2026/2027 COMPREHENSIVE PRACTICE QUESTIONS
AND STUDY GUIDE COMPLETE ACCURATE EXAM
APPROVED QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH DETAILED RATIONALES (RELIABLE
ANSWERS) CURRENTLY UPDATED VERSION 2026
EDITION
Question 1
A 58-year-old male with type 2 diabetes reports burning foot pain worse
at night. Exam reveals diminished pinprick sensation distal to ankles and
absent Achilles reflexes. What is the most likely diagnosis?
A. Peripheral artery disease
B. Lumbar radiculopathy
C. Diabetic peripheral neuropathy
D. Vitamin B12 deficiency
Correct Answer C. Diabetic peripheral neuropathy
Rationale:
,Distal symmetric polyneuropathy in diabetes presents with burning pain,
nocturnal exacerbation, loss of sensation, and areflexia. The stocking-
glove distribution and absent Achilles reflexes are classic findings of
diabetic peripheral neuropathy. Peripheral artery disease would present
with claudication and diminished pulses rather than burning pain and
sensory loss.
Question 2
A 45-year-old woman has BP 152/96 mmHg on two separate visits. She
has no comorbidities. According to 2024 ACC/AHA guidelines, what is
the first step in management?
A. Start amlodipine 5 mg daily
B. Start lisinopril 10 mg daily
C. Recommend DASH diet and exercise for 4–6 months
D. Order renal artery duplex ultrasound
Correct Answer: C. Recommend DASH diet and exercise for 4–6
months
Rationale:
Stage 2 hypertension without comorbidities or target organ damage first
receives therapeutic lifestyle changes for 4–6 months before
pharmacotherapy. The DASH diet, sodium restriction, and regular
,physical activity are first-line interventions. Pharmacotherapy is initiated
if BP remains elevated after lifestyle modifications.
Question 3:
A 32-year-old man has sudden onset of severe, tearing chest pain
radiating to the back. BP is 160/90 in the right arm and 100/60 in the left
arm. What is the most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct Answer: C. Aortic dissection
Rationale:
Aortic dissection presents with tearing chest pain and asymmetric blood
pressures between arms. The blood pressure differential is a hallmark
finding. Myocardial infarction typically presents with pressure-type
chest pain without blood pressure differentials. Pulmonary embolism
presents with pleuritic chest pain and dyspnea.
Question 4
, A 70-year-old woman with heart failure reports recent weight gain of 5
pounds over one week. What is the most appropriate initial intervention?
A. Increase loop diuretic dose
B. Assess for worsening heart failure and adjust medications
C. Order echocardiogram
D. Recommend low-sodium diet only
Correct Answer:B. Assess for worsening heart failure and adjust
medications
Rationale: Weight gain is the most sensitive early indicator of
worsening heart failure. A 2-3 pound weight gain over 24 hours or 5
pounds over one week warrants assessment for fluid overload and
medication adjustment. Early intervention can prevent hospitalization.
Dietary sodium restriction alone is insufficient without medication
adjustment.
Question 5
What is the CHADS2 score used to assess?
A. Risk of myocardial infarction
B. Stroke risk in atrial fibrillation
C. Risk of heart failure exacerbation