FITZ EXIT EXAM | 2025/2026
EDITION | 100 VERIFIED QUESTIONS
AND 100% CORRECT ANSWERS
WITH DETAILED RATIONALES | A+
GRADED NURSE PRACTITIONER
BOARD REVIEW
Cardiovascular System
1. A 55-year-old male presents with chest pain, diaphoresis, and nausea. ECG
shows ST elevation in leads II, III, and aVF. What is the most likely diagnosis?
A) Pericarditis
B) Pulmonary embolism
C) Acute myocardial infarction
D) Aortic dissection
Correct Answer: C) Acute myocardial infarction
Rationale: ST elevation in the inferior leads (II, III, aVF) accompanied by chest pain,
diaphoresis, and nausea is the classic presentation of an acute myocardial infarction,
likely involving the right coronary artery. Pericarditis typically shows diffuse ST
elevation, pulmonary embolism lacks ST elevation, and aortic dissection presents with
tearing pain and unequal pulses.
2. A 35-year-old female presents with unilateral leg swelling and pain. Doppler
ultrasound confirms deep vein thrombosis (DVT). What is the most appropriate
initial treatment?
A) Aspirin
B) Heparin
C) Clopidogrel
D) Warfarin alone
Correct Answer: B) Heparin
Rationale: Heparin (unfractionated or low-molecular-weight) is the initial treatment for
acute DVT to prevent clot extension. Aspirin and clopidogrel are not anticoagulants,
and warfarin requires bridging with heparin.
,Pharmacology
3. A 60-year-old female with hypertension is prescribed hydrochlorothiazide.
Which electrolyte abnormality should be monitored?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: B) Hypokalemia
Rationale: Hydrochlorothiazide, a thiazide diuretic, promotes potassium excretion,
leading to hypokalemia. Hyperkalemia is more commonly associated with ACE
inhibitors.
4. A 55-year-old male with type 2 diabetes is prescribed metformin. Which
laboratory value should be monitored regularly?
A) Serum creatinine
B) Liver enzymes
C) Serum potassium
D) Hemoglobin
Correct Answer: A) Serum creatinine
Rationale: Metformin requires renal function monitoring (serum creatinine) due to the
risk of lactic acidosis in renal impairment.
5. A 50-year-old female with depression is prescribed sertraline. What should
be monitored closely in the first few weeks of treatment?
A) Liver function tests
B) Suicidal ideation
C) Blood glucose
D) Serum sodium
Correct Answer: B) Suicidal ideation
Rationale: SSRIs like sertraline carry a black box warning for increased suicidal
ideation, especially early in treatment.
6. A 60-year-old male with atrial fibrillation is prescribed apixaban. What
should he be taught to avoid?
A) Green leafy vegetables
B) NSAIDs
C) Grapefruit juice
D) Dairy products
Correct Answer: B) NSAIDs
, Rationale: NSAIDs increase bleeding risk when taken with apixaban, a direct oral
anticoagulant. Green leafy vegetables affect warfarin, not apixaban.
Primary Care & Disease Management
7. A 45-year-old female with a BMI of 32 asks about type 2 diabetes prevention.
What is the most effective strategy?
A) Annual HbA1c screening
B) Weight loss and physical activity
C) Low-fat diet alone
D) Metformin initiation
Correct Answer: B) Weight loss and physical activity
Rationale: Weight loss and physical activity are the most effective lifestyle interventions
for preventing type 2 diabetes in high-risk individuals, per ADA guidelines. Screening
detects but does not prevent the disease.
8. A 50-year-old male with COPD presents with increased dyspnea. Spirometry
shows FEV1 45% predicted. What is the most appropriate treatment?
A) Albuterol alone
B) Tiotropium and inhaled corticosteroid
C) Oral prednisone
D) Azithromycin daily
Correct Answer: B) Tiotropium and inhaled corticosteroid
Rationale: For moderate COPD (FEV1 < 50%), GOLD guidelines recommend a long-
acting muscarinic antagonist (tiotropium) with an inhaled corticosteroid for symptom
control. Albuterol is for rescue, prednisone is for exacerbations, and azithromycin is for
frequent exacerbations.
9. A 30-year-old female presents with fatigue, weight gain, and constipation.
TSH is 6.2 mIU/L, and free T4 is low. What is the most appropriate action?
A) Order thyroid ultrasound
B) Initiate levothyroxine
C) Monitor TSH in 6 months
D) Start methimazole
Correct Answer: B) Initiate levothyroxine
Rationale: Elevated TSH and low free T4 indicate primary hypothyroidism, which is
treated with levothyroxine. Ultrasound is for nodules, monitoring delays treatment, and
methimazole is for hyperthyroidism.
10. A 2-year-old child presents with a barking cough and inspiratory stridor.
What is the most likely diagnosis?
