Certified Nurse Practitioner (CNP)
exams across specialties Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf
1. A 55-year-old male with hypertension presents for routine follow-up. His
BP today is 148/92 mmHg. Which is the most appropriate first step?
A. Increase current antihypertensive dose
B. Assess adherence and lifestyle modifications
C. Start a second antihypertensive immediately
D. Schedule repeat BP in 6 months
Rationale: Lifestyle modifications and adherence should always be assessed
before escalating therapy for stage 2 hypertension.
2. A 3-year-old child presents with a barking cough, stridor, and low-grade
fever. What is the most likely diagnosis?
A. Asthma exacerbation
B. Croup (viral laryngotracheitis)
C. Epiglottitis
D. Bronchiolitis
Rationale: Croup presents with barking cough, stridor, and mild fever, typically
in children 6 months–3 years.
3. A 28-year-old woman presents with dysuria and frequency. Urinalysis
shows positive nitrites and leukocyte esterase. What is the most appropriate
first-line treatment?
A. Ciprofloxacin
B. Nitrofurantoin
,C. Trimethoprim alone
D. Amoxicillin
Rationale: Nitrofurantoin is a first-line agent for uncomplicated cystitis in non-
pregnant women.
4. Which of the following is a characteristic feature of major depressive
disorder?
A. Hypomanic episodes
B. Persistent depressed mood for at least 2 weeks
C. Psychosis without mood symptoms
D. Mania
Rationale: Major depressive disorder requires a minimum of 2 weeks of
depressed mood or anhedonia along with other symptoms.
5. A 65-year-old man presents with exertional chest pain relieved by rest.
What is the next best step?
A. Echocardiogram
B. Exercise stress test
C. Coronary artery bypass surgery
D. Start high-dose statin immediately
Rationale: Stable angina should be evaluated initially with non-invasive stress
testing to confirm ischemia.
6. A 2-month-old infant has a harsh, holosystolic murmur at the lower left
sternal border. What is the most likely diagnosis?
A. Tetralogy of Fallot
B. Atrial septal defect
C. Ventricular septal defect
D. Patent ductus arteriosus
Rationale: Holosystolic murmur at the lower left sternal border in an infant is
most commonly due to VSD.
, 7. Which vaccination is contraindicated during pregnancy?
A. Influenza (inactivated)
B. Tdap
C. MMR (measles, mumps, rubella)
D. Hepatitis B
Rationale: Live vaccines, such as MMR, are contraindicated in pregnancy due to
risk of fetal infection.
8. A 70-year-old woman presents with a 3-month history of progressive
memory loss and difficulty managing finances. Which is the most likely
diagnosis?
A. Delirium
B. Alzheimer’s disease
C. Vascular dementia
D. Depression
Rationale: Gradual, progressive cognitive decline without fluctuation is typical
of Alzheimer’s disease.
9. Which of the following medications is contraindicated in patients with
asthma?
A. Albuterol
B. Non-selective beta-blockers (e.g., propranolol)
C. Montelukast
D. Fluticasone
Rationale: Non-selective beta-blockers can precipitate bronchospasm in
asthmatic patients.
10. A 24-year-old woman presents with amenorrhea for 6 months. Pregnancy
test is negative. Which is the next best step?
exams across specialties Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf
1. A 55-year-old male with hypertension presents for routine follow-up. His
BP today is 148/92 mmHg. Which is the most appropriate first step?
A. Increase current antihypertensive dose
B. Assess adherence and lifestyle modifications
C. Start a second antihypertensive immediately
D. Schedule repeat BP in 6 months
Rationale: Lifestyle modifications and adherence should always be assessed
before escalating therapy for stage 2 hypertension.
2. A 3-year-old child presents with a barking cough, stridor, and low-grade
fever. What is the most likely diagnosis?
A. Asthma exacerbation
B. Croup (viral laryngotracheitis)
C. Epiglottitis
D. Bronchiolitis
Rationale: Croup presents with barking cough, stridor, and mild fever, typically
in children 6 months–3 years.
3. A 28-year-old woman presents with dysuria and frequency. Urinalysis
shows positive nitrites and leukocyte esterase. What is the most appropriate
first-line treatment?
A. Ciprofloxacin
B. Nitrofurantoin
,C. Trimethoprim alone
D. Amoxicillin
Rationale: Nitrofurantoin is a first-line agent for uncomplicated cystitis in non-
pregnant women.
4. Which of the following is a characteristic feature of major depressive
disorder?
A. Hypomanic episodes
B. Persistent depressed mood for at least 2 weeks
C. Psychosis without mood symptoms
D. Mania
Rationale: Major depressive disorder requires a minimum of 2 weeks of
depressed mood or anhedonia along with other symptoms.
5. A 65-year-old man presents with exertional chest pain relieved by rest.
What is the next best step?
A. Echocardiogram
B. Exercise stress test
C. Coronary artery bypass surgery
D. Start high-dose statin immediately
Rationale: Stable angina should be evaluated initially with non-invasive stress
testing to confirm ischemia.
6. A 2-month-old infant has a harsh, holosystolic murmur at the lower left
sternal border. What is the most likely diagnosis?
A. Tetralogy of Fallot
B. Atrial septal defect
C. Ventricular septal defect
D. Patent ductus arteriosus
Rationale: Holosystolic murmur at the lower left sternal border in an infant is
most commonly due to VSD.
, 7. Which vaccination is contraindicated during pregnancy?
A. Influenza (inactivated)
B. Tdap
C. MMR (measles, mumps, rubella)
D. Hepatitis B
Rationale: Live vaccines, such as MMR, are contraindicated in pregnancy due to
risk of fetal infection.
8. A 70-year-old woman presents with a 3-month history of progressive
memory loss and difficulty managing finances. Which is the most likely
diagnosis?
A. Delirium
B. Alzheimer’s disease
C. Vascular dementia
D. Depression
Rationale: Gradual, progressive cognitive decline without fluctuation is typical
of Alzheimer’s disease.
9. Which of the following medications is contraindicated in patients with
asthma?
A. Albuterol
B. Non-selective beta-blockers (e.g., propranolol)
C. Montelukast
D. Fluticasone
Rationale: Non-selective beta-blockers can precipitate bronchospasm in
asthmatic patients.
10. A 24-year-old woman presents with amenorrhea for 6 months. Pregnancy
test is negative. Which is the next best step?
