NR603 FNP PRE-DIAGNOSTIC EXAM
(QUESTIONS 1- 100) | NR 603 FAMILY NURSE
PRACTITIONER COMPLETE PRACTICE TEST
BANK & STUDY GUIDE | RATED A+
CHAMBERLAIN UNIVERSITY
SECTION 1: CARDIOLOGY & CARDIOVASCULAR DISORDERS
Question 1
A 74-year-old patient with COPD has a resting oxygen saturation of 86% on room
air when stable. Which therapy should be evaluated?
A) Daily oral steroids indefinitely
B) Chronic high-dose opioids for dyspnea first
C) Avoid vaccination
D) Long-term oxygen therapy qualification
Answer: D
Rationale: Long-term oxygen therapy is indicated for patients with COPD who have
resting oxygen saturation ≤88% or PaO2 ≤55 mmHg. This patient qualifies and
should be evaluated for home oxygen therapy. Daily oral steroids are not
recommended long-term due to significant side effects. Opioids are not first-line
for dyspnea in COPD .
Question 2
A 34-year-old patient presents with epigastric pain, positive urea breath test, and
no alarm features. What is the appropriate plan?
,A) Triple therapy for H. pylori eradication
B) Proton pump inhibitor alone for 8 weeks
C) Endoscopy immediately
D) Antacids as needed only
Answer: A
Rationale: A positive urea breath test confirms H. pylori infection. In patients
without alarm features (weight loss, GI bleeding, anemia, dysphagia), triple
therapy (PPI + clarithromycin + amoxicillin or metronidazole) is recommended for
eradication. PPIs alone would not treat the infection .
Question 3
A 45-year-old female complains of right upper quadrant abdominal pain
worsening after fatty meals. Physical exam reveals localized pain on deep
inspiration (Murphy's sign). What is the initial imaging test of choice?
A) Right upper quadrant abdominal ultrasound
B) Plain abdominal radiograph
C) Endoscopic retrograde cholangiopancreatography (ERCP)
D) CT abdomen with contrast
Answer: A
Rationale: RUQ ultrasound is the initial imaging test of choice for suspected
cholecystitis. It has high sensitivity and specificity for gallstones and can assess
gallbladder wall thickness, pericholecystic fluid, and sonographic Murphy's sign.
ERCP is invasive and reserved for suspected common bile duct stones .
Question 4
Which cardiac biomarker is the most specific for myocardial infarction?
A) CK-MB
B) BNP
,C) Troponin I
D) D-dimer
Answer: C
Rationale: Cardiac troponins (I and T) are the most specific biomarkers for
myocardial injury. Troponin I is highly specific for cardiac muscle and is not found
in skeletal muscle. CK-MB can be elevated with skeletal muscle injury. BNP is a
marker of heart failure, and D-dimer is used for thromboembolic evaluation .
Question 5
A 68-year-old female presents with dyspnea on exertion and a grade III/VI systolic
murmur at the right 2nd intercostal space that radiates to the neck. What is your
top differential?
A) Mitral regurgitation
B) Aortic stenosis
C) Mitral valve prolapse
D) Aortic regurgitation
Answer: B
Rationale: Aortic stenosis produces a systolic ejection murmur best heard at the
right upper sternal border (2nd intercostal space) that radiates to the carotid
arteries. The murmur is harsh and crescendo-decrescendo. Mitral regurgitation is
best heard at the apex. Aortic regurgitation is a diastolic murmur .
Question 6
A patient with known CAD presents with chest pressure that occurs with exertion
and resolves with rest. Symptoms have been stable for 2 years. What is the most
likely diagnosis?
A) Unstable angina
B) Stable angina
, C) NSTEMI
D) Pericarditis
Answer: B
Rationale: Stable angina is characterized by exertional chest pain that resolves
with rest or nitroglycerin, with a stable pattern of frequency, duration, and
intensity over time. Unstable angina is new-onset or worsening angina. NSTEMI
involves myocardial injury with elevated troponins .
Question 7
What ECG finding is most characteristic of acute pericarditis?
A) ST-segment elevation in all leads without reciprocal changes
B) Q waves in leads II, III, aVF
C) Hyperacute T waves
D) ST-segment depression in V1-V4
Answer: A
Rationale: Acute pericarditis typically causes diffuse, concave-up ST-segment
elevation across most leads with PR-segment depression. There are no reciprocal
changes (which would suggest STEMI). Q waves suggest prior MI. Hyperacute T
waves are associated with hyperkalemia or early STEMI .
