NP PRACTICE EXAM|VERIFIED QUESTIONS AND CORRECT DETAILED
ANSWERS|RATED AND GRADED A+ NEW UPDATE| 2026/2027
A 16-year-old presents with moderate acne consisting of about 25 inflammatory lesions on her face,
neck, and shoulders. First-line treatment can include:
Alcohol-based facial wash.
Oral antimicrobial plus topical salicylic acid.
Topical benzoyl peroxide plus topical antimicrobial.
Oral isotretinoin. - ANSWER✔ Topical benzoyl peroxide plus topical antimicrobial.
Combination therapy is preferred for moderate acne while monotherapy with topical benzoyl peroxide
or a topical retinoid can be considered for initial therapy of mild acne. Alcohol-based facial wash is not
recommended for the treatment of acne (A). A topical antibacterial cream or lotion is generally
preferred over a systemic antimicrobial as first-line therapy in moderate acne (B). A topical retinoid is
also preferred over topical salicylic acid when used as part of combination therapy for moderate acne.
Oral isotretinoin is generally reserved for severe acne when prior treatments result in an inadequate
response (D).
Lisa is a 48-year-old woman who presents with a 5-day history of painful urination and mucopurulent
vaginal discharge. Suspecting chlamydial infection, which of the following findings would support this
diagnosis?
Large numbers of motile organisms upon microscopic exam
Friable cervix
Positive psoas sign
Rebound tenderness - ANSWER✔ Friable cervix
A large number of motile organisms upon microscopic examination is more indicative of trichomoniasis
rather than chlamydial infection (A). A positive psoas sign indicates appendicitis (C), and it is cervical
motion tenderness rather than rebound tenderness that is associated with chlamydia infection (D).
,The NAAT assay is performed for Lisa and chlamydia infection is confirmed. Which of the following is the
most appropriate treatment choice?
IM or oral penicillin
Oral TMP-SMX
Oral azithromycin
Oral ciprofloxacin - ANSWER✔ Oral azithromycin
Penicillin is not effective against intracellular pathogens and so is not recommended in the treatment of
chlamydial infection (A). TMP-SMX is used to treat urinary tract infections but is not preferred for
chlamydia (B). Fluoroquinolones are also not considered first-line therapy for chlamydial infection and
should be avoided due to risk of adverse effects and increasing rates of resistance by certain pathogens
(D).
Which of the following is recommended prior to Lisa leaving the clinic?
Encourage all household members to be tested for chlamydia
Recommend the HPV vaccine
Screen for meningococcal disease
Encourage screening for HIV - ANSWER✔ Encourage screening for HIV
For patients diagnosed and treated for chlamydial infection, expedited partner therapy (EPT) should be
considered, which would provide the medication or a prescription of the medication for the patient to
take to his/her sexual partner. However, STI screening is not needed for all household members as
intimate contact is needed to spread the infection (A). The HPV vaccine is recommended for adults up to
26 years of age. Adults up to 45 years of age can also be considered for HPV vaccination following
shared clinical decision-making (B). Screening for meningococcal disease is also not warranted with no
presenting signs or symptoms and/or during times of no known community outbreak of the infection
(C).
A 27-year-old male is diagnosed with gonorrhea. He is otherwise healthy, has no drug allergies, and has
not been treated with an antimicrobial in the past year. Recommended treatment is:
,Mark For Review
IM or oral penicillin.
Oral azithromycin.
IM ceftriaxone.
Oral levofloxacin. - ANSWER✔ IM ceftriaxone
Penicillin or amoxicillin are not recommended for the treatment of gonorrhea due to the high
prevalence of beta-lactamase production by these organisms (A). The fluoroquinolones are no longer
recommended to treat gonorrhea due to high rates of resistance (D). Azithromycin can be considered
for treatment but in combination with gentamicin as an alternative approach (B).
The NP is counseling Rene, a 22-year-old woman, who reports having unprotected intercourse 3 days
ago and asks about emergency contraception. She is not currently taking any form of contraception and
her last menses ended 7 days ago. The NP advises:
A pregnancy test is needed prior to using emergency contraception.
A prescription is not needed for levonorgestrel emergency contraception.
Ulipristal is effective only up to 48 hours after unprotected intercourse.
The use of emergency contraception can increase infertility risk in the future. - ANSWER✔ A
prescription is not needed for levonorgestrel emergency contraception.
