NURSE PRACTITIONER
CERTIFICATION HIGH-LEVEL
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 62-year-old African American male with Stage 2 Hypertension and Type 2 Diabetes is
evaluated. His blood pressure is 152/94 mmHg. Which medication is the most appropriate
initial therapy?
A. Lisinopril
B. Losartan
C. Chlorthalidone
D. Metoprolol
Answer: C
Conceptual Explanation: According to JNC-8 and AHA guidelines, African American
patients with or without diabetes should be started on a Thiazide-type diuretic or a
Calcium Channel Blocker as initial therapy.
,2. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
smaller maculopapular lesions. What is the most likely diagnosis?
A. Tinea Corporis
B. Pityriasis Rosea
C. Guttate Psoriasis
D. Secondary Syphilis
Answer: B
Conceptual Explanation: Pityriasis Rosea typically presents with a single herald patch
followed by a generalized eruption in a Christmas tree pattern on the trunk.
3. Which of the following laboratory findings is most characteristic of Thalassemia?
A. Elevated RDW
B. Low Serum Ferritin
C. Elevated TIBC
D. Mentzer Index less than 13
Answer: D
Conceptual Explanation: The Mentzer Index (MCV/RBC count) less than 13 is highly
suggestive of Thalassemia, whereas a value greater than 13 suggests Iron Deficiency
Anemia.
, 4. A 75-year-old patient with Chronic Kidney Disease (Stage 3) requires treatment for a UTI.
Which medication should be avoided per the Beers Criteria?
A. Cephalexin
B. Ciprofloxacin
C. Nitrofurantoin
D. Fosfomycin
Answer: C
Conceptual Explanation: Nitrofurantoin should be avoided in patients with a CrCl less
than 30 mL/min due to lack of efficacy and potential for toxicity.
5. An 8-year-old child presents with high fever for 6 days, strawberry tongue, and
desquamation of the hands. What is the priority treatment?
A. Prednisone
B. Amoxicillin 90mg/kg
C. High-dose Aspirin and IVIG
D. Acetaminophen and observation
Answer: C
Conceptual Explanation: These are classic signs of Kawasaki disease. The standard
treatment to prevent coronary artery aneurysms is high-dose aspirin and Intravenous
Immunoglobulin (IVIG).
CERTIFICATION HIGH-LEVEL
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 62-year-old African American male with Stage 2 Hypertension and Type 2 Diabetes is
evaluated. His blood pressure is 152/94 mmHg. Which medication is the most appropriate
initial therapy?
A. Lisinopril
B. Losartan
C. Chlorthalidone
D. Metoprolol
Answer: C
Conceptual Explanation: According to JNC-8 and AHA guidelines, African American
patients with or without diabetes should be started on a Thiazide-type diuretic or a
Calcium Channel Blocker as initial therapy.
,2. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
smaller maculopapular lesions. What is the most likely diagnosis?
A. Tinea Corporis
B. Pityriasis Rosea
C. Guttate Psoriasis
D. Secondary Syphilis
Answer: B
Conceptual Explanation: Pityriasis Rosea typically presents with a single herald patch
followed by a generalized eruption in a Christmas tree pattern on the trunk.
3. Which of the following laboratory findings is most characteristic of Thalassemia?
A. Elevated RDW
B. Low Serum Ferritin
C. Elevated TIBC
D. Mentzer Index less than 13
Answer: D
Conceptual Explanation: The Mentzer Index (MCV/RBC count) less than 13 is highly
suggestive of Thalassemia, whereas a value greater than 13 suggests Iron Deficiency
Anemia.
, 4. A 75-year-old patient with Chronic Kidney Disease (Stage 3) requires treatment for a UTI.
Which medication should be avoided per the Beers Criteria?
A. Cephalexin
B. Ciprofloxacin
C. Nitrofurantoin
D. Fosfomycin
Answer: C
Conceptual Explanation: Nitrofurantoin should be avoided in patients with a CrCl less
than 30 mL/min due to lack of efficacy and potential for toxicity.
5. An 8-year-old child presents with high fever for 6 days, strawberry tongue, and
desquamation of the hands. What is the priority treatment?
A. Prednisone
B. Amoxicillin 90mg/kg
C. High-dose Aspirin and IVIG
D. Acetaminophen and observation
Answer: C
Conceptual Explanation: These are classic signs of Kawasaki disease. The standard
treatment to prevent coronary artery aneurysms is high-dose aspirin and Intravenous
Immunoglobulin (IVIG).
