NP Exam Practice Questions and Answers
NP Exam Practice Questions and Answers
Question 1
A 16-year-old presents with moderate acne consisting of about 25 inflammatory
lesions on her face, neck, and shoulders. First-line treatment can include:
Alcohol-based facial wash.
Oral antimicrobial plus topical salicylic acid.
Topical benzoyl peroxide plus topical antimicrobial.
Oral isotretinoin.
Correct Answer
Topical benzoyl peroxide plus topical antimicrobial.
Combination therapy is preferred for moderate acne while monotherapy with
topical benzoyl peroxide or a topical retinoid can be considered for initial therapy of
mild acne. Alcohol-based facial wash is not recommended for the treatment of acne
(A). A topical antibacterial cream or lotion is generally preferred over a systemic
antimicrobial as first-line therapy in moderate acne (B). A topical retinoid is also
preferred over topical salicylic acid when used as part of combination therapy for
moderate acne. Oral isotretinoin is generally reserved for severe acne when prior
treatments result in an inadequate response (D).
Page 1 of 76
, NP Exam Practice Questions and Answers
Question 2
Lisa is a 48-year-old woman who presents with a 5-day history of painful urination
and mucopurulent vaginal discharge. Suspecting chlamydial infection, which of the
following findings would support this diagnosis?
Large numbers of motile organisms upon microscopic exam
Friable cervix
Positive psoas sign
Rebound tenderness
Correct Answer
Friable cervix
A large number of motile organisms upon microscopic examination is more
indicative of trichomoniasis rather than chlamydial infection (A). A positive psoas
sign indicates appendicitis (C), and it is cervical motion tenderness rather than
rebound tenderness that is associated with chlamydia infection (D).
Question 3
The NAAT assay is performed for Lisa and chlamydia infection is confirmed. Which of
the following is the most appropriate treatment choice?
IM or oral penicillin
Oral TMP-SMX
Oral azithromycin
Oral ciprofloxacin
Correct Answer
Oral azithromycin
Penicillin is not effective against intracellular pathogens and so is not recommended
in the treatment of chlamydial infection (A). TMP-SMX is used to treat urinary tract
infections but is not preferred for chlamydia (B). Fluoroquinolones are also not
considered first-line therapy for chlamydial infection and should be avoided due to
risk of adverse effects and increasing rates of resistance by certain pathogens (D).
Page 2 of 76
, NP Exam Practice Questions and Answers
Question 4
Which of the following is recommended prior to Lisa leaving the clinic?
Encourage all household members to be tested for chlamydia
Recommend the HPV vaccine
Screen for meningococcal disease
Encourage screening for HIV
Correct Answer
Encourage screening for HIV
For patients diagnosed and treated for chlamydial infection, expedited partner
therapy (EPT) should be considered, which would provide the medication or a
prescription of the medication for the patient to take to his/her sexual partner.
However, STI screening is not needed for all household members as intimate
contact is needed to spread the infection (A). The HPV vaccine is recommended for
adults up to 26 years of age. Adults up to 45 years of age can also be considered for
HPV vaccination following shared clinical decision-making (B). Screening for
meningococcal disease is also not warranted with no presenting signs or symptoms
and/or during times of no known community outbreak of the infection (C).
Question 5
A 27-year-old male is diagnosed with gonorrhea. He is otherwise healthy, has no drug
allergies, and has not been treated with an antimicrobial in the past year.
Recommended treatment is:
Mark For Review
IM or oral penicillin.
Oral azithromycin.
IM ceftriaxone.
Oral levofloxacin.
Correct Answer
IM ceftriaxone
Penicillin or amoxicillin are not recommended for the treatment of gonorrhea due
to the high prevalence of beta-lactamase production by these organisms (A). The
fluoroquinolones are no longer recommended to treat gonorrhea due to high rates
of resistance (D). Azithromycin can be considered for treatment but in combination
with gentamicin as an alternative approach (B).
Page 3 of 76
, NP Exam Practice Questions and Answers
Question 6
The NP is counseling Rene, a 22-year-old woman, who reports having unprotected
intercourse 3 days ago and asks about emergency contraception. She is not currently
taking any form of contraception and her last menses ended 7 days ago. The NP
advises:
A pregnancy test is needed prior to using emergency contraception.
A prescription is not needed for levonorgestrel emergency contraception.
Ulipristal is effective only up to 48 hours after unprotected intercourse.
The use of emergency contraception can increase infertility risk in the future.
Correct Answer
A prescription is not needed for levonorgestrel emergency contraception.
A pregnancy test is not required prior to using emergency contraception (A).
Ulipristal and copper-containing IUD can be used as emergency contraception up
to 5 days after unprotected coitus (C). Levonorgestrel emergency contraception can
also be used up to 5 days following unprotected coitus, but is most effective up to 3
days following unprotected coitus. There is no association between the use of
emergency contraception and risk of infertility (D).
Question 7
Rene calls the clinic 4 weeks after taking emergency contraception and reports that
she has not yet started her menses. She is concerned because her cycle is normally
predictable. The NP recommends:
Waiting another week to see if menstruation begins.
Take another dose of emergency contraception.
Taking a pregnancy test.
Starting combined oral contraception.
Correct Answer
Taking a pregnancy test
Since it has been 5 weeks since her last menses, a pregnancy test should be
administered promptly without waiting another week (A). Taking emergency
contraception or initiating combined oral contraception is not recommended due to
the possibility of a pregnancy (B, D). Emergency contraception should also not be
taken beyond 5 days of unprotected intercourse.