A pregnancy test is not required prior to using emergency contraception (A). Ulipristal and copper-
containing IUD can be used as emergency contraception up to 5 days after unprotected coitus (C).
Levonorgestrel emergency contraception can also be used up to 5 days following unprotected coitus,
but is most effective up to 3 days following unprotected coitus. There is no association between the use
of emergency contraception and risk of infertility (D).
Rene calls the clinic 4 weeks after taking emergency contraception and reports that she has not yet
started her menses. She is concerned because her cycle is normally predictable. The NP recommends:
Waiting another week to see if menstruation begins.
Take another dose of emergency contraception.
, Taking a pregnancy test.
Starting combined oral contraception. - ANSWER✔ Taking a pregnancy test
Since it has been 5 weeks since her last menses, a pregnancy test should be administered promptly
without waiting another week (A). Taking emergency contraception or initiating combined oral
contraception is not recommended due to the possibility of a pregnancy (B, D). Emergency
contraception should also not be taken beyond 5 days of unprotected intercourse.
Wellman is a 48-year-old roofer who presents because he is concerned about a painless nodule that
developed on the tip of his nose over the past couple of months. The nodule is about 8 mm in diameter,
opaque, ulcerating, with non-distinct borders. This most likely represents:
Phymatous rosacea.
Squamous cell carcinoma.
Malignant melanoma.
Actinic keratosis. - ANSWER✔ Squamous cell carcinoma
Phymatous rosacea will cause the skin to thicken and scar and make the area of skin bumpy and swollen,
but would not present as a single distinct nodule (A). Malignant melanoma is described as asymmetric,
irregular, and with non-uniform color (often black or brown). Actinic keratosis consists of small, flesh-
colored lesions with a sandpaper-like texture on sun-exposed areas (D).
The next-best course of action for Wellman is:
Initiate topical antimicrobial therapy.
Schedule a chemical peel.
Schedule a biopsy of the lesion.
Recommend treatment with topical benzoyl peroxide and retinoic acid. - ANSWER✔ Schedule a
biopsy of the lesion
Lesions that are suspected to be cancerous should be referred for a biopsy without delay due to the risk
of malignancy. Treatment should not be initiated until a diagnosis is confirmed. Antimicrobial therapy,
ANSWERS|RATED AND GRADED A+ NEW UPDATE| 2026/2027
A 16-year-old presents with moderate acne consisting of about 25 inflammatory lesions on her face,
neck, and shoulders. First-line treatment can include:
Alcohol-based facial wash.
Oral antimicrobial plus topical salicylic acid.
Topical benzoyl peroxide plus topical antimicrobial.
Oral isotretinoin. - ANSWER✔ Topical benzoyl peroxide plus topical antimicrobial.
Combination therapy is preferred for moderate acne while monotherapy with topical benzoyl peroxide
or a topical retinoid can be considered for initial therapy of mild acne. Alcohol-based facial wash is not
recommended for the treatment of acne (A). A topical antibacterial cream or lotion is generally
preferred over a systemic antimicrobial as first-line therapy in moderate acne (B). A topical retinoid is
also preferred over topical salicylic acid when used as part of combination therapy for moderate acne.
Oral isotretinoin is generally reserved for severe acne when prior treatments result in an inadequate
response (D).
Lisa is a 48-year-old woman who presents with a 5-day history of painful urination and mucopurulent
vaginal discharge. Suspecting chlamydial infection, which of the following findings would support this
diagnosis?
Large numbers of motile organisms upon microscopic exam
Friable cervix
Positive psoas sign
Rebound tenderness - ANSWER✔ Friable cervix
A large number of motile organisms upon microscopic examination is more indicative of trichomoniasis
rather than chlamydial infection (A). A positive psoas sign indicates appendicitis (C), and it is cervical
motion tenderness rather than rebound tenderness that is associated with chlamydia infection (D).
,The NAAT assay is performed for Lisa and chlamydia infection is confirmed. Which of the following is the
most appropriate treatment choice?
IM or oral penicillin
Oral TMP-SMX
Oral azithromycin
Oral ciprofloxacin - ANSWER✔ Oral azithromycin
Penicillin is not effective against intracellular pathogens and so is not recommended in the treatment of
chlamydial infection (A). TMP-SMX is used to treat urinary tract infections but is not preferred for
chlamydia (B). Fluoroquinolones are also not considered first-line therapy for chlamydial infection and
should be avoided due to risk of adverse effects and increasing rates of resistance by certain pathogens
(D).
