FITZ Exit Exam Latest
Edition Update | Verified
Questions and 100%
Correct Answers | A+
Graded Nurse Practitioner
Board Review
,FITZ Exit Exam Study Guide
2026 Edition | Comprehensive Nurse Practitioner Board
Review
100 Verified Questions and 100% Correct Answers | A+
Graded
PART 1: CARDIOVASCULAR SYSTEM
Question 1
A 58-year-old male with a history of hypertension presents with substernal chest
pressure radiating to his left arm, diaphoresis, and nausea. The pain began 45 minutes
ago while resting. His ECG shows ST-segment elevation in leads V1-V4. What is the most
appropriate immediate intervention?
A) Administer sublingual nitroglycerin and monitor for relief
B) Administer aspirin 324 mg chewed and activate emergency medical services
C) Administer morphine sulfate 4 mg IV push
D) Obtain cardiac enzymes and wait for results before activating cardiology
Answer: B) Administer aspirin 324 mg chewed and activate emergency medical
services
Clinical Pearl: This patient is presenting with an acute ST-elevation myocardial
infarction (STEMI). The immediate priority is antiplatelet therapy with aspirin and
emergent revascularization. "Time is muscle" — door-to-balloon time should be <90
minutes.
Rationale: Aspirin 324 mg chewed provides rapid antiplatelet effect and is the first-line
intervention for suspected acute coronary syndrome. Activating EMS or cath lab is
essential for emergent revascularization. Option A is incorrect because nitroglycerin may
,be given but not before aspirin. Option C is for pain relief but not first priority. Option D
delays critical intervention.
Question 2
A 72-year-old female with a history of heart failure presents with worsening dyspnea,
orthopnea, and 3+ pitting edema in both lower extremities. Her blood pressure is
145/88, heart rate 102, respiratory rate 24. Which medication is most appropriate for
immediate symptom management?
A) Metoprolol succinate 25 mg daily
B) Furosemide 40 mg IV
C) Lisinopril 10 mg daily
D) Digoxin 0.25 mg daily
Answer: B) Furosemide 40 mg IV
Clinical Pearl: In acute decompensated heart failure with fluid overload, IV loop
diuretics are first-line to relieve pulmonary congestion and peripheral edema. Weight-
based dosing (0.5-1 mg/kg) is often used.
Rationale: Furosemide IV provides rapid diuresis, reducing preload and relieving
symptoms of fluid overload. Option A (beta-blocker) is important for chronic
management but not acute. Option C (ACE inhibitor) is for chronic management and
may cause hypotension acutely. Option D (digoxin) is not first-line for acute
decompensated heart failure.
Question 3
A 65-year-old male with hypertension and diabetes presents with a blood pressure of
185/110 in the clinic. He is asymptomatic. What is the most appropriate management?
A) Admit to hospital for IV antihypertensive therapy
B) Prescribe amlodipine 5 mg daily and have patient follow up in 1 week
, C) Prescribe clonidine 0.2 mg PO now and have patient stay in clinic for observation
D) Obtain a stat CT head to rule out intracranial hemorrhage
Answer: B) Prescribe amlodipine 5 mg daily and have patient follow up in 1 week
Clinical Pearl: Hypertensive urgency (asymptomatic severely elevated BP) does not
require acute lowering. Rapid reduction can cause cerebral hypoperfusion. Outpatient
management with oral antihypertensives and follow-up is appropriate.
Rationale: Asymptomatic severely elevated blood pressure (hypertensive urgency) is
managed with oral antihypertensives as an outpatient. Option A is incorrect; inpatient
management is for hypertensive emergency with end-organ damage. Option C is
inappropriate; clonidine is not first-line and can cause rebound hypertension. Option D
is unnecessary without neurologic symptoms.
Question 4
A 55-year-old female presents with complaints of palpitations and lightheadedness. Her
ECG shows a narrow QRS complex tachycardia at 180 bpm with no visible P waves. What
is the most likely rhythm?
A) Atrial fibrillation
B) Atrioventricular nodal reentrant tachycardia (AVNRT)
C) Atrial flutter
D) Ventricular tachycardia
Answer: B) Atrioventricular nodal reentrant tachycardia (AVNRT)
Clinical Pearl: AVNRT is a common supraventricular tachycardia (SVT) characterized by
narrow QRS, rate 150-250 bpm, and often no visible P waves. Vagal maneuvers (Valsalva,
carotid massage) can terminate the rhythm.
Rationale: AVNRT presents with narrow QRS tachycardia, rate typically 150-250 bpm,
and P waves often buried in QRS complex. Option A (atrial fibrillation) would have
irregularly irregular rhythm. Option C (atrial flutter) typically has sawtooth flutter waves.
Option D (ventricular tachycardia) would have wide QRS (>120 ms).
