FNP Systems Review Clinical Test Bank – 150
Solved Questions, Answers Rationale Included
2025/2026
1. Which heart sound is commonly heard in patients with heart
failure?
A. S1
B. S2
C. S3
D. S4
C. S3
Rationale: S3, also known as a ventricular gallop, is often associated
with increased left ventricular filling pressures seen in heart failure.
2. The most common cause of community-acquired pneumonia in
adults is:
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae is the leading cause of
community-acquired pneumonia in adults, especially in older adults
and those with comorbidities.
3. A 55-year-old patient presents with sudden vision loss in one eye.
Fundoscopy shows a pale retina with a cherry-red spot at the
macula. The most likely diagnosis is:
A. Central retinal vein occlusion
, B. Central retinal artery occlusion
C. Retinal detachment
D. Macular degeneration
B. Central retinal artery occlusion
Rationale: The classic presentation of sudden, painless monocular
vision loss with a cherry-red spot indicates central retinal artery
occlusion.
4. Which of the following is the most sensitive test for diagnosing
hypothyroidism?
A. Free T4
B. Total T4
C. TSH
D. Total T3
C. TSH
Rationale: TSH is the most sensitive indicator of primary
hypothyroidism, as even minor decreases in thyroid hormone levels
lead to elevated TSH.
5. A patient presents with acute onset of severe right upper
quadrant pain, fever, and jaundice. The most likely diagnosis is:
A. Acute cholecystitis
B. Acute cholangitis
C. Hepatitis A infection
D. Pancreatitis
B. Acute cholangitis
Rationale: Charcot’s triad (fever, right upper quadrant pain, jaundice)
is classic for acute cholangitis.
6. A 45-year-old patient presents with progressive fatigue, pallor,
and spoon-shaped nails. Laboratory studies reveal microcytic
, hypochromic anemia. The most likely cause is:
A. Iron deficiency anemia
B. Vitamin B12 deficiency
C. Folate deficiency
D. Anemia of chronic disease
A. Iron deficiency anemia
Rationale: Microcytic hypochromic anemia with pallor and spoon nails
strongly suggests iron deficiency.
7. The first-line treatment for Type 2 diabetes mellitus in most adults
is:
A. Insulin
B. Metformin
C. Sulfonylureas
D. GLP-1 agonists
B. Metformin
Rationale: Metformin is the recommended first-line agent due to
efficacy, safety profile, and cardiovascular benefit.
8. In a patient with COPD, which of the following findings is most
consistent with emphysema?
A. Productive cough with purulent sputum
B. Hyperresonance on percussion
C. Wheezing that improves with bronchodilator
D. Cyanosis and fluid overload
B. Hyperresonance on percussion
Rationale: Emphysema leads to air trapping, hyperinflation, and
hyperresonant lung fields on percussion.
9. The hallmark of nephrotic syndrome is:
A. Hematuria
, B. Proteinuria >3.5 g/day
C. Hypertension
D. Reduced creatinine
B. Proteinuria >3.5 g/day
Rationale: Nephrotic syndrome is defined by heavy proteinuria (>3.5
g/day), hypoalbuminemia, hyperlipidemia, and edema.
10. Which type of murmur is described as a crescendo-
decrescendo systolic murmur best heard at the right upper sternal
border?
A. Mitral regurgitation
B. Aortic stenosis
C. Pulmonic stenosis
D. Tricuspid regurgitation
B. Aortic stenosis
Rationale: Aortic stenosis produces a systolic ejection murmur with
crescendo-decrescendo pattern heard best at the right upper sternal
border.
11. The primary treatment for acute gout flare is:
A. Allopurinol
B. Colchicine
C. Febuxostat
D. Probenecid
B. Colchicine
Rationale: Colchicine or NSAIDs are first-line treatments for acute
gout flares; allopurinol is for chronic urate-lowering therapy.
