FITZ EXIT EXAM | 2025/2026 EDITION | STUDY GUIDE |
LATEST UPDATE | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | VERIFIED QUESTIONS AND 100%
CORRECT ANSWERS | A+ GRADED NURSE
PRACTITIONER BOARD REVIEW
Table of Contents
1. Cardiovascular Disorders and Hypertension Management
2. Pulmonary and Respiratory Conditions
3. Endocrine and Metabolic Disorders
4. Gastrointestinal and Hepatic Disorders
5. Musculoskeletal and Rheumatologic Conditions
6. Neurological and Psychiatric Disorders
7. Women's Health and Prenatal Care
8. Pediatric and Adolescent Health
9. Geriatric Syndromes and Palliative Care
10. Infectious Disease and Pharmacology
11. Health Promotion, Screening, and Disease Prevention
12. Professional Issues, Ethics, and Practice Management
,Question 1: A 56-year-old male presents with substernal chest pain radiating to the left arm.
ECG shows ST-segment elevation in leads II, III, and aVF. What is the most likely diagnosis?
A. Anterior wall myocardial infarction
B. Inferior wall myocardial infarction
C. Lateral wall myocardial infarction
D. Non-ST elevation myocardial infarction
Correct Answer: B. Inferior wall myocardial infarction
Leads II, III, and aVF correspond to the inferior wall of the left ventricle, usually supplied by
the right coronary artery. ST-segment elevation in these leads indicates an acute inferior wall
STEMI, which requires immediate reperfusion therapy.
Question 2: Which antihypertensive medication is preferred for a diabetic patient with
proteinuria?
A. Thiazide diuretic
B. ACE inhibitor
C. Beta-blocker
D. Calcium channel blocker
Correct Answer: B. ACE inhibitor
ACE inhibitors slow the progression of diabetic nephropathy by reducing glomerular
pressure and proteinuria. They are first-line therapy for hypertension in diabetic patients with
proteinuria due to their renoprotective effects.
Question 3: A patient with COPD has increased sputum production and purulence. What is
the next best step?
A. Increase bronchodilators only
B. Add antibiotic therapy
C. Begin oral corticosteroids only
D. Hospitalize immediately
Correct Answer: B. Add antibiotic therapy
COPD exacerbation with purulent sputum suggests bacterial infection; antibiotics reduce
morbidity and improve outcomes. Antibiotics are indicated when sputum purulence is present
along with increased dyspnea or sputum volume.
,Question 4: The most common cause of community-acquired pneumonia in adults is:
A. Haemophilus influenzae
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Chlamydia pneumoniae
Correct Answer: B. Streptococcus pneumoniae
S. pneumoniae remains the leading cause of bacterial pneumonia in adults. It classically
presents with sudden onset fever, productive cough with rust-colored sputum, and lobar
consolidation on chest X-ray.
Question 5: A 45-year-old woman presents with tremor, tachycardia, and weight loss. TSH is
low, and free T4 is high. What is the most likely diagnosis?
A. Graves' disease
B. Hashimoto's thyroiditis
C. Subacute thyroiditis
D. Pituitary adenoma
Correct Answer: A. Graves' disease
Low TSH and high T4 indicate primary hyperthyroidism, most commonly caused by Graves'
disease. Graves' disease is an autoimmune condition caused by TSH receptor antibodies that
stimulate the thyroid gland.
Question 6: Which of the following is a hallmark finding in diabetic ketoacidosis (DKA)?
A. Metabolic alkalosis
B. Kussmaul respirations
C. Bradycardia
D. Hypoglycemia
Correct Answer: B. Kussmaul respirations
Kussmaul respirations are compensatory deep, rapid breathing due to metabolic acidosis in
DKA. The body attempts to blow off carbon dioxide to correct the acid-base imbalance.
Question 7: A 45-year-old female presents with fatigue, weight gain, constipation, and cold
intolerance for 3 months. TSH is 12.5 mIU/L (normal 0.4-4.0). What is the most appropriate
next step?
A. Levothyroxine 1.6 mcg/kg/day
, B. Levothyroxine 25 mcg daily with recheck in 6 weeks
C. Triiodothyronine (T3) 25 mcg daily
D. Observe and recheck TSH in 3 months
Correct Answer: B. Levothyroxine 25 mcg daily with recheck in 6 weeks
For mild hypothyroidism in a younger adult without cardiac disease, start low-dose
levothyroxine (25-50 mcg) and titrate every 4-6 weeks. Full replacement is too aggressive
initially, T3 is not first-line, and observation is inappropriate given symptoms.
Question 8: A 32-year-old G2P1 at 28 weeks gestation reports headache, blurred vision, and
right upper quadrant pain. BP 168/104. Urine dipstick: 3+ protein. Which medication is
contraindicated?
A. Labetalol IV
B. Hydralazine IV
C. Nifedipine PO
D. Lisinopril PO
Correct Answer: D. Lisinopril PO
ACE inhibitors (lisinopril) are contraindicated in pregnancy (fetotoxic). Labetalol,
hydralazine, and nifedipine are first-line for acute severe hypertension in
pregnancy/preeclampsia.
Question 9: A 70-year-old male with osteoporosis presents with acute back pain after lifting a
box. X-ray shows vertebral height loss >20%. What is the most appropriate next step?
A. Bed rest for 6 weeks
B. Physical therapy referral
C. Vertebroplasty referral
D. Calcitonin nasal spray
Correct Answer: C. Vertebroplasty referral
Vertebral compression fractures with >20% height loss and acute pain may benefit from
vertebroplasty or kyphoplasty. These minimally invasive procedures can provide significant
pain relief and stabilize the fracture.
Question 10: A 28-year-old woman with migraines with aura requests contraception. Which
method is contraindicated?
