,FITZ Exit Exam (PDF) | (2026/2027) Nurse
Practitioner Q&A | Fitzgerald
1. A 55-year-old patient with hypertension is started on hydrochlorothiazide.
Which electrolyte imbalance should the NP monitor most closely?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Thiazide diuretics promote potassium excretion, leading to
hypokalemia. Potassium levels should be checked at baseline and periodically.
Hyperkalemia is more typical of potassium-sparing diuretics or ACE inhibitors.
Hyponatremia can occur but hypokalemia is the classic electrolyte disturbance.
2. The NP is reviewing the medication profile of a patient with atrial fibrillation
who is taking warfarin. Which lab is used to monitor therapeutic effect?
A) INR
B) aPTT
C) Platelet count
D) D-dimer
Correct Answer: INR
,Rationale: Warfarin inhibits vitamin K–dependent clotting factors. The INR
standardizes prothrombin time to monitor anticoagulation intensity. aPTT is
used for unfractionated heparin. Platelet count does not reflect warfarin effect.
3. For a patient with chronic heart failure taking digoxin, which symptom should
prompt the NP to assess for toxicity?
A) Polyuria
B) Tinnitus
C) Yellow-green halos around lights
D) Muscle cramps
Correct Answer: Yellow-green halos around lights
Rationale: Digoxin toxicity commonly presents with gastrointestinal symptoms
and visual disturbances such as yellow-green halos. Tinnitus is more typical of
salicylate toxicity. Muscle cramps and polyuria are not classic digoxin toxicity
signs.
4. According to ethical principles in nursing, beneficence is best defined as the
obligation to:
A) Respect patient autonomy
B) Remain truthful
C) Do no harm
D) Help people in need
Correct Answer: Help people in need
, Rationale: Beneficence requires acting in the best interest of the patient by
promoting well-being. Veracity is truthfulness; non-maleficence is “do no
harm”; autonomy is respecting the patient’s right to make decisions.
5. A client newly diagnosed with terminal cancer states, “I don’t want any life-
prolonging measures.” Which action should the NP take first?
A) Discuss the patient’s understanding of advance directives and document
wishes
B) Immediately place a DNR order in the chart
C) Notify the hospital ethics committee
D) Refer to hospice
Correct Answer: Discuss the patient’s understanding of advance directives and
document wishes
Rationale: The first step is to explore the patient’s existing advance directive or
initiate a goals-of-care conversation. The NP cannot place a DNR order
independently; the provider must write it. Ethics committee consultation is not
the immediate priority.
6. The charge nurse is making assignments on a medical-surgical unit. Which
patient should be assigned to an RN rather than an LPN?
A) A patient with stable diabetes mellitus requiring scheduled insulin
B) A patient with new-onset chest pain and possible myocardial infarction
C) A patient with a stage 2 pressure injury needing a dressing change
D) A patient receiving oral antibiotics for a urinary tract infection
Practitioner Q&A | Fitzgerald
1. A 55-year-old patient with hypertension is started on hydrochlorothiazide.
Which electrolyte imbalance should the NP monitor most closely?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Thiazide diuretics promote potassium excretion, leading to
hypokalemia. Potassium levels should be checked at baseline and periodically.
Hyperkalemia is more typical of potassium-sparing diuretics or ACE inhibitors.
Hyponatremia can occur but hypokalemia is the classic electrolyte disturbance.
2. The NP is reviewing the medication profile of a patient with atrial fibrillation
who is taking warfarin. Which lab is used to monitor therapeutic effect?
A) INR
B) aPTT
C) Platelet count
D) D-dimer
Correct Answer: INR
,Rationale: Warfarin inhibits vitamin K–dependent clotting factors. The INR
standardizes prothrombin time to monitor anticoagulation intensity. aPTT is
used for unfractionated heparin. Platelet count does not reflect warfarin effect.
3. For a patient with chronic heart failure taking digoxin, which symptom should
prompt the NP to assess for toxicity?
A) Polyuria
B) Tinnitus
C) Yellow-green halos around lights
D) Muscle cramps
Correct Answer: Yellow-green halos around lights
Rationale: Digoxin toxicity commonly presents with gastrointestinal symptoms
and visual disturbances such as yellow-green halos. Tinnitus is more typical of
salicylate toxicity. Muscle cramps and polyuria are not classic digoxin toxicity
signs.
4. According to ethical principles in nursing, beneficence is best defined as the
obligation to:
A) Respect patient autonomy
B) Remain truthful
C) Do no harm
D) Help people in need
Correct Answer: Help people in need
, Rationale: Beneficence requires acting in the best interest of the patient by
promoting well-being. Veracity is truthfulness; non-maleficence is “do no
harm”; autonomy is respecting the patient’s right to make decisions.
5. A client newly diagnosed with terminal cancer states, “I don’t want any life-
prolonging measures.” Which action should the NP take first?
A) Discuss the patient’s understanding of advance directives and document
wishes
B) Immediately place a DNR order in the chart
C) Notify the hospital ethics committee
D) Refer to hospice
Correct Answer: Discuss the patient’s understanding of advance directives and
document wishes
Rationale: The first step is to explore the patient’s existing advance directive or
initiate a goals-of-care conversation. The NP cannot place a DNR order
independently; the provider must write it. Ethics committee consultation is not
the immediate priority.
6. The charge nurse is making assignments on a medical-surgical unit. Which
patient should be assigned to an RN rather than an LPN?
A) A patient with stable diabetes mellitus requiring scheduled insulin
B) A patient with new-onset chest pain and possible myocardial infarction
C) A patient with a stage 2 pressure injury needing a dressing change
D) A patient receiving oral antibiotics for a urinary tract infection
