FITZ EXIT EXAM | NURSE PRACTITIONER BOARD
REVIEW LATEST UPDATED 2026-2027 ACTUAL FINAL
EXAM PREP WITH ALL POSSIBLE TESTED
QUESTIONS AND 100% CORRECT VERIFIED
ANSWERS WITH DETAILED RATIONALES PLUS
CERTIFIED ANSWER KEY RATED A+ GRADE
1. A 68-year-old male presents with a sudden onset
of severe, tearing chest pain that radiates to his
back. He has a history of hypertension. Which of
the following is the most critical initial
diagnostic test?
A. 12-lead ECG
B. Chest X-ray
C. CT angiography of the chest
D. Transthoracic echocardiogram
*Rationale: The presentation is classic for an
aortic dissection. A CT angiogram of the
chest is the gold standard for diagnosis,
allowing visualization of the dissection flap.
An ECG is important to rule out myocardial
infarction but is not diagnostic for
dissection. *
,2. A 24-year-old female presents with a 3-day
history of dysuria, frequency, and urgency. She
has no fever or flank pain. A urinalysis is
positive for leukocyte esterase and nitrites. What
is the most appropriate initial management?
A. Nitrofurantoin 100 mg PO BID for 5 days
B. Ciprofloxacin 500 mg PO BID for 7 days
C. Levofloxacin 750 mg PO daily for 5 days
D. Trimethoprim-sulfamethoxazole 160/800 mg
PO BID for 10 days
*Rationale: This is an uncomplicated lower
urinary tract infection (cystitis). First-line
treatment includes nitrofurantoin,
trimethoprim-sulfamethoxazole (if local
resistance is <20%), or fosfomycin.
Fluoroquinolones are reserved for more
complicated infections due to concerns about
collateral damage and resistance. *
3. Which of the following is the most common
cause of community-acquired pneumonia (CAP)
in adults?
A. Haemophilus influenzae
B. Streptococcus pneumoniae
, C. Mycoplasma pneumoniae
D. Legionella pneumophila
*Rationale: Streptococcus pneumoniae
remains the most frequently identified
bacterial cause of community-acquired
pneumonia in adults. *
4. A 55-year-old male with a history of type 2
diabetes and hypertension presents for a routine
visit. His blood pressure is 148/92 mmHg. He is
currently on lisinopril 20 mg daily. According to
JNC 8 guidelines, what is the most appropriate
next step in management?
A. Add a beta-blocker.
B. Increase lisinopril to 40 mg daily.
C. Add a thiazide diuretic or a calcium
channel blocker.
D. Add an alpha-blocker.
*Rationale: For a patient with diabetes and
hypertension, the goal BP is <140/90 mmHg.
If the patient is not at goal on a single agent
(ACE inhibitor), the guidelines recommend
adding a thiazide diuretic or a calcium
channel blocker (CCB) rather than
, increasing the dose of the ACE inhibitor or
adding a beta-blocker. *
5. A 30-year-old female presents with a 2-week
history of palpitations, heat intolerance, and a
10-pound weight loss despite a good appetite.
Her physical exam reveals a heart rate of 110
bpm, fine tremor, and a mildly enlarged, non-
tender thyroid gland. Which laboratory test is
the most appropriate to confirm the suspected
diagnosis?
A. Serum TSH only
B. Serum TSH and free T4
C. Thyroid stimulating immunoglobulin (TSI)
D. Radioactive iodine uptake (RAIU) scan
*Rationale: The clinical presentation is highly
suggestive of hyperthyroidism (likely Graves'
disease). The initial diagnostic step is to
measure serum TSH and free T4. A
suppressed TSH with an elevated free T4
confirms primary hyperthyroidism. TSI and
RAIU are used to determine the etiology. *
6. A 72-year-old male is brought to the clinic by
his daughter who reports he has been more
REVIEW LATEST UPDATED 2026-2027 ACTUAL FINAL
EXAM PREP WITH ALL POSSIBLE TESTED
QUESTIONS AND 100% CORRECT VERIFIED
ANSWERS WITH DETAILED RATIONALES PLUS
CERTIFIED ANSWER KEY RATED A+ GRADE
1. A 68-year-old male presents with a sudden onset
of severe, tearing chest pain that radiates to his
back. He has a history of hypertension. Which of
the following is the most critical initial
diagnostic test?
A. 12-lead ECG
B. Chest X-ray
C. CT angiography of the chest
D. Transthoracic echocardiogram
*Rationale: The presentation is classic for an
aortic dissection. A CT angiogram of the
chest is the gold standard for diagnosis,
allowing visualization of the dissection flap.
An ECG is important to rule out myocardial
infarction but is not diagnostic for
dissection. *
,2. A 24-year-old female presents with a 3-day
history of dysuria, frequency, and urgency. She
has no fever or flank pain. A urinalysis is
positive for leukocyte esterase and nitrites. What
is the most appropriate initial management?
A. Nitrofurantoin 100 mg PO BID for 5 days
B. Ciprofloxacin 500 mg PO BID for 7 days
C. Levofloxacin 750 mg PO daily for 5 days
D. Trimethoprim-sulfamethoxazole 160/800 mg
PO BID for 10 days
*Rationale: This is an uncomplicated lower
urinary tract infection (cystitis). First-line
treatment includes nitrofurantoin,
trimethoprim-sulfamethoxazole (if local
resistance is <20%), or fosfomycin.
Fluoroquinolones are reserved for more
complicated infections due to concerns about
collateral damage and resistance. *
3. Which of the following is the most common
cause of community-acquired pneumonia (CAP)
in adults?
A. Haemophilus influenzae
B. Streptococcus pneumoniae
, C. Mycoplasma pneumoniae
D. Legionella pneumophila
*Rationale: Streptococcus pneumoniae
remains the most frequently identified
bacterial cause of community-acquired
pneumonia in adults. *
4. A 55-year-old male with a history of type 2
diabetes and hypertension presents for a routine
visit. His blood pressure is 148/92 mmHg. He is
currently on lisinopril 20 mg daily. According to
JNC 8 guidelines, what is the most appropriate
next step in management?
A. Add a beta-blocker.
B. Increase lisinopril to 40 mg daily.
C. Add a thiazide diuretic or a calcium
channel blocker.
D. Add an alpha-blocker.
*Rationale: For a patient with diabetes and
hypertension, the goal BP is <140/90 mmHg.
If the patient is not at goal on a single agent
(ACE inhibitor), the guidelines recommend
adding a thiazide diuretic or a calcium
channel blocker (CCB) rather than
, increasing the dose of the ACE inhibitor or
adding a beta-blocker. *
5. A 30-year-old female presents with a 2-week
history of palpitations, heat intolerance, and a
10-pound weight loss despite a good appetite.
Her physical exam reveals a heart rate of 110
bpm, fine tremor, and a mildly enlarged, non-
tender thyroid gland. Which laboratory test is
the most appropriate to confirm the suspected
diagnosis?
A. Serum TSH only
B. Serum TSH and free T4
C. Thyroid stimulating immunoglobulin (TSI)
D. Radioactive iodine uptake (RAIU) scan
*Rationale: The clinical presentation is highly
suggestive of hyperthyroidism (likely Graves'
disease). The initial diagnostic step is to
measure serum TSH and free T4. A
suppressed TSH with an elevated free T4
confirms primary hyperthyroidism. TSI and
RAIU are used to determine the etiology. *
6. A 72-year-old male is brought to the clinic by
his daughter who reports he has been more