Edition Update | Verified
Questions and 100%
Correct Answers | A+
Graded Nurse Practitioner
Board Review
,FITZ Exit Exam Study Guide
2026 Edition | Comprehensive Nurse Practitioner Board
Review
100 Verified Questions and 100% Correct Answers | A+
Graded
PART 1: CARDIOVASCULAR SYSTEM
Question 1
A 58-year-old male with a history of hypertension presents with substernal chest
pressure radiating to his left arm, diaphoresis, and nausea. The pain began 45 minutes
ago while resting. His ECG shows ST-segment elevation in leads V1-V4. What is the most
appropriate immediate intervention?
A) Administer sublingual nitroglycerin and monitor for relief
B) Administer aspirin 324 mg chewed and activate emergency medical services
C) Administer morphine sulfate 4 mg IV push
D) Obtain cardiac enzymes and wait for results before activating cardiology
Answer: B) Administer aspirin 324 mg chewed and activate emergency medical
services
Clinical Pearl: This patient is presenting with an acute ST-elevation myocardial
infarction (STEMI). The immediate priority is antiplatelet therapy with aspirin and
emergent revascularization. "Time is muscle" — door-to-balloon time should be <90
minutes.
Rationale: Aspirin 324 mg chewed provides rapid antiplatelet effect and is the first-line
intervention for suspected acute coronary syndrome. Activating EMS or cath lab is
essential for emergent revascularization. Option A is incorrect because nitroglycerin may
,be given but not before aspirin. Option C is for pain relief but not first priority. Option D
delays critical intervention.
Question 2
A 72-year-old female with a history of heart failure presents with worsening dyspnea,
orthopnea, and 3+ pitting edema in both lower extremities. Her blood pressure is
145/88, heart rate 102, respiratory rate 24. Which medication is most appropriate for
immediate symptom management?
A) Metoprolol succinate 25 mg daily
B) Furosemide 40 mg IV
C) Lisinopril 10 mg daily
D) Digoxin 0.25 mg daily
Answer: B) Furosemide 40 mg IV
Clinical Pearl: In acute decompensated heart failure with fluid overload, IV loop
diuretics are first-line to relieve pulmonary congestion and peripheral edema. Weight-
based dosing (0.5-1 mg/kg) is often used.
Rationale: Furosemide IV provides rapid diuresis, reducing preload and relieving
symptoms of fluid overload. Option A (beta-blocker) is important for chronic
management but not acute. Option C (ACE inhibitor) is for chronic management and
may cause hypotension acutely. Option D (digoxin) is not first-line for acute
decompensated heart failure.
Question 3
A 65-year-old male with hypertension and diabetes presents with a blood pressure of
185/110 in the clinic. He is asymptomatic. What is the most appropriate management?
A) Admit to hospital for IV antihypertensive therapy
B) Prescribe amlodipine 5 mg daily and have patient follow up in 1 week
, C) Prescribe clonidine 0.2 mg PO now and have patient stay in clinic for observation
D) Obtain a stat CT head to rule out intracranial hemorrhage
Answer: B) Prescribe amlodipine 5 mg daily and have patient follow up in 1 week
Clinical Pearl: Hypertensive urgency (asymptomatic severely elevated BP) does not
require acute lowering. Rapid reduction can cause cerebral hypoperfusion. Outpatient
management with oral antihypertensives and follow-up is appropriate.
Rationale: Asymptomatic severely elevated blood pressure (hypertensive urgency) is
managed with oral antihypertensives as an outpatient. Option A is incorrect; inpatient
management is for hypertensive emergency with end-organ damage. Option C is
inappropriate; clonidine is not first-line and can cause rebound hypertension. Option D
is unnecessary without neurologic symptoms.
Question 4
A 55-year-old female presents with complaints of palpitations and lightheadedness. Her
ECG shows a narrow QRS complex tachycardia at 180 bpm with no visible P waves. What
is the most likely rhythm?
A) Atrial fibrillation
B) Atrioventricular nodal reentrant tachycardia (AVNRT)
C) Atrial flutter
D) Ventricular tachycardia
Answer: B) Atrioventricular nodal reentrant tachycardia (AVNRT)
Clinical Pearl: AVNRT is a common supraventricular tachycardia (SVT) characterized by
narrow QRS, rate 150-250 bpm, and often no visible P waves. Vagal maneuvers (Valsalva,
carotid massage) can terminate the rhythm.
Rationale: AVNRT presents with narrow QRS tachycardia, rate typically 150-250 bpm,
and P waves often buried in QRS complex. Option A (atrial fibrillation) would have
irregularly irregular rhythm. Option C (atrial flutter) typically has sawtooth flutter waves.
Option D (ventricular tachycardia) would have wide QRS (>120 ms).