EDITION | 100 VERIFIED QUESTIONS
AND 100% CORRECT ANSWERS
WITH DETAILED RATIONALES | A+
GRADED NURSE PRACTITIONER
BOARD REVIEW
Cardiovascular System
1. A 55-year-old male presents with chest pain, diaphoresis, and nausea. ECG
shows ST elevation in leads II, III, and aVF. What is the most likely diagnosis?
A) Pericarditis
B) Pulmonary embolism
C) Acute myocardial infarction
D) Aortic dissection
Correct Answer: C) Acute myocardial infarction
Rationale: ST elevation in the inferior leads (II, III, aVF) accompanied by chest pain,
diaphoresis, and nausea is the classic presentation of an acute myocardial infarction,
likely involving the right coronary artery. Pericarditis typically shows diffuse ST
elevation, pulmonary embolism lacks ST elevation, and aortic dissection presents with
tearing pain and unequal pulses.
2. A 35-year-old female presents with unilateral leg swelling and pain. Doppler
ultrasound confirms deep vein thrombosis (DVT). What is the most appropriate
initial treatment?
A) Aspirin
B) Heparin
C) Clopidogrel
D) Warfarin alone
Correct Answer: B) Heparin
Rationale: Heparin (unfractionated or low-molecular-weight) is the initial treatment for
acute DVT to prevent clot extension. Aspirin and clopidogrel are not anticoagulants,
and warfarin requires bridging with heparin.
,Pharmacology
3. A 60-year-old female with hypertension is prescribed hydrochlorothiazide.
Which electrolyte abnormality should be monitored?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: B) Hypokalemia
Rationale: Hydrochlorothiazide, a thiazide diuretic, promotes potassium excretion,
leading to hypokalemia. Hyperkalemia is more commonly associated with ACE
inhibitors.
4. A 55-year-old male with type 2 diabetes is prescribed metformin. Which
laboratory value should be monitored regularly?
A) Serum creatinine
B) Liver enzymes
C) Serum potassium
D) Hemoglobin
Correct Answer: A) Serum creatinine
Rationale: Metformin requires renal function monitoring (serum creatinine) due to the
risk of lactic acidosis in renal impairment.
5. A 50-year-old female with depression is prescribed sertraline. What should
be monitored closely in the first few weeks of treatment?
A) Liver function tests
B) Suicidal ideation
C) Blood glucose
D) Serum sodium
Correct Answer: B) Suicidal ideation
Rationale: SSRIs like sertraline carry a black box warning for increased suicidal
ideation, especially early in treatment.
6. A 60-year-old male with atrial fibrillation is prescribed apixaban. What
should he be taught to avoid?
A) Green leafy vegetables
B) NSAIDs
C) Grapefruit juice
D) Dairy products
Correct Answer: B) NSAIDs
, Rationale: NSAIDs increase bleeding risk when taken with apixaban, a direct oral
anticoagulant. Green leafy vegetables affect warfarin, not apixaban.
Primary Care & Disease Management
7. A 45-year-old female with a BMI of 32 asks about type 2 diabetes prevention.
What is the most effective strategy?
A) Annual HbA1c screening
B) Weight loss and physical activity
C) Low-fat diet alone
D) Metformin initiation
Correct Answer: B) Weight loss and physical activity
Rationale: Weight loss and physical activity are the most effective lifestyle interventions
for preventing type 2 diabetes in high-risk individuals, per ADA guidelines. Screening
detects but does not prevent the disease.
8. A 50-year-old male with COPD presents with increased dyspnea. Spirometry
shows FEV1 45% predicted. What is the most appropriate treatment?
A) Albuterol alone
B) Tiotropium and inhaled corticosteroid
C) Oral prednisone
D) Azithromycin daily
Correct Answer: B) Tiotropium and inhaled corticosteroid
Rationale: For moderate COPD (FEV1 < 50%), GOLD guidelines recommend a long-
acting muscarinic antagonist (tiotropium) with an inhaled corticosteroid for symptom
control. Albuterol is for rescue, prednisone is for exacerbations, and azithromycin is for
frequent exacerbations.
9. A 30-year-old female presents with fatigue, weight gain, and constipation.
TSH is 6.2 mIU/L, and free T4 is low. What is the most appropriate action?
A) Order thyroid ultrasound
B) Initiate levothyroxine
C) Monitor TSH in 6 months
D) Start methimazole
Correct Answer: B) Initiate levothyroxine
Rationale: Elevated TSH and low free T4 indicate primary hypothyroidism, which is
treated with levothyroxine. Ultrasound is for nodules, monitoring delays treatment, and
methimazole is for hyperthyroidism.
10. A 2-year-old child presents with a barking cough and inspiratory stridor.
What is the most likely diagnosis?
