SARAH MICHELLE AANP/NP TEST BANK 2026/2027 |
All Possible Q&A with Rationales | Expert Verified |
Guaranteed Pass | Pass Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (40 Questions)
Q1: A 58-year-old male with HTN presents with BP 168/104 mmHg on three occasions.
He has no history of CVD, diabetes, or CKD. His PREVENT 10-year CVD risk is 6.2%.
According to the 2025 ACC/AHA guideline, what is the recommended management?
A. Lifestyle modification only for 3-6 months
B. Start single antihypertensive agent immediately
C. Start two-drug combination therapy immediately
D. Recheck BP in 1 year
C. Start two-drug combination therapy immediately [CORRECT]
Correct Answer: C
Rationale: The 2025 ACC/AHA guideline recommends pharmacologic treatment for
stage 2 hypertension (≥140/90) regardless of CVD risk. For stage 2 HTN, initiation with
two agents from complementary classes (preferably in a single-pill combination) is
recommended to achieve the <130/80 mmHg target. Lifestyle modification alone is
insufficient for stage 2 HTN. EXPERT VERIFIED.
Q2: A 67-year-old female with resistant hypertension (on ACE-I, CCB, thiazide) has a
basic metabolic panel showing K+ 3.2 mEq/L. What is the next best step in
management?
,A. Increase thiazide dose
B. Screen for primary aldosteronism regardless of hypokalemia
C. Add a beta-blocker
D. Order renal artery ultrasound
B. Screen for primary aldosteronism regardless of hypokalemia [CORRECT]
Correct Answer: B
Rationale: The 2025 ACC/AHA guideline recommends screening for primary
aldosteronism in all adults with resistant hypertension, regardless of potassium status,
to increase detection and enable targeted therapy. Continue most antihypertensives
(except MRA) prior to screening. Hypokalemia is not required for screening. EXPERT
VERIFIED.
Q3: A 72-year-old male with HFrEF (EF 30%) reports increasing dyspnea and weight gain
of 6 lbs in 3 days. Exam reveals JVD, bilateral crackles, and 2+ pitting edema. He is on
lisinopril, metoprolol succinate, and furosemide. What is the priority intervention?
A. Increase metoprolol dose
B. Increase furosemide dose and monitor daily weights
C. Switch lisinopril to losartan
D. Add digoxin
B. Increase furosemide dose and monitor daily weights [CORRECT]
Correct Answer: B
Rationale: Acute decompensated HF requires diuretic optimization first. Loop diuretics
remain first-line for volume overload in HFrEF. Guideline-directed medical therapy
(GDMT) including ACE-I and beta-blocker should be continued, but diuretic adjustment
,addresses the acute fluid retention. Daily weight monitoring is essential for assessing
response. EXPERT VERIFIED.
Q4: A 55-year-old male with stable CAD on atorvastatin 40 mg has LDL 110 mg/dL.
According to current guidelines, what is the recommended target?
A. LDL <130 mg/dL
B. LDL <100 mg/dL
C. LDL <70 mg/dL for very high risk
D. Increase to high-intensity statin aiming for ≥50% reduction
D. Increase to high-intensity statin aiming for ≥50% reduction [CORRECT]
Correct Answer: D
Rationale: For stable CAD (clinical ASCVD), high-intensity statin therapy is indicated to
achieve ≥50% LDL reduction. If LDL remains ≥70 mg/dL on maximally tolerated statin,
add ezetimibe; consider PCSK9 inhibitor if still above target. The goal is percent
reduction, not a specific absolute number for statin titration decisions. EXPERT
VERIFIED.
Q5: A 45-year-old female presents with sudden onset tearing chest pain radiating to the
back. BP is 190/110 mmHg in the right arm and 150/90 mmHg in the left arm. What is
the priority diagnostic test?
A. CT chest with contrast
B. Transthoracic echocardiogram
C. Cardiac catheterization
D. D-dimer
A. CT chest with contrast [CORRECT]
Correct Answer: A
, Rationale: Acute aortic dissection presents with tearing chest pain, blood pressure
differential between arms (>20 mmHg suggests involvement), and severe hypertension.
CT angiography with contrast is the gold standard for diagnosis. Immediate surgical
consultation is required for ascending aortic involvement (Stanford A). EXPERT
VERIFIED.
Q6: A 62-year-old male with AFib on warfarin (INR 2.5) presents with melena and Hgb
8.2 g/dL. What is the immediate priority?
A. Stop warfarin, give IV vitamin K and PCC
B. Stop warfarin, give oral vitamin K
C. Continue warfarin and transfuse PRBCs
D. Stop warfarin and give fresh frozen plasma only
A. Stop warfarin, give IV vitamin K and PCC [CORRECT]
Correct Answer: A
Rationale: Major bleeding on warfarin requires immediate reversal with 4-factor
prothrombin complex concentrate (PCC) plus IV vitamin K 10 mg. PCC provides rapid
INR reversal within 1 hour. FFP alone is insufficient and slower. Hold warfarin and
transfuse PRBCs as needed for hemodynamic instability. EXPERT VERIFIED.
Q7: A 50-year-old female with new-onset AFib (HR 140 bpm, BP 110/70) is
hemodynamically stable. What is the first-line pharmacologic rate control strategy?