12. A patient presents with fatigue, weight loss, and
palpitations. Laboratory results show suppressed TSH and
elevated free T4. The most likely diagnosis is:
Solved Questions, Answers Rationale Included
2025/2026
1. Which heart sound is commonly heard in patients with heart
failure?
A. S1
B. S2
C. S3
D. S4
C. S3
Rationale: S3, also known as a ventricular gallop, is often associated
with increased left ventricular filling pressures seen in heart failure.
2. The most common cause of community-acquired pneumonia in
adults is:
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae is the leading cause of
community-acquired pneumonia in adults, especially in older adults
and those with comorbidities.
3. A 55-year-old patient presents with sudden vision loss in one eye.
Fundoscopy shows a pale retina with a cherry-red spot at the
macula. The most likely diagnosis is:
A. Central retinal vein occlusion
, B. Central retinal artery occlusion
C. Retinal detachment
D. Macular degeneration
B. Central retinal artery occlusion
Rationale: The classic presentation of sudden, painless monocular
vision loss with a cherry-red spot indicates central retinal artery
occlusion.
4. Which of the following is the most sensitive test for diagnosing
hypothyroidism?
A. Free T4
B. Total T4
C. TSH
D. Total T3
C. TSH
Rationale: TSH is the most sensitive indicator of primary
hypothyroidism, as even minor decreases in thyroid hormone levels
lead to elevated TSH.
5. A patient presents with acute onset of severe right upper
quadrant pain, fever, and jaundice. The most likely diagnosis is:
A. Acute cholecystitis
B. Acute cholangitis
C. Hepatitis A infection
D. Pancreatitis
B. Acute cholangitis
Rationale: Charcot’s triad (fever, right upper quadrant pain, jaundice)
is classic for acute cholangitis.
6. A 45-year-old patient presents with progressive fatigue, pallor,
and spoon-shaped nails. Laboratory studies reveal microcytic
, hypochromic anemia. The most likely cause is:
A. Iron deficiency anemia
B. Vitamin B12 deficiency
C. Folate deficiency
D. Anemia of chronic disease
A. Iron deficiency anemia
Rationale: Microcytic hypochromic anemia with pallor and spoon nails
strongly suggests iron deficiency.
7. The first-line treatment for Type 2 diabetes mellitus in most adults
is:
A. Insulin
B. Metformin
C. Sulfonylureas
D. GLP-1 agonists
B. Metformin
Rationale: Metformin is the recommended first-line agent due to
efficacy, safety profile, and cardiovascular benefit.
8. In a patient with COPD, which of the following findings is most
consistent with emphysema?
A. Productive cough with purulent sputum
B. Hyperresonance on percussion
C. Wheezing that improves with bronchodilator
D. Cyanosis and fluid overload
B. Hyperresonance on percussion
Rationale: Emphysema leads to air trapping, hyperinflation, and
hyperresonant lung fields on percussion.
9. The hallmark of nephrotic syndrome is:
A. Hematuria
, B. Proteinuria >3.5 g/day
C. Hypertension
D. Reduced creatinine
B. Proteinuria >3.5 g/day
Rationale: Nephrotic syndrome is defined by heavy proteinuria (>3.5
g/day), hypoalbuminemia, hyperlipidemia, and edema.
10. Which type of murmur is described as a crescendo-
decrescendo systolic murmur best heard at the right upper sternal
border?
A. Mitral regurgitation
B. Aortic stenosis
C. Pulmonic stenosis
D. Tricuspid regurgitation
B. Aortic stenosis
Rationale: Aortic stenosis produces a systolic ejection murmur with
crescendo-decrescendo pattern heard best at the right upper sternal
border.
11. The primary treatment for acute gout flare is:
A. Allopurinol
B. Colchicine
C. Febuxostat
D. Probenecid
B. Colchicine
Rationale: Colchicine or NSAIDs are first-line treatments for acute
gout flares; allopurinol is for chronic urate-lowering therapy.
12. A patient presents with fatigue, weight loss, and
palpitations. Laboratory results show suppressed TSH and
elevated free T4. The most likely diagnosis is:
