CERTIFIED NURSE PRACTITIONER (NP)
EXAM QUESTION AND CORRECT
VERIFIED ANSWER 2026.
1. A 65-year-old woman with a history of hypertension presents with a
blood pressure of 165/95 mm Hg. She is currently taking lisinopril 10 mg
daily. What is the most appropriate next step in her management?
a) Increase lisinopril to 20 mg daily
b) Add hydrochlorothiazide 25 mg daily
c) Start a calcium channel blocker
d) Refer to a cardiologist for further evaluation
Answer: b) Add hydrochlorothiazide 25 mg daily
Rationale: This patient is presenting with uncontrolled hypertension
despite being on a single antihypertensive agent. A thiazide diuretic like
hydrochlorothiazide is commonly added to help achieve blood pressure
control.
2. A 55-year-old male presents with fatigue, weight loss, and muscle
weakness. His thyroid function test reveals elevated TSH and low free T4.
What is the most likely diagnosis?
a) Hypothyroidism
b) Hyperthyroidism
c) Thyroiditis
d) Grave’s disease
Answer: a) Hypothyroidism
Rationale: An elevated TSH with low free T4 is consistent with primary
,hypothyroidism, where the thyroid is not producing enough hormone
despite signals from the pituitary.
3. A 28-year-old pregnant woman is 32 weeks gestation and presents with
headache, visual changes, and swelling in her hands and feet. Her blood
pressure is 160/100 mm Hg. What is the most likely diagnosis?
a) Chronic hypertension
b) Gestational hypertension
c) Preeclampsia
d) Eclampsia
Answer: c) Preeclampsia
Rationale: The patient’s symptoms of elevated blood pressure, edema, and
visual disturbances at 32 weeks suggest preeclampsia, a condition that can
occur after 20 weeks of pregnancy.
4. A 40-year-old woman presents with joint pain, a butterfly-shaped rash,
and a history of photosensitivity. What is the most likely diagnosis?
a) Rheumatoid arthritis
b) Systemic lupus erythematosus (SLE)
c) Osteoarthritis
d) Psoriatic arthritis
Answer: b) Systemic lupus erythematosus (SLE)
Rationale: The classic presentation of SLE includes a butterfly-shaped rash,
photosensitivity, and joint pain, all of which are present in this case.
5. A 50-year-old male with a history of type 2 diabetes presents with a
wound on his foot that has not healed despite appropriate care. What is
the most appropriate intervention?
,a) Start oral antibiotics
b) Refer to a podiatrist
c) Perform a wound culture
d) Refer to an endocrinologist
Answer: b) Refer to a podiatrist
Rationale: Diabetic foot wounds require specialized care to prevent
complications, and a podiatrist is best equipped to manage such wounds.
6. A 23-year-old female presents with abdominal pain, nausea, and
irregular periods. A pelvic ultrasound shows an adnexal mass. What is the
next step in management?
a) Start oral contraceptives
b) Obtain a pregnancy test
c) Refer for laparoscopy
d) Begin antibiotics
Answer: b) Obtain a pregnancy test
Rationale: Given the risk of an ectopic pregnancy, it’s critical to rule this
out first, especially in a woman of reproductive age with an adnexal mass.
7. A 72-year-old woman presents with memory loss, difficulty managing
daily activities, and confusion. Her symptoms have worsened over the past
6 months. What is the most likely diagnosis?
a) Depression
b) Alzheimer's disease
c) Vascular dementia
d) Normal aging
Answer: b) Alzheimer's disease
Rationale: The gradual onset and progression of cognitive decline,
, particularly with memory loss and difficulty with daily activities, is
characteristic of Alzheimer’s disease.
8. A 60-year-old male smoker presents with a persistent cough, weight
loss, and hemoptysis. A chest X-ray shows a mass in the upper lobe of the
right lung. What is the next step in management?
a) Start antibiotics
b) Refer to a pulmonologist for biopsy
c) Order a CT scan of the chest
d) Schedule a follow-up in 3 months
Answer: c) Order a CT scan of the chest
Rationale: A CT scan provides more detailed imaging than a chest X-ray
and is essential in evaluating a suspicious mass for malignancy.
9. A 25-year-old woman presents with a painful, swollen right knee after a
recent skiing injury. The knee is tender to touch and there is limited range
of motion. What is the most likely diagnosis?
a) Patellar tendinitis
b) Meniscal tear
c) Ligament sprain
d) Osteoarthritis
Answer: b) Meniscal tear
Rationale: A meniscal tear commonly presents with pain, swelling, and
limited range of motion, especially after a traumatic event such as an
injury.
10. A 47-year-old woman presents with hot flashes, night sweats, and
irregular periods. What is the most likely diagnosis?
EXAM QUESTION AND CORRECT
VERIFIED ANSWER 2026.
1. A 65-year-old woman with a history of hypertension presents with a
blood pressure of 165/95 mm Hg. She is currently taking lisinopril 10 mg
daily. What is the most appropriate next step in her management?
a) Increase lisinopril to 20 mg daily
b) Add hydrochlorothiazide 25 mg daily
c) Start a calcium channel blocker
d) Refer to a cardiologist for further evaluation
Answer: b) Add hydrochlorothiazide 25 mg daily
Rationale: This patient is presenting with uncontrolled hypertension
despite being on a single antihypertensive agent. A thiazide diuretic like
hydrochlorothiazide is commonly added to help achieve blood pressure
control.
2. A 55-year-old male presents with fatigue, weight loss, and muscle
weakness. His thyroid function test reveals elevated TSH and low free T4.
What is the most likely diagnosis?
a) Hypothyroidism
b) Hyperthyroidism
c) Thyroiditis
d) Grave’s disease
Answer: a) Hypothyroidism
Rationale: An elevated TSH with low free T4 is consistent with primary
,hypothyroidism, where the thyroid is not producing enough hormone
despite signals from the pituitary.
3. A 28-year-old pregnant woman is 32 weeks gestation and presents with
headache, visual changes, and swelling in her hands and feet. Her blood
pressure is 160/100 mm Hg. What is the most likely diagnosis?
a) Chronic hypertension
b) Gestational hypertension
c) Preeclampsia
d) Eclampsia
Answer: c) Preeclampsia
Rationale: The patient’s symptoms of elevated blood pressure, edema, and
visual disturbances at 32 weeks suggest preeclampsia, a condition that can
occur after 20 weeks of pregnancy.
4. A 40-year-old woman presents with joint pain, a butterfly-shaped rash,
and a history of photosensitivity. What is the most likely diagnosis?
a) Rheumatoid arthritis
b) Systemic lupus erythematosus (SLE)
c) Osteoarthritis
d) Psoriatic arthritis
Answer: b) Systemic lupus erythematosus (SLE)
Rationale: The classic presentation of SLE includes a butterfly-shaped rash,
photosensitivity, and joint pain, all of which are present in this case.
5. A 50-year-old male with a history of type 2 diabetes presents with a
wound on his foot that has not healed despite appropriate care. What is
the most appropriate intervention?
,a) Start oral antibiotics
b) Refer to a podiatrist
c) Perform a wound culture
d) Refer to an endocrinologist
Answer: b) Refer to a podiatrist
Rationale: Diabetic foot wounds require specialized care to prevent
complications, and a podiatrist is best equipped to manage such wounds.
6. A 23-year-old female presents with abdominal pain, nausea, and
irregular periods. A pelvic ultrasound shows an adnexal mass. What is the
next step in management?
a) Start oral contraceptives
b) Obtain a pregnancy test
c) Refer for laparoscopy
d) Begin antibiotics
Answer: b) Obtain a pregnancy test
Rationale: Given the risk of an ectopic pregnancy, it’s critical to rule this
out first, especially in a woman of reproductive age with an adnexal mass.
7. A 72-year-old woman presents with memory loss, difficulty managing
daily activities, and confusion. Her symptoms have worsened over the past
6 months. What is the most likely diagnosis?
a) Depression
b) Alzheimer's disease
c) Vascular dementia
d) Normal aging
Answer: b) Alzheimer's disease
Rationale: The gradual onset and progression of cognitive decline,
, particularly with memory loss and difficulty with daily activities, is
characteristic of Alzheimer’s disease.
8. A 60-year-old male smoker presents with a persistent cough, weight
loss, and hemoptysis. A chest X-ray shows a mass in the upper lobe of the
right lung. What is the next step in management?
a) Start antibiotics
b) Refer to a pulmonologist for biopsy
c) Order a CT scan of the chest
d) Schedule a follow-up in 3 months
Answer: c) Order a CT scan of the chest
Rationale: A CT scan provides more detailed imaging than a chest X-ray
and is essential in evaluating a suspicious mass for malignancy.
9. A 25-year-old woman presents with a painful, swollen right knee after a
recent skiing injury. The knee is tender to touch and there is limited range
of motion. What is the most likely diagnosis?
a) Patellar tendinitis
b) Meniscal tear
c) Ligament sprain
d) Osteoarthritis
Answer: b) Meniscal tear
Rationale: A meniscal tear commonly presents with pain, swelling, and
limited range of motion, especially after a traumatic event such as an
injury.
10. A 47-year-old woman presents with hot flashes, night sweats, and
irregular periods. What is the most likely diagnosis?
