Fnp Predictor 2025 Actul
Exam Complete
Questions And Correct
Answers/Brand New!!
1. A 54-year-old man with HTN and diabetes has BP 152/94 on lisinopril 20 mg
daily. Best next step?
A. Increase lisinopril to 40 mg
B. Add amlodipine 5 mg
C. Add atenolol
D. Reassure and recheck in 6 months
Answer: A
Rationale: For BP above goal on a single agent, first maximize that agent (ACE
inhibitor) before adding a second drug. B is appropriate if max dose fails. C —
beta-blockers are not first-line for uncomplicated HTN. D is unsafe given diabetes.
2. A 28-year-old G2P1 at 32 weeks has BP 148/96 and 1+ proteinuria. Most likely
diagnosis?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia without severe features
D. Eclampsia
Answer: C
Rationale: New HTN after 20 weeks + proteinuria = preeclampsia. No severe
features (no BP ≥160/110, no organ dysfunction). A predates pregnancy. B lacks
proteinuria. D involves seizures.
,3. A 3-year-old with fever 103°F, drooling, tripod positioning, and muffled voice.
Priority action?
A. Oral amoxicillin
B. Inspect throat with tongue blade
C. Immediate EMS transfer for suspected epiglottitis
D. Cool mist and observe
Answer: C
Rationale: Classic epiglottitis — airway emergency. Do NOT examine the throat
(B) as it can precipitate laryngospasm. A delays care. D is inappropriate.
4. First-line treatment for a 25-year-old with uncomplicated chlamydia?
A. Azithromycin 1 g PO single dose
B. Doxycycline 100 mg BID x 7 days
C. Ceftriaxone 250 mg IM
D. Metronidazole 500 mg BID x 7 days
Answer: B
Rationale: CDC now recommends doxycycline 100 mg BID x 7 days as first-line for
chlamydia (superior efficacy). A is an alternative. C treats gonorrhea. D treats
trichomonas/BV.
5. A 70-year-old with new-onset AFib, HR 128, stable BP. Best rate control?
A. Adenosine
B. Metoprolol IV/PO
C. Amiodarone
D. Cardioversion
Answer: B
Rationale: Beta-blockers are first-line for rate control in stable AFib. A is for SVT. C
is for rhythm control/hemodynamic instability. D requires anticoagulation
consideration and is not first-line if stable.
,6. A 6-week-old with projectile vomiting after feeds, palpable olive-shaped
mass. Diagnosis?
A. GERD
B. Pyloric stenosis
C. Intussusception
D. Malrotation
Answer: B
Rationale: Nonbilious projectile vomiting + olive mass at 3–6 weeks =
hypertrophic pyloric stenosis. A is non-projectile. C presents with currant-jelly
stool and colicky pain. D presents earlier with bilious emesis.
7. A 45-year-old woman with fatigue, cold intolerance, weight gain, and
constipation. Expected labs?
A. ↓TSH, ↑free T4
B. ↑TSH, ↓free T4
C. ↑TSH, ↑free T4
D. ↓TSH, ↓free T4
Answer: B
Rationale: Primary hypothyroidism (likely Hashimoto's). A = hyperthyroidism. C =
TSH-secreting adenoma. D = central hypothyroidism.
8. A 62-year-old smoker with chronic productive cough ≥3 months/year for 2
years. Diagnosis?
A. Asthma
B. Chronic bronchitis
C. Emphysema
D. Bronchiectasis
Answer: B
Rationale: Chronic bronchitis definition = productive cough ≥3 months/year for 2
consecutive years. C = dyspnea/weight loss. A = reversible. D = copious purulent
sputum, recurrent infections.
, 9. A 30-year-old with first UTI in pregnancy at 16 weeks. Best treatment?
A. Nitrofurantoin x 5 days
B. Ciprofloxacin x 7 days
C. TMP-SMX x 3 days
D. Doxycycline x 7 days
Answer: A
Rationale: Nitrofurantoin is safe in 2nd trimester and effective. B and D are
contraindicated in pregnancy. C is avoided in 1st trimester and near term.
10. A 55-year-old with crushing chest pain, diaphoresis, and ST elevation on
ECG. Priority?
A. Aspirin 325 mg chewed + activate EMS/STEMI protocol
B. Nitroglycerin SL and discharge
C. Obtain troponin and wait
D. Start PO metoprolol
Answer: A
Rationale: STEMI = emergent reperfusion. Aspirin + EMS activation is immediate.
B, C, D delay definitive care.
11. A 4-year-old with barking cough, inspiratory stridor, low-grade fever.
Diagnosis?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Foreign body
Answer: B
Rationale: Barking cough + stridor = croup. A = drooling, no bark. C = wheezing in
<2. D = sudden onset, no fever.