A. Metoprolol or diltiazem
B. Digoxin
C. Amiodarone
D. Adenosine
A. Metoprolol or diltiazem [CORRECT]
All Possible Q&A with Rationales | Expert Verified |
Guaranteed Pass | Pass Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (40 Questions)
Q1: A 58-year-old male with HTN presents with BP 168/104 mmHg on three occasions.
He has no history of CVD, diabetes, or CKD. His PREVENT 10-year CVD risk is 6.2%.
According to the 2025 ACC/AHA guideline, what is the recommended management?
A. Lifestyle modification only for 3-6 months
B. Start single antihypertensive agent immediately
C. Start two-drug combination therapy immediately
D. Recheck BP in 1 year
C. Start two-drug combination therapy immediately [CORRECT]
Correct Answer: C
Rationale: The 2025 ACC/AHA guideline recommends pharmacologic treatment for
stage 2 hypertension (≥140/90) regardless of CVD risk. For stage 2 HTN, initiation with
two agents from complementary classes (preferably in a single-pill combination) is
recommended to achieve the <130/80 mmHg target. Lifestyle modification alone is
insufficient for stage 2 HTN. EXPERT VERIFIED.
Q2: A 67-year-old female with resistant hypertension (on ACE-I, CCB, thiazide) has a
basic metabolic panel showing K+ 3.2 mEq/L. What is the next best step in
management?
,A. Increase thiazide dose
B. Screen for primary aldosteronism regardless of hypokalemia
C. Add a beta-blocker
D. Order renal artery ultrasound
B. Screen for primary aldosteronism regardless of hypokalemia [CORRECT]
Correct Answer: B
Rationale: The 2025 ACC/AHA guideline recommends screening for primary
aldosteronism in all adults with resistant hypertension, regardless of potassium status,
to increase detection and enable targeted therapy. Continue most antihypertensives
(except MRA) prior to screening. Hypokalemia is not required for screening. EXPERT
VERIFIED.
Q3: A 72-year-old male with HFrEF (EF 30%) reports increasing dyspnea and weight gain
of 6 lbs in 3 days. Exam reveals JVD, bilateral crackles, and 2+ pitting edema. He is on
lisinopril, metoprolol succinate, and furosemide. What is the priority intervention?
A. Increase metoprolol dose
B. Increase furosemide dose and monitor daily weights
C. Switch lisinopril to losartan
D. Add digoxin
B. Increase furosemide dose and monitor daily weights [CORRECT]
Correct Answer: B
Rationale: Acute decompensated HF requires diuretic optimization first. Loop diuretics
remain first-line for volume overload in HFrEF. Guideline-directed medical therapy
(GDMT) including ACE-I and beta-blocker should be continued, but diuretic adjustment
,addresses the acute fluid retention. Daily weight monitoring is essential for assessing
response. EXPERT VERIFIED.
Q4: A 55-year-old male with stable CAD on atorvastatin 40 mg has LDL 110 mg/dL.
According to current guidelines, what is the recommended target?
A. LDL <130 mg/dL
B. LDL <100 mg/dL
C. LDL <70 mg/dL for very high risk
D. Increase to high-intensity statin aiming for ≥50% reduction
D. Increase to high-intensity statin aiming for ≥50% reduction [CORRECT]
Correct Answer: D
Rationale: For stable CAD (clinical ASCVD), high-intensity statin therapy is indicated to
achieve ≥50% LDL reduction. If LDL remains ≥70 mg/dL on maximally tolerated statin,
add ezetimibe; consider PCSK9 inhibitor if still above target. The goal is percent
reduction, not a specific absolute number for statin titration decisions. EXPERT
VERIFIED.
Q5: A 45-year-old female presents with sudden onset tearing chest pain radiating to the
back. BP is 190/110 mmHg in the right arm and 150/90 mmHg in the left arm. What is
the priority diagnostic test?
A. CT chest with contrast
B. Transthoracic echocardiogram
C. Cardiac catheterization
D. D-dimer
A. CT chest with contrast [CORRECT]
Correct Answer: A
, Rationale: Acute aortic dissection presents with tearing chest pain, blood pressure
differential between arms (>20 mmHg suggests involvement), and severe hypertension.
CT angiography with contrast is the gold standard for diagnosis. Immediate surgical
consultation is required for ascending aortic involvement (Stanford A). EXPERT
VERIFIED.
Q6: A 62-year-old male with AFib on warfarin (INR 2.5) presents with melena and Hgb
8.2 g/dL. What is the immediate priority?
A. Stop warfarin, give IV vitamin K and PCC
B. Stop warfarin, give oral vitamin K
C. Continue warfarin and transfuse PRBCs
D. Stop warfarin and give fresh frozen plasma only
A. Stop warfarin, give IV vitamin K and PCC [CORRECT]
Correct Answer: A
Rationale: Major bleeding on warfarin requires immediate reversal with 4-factor
prothrombin complex concentrate (PCC) plus IV vitamin K 10 mg. PCC provides rapid
INR reversal within 1 hour. FFP alone is insufficient and slower. Hold warfarin and
transfuse PRBCs as needed for hemodynamic instability. EXPERT VERIFIED.
Q7: A 50-year-old female with new-onset AFib (HR 140 bpm, BP 110/70) is
hemodynamically stable. What is the first-line pharmacologic rate control strategy?
A. Metoprolol or diltiazem
B. Digoxin
C. Amiodarone
D. Adenosine
A. Metoprolol or diltiazem [CORRECT]