Question 8
A patient with a history of heart failure presents with a low-pitched extra heart
sound early in diastole (just after S2). This is most likely:
A) S4 (atrial gallop)
B) S3 (ventricular gallop)
C) Opening snap
D) Systolic ejection click
(QUESTIONS 1- 100) | NR 603 FAMILY NURSE
PRACTITIONER COMPLETE PRACTICE TEST
BANK & STUDY GUIDE | RATED A+
CHAMBERLAIN UNIVERSITY
SECTION 1: CARDIOLOGY & CARDIOVASCULAR DISORDERS
Question 1
A 74-year-old patient with COPD has a resting oxygen saturation of 86% on room
air when stable. Which therapy should be evaluated?
A) Daily oral steroids indefinitely
B) Chronic high-dose opioids for dyspnea first
C) Avoid vaccination
D) Long-term oxygen therapy qualification
Answer: D
Rationale: Long-term oxygen therapy is indicated for patients with COPD who have
resting oxygen saturation ≤88% or PaO2 ≤55 mmHg. This patient qualifies and
should be evaluated for home oxygen therapy. Daily oral steroids are not
recommended long-term due to significant side effects. Opioids are not first-line
for dyspnea in COPD .
Question 2
A 34-year-old patient presents with epigastric pain, positive urea breath test, and
no alarm features. What is the appropriate plan?
,A) Triple therapy for H. pylori eradication
B) Proton pump inhibitor alone for 8 weeks
C) Endoscopy immediately
D) Antacids as needed only
Answer: A
Rationale: A positive urea breath test confirms H. pylori infection. In patients
without alarm features (weight loss, GI bleeding, anemia, dysphagia), triple
therapy (PPI + clarithromycin + amoxicillin or metronidazole) is recommended for
eradication. PPIs alone would not treat the infection .
Question 3
A 45-year-old female complains of right upper quadrant abdominal pain
worsening after fatty meals. Physical exam reveals localized pain on deep
inspiration (Murphy's sign). What is the initial imaging test of choice?
A) Right upper quadrant abdominal ultrasound
B) Plain abdominal radiograph
C) Endoscopic retrograde cholangiopancreatography (ERCP)
D) CT abdomen with contrast
Answer: A
Rationale: RUQ ultrasound is the initial imaging test of choice for suspected
cholecystitis. It has high sensitivity and specificity for gallstones and can assess
gallbladder wall thickness, pericholecystic fluid, and sonographic Murphy's sign.
ERCP is invasive and reserved for suspected common bile duct stones .
Question 4
Which cardiac biomarker is the most specific for myocardial infarction?
A) CK-MB
B) BNP
,C) Troponin I
D) D-dimer
Answer: C
Rationale: Cardiac troponins (I and T) are the most specific biomarkers for
myocardial injury. Troponin I is highly specific for cardiac muscle and is not found
in skeletal muscle. CK-MB can be elevated with skeletal muscle injury. BNP is a
marker of heart failure, and D-dimer is used for thromboembolic evaluation .
Question 5
A 68-year-old female presents with dyspnea on exertion and a grade III/VI systolic
murmur at the right 2nd intercostal space that radiates to the neck. What is your
top differential?
A) Mitral regurgitation
B) Aortic stenosis
C) Mitral valve prolapse
D) Aortic regurgitation
Answer: B
Rationale: Aortic stenosis produces a systolic ejection murmur best heard at the
right upper sternal border (2nd intercostal space) that radiates to the carotid
arteries. The murmur is harsh and crescendo-decrescendo. Mitral regurgitation is
best heard at the apex. Aortic regurgitation is a diastolic murmur .
Question 6
A patient with known CAD presents with chest pressure that occurs with exertion
and resolves with rest. Symptoms have been stable for 2 years. What is the most
likely diagnosis?
A) Unstable angina
B) Stable angina
, C) NSTEMI
D) Pericarditis
Answer: B
Rationale: Stable angina is characterized by exertional chest pain that resolves
with rest or nitroglycerin, with a stable pattern of frequency, duration, and
intensity over time. Unstable angina is new-onset or worsening angina. NSTEMI
involves myocardial injury with elevated troponins .
Question 7
What ECG finding is most characteristic of acute pericarditis?
A) ST-segment elevation in all leads without reciprocal changes
B) Q waves in leads II, III, aVF
C) Hyperacute T waves
D) ST-segment depression in V1-V4
Answer: A
Rationale: Acute pericarditis typically causes diffuse, concave-up ST-segment
elevation across most leads with PR-segment depression. There are no reciprocal
changes (which would suggest STEMI). Q waves suggest prior MI. Hyperacute T
waves are associated with hyperkalemia or early STEMI .
Question 8
A patient with a history of heart failure presents with a low-pitched extra heart
sound early in diastole (just after S2). This is most likely:
A) S4 (atrial gallop)
B) S3 (ventricular gallop)
C) Opening snap
D) Systolic ejection click
