SARAH MICHELLE LIVE REVIEW
FINAL EXAM 2026/2027 QUESTIONS &
ANSWERS 100% GUARANTEE PASS
1. A 68-year-old patient with a history of heart failure and a reduced ejection fraction (HFrEF)
presents for a follow-up. Which of the following medication classes is now considered a
cornerstone of ‘quadruple therapy’ to improve mortality?
A. SGLT2 Inhibitors
B. Calcium Channel Blockers
C. Loop Diuretics
D. Alpha-Blockers
Answer: A
Conceptual Explanation: Modern management of HFrEF includes the ‘four pillars’: an
ARNI (or ACEi/ARB), a beta-blocker, an MRA, and an SGLT2 inhibitor, all of which have
been shown to reduce mortality.
2. A 45-year-old female presents with a chief complaint of a ‘racing heart’ and heat
intolerance. Her labs reveal a TSH of <0.01 uIU/mL and a high Free T4. Which physical exam
finding is most specific to Graves’ disease?
A. Fine tremor of the hands
,B. Pretibial Myxedema
C. Tachycardia
D. Generalized weight loss
Answer: B
Conceptual Explanation: While tachycardia and tremors are common in all types of
hyperthyroidism, pretibial myxedema (dermopathy) and exophthalmos are specific to
Graves’ disease.
3. During a physical exam, the nurse practitioner notes a harsh, crescendo-decrescendo
systolic murmur heard best at the second intercostal space, right sternal border, which
radiates to the carotid arteries. What is the most likely diagnosis?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur at the
RUSB radiating to the carotids. Mitral regurgitation is heard at the apex and radiates to the
axilla.
, 4. A patient presents with a new-onset facial droop. He is unable to wrinkle his forehead on
the affected side and cannot close his eye tightly. Which cranial nerve is affected?
A. CN V (Trigeminal)
B. CN VII (Facial)
C. CN VIII (Vestibulocochlear)
D. CN X (Vagus)
B. CN VII (Facial)
Answer: B
Conceptual Explanation: CN VII (Facial nerve) controls facial expression. The inability to
wrinkle the forehead distinguishes Bell’s Palsy (peripheral CN VII) from a stroke (central,
where the forehead is often spared).
5. According to the GINA guidelines, what is the preferred ‘Reliever’ medication for a patient
in Step 1 or Step 2 of asthma management?
A. Albuterol (SABA) alone
B. Salmeterol (LABA) alone
C. Low-dose ICS-formoterol
D. Oral Prednisone
Answer: C
FINAL EXAM 2026/2027 QUESTIONS &
ANSWERS 100% GUARANTEE PASS
1. A 68-year-old patient with a history of heart failure and a reduced ejection fraction (HFrEF)
presents for a follow-up. Which of the following medication classes is now considered a
cornerstone of ‘quadruple therapy’ to improve mortality?
A. SGLT2 Inhibitors
B. Calcium Channel Blockers
C. Loop Diuretics
D. Alpha-Blockers
Answer: A
Conceptual Explanation: Modern management of HFrEF includes the ‘four pillars’: an
ARNI (or ACEi/ARB), a beta-blocker, an MRA, and an SGLT2 inhibitor, all of which have
been shown to reduce mortality.
2. A 45-year-old female presents with a chief complaint of a ‘racing heart’ and heat
intolerance. Her labs reveal a TSH of <0.01 uIU/mL and a high Free T4. Which physical exam
finding is most specific to Graves’ disease?
A. Fine tremor of the hands
,B. Pretibial Myxedema
C. Tachycardia
D. Generalized weight loss
Answer: B
Conceptual Explanation: While tachycardia and tremors are common in all types of
hyperthyroidism, pretibial myxedema (dermopathy) and exophthalmos are specific to
Graves’ disease.
3. During a physical exam, the nurse practitioner notes a harsh, crescendo-decrescendo
systolic murmur heard best at the second intercostal space, right sternal border, which
radiates to the carotid arteries. What is the most likely diagnosis?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur at the
RUSB radiating to the carotids. Mitral regurgitation is heard at the apex and radiates to the
axilla.
, 4. A patient presents with a new-onset facial droop. He is unable to wrinkle his forehead on
the affected side and cannot close his eye tightly. Which cranial nerve is affected?
A. CN V (Trigeminal)
B. CN VII (Facial)
C. CN VIII (Vestibulocochlear)
D. CN X (Vagus)
B. CN VII (Facial)
Answer: B
Conceptual Explanation: CN VII (Facial nerve) controls facial expression. The inability to
wrinkle the forehead distinguishes Bell’s Palsy (peripheral CN VII) from a stroke (central,
where the forehead is often spared).
5. According to the GINA guidelines, what is the preferred ‘Reliever’ medication for a patient
in Step 1 or Step 2 of asthma management?
A. Albuterol (SABA) alone
B. Salmeterol (LABA) alone
C. Low-dose ICS-formoterol
D. Oral Prednisone
Answer: C