Which of the following is recommended prior to Lisa leaving the clinic?
Encourage all household members to be tested for chlamydia
Recommend the HPV vaccine
Screen for meningococcal disease
Encourage screening for HIV - ANSWER✔ Encourage screening for HIV
For patients diagnosed and treated for chlamydial infection, expedited partner therapy (EPT) should be
considered, which would provide the medication or a prescription of the medication for the patient to
take to his/her sexual partner. However, STI screening is not needed for all household members as
intimate contact is needed to spread the infection (A). The HPV vaccine is recommended for adults up to
26 years of age. Adults up to 45 years of age can also be considered for HPV vaccination following
shared clinical decision-making (B). Screening for meningococcal disease is also not warranted with no
presenting signs or symptoms and/or during times of no known community outbreak of the infection
(C).
A 27-year-old male is diagnosed with gonorrhea. He is otherwise healthy, has no drug allergies, and has
not been treated with an antimicrobial in the past year. Recommended treatment is:
,Mark For Review
IM or oral penicillin.
Oral azithromycin.
IM ceftriaxone.
Oral levofloxacin. - ANSWER✔ IM ceftriaxone
Penicillin or amoxicillin are not recommended for the treatment of gonorrhea due to the high
prevalence of beta-lactamase production by these organisms (A). The fluoroquinolones are no longer
recommended to treat gonorrhea due to high rates of resistance (D). Azithromycin can be considered
for treatment but in combination with gentamicin as an alternative approach (B).
The NP is counseling Rene, a 22-year-old woman, who reports having unprotected intercourse 3 days
ago and asks about emergency contraception. She is not currently taking any form of contraception and
her last menses ended 7 days ago. The NP advises:
A pregnancy test is needed prior to using emergency contraception.
A prescription is not needed for levonorgestrel emergency contraception.
Ulipristal is effective only up to 48 hours after unprotected intercourse.
The use of emergency contraception can increase infertility risk in the future. - ANSWER✔ A
prescription is not needed for levonorgestrel emergency contraception.
A pregnancy test is not required prior to using emergency contraception (A). Ulipristal and copper-
containing IUD can be used as emergency contraception up to 5 days after unprotected coitus (C).
Levonorgestrel emergency contraception can also be used up to 5 days following unprotected coitus,
but is most effective up to 3 days following unprotected coitus. There is no association between the use
of emergency contraception and risk of infertility (D).
Rene calls the clinic 4 weeks after taking emergency contraception and reports that she has not yet
started her menses. She is concerned because her cycle is normally predictable. The NP recommends:
Waiting another week to see if menstruation begins.
Take another dose of emergency contraception.
, Taking a pregnancy test.
Starting combined oral contraception. - ANSWER✔ Taking a pregnancy test
Since it has been 5 weeks since her last menses, a pregnancy test should be administered promptly
without waiting another week (A). Taking emergency contraception or initiating combined oral
contraception is not recommended due to the possibility of a pregnancy (B, D). Emergency
contraception should also not be taken beyond 5 days of unprotected intercourse.
Wellman is a 48-year-old roofer who presents because he is concerned about a painless nodule that
developed on the tip of his nose over the past couple of months. The nodule is about 8 mm in diameter,
opaque, ulcerating, with non-distinct borders. This most likely represents:
Phymatous rosacea.
Squamous cell carcinoma.
Malignant melanoma.
Actinic keratosis. - ANSWER✔ Squamous cell carcinoma
Phymatous rosacea will cause the skin to thicken and scar and make the area of skin bumpy and swollen,
but would not present as a single distinct nodule (A). Malignant melanoma is described as asymmetric,
irregular, and with non-uniform color (often black or brown). Actinic keratosis consists of small, flesh-
colored lesions with a sandpaper-like texture on sun-exposed areas (D).
The next-best course of action for Wellman is:
Initiate topical antimicrobial therapy.
Schedule a chemical peel.
Schedule a biopsy of the lesion.
Recommend treatment with topical benzoyl peroxide and retinoic acid. - ANSWER✔ Schedule a
biopsy of the lesion
Lesions that are suspected to be cancerous should be referred for a biopsy without delay due to the risk
of malignancy. Treatment should not be initiated until a diagnosis is confirmed. Antimicrobial therapy,