Page 4 of 76
NP Exam Practice Questions and Answers
Question 1
A 16-year-old presents with moderate acne consisting of about 25 inflammatory
lesions on her face, neck, and shoulders. First-line treatment can include:
Alcohol-based facial wash.
Oral antimicrobial plus topical salicylic acid.
Topical benzoyl peroxide plus topical antimicrobial.
Oral isotretinoin.
Correct Answer
Topical benzoyl peroxide plus topical antimicrobial.
Combination therapy is preferred for moderate acne while monotherapy with
topical benzoyl peroxide or a topical retinoid can be considered for initial therapy of
mild acne. Alcohol-based facial wash is not recommended for the treatment of acne
(A). A topical antibacterial cream or lotion is generally preferred over a systemic
antimicrobial as first-line therapy in moderate acne (B). A topical retinoid is also
preferred over topical salicylic acid when used as part of combination therapy for
moderate acne. Oral isotretinoin is generally reserved for severe acne when prior
treatments result in an inadequate response (D).
Page 1 of 76
, NP Exam Practice Questions and Answers
Question 2
Lisa is a 48-year-old woman who presents with a 5-day history of painful urination
and mucopurulent vaginal discharge. Suspecting chlamydial infection, which of the
following findings would support this diagnosis?
Large numbers of motile organisms upon microscopic exam
Friable cervix
Positive psoas sign
Rebound tenderness
Correct Answer
Friable cervix
A large number of motile organisms upon microscopic examination is more
indicative of trichomoniasis rather than chlamydial infection (A). A positive psoas
sign indicates appendicitis (C), and it is cervical motion tenderness rather than
rebound tenderness that is associated with chlamydia infection (D).
Question 3
The NAAT assay is performed for Lisa and chlamydia infection is confirmed. Which of
the following is the most appropriate treatment choice?
IM or oral penicillin
Oral TMP-SMX
Oral azithromycin
Oral ciprofloxacin
Correct Answer
Oral azithromycin
Penicillin is not effective against intracellular pathogens and so is not recommended
in the treatment of chlamydial infection (A). TMP-SMX is used to treat urinary tract
infections but is not preferred for chlamydia (B). Fluoroquinolones are also not
considered first-line therapy for chlamydial infection and should be avoided due to
risk of adverse effects and increasing rates of resistance by certain pathogens (D).
Page 2 of 76
, NP Exam Practice Questions and Answers
Question 4
Which of the following is recommended prior to Lisa leaving the clinic?
Encourage all household members to be tested for chlamydia
Recommend the HPV vaccine
Screen for meningococcal disease
Encourage screening for HIV
Correct Answer
Encourage screening for HIV
For patients diagnosed and treated for chlamydial infection, expedited partner
therapy (EPT) should be considered, which would provide the medication or a
prescription of the medication for the patient to take to his/her sexual partner.
However, STI screening is not needed for all household members as intimate
contact is needed to spread the infection (A). The HPV vaccine is recommended for
adults up to 26 years of age. Adults up to 45 years of age can also be considered for
HPV vaccination following shared clinical decision-making (B). Screening for
meningococcal disease is also not warranted with no presenting signs or symptoms
and/or during times of no known community outbreak of the infection (C).
Question 5
A 27-year-old male is diagnosed with gonorrhea. He is otherwise healthy, has no drug
allergies, and has not been treated with an antimicrobial in the past year.
Recommended treatment is:
Mark For Review
IM or oral penicillin.
Oral azithromycin.
IM ceftriaxone.
Oral levofloxacin.
Correct Answer
IM ceftriaxone
Penicillin or amoxicillin are not recommended for the treatment of gonorrhea due
to the high prevalence of beta-lactamase production by these organisms (A). The
fluoroquinolones are no longer recommended to treat gonorrhea due to high rates
of resistance (D). Azithromycin can be considered for treatment but in combination
with gentamicin as an alternative approach (B).
Page 3 of 76
, NP Exam Practice Questions and Answers
Question 6
The NP is counseling Rene, a 22-year-old woman, who reports having unprotected
intercourse 3 days ago and asks about emergency contraception. She is not currently
taking any form of contraception and her last menses ended 7 days ago. The NP
advises:
A pregnancy test is needed prior to using emergency contraception.
A prescription is not needed for levonorgestrel emergency contraception.
Ulipristal is effective only up to 48 hours after unprotected intercourse.
The use of emergency contraception can increase infertility risk in the future.
Correct Answer
A prescription is not needed for levonorgestrel emergency contraception.
A pregnancy test is not required prior to using emergency contraception (A).
Ulipristal and copper-containing IUD can be used as emergency contraception up
to 5 days after unprotected coitus (C). Levonorgestrel emergency contraception can
also be used up to 5 days following unprotected coitus, but is most effective up to 3
days following unprotected coitus. There is no association between the use of
emergency contraception and risk of infertility (D).
Question 7
Rene calls the clinic 4 weeks after taking emergency contraception and reports that
she has not yet started her menses. She is concerned because her cycle is normally
predictable. The NP recommends:
Waiting another week to see if menstruation begins.
Take another dose of emergency contraception.
Taking a pregnancy test.
Starting combined oral contraception.
Correct Answer
Taking a pregnancy test
Since it has been 5 weeks since her last menses, a pregnancy test should be
administered promptly without waiting another week (A). Taking emergency
contraception or initiating combined oral contraception is not recommended due to
the possibility of a pregnancy (B, D). Emergency contraception should also not be
taken beyond 5 days of unprotected intercourse.
Page 4 of 76
