a petechial rash occurs in less than 15% of patients. A diagnosis is usually made using the Monospot. In
addition, neutropenia and lymphocytosis are usually detected in the CBC
Question: A 32 years old male patient complaint of urinary frequency and burning on urination for 3 days.
Urinalyses reveals bacteriuria and positive nitrites. He denies any past hx. Of urinary tract infections. The initial
treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10
day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose
Answer: . trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day Explanation:
trimethoprim-sulfamethoxazole (TMPS) is usually n appropriate medication to treat urinary tract infections in
most patients. In the case of community resistance to TMPS >20%^, another medication should be
substituted. In men, the appropriate length of time is 7 10 days. Women may be treated for 3 days for
uncomplicated UTI
Question: Which agent is most effective for the treatment of nodulocystic acne? Benzoyl peroxide (Benzac)
Retinoic acid (Retin A) Topical tetracycline Isotretinoin
Answer: Isotretinoin Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment with
severe inflammatory acne. Guidelines for its use must be clearly understood by the patient. A woman of
childbearing age must use an effective method of contraception because isotretinoin is 1 There are many
restrictions in prescribing this medication because of the teratogenic effects is given during pregnancy.
Therefore, it is a pregnancy category X.
Question: An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be instructed to use
a backup method for the prevention of pregnancy
a. Throughout the week of placebo pills
If prescribed topiramate (Topamax) for the treatment of migraines. If prescribed amoxicillin/clavulanate
(Augmentin) for a sinus infection if she forgets to take a single dose of the contraceptive
Answer: If prescribed topiramate (Topamax) for the treatment of migraines. Explanation: Anticonvulsant
including phenytoin (Dilantin), carbamazepine (Tegretol), primidone (Mysoline), topiramate (Topamax) and
oxcarbazepine (Trileptal) reduce the effectiveness of contraceptives. Depo-medroxyprogesterone acetate
injections or levonorgestrel-releasing intrauterine devices would be a better method of contraceptive for
patients taking anticonvulsants. Most commonly used antibiotics have not been proven to reduce the
effectiveness of contraceptives. Rifampin is an exception, and additional .... Be used by women taking this drug
and using oral contraceptives, transdermal, or vaginal ring preparations. Additional backup contraception
should be used if taking antifungal agents. No additional protection is needed thought the week of placebo
pills. Missing one single dose of contraceptive does not require additional protection, missing more than one
doses does.
, Question: A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl (6.5 mmol/L),
LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and triglycerides= 344 mg/dL (8.94 mmol/L).
What agent have the greatest effect on improving her lipid profile and reducing morbidity and mortality
associates with dyslipidemia? Atorvastatin Niacin (Niaspan) Omega 3 fatty acids Fenofibrates
Answer: Atorvastatin Explanation: First and foremost, it is essential to educate individuals on a heart-healthy
lifestyle. LDL-C is one of the major culprits in the development of atherosclerotic heart disease. The target level
of LDL-C is between 50 to 70mg/dl to prevent plaque formation in the blood vessels. Guidelines strongly
recommend statin therapy because they primarily lower LDL-C levels, but they also have the secondary effects
of lowering triglyceride and increasing HDL-C levels.
Question: A 30 years old female comes into a clinic with classic signs and symptoms of appendicitis. The NP
fails to refer the patient to a surgeon. The appendix ruptures and the woman die. This is an example of Failure
of diligence Professional liability Negligence Malpractice
Answer: Malpractice Explanation: malpractice, a negligence tort, occurs when a health care professional's
actions fall bellow the appropriate standard of care and hurts the patient. In this case the patient came with
sings and symptoms indicating appendicitis and the NP failed to refer the patient.
Question: A NP has recently been hired to work in a fast track facility. The NP employer asked if she has "a
problem prescribing medications for emergency contraception." The NP replies affirmatively. This is: a.
Grounds for dismissal An ethical dilemma for the NP Illegal according to the standards of nursing Patient
abandonment.
Answer: An ethical dilemma for the NP Explanation: in this instance, the NP has a difference of opinion with her
employer based on her religious or moral belief about providing emergency contraception. This situation is an
example of an ethical dilemma. Failure to participate in the provision of care to the patient based on the NP's
beliefs is neither against the law nor a violation of the standards of practice
Question: A patient presents with pruritic lesions on both knees. There are visible silver scales. How Should this
condition be managed? . Topical antifungal cream or ointment Oral antibiotics Topical corticosteroids cream .
Topical anti-fungal/ steroid cream
Answer: Topical corticosteroids cream Explanation: Psoriasis is characterized by erythematous papules, as well
as itchy, red, precisely defined plaques with silvery scales. Auspitz sings is another common finding. Topical
agents containing tar and salicylic acid may be used. Topical steroids, such as betamethasone, may also be
ordered.
Question: Antidepressant discontinuation syndrome is less likely if the patient Is male Is less than 35 y/o Has
taken an SSRI with a short half life Gradually tapers SSRI use
Answer: Gradually tapers SSRI use Explanation: Antidepressant discontinuation syndrome is most often seen in
the primary care office in association with SSRI discontinuation, because SSRIs are the most commonly
prescribed class of antidepressant medications. Interruption of treatment with an anti-depressant medication is
sometimes associated with an antidepressant discontinuation syndrome; in early reports it was referred to as a
"withdrawal reaction. Symptoms of antidepressant discontinuation syndrome can include flu-like symptoms,
insomnia, nausea, imbalance, sensory disturbances, and hyperarousal. Tapering is recommended by experts.
Question: Patient with benign prostatic hyperplasia (BPH) should be taught to avoid which one of the following
drug classes? . Alpha adrenergic antagonist Anti-androgen agents Tricyclic antidepressant (TCA) Sulfonamides
Answer: Tricyclic antidepressant (TCA) Explanation: tricyclic antidepressant should not be used by men with
benign prostatic hyperplasia because of the increased risk of urinary retention secondary to the anticholigergic
effects of TCAs.
