SARAH MICHELLE LIVE REVIEW NP
EXAM PREP PRACTICE QUESTIONS
AND ANSWERS
1. A 65-year-old African American male presents for a follow-up of hypertension. His blood
pressure is 158/94 mmHg. He has no history of chronic kidney disease or diabetes. According
to JNC 8 guidelines, which of the following is the most appropriate initial treatment?
A. Lisinopril
B. Losartan
C. Metoprolol
D. Amlodipine
Answer: D
Conceptual Explanation: For African American patients without chronic kidney disease,
initial antihypertensive therapy should include a thiazide-type diuretic or a calcium
channel blocker (CCB). Amlodipine is a CCB. ACE inhibitors (Lisinopril) and ARBs
(Losartan) are generally less effective as monotherapy in this population unless CKD is
present.
,2. Which heart sound is considered a hallmark finding in patients with fluid volume overload
and congestive heart failure?
A. S3
B. S2
C. S1
D. S4
Answer: A
Conceptual Explanation: S3, or the ventricular gallop, occurs early in diastole and is
associated with rapid ventricular filling and fluid overload, common in heart failure. S4 is
associated with stiff ventricles and hypertension.
3. A 4-year-old child presents with a ‘barking’ cough and inspiratory stridor. On X-ray, the
‘steeple sign’ is noted. What is the most likely diagnosis?
A. Epiglottitis
B. Bronchiolitis
C. Croup (Laryngotracheobronchitis)
D. Pertussis
Answer: C
, Conceptual Explanation: Croup is characterized by a barking cough and the ‘steeple sign’
(subglottic narrowing) on X-ray. Epiglottitis usually presents with the ‘thumbprint sign’
and high fever/drooling.
4. A patient presents with a ‘curtain dropping’ sensation over their vision in the right eye.
This is a classic presentation of:
A. Retinal detachment
B. Cataracts
C. Macular degeneration
D. Acute angle-closure glaucoma
Answer: A
Conceptual Explanation: Retinal detachment is often described as a shadow or curtain
falling over the field of vision, often accompanied by floaters or flashes of light. This is a
medical emergency.
5. Which of the following is a ‘live attenuated’ vaccine and should be avoided in pregnant
women?
A. Tdap
B. Inactivated Influenza
C. Hepatitis B
D. MMR
EXAM PREP PRACTICE QUESTIONS
AND ANSWERS
1. A 65-year-old African American male presents for a follow-up of hypertension. His blood
pressure is 158/94 mmHg. He has no history of chronic kidney disease or diabetes. According
to JNC 8 guidelines, which of the following is the most appropriate initial treatment?
A. Lisinopril
B. Losartan
C. Metoprolol
D. Amlodipine
Answer: D
Conceptual Explanation: For African American patients without chronic kidney disease,
initial antihypertensive therapy should include a thiazide-type diuretic or a calcium
channel blocker (CCB). Amlodipine is a CCB. ACE inhibitors (Lisinopril) and ARBs
(Losartan) are generally less effective as monotherapy in this population unless CKD is
present.
,2. Which heart sound is considered a hallmark finding in patients with fluid volume overload
and congestive heart failure?
A. S3
B. S2
C. S1
D. S4
Answer: A
Conceptual Explanation: S3, or the ventricular gallop, occurs early in diastole and is
associated with rapid ventricular filling and fluid overload, common in heart failure. S4 is
associated with stiff ventricles and hypertension.
3. A 4-year-old child presents with a ‘barking’ cough and inspiratory stridor. On X-ray, the
‘steeple sign’ is noted. What is the most likely diagnosis?
A. Epiglottitis
B. Bronchiolitis
C. Croup (Laryngotracheobronchitis)
D. Pertussis
Answer: C
, Conceptual Explanation: Croup is characterized by a barking cough and the ‘steeple sign’
(subglottic narrowing) on X-ray. Epiglottitis usually presents with the ‘thumbprint sign’
and high fever/drooling.
4. A patient presents with a ‘curtain dropping’ sensation over their vision in the right eye.
This is a classic presentation of:
A. Retinal detachment
B. Cataracts
C. Macular degeneration
D. Acute angle-closure glaucoma
Answer: A
Conceptual Explanation: Retinal detachment is often described as a shadow or curtain
falling over the field of vision, often accompanied by floaters or flashes of light. This is a
medical emergency.
5. Which of the following is a ‘live attenuated’ vaccine and should be avoided in pregnant
women?
A. Tdap
B. Inactivated Influenza
C. Hepatitis B
D. MMR
