Missouri Nurse Practitioner
Certification Exam Practice Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
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1. A 58-year-old male with hypertension presents with a BP of 152/94
mmHg on two separate visits. Which is the best initial pharmacologic
treatment?
A. Atenolol
B. Lisinopril
C. Furosemide
D. Clonidine
Rationale: ACE inhibitors like lisinopril are first-line for
uncomplicated hypertension, especially with comorbid
cardiovascular risk.
2. A patient with type 2 diabetes has an HbA1c of 9.2% despite
metformin therapy. What is the next best step?
, A. Stop metformin and start insulin only
B. Add a GLP-1 receptor agonist
C. Start antibiotics
D. Discontinue all medications
Rationale: GLP-1 receptor agonists are recommended as add-on
therapy when metformin alone is insufficient.
3. A 25-year-old female presents with dysuria and urinary frequency. No
fever or flank pain. Most likely diagnosis?
A. Pyelonephritis
B. Acute uncomplicated cystitis
C. Interstitial nephritis
D. Urethral cancer
Rationale: Symptoms without systemic signs strongly suggest
uncomplicated UTI.
4. Which lab finding is most consistent with iron deficiency anemia?
A. High ferritin
B. High MCV
C. Low ferritin
D. High serum iron
Rationale: Ferritin is the best indicator of iron stores and is low in
iron deficiency.
5. First-line treatment for acute otitis media in children?
A. Azithromycin
, B. Amoxicillin
C. Ciprofloxacin
D. Doxycycline
Rationale: Amoxicillin is first-line unless allergy or resistance risk
exists.
6. A 65-year-old smoker presents with chronic cough and sputum
production. Likely diagnosis?
A. Asthma
B. Chronic bronchitis
C. Pneumothorax
D. Pulmonary embolism
Rationale: Chronic productive cough in a smoker suggests chronic
bronchitis.
7. Which condition is associated with “ground-glass” lung opacities on
CT?
A. Asthma
B. COVID-19 pneumonia
C. Migraine
D. Appendicitis
Rationale: Ground-glass opacities are typical in viral pneumonias
including COVID-19.
8. Best screening test for colorectal cancer in average-risk adults?
A. MRI abdomen
Certification Exam Practice Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 58-year-old male with hypertension presents with a BP of 152/94
mmHg on two separate visits. Which is the best initial pharmacologic
treatment?
A. Atenolol
B. Lisinopril
C. Furosemide
D. Clonidine
Rationale: ACE inhibitors like lisinopril are first-line for
uncomplicated hypertension, especially with comorbid
cardiovascular risk.
2. A patient with type 2 diabetes has an HbA1c of 9.2% despite
metformin therapy. What is the next best step?
, A. Stop metformin and start insulin only
B. Add a GLP-1 receptor agonist
C. Start antibiotics
D. Discontinue all medications
Rationale: GLP-1 receptor agonists are recommended as add-on
therapy when metformin alone is insufficient.
3. A 25-year-old female presents with dysuria and urinary frequency. No
fever or flank pain. Most likely diagnosis?
A. Pyelonephritis
B. Acute uncomplicated cystitis
C. Interstitial nephritis
D. Urethral cancer
Rationale: Symptoms without systemic signs strongly suggest
uncomplicated UTI.
4. Which lab finding is most consistent with iron deficiency anemia?
A. High ferritin
B. High MCV
C. Low ferritin
D. High serum iron
Rationale: Ferritin is the best indicator of iron stores and is low in
iron deficiency.
5. First-line treatment for acute otitis media in children?
A. Azithromycin
, B. Amoxicillin
C. Ciprofloxacin
D. Doxycycline
Rationale: Amoxicillin is first-line unless allergy or resistance risk
exists.
6. A 65-year-old smoker presents with chronic cough and sputum
production. Likely diagnosis?
A. Asthma
B. Chronic bronchitis
C. Pneumothorax
D. Pulmonary embolism
Rationale: Chronic productive cough in a smoker suggests chronic
bronchitis.
7. Which condition is associated with “ground-glass” lung opacities on
CT?
A. Asthma
B. COVID-19 pneumonia
C. Migraine
D. Appendicitis
Rationale: Ground-glass opacities are typical in viral pneumonias
including COVID-19.
8. Best screening test for colorectal cancer in average-risk adults?
A. MRI abdomen
