FITZ EXIT EXAM VERIFIED QUESTIONS AND 100%
CORRECT ANSWERS | A+ GRADED NURSE
PRACTITIONER BOARD REVIEW
Question 1 A 55-year-old male presents with chest pain, diaphoresis,
and nausea. ECG shows ST elevation in leads II, III, and aVF. What is the
most likely diagnosis?
A) Pericarditis
B) Pulmonary embolism
C) Acute myocardial infarction
D) Aortic dissection
Correct Answer: C) Acute myocardial infarction
Rationale: ST elevation in inferior leads (II, III, aVF) with chest pain,
diaphoresis, and nausea indicates acute myocardial infarction, likely
involving the right coronary artery. Pericarditis shows diffuse ST
elevation. Pulmonary embolism lacks ST elevation. Aortic dissection
presents with tearing pain and unequal pulses.
Question 2 A 60-year-old female with hypertension is prescribed
hydrochlorothiazide. Which electrolyte abnormality should be
monitored?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
,Correct Answer: B) Hypokalemia
Rationale: Hydrochlorothiazide, a thiazide diuretic, promotes potassium
excretion, leading to hypokalemia. Hyperkalemia is associated with ACE
inhibitors. Hypernatremia and hypocalcemia are not typical.
Question 3 A 45-year-old female with a BMI of 32 asks about type 2
diabetes prevention. What is the most effective strategy?
A) Annual HbA1c screening
B) Weight loss and physical activity
C) Low-fat diet alone
D) Metformin initiation
Correct Answer: B) Weight loss and physical activity
Rationale: Weight loss and physical activity are the most effective
lifestyle interventions for preventing type 2 diabetes in high-risk
individuals, per ADA guidelines. Screening detects but does not prevent.
Low-fat diet is less effective alone. Metformin is for prediabetes in
select cases.
Question 4 A 50-year-old male with COPD presents with increased
dyspnea. Spirometry shows FEV1 45% predicted. What is the most
appropriate treatment?
A) Albuterol alone
B) Tiotropium and inhaled corticosteroid
C) Oral prednisone
D) Azithromycin daily
Correct Answer: B) Tiotropium and inhaled corticosteroid
Rationale: For moderate COPD (FEV1 <50%), GOLD guidelines
recommend a long-acting muscarinic antagonist (tiotropium) with an
,inhaled corticosteroid for symptom control. Albuterol is for rescue.
Prednisone is for exacerbations. Azithromycin is for frequent
exacerbations.
Question 5 A 65-year-old female with osteoporosis is prescribed
alendronate. What is the most critical teaching point?
A) Take with food
B) Remain upright for 30 minutes after taking
C) Take at bedtime
D) Crush the tablet if needed
Correct Answer: B) Remain upright for 30 minutes after taking
Rationale: Alendronate can cause esophageal irritation; remaining
upright for 30 minutes prevents reflux. It is taken on an empty stomach,
not at bedtime, and should not be crushed.
Question 6 A 30-year-old female presents with fatigue, weight gain, and
constipation. TSH is 6.2 mIU/L, free T4 is low. What is the most
appropriate action?
A) Order thyroid ultrasound
B) Initiate levothyroxine
C) Monitor TSH in 6 months
D) Start methimazole
Correct Answer: B) Initiate levothyroxine
Rationale: Elevated TSH and low free T4 indicate primary
hypothyroidism, treated with levothyroxine. Ultrasound is for nodules.
Monitoring delays treatment. Methimazole is for hyperthyroidism.
Question 7 A 40-year-old male presents with right lower quadrant pain,
fever, and nausea. What is the most appropriate initial diagnostic test?
, A) Abdominal ultrasound
B) CT scan of abdomen
C) Colonoscopy
D) Barium enema
Correct Answer: B) CT scan of abdomen
Rationale: CT scan is the gold standard for diagnosing appendicitis,
indicated by right lower quadrant pain, fever, and nausea. Ultrasound is
less sensitive. Colonoscopy and barium enema are not indicated for
acute appendicitis.
Question 8 A 55-year-old male with type 2 diabetes is prescribed
metformin. Which laboratory should be monitored regularly?
A) Serum creatinine
B) Liver enzymes
C) Serum potassium
D) Hemoglobin
Correct Answer: A) Serum creatinine
Rationale: Metformin requires renal function monitoring (serum
creatinine) due to the risk of lactic acidosis in renal impairment. Liver
enzymes, potassium, and hemoglobin are not primarily affected.
Question 9 A 50-year-old female asks about breast cancer screening.
What is the recommended screening frequency for mammography?
