NRP 571 EXAM 2 COMPREHENSIVE
PRACTICE TEST QUESTIONS AND
ANSWERS | 2026/2027 UPDATE | 100%
CORRECT
1. A 19-year-old male presents with a persistent cough for 3 weeks following a viral URI. He
has no fever or chills but reports wheezing at night. Spirometry shows an FEV1/FVC ratio of
0.75. What is the most appropriate next step in management?
A. Initiate a trial of a Low-Dose ICS-Formoterol as needed.
B. Prescribe a 5-day course of azithromycin.
C. Order a chest X-ray to rule out pneumonia.
D. Prescribe an oral corticosteroid burst for 10 days.
Answer: A
Conceptual Explanation: Current GINA guidelines recommend low-dose ICS-formoterol
as the preferred reliever and initial step for mild asthma symptoms to reduce the risk of
exacerbations, even if FEV1 is relatively normal.
2. A 65-year-old patient with COPD (GOLD Group B) remains symptomatic despite SABA use.
What is the recommended first-line long-term maintenance therapy?
A. Long-acting Beta-2 Agonist (LABA) or Long-acting Muscarinic Antagonist (LAMA).
,B. High-dose Inhaled Corticosteroid (ICS) monotherapy.
C. Oral Theophylline.
D. Chronic low-dose Prednisone.
Answer: A
Conceptual Explanation: For GOLD Group B (symptomatic but low risk of exacerbations),
a long-acting bronchodilator (LABA or LAMA) is the standard of care. ICS is not used as
monotherapy in COPD.
3. A 45-year-old patient with no significant history has a blood pressure of 142/92 mmHg
today and 144/94 mmHg two weeks ago. According to ACC/AHA guidelines, how should this
patient be classified?
A. Elevated Blood Pressure
B. Stage 1 Hypertension
C. Hypertensive Urgency
D. Stage 2 Hypertension
Answer: D
Conceptual Explanation: Stage 2 Hypertension is defined as SBP ≥140 mmHg or DBP ≥90
mmHg based on an average of ≥2 readings obtained on ≥2 occasions.
, 4. Which of the following is a contraindication for the use of Metformin in a patient with Type
2 Diabetes?
A. BMI greater than 35.
B. eGFR less than 30 mL/min/1.73 m².
C. Age over 65 years.
D. History of gestational diabetes.
Answer: B
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR < 30 due
to the increased risk of lactic acidosis.
5. A patient presents with a TSH of 0.1 mIU/L and an elevated Free T4. Which physical exam
finding is most specific for Grave’s Disease?
A. Tachycardia
B. Fine tremor of the hands
C. Pretibial Myxedema
D. Weight loss
Answer: C
Conceptual Explanation: Pretibial myxedema (dermopathy) and exophthalmos
(ophthalmopathy) are specific findings for Grave’s disease, whereas tachycardia and
tremors occur in all forms of hyperthyroidism.
PRACTICE TEST QUESTIONS AND
ANSWERS | 2026/2027 UPDATE | 100%
CORRECT
1. A 19-year-old male presents with a persistent cough for 3 weeks following a viral URI. He
has no fever or chills but reports wheezing at night. Spirometry shows an FEV1/FVC ratio of
0.75. What is the most appropriate next step in management?
A. Initiate a trial of a Low-Dose ICS-Formoterol as needed.
B. Prescribe a 5-day course of azithromycin.
C. Order a chest X-ray to rule out pneumonia.
D. Prescribe an oral corticosteroid burst for 10 days.
Answer: A
Conceptual Explanation: Current GINA guidelines recommend low-dose ICS-formoterol
as the preferred reliever and initial step for mild asthma symptoms to reduce the risk of
exacerbations, even if FEV1 is relatively normal.
2. A 65-year-old patient with COPD (GOLD Group B) remains symptomatic despite SABA use.
What is the recommended first-line long-term maintenance therapy?
A. Long-acting Beta-2 Agonist (LABA) or Long-acting Muscarinic Antagonist (LAMA).
,B. High-dose Inhaled Corticosteroid (ICS) monotherapy.
C. Oral Theophylline.
D. Chronic low-dose Prednisone.
Answer: A
Conceptual Explanation: For GOLD Group B (symptomatic but low risk of exacerbations),
a long-acting bronchodilator (LABA or LAMA) is the standard of care. ICS is not used as
monotherapy in COPD.
3. A 45-year-old patient with no significant history has a blood pressure of 142/92 mmHg
today and 144/94 mmHg two weeks ago. According to ACC/AHA guidelines, how should this
patient be classified?
A. Elevated Blood Pressure
B. Stage 1 Hypertension
C. Hypertensive Urgency
D. Stage 2 Hypertension
Answer: D
Conceptual Explanation: Stage 2 Hypertension is defined as SBP ≥140 mmHg or DBP ≥90
mmHg based on an average of ≥2 readings obtained on ≥2 occasions.
, 4. Which of the following is a contraindication for the use of Metformin in a patient with Type
2 Diabetes?
A. BMI greater than 35.
B. eGFR less than 30 mL/min/1.73 m².
C. Age over 65 years.
D. History of gestational diabetes.
Answer: B
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR < 30 due
to the increased risk of lactic acidosis.
5. A patient presents with a TSH of 0.1 mIU/L and an elevated Free T4. Which physical exam
finding is most specific for Grave’s Disease?
A. Tachycardia
B. Fine tremor of the hands
C. Pretibial Myxedema
D. Weight loss
Answer: C
Conceptual Explanation: Pretibial myxedema (dermopathy) and exophthalmos
(ophthalmopathy) are specific findings for Grave’s disease, whereas tachycardia and
tremors occur in all forms of hyperthyroidism.