Exam Complete
Questions And Correct
Answers/Brand New!!
1. A 54-year-old man with HTN and diabetes has BP 152/94 on lisinopril 20 mg
daily. Best next step?
A. Increase lisinopril to 40 mg
B. Add amlodipine 5 mg
C. Add atenolol
D. Reassure and recheck in 6 months
Answer: A
Rationale: For BP above goal on a single agent, first maximize that agent (ACE
inhibitor) before adding a second drug. B is appropriate if max dose fails. C —
beta-blockers are not first-line for uncomplicated HTN. D is unsafe given diabetes.
2. A 28-year-old G2P1 at 32 weeks has BP 148/96 and 1+ proteinuria. Most likely
diagnosis?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia without severe features
D. Eclampsia
Answer: C
Rationale: New HTN after 20 weeks + proteinuria = preeclampsia. No severe
features (no BP ≥160/110, no organ dysfunction). A predates pregnancy. B lacks
proteinuria. D involves seizures.
,3. A 3-year-old with fever 103°F, drooling, tripod positioning, and muffled voice.
Priority action?
A. Oral amoxicillin
B. Inspect throat with tongue blade
C. Immediate EMS transfer for suspected epiglottitis
D. Cool mist and observe
Answer: C
Rationale: Classic epiglottitis — airway emergency. Do NOT examine the throat
(B) as it can precipitate laryngospasm. A delays care. D is inappropriate.
4. First-line treatment for a 25-year-old with uncomplicated chlamydia?
A. Azithromycin 1 g PO single dose
B. Doxycycline 100 mg BID x 7 days
C. Ceftriaxone 250 mg IM
D. Metronidazole 500 mg BID x 7 days
Answer: B
Rationale: CDC now recommends doxycycline 100 mg BID x 7 days as first-line for
chlamydia (superior efficacy). A is an alternative. C treats gonorrhea. D treats
trichomonas/BV.
5. A 70-year-old with new-onset AFib, HR 128, stable BP. Best rate control?
A. Adenosine
B. Metoprolol IV/PO
C. Amiodarone
D. Cardioversion
Answer: B
Rationale: Beta-blockers are first-line for rate control in stable AFib. A is for SVT. C
is for rhythm control/hemodynamic instability. D requires anticoagulation
consideration and is not first-line if stable.
,6. A 6-week-old with projectile vomiting after feeds, palpable olive-shaped
mass. Diagnosis?
A. GERD
B. Pyloric stenosis
C. Intussusception
D. Malrotation
Answer: B
Rationale: Nonbilious projectile vomiting + olive mass at 3–6 weeks =
hypertrophic pyloric stenosis. A is non-projectile. C presents with currant-jelly
stool and colicky pain. D presents earlier with bilious emesis.
7. A 45-year-old woman with fatigue, cold intolerance, weight gain, and
constipation. Expected labs?
A. ↓TSH, ↑free T4
B. ↑TSH, ↓free T4
C. ↑TSH, ↑free T4
D. ↓TSH, ↓free T4
Answer: B
Rationale: Primary hypothyroidism (likely Hashimoto's). A = hyperthyroidism. C =
TSH-secreting adenoma. D = central hypothyroidism.
8. A 62-year-old smoker with chronic productive cough ≥3 months/year for 2
years. Diagnosis?
A. Asthma
B. Chronic bronchitis
C. Emphysema
D. Bronchiectasis
Answer: B
Rationale: Chronic bronchitis definition = productive cough ≥3 months/year for 2
consecutive years. C = dyspnea/weight loss. A = reversible. D = copious purulent
sputum, recurrent infections.
, 9. A 30-year-old with first UTI in pregnancy at 16 weeks. Best treatment?
A. Nitrofurantoin x 5 days
B. Ciprofloxacin x 7 days
C. TMP-SMX x 3 days
D. Doxycycline x 7 days
Answer: A
Rationale: Nitrofurantoin is safe in 2nd trimester and effective. B and D are
contraindicated in pregnancy. C is avoided in 1st trimester and near term.
10. A 55-year-old with crushing chest pain, diaphoresis, and ST elevation on
ECG. Priority?
A. Aspirin 325 mg chewed + activate EMS/STEMI protocol
B. Nitroglycerin SL and discharge
C. Obtain troponin and wait
D. Start PO metoprolol
Answer: A
Rationale: STEMI = emergent reperfusion. Aspirin + EMS activation is immediate.
B, C, D delay definitive care.
11. A 4-year-old with barking cough, inspiratory stridor, low-grade fever.
Diagnosis?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Foreign body
Answer: B
Rationale: Barking cough + stridor = croup. A = drooling, no bark. C = wheezing in
<2. D = sudden onset, no fever.