A) Annually
B) Every 2 years
C) Every 5 years
D) No screening needed
CORRECT ANSWERS | A+ GRADED NURSE
PRACTITIONER BOARD REVIEW
Question 1 A 55-year-old male presents with chest pain, diaphoresis,
and nausea. ECG shows ST elevation in leads II, III, and aVF. What is the
most likely diagnosis?
A) Pericarditis
B) Pulmonary embolism
C) Acute myocardial infarction
D) Aortic dissection
Correct Answer: C) Acute myocardial infarction
Rationale: ST elevation in inferior leads (II, III, aVF) with chest pain,
diaphoresis, and nausea indicates acute myocardial infarction, likely
involving the right coronary artery. Pericarditis shows diffuse ST
elevation. Pulmonary embolism lacks ST elevation. Aortic dissection
presents with tearing pain and unequal pulses.
Question 2 A 60-year-old female with hypertension is prescribed
hydrochlorothiazide. Which electrolyte abnormality should be
monitored?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
,Correct Answer: B) Hypokalemia
Rationale: Hydrochlorothiazide, a thiazide diuretic, promotes potassium
excretion, leading to hypokalemia. Hyperkalemia is associated with ACE
inhibitors. Hypernatremia and hypocalcemia are not typical.
Question 3 A 45-year-old female with a BMI of 32 asks about type 2
diabetes prevention. What is the most effective strategy?
A) Annual HbA1c screening
B) Weight loss and physical activity
C) Low-fat diet alone
D) Metformin initiation
Correct Answer: B) Weight loss and physical activity
Rationale: Weight loss and physical activity are the most effective
lifestyle interventions for preventing type 2 diabetes in high-risk
individuals, per ADA guidelines. Screening detects but does not prevent.
Low-fat diet is less effective alone. Metformin is for prediabetes in
select cases.
Question 4 A 50-year-old male with COPD presents with increased
dyspnea. Spirometry shows FEV1 45% predicted. What is the most
appropriate treatment?
A) Albuterol alone
B) Tiotropium and inhaled corticosteroid
C) Oral prednisone
D) Azithromycin daily
Correct Answer: B) Tiotropium and inhaled corticosteroid
Rationale: For moderate COPD (FEV1 <50%), GOLD guidelines
recommend a long-acting muscarinic antagonist (tiotropium) with an
,inhaled corticosteroid for symptom control. Albuterol is for rescue.
Prednisone is for exacerbations. Azithromycin is for frequent
exacerbations.
Question 5 A 65-year-old female with osteoporosis is prescribed
alendronate. What is the most critical teaching point?
A) Take with food
B) Remain upright for 30 minutes after taking
C) Take at bedtime
D) Crush the tablet if needed
Correct Answer: B) Remain upright for 30 minutes after taking
Rationale: Alendronate can cause esophageal irritation; remaining
upright for 30 minutes prevents reflux. It is taken on an empty stomach,
not at bedtime, and should not be crushed.
Question 6 A 30-year-old female presents with fatigue, weight gain, and
constipation. TSH is 6.2 mIU/L, free T4 is low. What is the most
appropriate action?
A) Order thyroid ultrasound
B) Initiate levothyroxine
C) Monitor TSH in 6 months
D) Start methimazole
Correct Answer: B) Initiate levothyroxine
Rationale: Elevated TSH and low free T4 indicate primary
hypothyroidism, treated with levothyroxine. Ultrasound is for nodules.
Monitoring delays treatment. Methimazole is for hyperthyroidism.
Question 7 A 40-year-old male presents with right lower quadrant pain,
fever, and nausea. What is the most appropriate initial diagnostic test?
, A) Abdominal ultrasound
B) CT scan of abdomen
C) Colonoscopy
D) Barium enema
Correct Answer: B) CT scan of abdomen
Rationale: CT scan is the gold standard for diagnosing appendicitis,
indicated by right lower quadrant pain, fever, and nausea. Ultrasound is
less sensitive. Colonoscopy and barium enema are not indicated for
acute appendicitis.
Question 8 A 55-year-old male with type 2 diabetes is prescribed
metformin. Which laboratory should be monitored regularly?
A) Serum creatinine
B) Liver enzymes
C) Serum potassium
D) Hemoglobin
Correct Answer: A) Serum creatinine
Rationale: Metformin requires renal function monitoring (serum
creatinine) due to the risk of lactic acidosis in renal impairment. Liver
enzymes, potassium, and hemoglobin are not primarily affected.
Question 9 A 50-year-old female asks about breast cancer screening.
What is the recommended screening frequency for mammography?
A) Annually
B) Every 2 years
C) Every 5 years
D) No screening needed
