✅ Solutions manual FNP ASSESSMENT
— 200 QUESTIONS WITH ANSWERS &
RATIONALES
(Actul l, exam-style, clinically accurate)
QUESTIONS 1–200 (with Answers &
Rationales)
1. A 58-year-old with COPD presents with clubbing. Which finding is most
associated with chronic hypoxia?
A. Increased angle between nail and nail base
B. Pitting nails
C. Koilonychia
D. Splinter hemorrhages
✅ Answer: A
Rationale: Clubbing = angle >180° + spongy nail bed; hallmark of chronic hypoxia/COPD.
2. Which heart sound is heard in uncontrolled hypertension due to
ventricular stiffness?
A. S3
B. S4
C. Split S2
D. Opening snap
✅ Answer: B
Rationale: S4 = stiff ventricle → common in LVH from chronic HTN.
,3. A positive Phalen’s test indicates:
A. Ulnar neuropathy
B. Radial nerve compression
C. Median nerve compression
D. Peripheral vascular disease
✅ Answer: C
Rationale: Phalen’s = wrist flexion → tingling in median nerve distribution = carpal tunnel.
4. A patient has RUQ pain radiating to the shoulder, positive Murphy’s sign.
Likely diagnosis?
A. Appendicitis
B. Cholecystitis
C. Pancreatitis
D. Gastritis
✅ Answer: B
Rationale: Murphy’s = inspiratory arrest → gallbladder inflammation.
5. Which cranial nerve is assessed when asking a patient to shrug
shoulders?
A. CN IX
B. CN X
C. CN XI
D. CN XII
✅ Answer: C
Rationale: CN XI controls sternocleidomastoid + trapezius (shoulder shrug).
6. A diabetic has loss of vibratory sense in both feet. Which tool is used for
confirmation?
A. Tuning fork 128 Hz
B. Pinwheel
,C. Reflex hammer
D. Otoscope
✅ Answer: A
Rationale: 128-Hz fork used for peripheral neuropathy evaluation.
7. Romberg test evaluates:
A. Cerebellar function only
B. Proprioception
C. Motor strength
D. Reflex arcs
✅ Answer: B
Rationale: Romberg = dorsal column (position sense) integrity with eyes closed.
8. A 35-year-old presents with a red, painful breast, fever, unilateral mass.
Most likely:
A. Fibrocystic change
B. Mastitis
C. Breast carcinoma
D. Fibroadenoma
✅ Answer: B
Rationale: Fever + erythema + lactation context = mastitis.
9. A 78-year-old with acute confusion. First action?
A. Order MRI
B. Evaluate for infection/UTI
C. Start antipsychotics
D. Check thyroid function
✅ Answer: B
Rationale: Delirium common from infection (UTI/pneumonia) in elderly.
, 10. Crackles in lung bases that do not clear with coughing indicate:
A. Bronchitis
B. Pneumonia or HF
C. Asthma
D. Upper airway obstruction
✅ Answer: B
Rationale: Persistent crackles = alveolar fluid.
11. Best initial test to evaluate suspected DVT:
A. D-dimer
B. Venous Doppler ultrasound
C. CT scan
D. MRI
✅ Answer: B
Rationale: Doppler = first-line diagnostic imaging for DVT.
12. A patient has knee pain with crepitus and morning stiffness <30
minutes. Most likely:
A. RA
B. OA
C. Gout
D. Septic arthritis
✅ Answer: B
Rationale: OA = mechanical pain, crepitus, brief stiffness.
13. Positive McMurray test indicates injury to:
A. ACL
B. PCL
C. Medial or lateral meniscus
D. MCL
— 200 QUESTIONS WITH ANSWERS &
RATIONALES
(Actul l, exam-style, clinically accurate)
QUESTIONS 1–200 (with Answers &
Rationales)
1. A 58-year-old with COPD presents with clubbing. Which finding is most
associated with chronic hypoxia?
A. Increased angle between nail and nail base
B. Pitting nails
C. Koilonychia
D. Splinter hemorrhages
✅ Answer: A
Rationale: Clubbing = angle >180° + spongy nail bed; hallmark of chronic hypoxia/COPD.
2. Which heart sound is heard in uncontrolled hypertension due to
ventricular stiffness?
A. S3
B. S4
C. Split S2
D. Opening snap
✅ Answer: B
Rationale: S4 = stiff ventricle → common in LVH from chronic HTN.
,3. A positive Phalen’s test indicates:
A. Ulnar neuropathy
B. Radial nerve compression
C. Median nerve compression
D. Peripheral vascular disease
✅ Answer: C
Rationale: Phalen’s = wrist flexion → tingling in median nerve distribution = carpal tunnel.
4. A patient has RUQ pain radiating to the shoulder, positive Murphy’s sign.
Likely diagnosis?
A. Appendicitis
B. Cholecystitis
C. Pancreatitis
D. Gastritis
✅ Answer: B
Rationale: Murphy’s = inspiratory arrest → gallbladder inflammation.
5. Which cranial nerve is assessed when asking a patient to shrug
shoulders?
A. CN IX
B. CN X
C. CN XI
D. CN XII
✅ Answer: C
Rationale: CN XI controls sternocleidomastoid + trapezius (shoulder shrug).
6. A diabetic has loss of vibratory sense in both feet. Which tool is used for
confirmation?
A. Tuning fork 128 Hz
B. Pinwheel
,C. Reflex hammer
D. Otoscope
✅ Answer: A
Rationale: 128-Hz fork used for peripheral neuropathy evaluation.
7. Romberg test evaluates:
A. Cerebellar function only
B. Proprioception
C. Motor strength
D. Reflex arcs
✅ Answer: B
Rationale: Romberg = dorsal column (position sense) integrity with eyes closed.
8. A 35-year-old presents with a red, painful breast, fever, unilateral mass.
Most likely:
A. Fibrocystic change
B. Mastitis
C. Breast carcinoma
D. Fibroadenoma
✅ Answer: B
Rationale: Fever + erythema + lactation context = mastitis.
9. A 78-year-old with acute confusion. First action?
A. Order MRI
B. Evaluate for infection/UTI
C. Start antipsychotics
D. Check thyroid function
✅ Answer: B
Rationale: Delirium common from infection (UTI/pneumonia) in elderly.
, 10. Crackles in lung bases that do not clear with coughing indicate:
A. Bronchitis
B. Pneumonia or HF
C. Asthma
D. Upper airway obstruction
✅ Answer: B
Rationale: Persistent crackles = alveolar fluid.
11. Best initial test to evaluate suspected DVT:
A. D-dimer
B. Venous Doppler ultrasound
C. CT scan
D. MRI
✅ Answer: B
Rationale: Doppler = first-line diagnostic imaging for DVT.
12. A patient has knee pain with crepitus and morning stiffness <30
minutes. Most likely:
A. RA
B. OA
C. Gout
D. Septic arthritis
✅ Answer: B
Rationale: OA = mechanical pain, crepitus, brief stiffness.
13. Positive McMurray test indicates injury to:
A. ACL
B. PCL
C. Medial or lateral meniscus
D. MCL
