SARAH MICHELLE NP LIVE REVIEW -
ADVANCED PRACTICE
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 65-year-old male presents with sudden onset of substernal chest pain. The EKG shows
ST-segment elevation in leads V1-V4. Which coronary artery is most likely occluded?
A. Right Coronary Artery (RCA)
B. Posterior Descending Artery
C. Circumflex Artery
D. Left Anterior Descending (LAD)
Answer: D
Conceptual Explanation: ST elevation in V1-V4 indicates an anterior wall myocardial
infarction, which is typically caused by occlusion of the Left Anterior Descending (LAD)
artery.
2. Which of the following physical exam findings is most characteristic of Aortic Stenosis?
A. Holosystolic murmur at the 5th intercostal space, midclavicular line
,B. Diastolic murmur at the apex heard best in the left lateral decubitus position
C. Systolic murmur at the 2nd right intercostal space radiating to the neck
D. Opening snap followed by a mid-diastolic rumble
Answer: C
Conceptual Explanation: Aortic stenosis presents as a crescendo-decrescendo systolic
murmur at the right upper sternal border that radiates to the carotids.
3. A patient with a history of hypertension and HFrEF is started on an ACE inhibitor. Which lab
value must be monitored closely due to potential medication side effects?
A. Serum Calcium
B. Serum Sodium
C. Serum Magnesium
D. Serum Potassium
Answer: D
Conceptual Explanation: ACE inhibitors can cause hyperkalemia by inhibiting aldosterone
secretion; therefore, potassium levels must be monitored.
4. A 28-year-old female presents with a ‘strawberry cervix’ and a profuse, malodorous,
greenish-yellow vaginal discharge. What is the most likely diagnosis?
A. Bacterial Vaginosis
B. Trichomoniasis
, C. Vulvovaginal Candidiasis
D. Chlamydia
Answer: B
Conceptual Explanation: Trichomoniasis is characterized by a strawberry cervix
(petechiae) and frothy greenish-yellow discharge.
5. Which cranial nerve is primarily affected in a patient diagnosed with Bell’s Palsy?
A. Cranial Nerve V
B. Cranial Nerve X
C. Cranial Nerve III
D. Cranial Nerve VII
Answer: D
Conceptual Explanation: Bell’s Palsy is an acute peripheral facial nerve palsy involving
Cranial Nerve VII.
6. An 8-year-old child presents with a ‘slapped cheek’ rash and a lacy reticular rash on the
extremities. What is the causative agent?
A. Parvovirus B19
B. Coxsackievirus A16
C. Human Herpesvirus 6
ADVANCED PRACTICE
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 65-year-old male presents with sudden onset of substernal chest pain. The EKG shows
ST-segment elevation in leads V1-V4. Which coronary artery is most likely occluded?
A. Right Coronary Artery (RCA)
B. Posterior Descending Artery
C. Circumflex Artery
D. Left Anterior Descending (LAD)
Answer: D
Conceptual Explanation: ST elevation in V1-V4 indicates an anterior wall myocardial
infarction, which is typically caused by occlusion of the Left Anterior Descending (LAD)
artery.
2. Which of the following physical exam findings is most characteristic of Aortic Stenosis?
A. Holosystolic murmur at the 5th intercostal space, midclavicular line
,B. Diastolic murmur at the apex heard best in the left lateral decubitus position
C. Systolic murmur at the 2nd right intercostal space radiating to the neck
D. Opening snap followed by a mid-diastolic rumble
Answer: C
Conceptual Explanation: Aortic stenosis presents as a crescendo-decrescendo systolic
murmur at the right upper sternal border that radiates to the carotids.
3. A patient with a history of hypertension and HFrEF is started on an ACE inhibitor. Which lab
value must be monitored closely due to potential medication side effects?
A. Serum Calcium
B. Serum Sodium
C. Serum Magnesium
D. Serum Potassium
Answer: D
Conceptual Explanation: ACE inhibitors can cause hyperkalemia by inhibiting aldosterone
secretion; therefore, potassium levels must be monitored.
4. A 28-year-old female presents with a ‘strawberry cervix’ and a profuse, malodorous,
greenish-yellow vaginal discharge. What is the most likely diagnosis?
A. Bacterial Vaginosis
B. Trichomoniasis
, C. Vulvovaginal Candidiasis
D. Chlamydia
Answer: B
Conceptual Explanation: Trichomoniasis is characterized by a strawberry cervix
(petechiae) and frothy greenish-yellow discharge.
5. Which cranial nerve is primarily affected in a patient diagnosed with Bell’s Palsy?
A. Cranial Nerve V
B. Cranial Nerve X
C. Cranial Nerve III
D. Cranial Nerve VII
Answer: D
Conceptual Explanation: Bell’s Palsy is an acute peripheral facial nerve palsy involving
Cranial Nerve VII.
6. An 8-year-old child presents with a ‘slapped cheek’ rash and a lacy reticular rash on the
extremities. What is the causative agent?
A. Parvovirus B19
B. Coxsackievirus A16
C. Human Herpesvirus 6