A. Etonogestrel implant
LATEST UPDATE | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | VERIFIED QUESTIONS AND 100%
CORRECT ANSWERS | A+ GRADED NURSE
PRACTITIONER BOARD REVIEW
Table of Contents
1. Cardiovascular Disorders and Hypertension Management
2. Pulmonary and Respiratory Conditions
3. Endocrine and Metabolic Disorders
4. Gastrointestinal and Hepatic Disorders
5. Musculoskeletal and Rheumatologic Conditions
6. Neurological and Psychiatric Disorders
7. Women's Health and Prenatal Care
8. Pediatric and Adolescent Health
9. Geriatric Syndromes and Palliative Care
10. Infectious Disease and Pharmacology
11. Health Promotion, Screening, and Disease Prevention
12. Professional Issues, Ethics, and Practice Management
,Question 1: A 56-year-old male presents with substernal chest pain radiating to the left arm.
ECG shows ST-segment elevation in leads II, III, and aVF. What is the most likely diagnosis?
A. Anterior wall myocardial infarction
B. Inferior wall myocardial infarction
C. Lateral wall myocardial infarction
D. Non-ST elevation myocardial infarction
Correct Answer: B. Inferior wall myocardial infarction
Leads II, III, and aVF correspond to the inferior wall of the left ventricle, usually supplied by
the right coronary artery. ST-segment elevation in these leads indicates an acute inferior wall
STEMI, which requires immediate reperfusion therapy.
Question 2: Which antihypertensive medication is preferred for a diabetic patient with
proteinuria?
A. Thiazide diuretic
B. ACE inhibitor
C. Beta-blocker
D. Calcium channel blocker
Correct Answer: B. ACE inhibitor
ACE inhibitors slow the progression of diabetic nephropathy by reducing glomerular
pressure and proteinuria. They are first-line therapy for hypertension in diabetic patients with
proteinuria due to their renoprotective effects.
Question 3: A patient with COPD has increased sputum production and purulence. What is
the next best step?
A. Increase bronchodilators only
B. Add antibiotic therapy
C. Begin oral corticosteroids only
D. Hospitalize immediately
Correct Answer: B. Add antibiotic therapy
COPD exacerbation with purulent sputum suggests bacterial infection; antibiotics reduce
morbidity and improve outcomes. Antibiotics are indicated when sputum purulence is present
along with increased dyspnea or sputum volume.
,Question 4: The most common cause of community-acquired pneumonia in adults is:
A. Haemophilus influenzae
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Chlamydia pneumoniae
Correct Answer: B. Streptococcus pneumoniae
S. pneumoniae remains the leading cause of bacterial pneumonia in adults. It classically
presents with sudden onset fever, productive cough with rust-colored sputum, and lobar
consolidation on chest X-ray.
Question 5: A 45-year-old woman presents with tremor, tachycardia, and weight loss. TSH is
low, and free T4 is high. What is the most likely diagnosis?
A. Graves' disease
B. Hashimoto's thyroiditis
C. Subacute thyroiditis
D. Pituitary adenoma
Correct Answer: A. Graves' disease
Low TSH and high T4 indicate primary hyperthyroidism, most commonly caused by Graves'
disease. Graves' disease is an autoimmune condition caused by TSH receptor antibodies that
stimulate the thyroid gland.
Question 6: Which of the following is a hallmark finding in diabetic ketoacidosis (DKA)?
A. Metabolic alkalosis
B. Kussmaul respirations
C. Bradycardia
D. Hypoglycemia
Correct Answer: B. Kussmaul respirations
Kussmaul respirations are compensatory deep, rapid breathing due to metabolic acidosis in
DKA. The body attempts to blow off carbon dioxide to correct the acid-base imbalance.
Question 7: A 45-year-old female presents with fatigue, weight gain, constipation, and cold
intolerance for 3 months. TSH is 12.5 mIU/L (normal 0.4-4.0). What is the most appropriate
next step?
A. Levothyroxine 1.6 mcg/kg/day
, B. Levothyroxine 25 mcg daily with recheck in 6 weeks
C. Triiodothyronine (T3) 25 mcg daily
D. Observe and recheck TSH in 3 months
Correct Answer: B. Levothyroxine 25 mcg daily with recheck in 6 weeks
For mild hypothyroidism in a younger adult without cardiac disease, start low-dose
levothyroxine (25-50 mcg) and titrate every 4-6 weeks. Full replacement is too aggressive
initially, T3 is not first-line, and observation is inappropriate given symptoms.
Question 8: A 32-year-old G2P1 at 28 weeks gestation reports headache, blurred vision, and
right upper quadrant pain. BP 168/104. Urine dipstick: 3+ protein. Which medication is
contraindicated?
A. Labetalol IV
B. Hydralazine IV
C. Nifedipine PO
D. Lisinopril PO
Correct Answer: D. Lisinopril PO
ACE inhibitors (lisinopril) are contraindicated in pregnancy (fetotoxic). Labetalol,
hydralazine, and nifedipine are first-line for acute severe hypertension in
pregnancy/preeclampsia.
Question 9: A 70-year-old male with osteoporosis presents with acute back pain after lifting a
box. X-ray shows vertebral height loss >20%. What is the most appropriate next step?
A. Bed rest for 6 weeks
B. Physical therapy referral
C. Vertebroplasty referral
D. Calcitonin nasal spray
Correct Answer: C. Vertebroplasty referral
Vertebral compression fractures with >20% height loss and acute pain may benefit from
vertebroplasty or kyphoplasty. These minimally invasive procedures can provide significant
pain relief and stabilize the fracture.
Question 10: A 28-year-old woman with migraines with aura requests contraception. Which
method is contraindicated?
A. Etonogestrel implant
