SARAH MICHELLE LIVE REVIEW
PRACTICE QUESTIONS & VERIFIED
ANSWERS FOR NURSE PRACTITIONER
EXAM PREP 2026/2027
1
. A 65-year-old patient with chronic kidney disease and hypertension presents for a follow-
up. According to the current guidelines, which class of medication is the preferred first-line
treatment for blood pressure management in this patient?
A. Thiazide diuretics
B. ACE inhibitors or ARBs
C. Calcium channel blockers
D. Beta-blockers
Answer: B
Conceptual Explanation: ACE inhibitors or ARBs are preferred in patients with CKD due
to their renoprotective effects and ability to reduce albuminuria.
,2. Which of the following physical examination findings is most characteristic of a patient
presenting with acute cholecystitis?
A. Murphy’s sign
B. McBurney’s point tenderness
C. Rovsing’s sign
D. Psoas sign
Answer: A
Conceptual Explanation: Murphy’s sign is an inspiratory arrest upon deep palpation of
the right upper quadrant and is a classic finding for acute cholecystitis.
3. An 8-year-old child presents with a ‘slapped cheek’ rash and a lacy reticular rash on the
extremities. What is the most likely diagnosis?
A. Roseola infantum
B. Erythema infectiosum
C. Scarlet fever
D. Hand, foot, and mouth disease
Answer: B
Conceptual Explanation: Erythema infectiosum (Fifth disease), caused by Parvovirus B19,
typically presents with a ‘slapped cheek’ appearance followed by a lacy rash.
, 4. A patient with a history of heart failure with reduced ejection fraction (HFrEF) presents
with new-onset fatigue. Which heart sound is most likely to be heard on auscultation during
the early diastolic filling phase?
A. Systolic click
B. S4
C. S3
D. Opening snap
Answer: C
Conceptual Explanation: An S3 gallop is associated with fluid volume overload and is
common in patients with HFrEF during the rapid filling phase of diastole.
5. According to the GOLD guidelines, which of the following is the primary diagnostic criterion
for COPD using spirometry?
A. FEV1/FVC ratio < 0.70 post-bronchodilator
B. FEV1/FVC ratio < 0.80 post-bronchodilator
C. FVC < 80% predicted
D. FEV1 increase of 12% post-bronchodilator
Answer: A
Conceptual Explanation: The GOLD criteria define COPD as a post-bronchodilator
FEV1/FVC ratio of less than 0.70.
PRACTICE QUESTIONS & VERIFIED
ANSWERS FOR NURSE PRACTITIONER
EXAM PREP 2026/2027
1
. A 65-year-old patient with chronic kidney disease and hypertension presents for a follow-
up. According to the current guidelines, which class of medication is the preferred first-line
treatment for blood pressure management in this patient?
A. Thiazide diuretics
B. ACE inhibitors or ARBs
C. Calcium channel blockers
D. Beta-blockers
Answer: B
Conceptual Explanation: ACE inhibitors or ARBs are preferred in patients with CKD due
to their renoprotective effects and ability to reduce albuminuria.
,2. Which of the following physical examination findings is most characteristic of a patient
presenting with acute cholecystitis?
A. Murphy’s sign
B. McBurney’s point tenderness
C. Rovsing’s sign
D. Psoas sign
Answer: A
Conceptual Explanation: Murphy’s sign is an inspiratory arrest upon deep palpation of
the right upper quadrant and is a classic finding for acute cholecystitis.
3. An 8-year-old child presents with a ‘slapped cheek’ rash and a lacy reticular rash on the
extremities. What is the most likely diagnosis?
A. Roseola infantum
B. Erythema infectiosum
C. Scarlet fever
D. Hand, foot, and mouth disease
Answer: B
Conceptual Explanation: Erythema infectiosum (Fifth disease), caused by Parvovirus B19,
typically presents with a ‘slapped cheek’ appearance followed by a lacy rash.
, 4. A patient with a history of heart failure with reduced ejection fraction (HFrEF) presents
with new-onset fatigue. Which heart sound is most likely to be heard on auscultation during
the early diastolic filling phase?
A. Systolic click
B. S4
C. S3
D. Opening snap
Answer: C
Conceptual Explanation: An S3 gallop is associated with fluid volume overload and is
common in patients with HFrEF during the rapid filling phase of diastole.
5. According to the GOLD guidelines, which of the following is the primary diagnostic criterion
for COPD using spirometry?
A. FEV1/FVC ratio < 0.70 post-bronchodilator
B. FEV1/FVC ratio < 0.80 post-bronchodilator
C. FVC < 80% predicted
D. FEV1 increase of 12% post-bronchodilator
Answer: A
Conceptual Explanation: The GOLD criteria define COPD as a post-bronchodilator
FEV1/FVC ratio of less than 0.70.
