Maryland Nurse Practitioner (NP) Exam
With Actual Questions & Correct Answers,
Plus Rationales/Expert Verified For
Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
1. A 65-year-old patient with hypertension is prescribed lisinopril.
Which laboratory value should the NP monitor closely?
A. Hemoglobin
B. Potassium
C. Platelet count
D. Sodium
Answer: B. Potassium
Rationale: ACE inhibitors like lisinopril can cause hyperkalemia due to
reduced aldosterone secretion.
2. A patient presents with chest pain radiating to the left arm. What
is the NP’s first action?
A. Administer aspirin
B. Order chest X-ray
C. Obtain ECG
D. Give nitroglycerin
Answer: C. Obtain ECG
Rationale: Immediate ECG is priority to assess for acute myocardial
infarction.
, 3. Which condition is a contraindication for metformin use?
A. Hypertension
B. Chronic kidney disease
C. Hyperlipidemia
D. Asthma
Answer: B. Chronic kidney disease
Rationale: Metformin is contraindicated in significant renal
impairment due to lactic acidosis risk.
4. A patient taking warfarin has an INR of 6. What is the appropriate
action?
A. Increase dose
B. Hold medication
C. Give vitamin K
D. Continue same dose
Answer: B. Hold medication
Rationale: An INR of 6 indicates high bleeding risk; warfarin should be
held and reassessed.
5. Which symptom is most suggestive of hypothyroidism?
A. Weight loss
B. Heat intolerance
C. Bradycardia
D. Tachycardia
Answer: C. Bradycardia
Rationale: Hypothyroidism slows metabolism leading to bradycardia.
, 6. A patient with asthma is prescribed albuterol. What is its
mechanism of action?
A. Steroid anti-inflammatory
B. Beta-2 agonist bronchodilation
C. Anticholinergic effect
D. Leukotriene inhibition
Answer: B. Beta-2 agonist bronchodilation
Rationale: Albuterol relaxes bronchial smooth muscle via beta-2
receptor stimulation.
7. Which lab value indicates diabetes mellitus diagnosis?
A. Fasting glucose 90 mg/dL
B. A1C 5.0%
C. Fasting glucose 130 mg/dL
D. Random glucose 90 mg/dL
Answer: C. Fasting glucose 130 mg/dL
Rationale: Fasting glucose ≥126 mg/dL confirms diabetes.
8. A patient has signs of stroke. What is the priority intervention?
A. CT scan without contrast
B. MRI in 24 hours
C. Start anticoagulants
D. Lower blood pressure immediately
Answer: A. CT scan without contrast
Rationale: CT is first-line to differentiate ischemic vs hemorrhagic
stroke.
With Actual Questions & Correct Answers,
Plus Rationales/Expert Verified For
Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
1. A 65-year-old patient with hypertension is prescribed lisinopril.
Which laboratory value should the NP monitor closely?
A. Hemoglobin
B. Potassium
C. Platelet count
D. Sodium
Answer: B. Potassium
Rationale: ACE inhibitors like lisinopril can cause hyperkalemia due to
reduced aldosterone secretion.
2. A patient presents with chest pain radiating to the left arm. What
is the NP’s first action?
A. Administer aspirin
B. Order chest X-ray
C. Obtain ECG
D. Give nitroglycerin
Answer: C. Obtain ECG
Rationale: Immediate ECG is priority to assess for acute myocardial
infarction.
, 3. Which condition is a contraindication for metformin use?
A. Hypertension
B. Chronic kidney disease
C. Hyperlipidemia
D. Asthma
Answer: B. Chronic kidney disease
Rationale: Metformin is contraindicated in significant renal
impairment due to lactic acidosis risk.
4. A patient taking warfarin has an INR of 6. What is the appropriate
action?
A. Increase dose
B. Hold medication
C. Give vitamin K
D. Continue same dose
Answer: B. Hold medication
Rationale: An INR of 6 indicates high bleeding risk; warfarin should be
held and reassessed.
5. Which symptom is most suggestive of hypothyroidism?
A. Weight loss
B. Heat intolerance
C. Bradycardia
D. Tachycardia
Answer: C. Bradycardia
Rationale: Hypothyroidism slows metabolism leading to bradycardia.
, 6. A patient with asthma is prescribed albuterol. What is its
mechanism of action?
A. Steroid anti-inflammatory
B. Beta-2 agonist bronchodilation
C. Anticholinergic effect
D. Leukotriene inhibition
Answer: B. Beta-2 agonist bronchodilation
Rationale: Albuterol relaxes bronchial smooth muscle via beta-2
receptor stimulation.
7. Which lab value indicates diabetes mellitus diagnosis?
A. Fasting glucose 90 mg/dL
B. A1C 5.0%
C. Fasting glucose 130 mg/dL
D. Random glucose 90 mg/dL
Answer: C. Fasting glucose 130 mg/dL
Rationale: Fasting glucose ≥126 mg/dL confirms diabetes.
8. A patient has signs of stroke. What is the priority intervention?
A. CT scan without contrast
B. MRI in 24 hours
C. Start anticoagulants
D. Lower blood pressure immediately
Answer: A. CT scan without contrast
Rationale: CT is first-line to differentiate ischemic vs hemorrhagic
stroke.
