✅ FNP / Advanced Practice — 200
Original Questions, Answers & Rationales
Questions 1–50
1. A 62-year-old female presents with unilateral temporal
headache, jaw claudication, and visual changes. Which
diagnostic test is most appropriate first?
A. Temporal artery ultrasound
B. ESR and CRP
C. MRI of the brain
D. CBC
Correct Answer: B. ESR and CRP
Rationale: Giant cell arteritis workup begins with inflammatory markers. ESR >50 strongly
suggests diagnosis.
2. A patient with COPD has worsening dyspnea, purulent
sputum, and fever. What is the most appropriate initial
management?
A. Start azithromycin
B. Start prednisone only
C. Increase inhaled corticosteroid dose
D. Start amoxicillin
Correct Answer: A. Start azithromycin
Rationale: COPD exacerbation + purulent sputum → antibiotics recommended; macrolides
preferred.
3. Which medication is first-line for essential tremor?
,A. Carbidopa/levodopa
B. Primidone
C. Propranolol
D. Gabapentin
Correct Answer: C. Propranolol
Rationale: Non-selective beta-blockers are gold standard for essential tremor.
4. A 36-year-old presents with fatigue, palpitations,
tachycardia, and low TSH. What is the next best step?
A. Order thyroid ultrasound
B. Start levothyroxine
C. Order free T4
D. Refer to endocrine
Correct Answer: C. Order free T4
Rationale: Low TSH requires confirmation with T4 to determine hyperthyroidism severity.
5. A child has barky cough, stridor, and hoarse voice.
What is the likely diagnosis?
A. Epiglottitis
B. Croup
C. Pertussis
D. Asthma
Correct Answer: B. Croup
Rationale: Parainfluenza → steeple sign + barky cough.
6. A patient has sudden sharp chest pain that improves
when leaning forward. ECG shows diffuse ST elevations.
Diagnosis?
, A. MI
B. Pericarditis
C. PE
D. Aortic dissection
Correct Answer: B. Pericarditis
Rationale: Positional pain + diffuse ST elevations are classic.
7. Which physical exam finding suggests pneumonia?
A. Hyperresonance
B. Decreased breath sounds
C. Increased tactile fremitus
D. Wheezing
Correct Answer: C. Increased tactile fremitus
Rationale: Consolidation transmits vibrations more efficiently.
8. Treatment of uncomplicated chlamydia?
A. Ciprofloxacin
B. Doxycycline 100 mg BID for 7 days
C. Penicillin G
D. Azithromycin 500 mg daily × 3 days
Correct Answer: B. Doxycycline
Rationale: CDC guidelines recommend doxycycline as first-line.
9. A 44-year-old woman with obesity and RUQ pain after
fatty meals likely has:
A. Peptic ulcer disease
B. Cholelithiasis
C. Appendicitis
D. IBS
Original Questions, Answers & Rationales
Questions 1–50
1. A 62-year-old female presents with unilateral temporal
headache, jaw claudication, and visual changes. Which
diagnostic test is most appropriate first?
A. Temporal artery ultrasound
B. ESR and CRP
C. MRI of the brain
D. CBC
Correct Answer: B. ESR and CRP
Rationale: Giant cell arteritis workup begins with inflammatory markers. ESR >50 strongly
suggests diagnosis.
2. A patient with COPD has worsening dyspnea, purulent
sputum, and fever. What is the most appropriate initial
management?
A. Start azithromycin
B. Start prednisone only
C. Increase inhaled corticosteroid dose
D. Start amoxicillin
Correct Answer: A. Start azithromycin
Rationale: COPD exacerbation + purulent sputum → antibiotics recommended; macrolides
preferred.
3. Which medication is first-line for essential tremor?
,A. Carbidopa/levodopa
B. Primidone
C. Propranolol
D. Gabapentin
Correct Answer: C. Propranolol
Rationale: Non-selective beta-blockers are gold standard for essential tremor.
4. A 36-year-old presents with fatigue, palpitations,
tachycardia, and low TSH. What is the next best step?
A. Order thyroid ultrasound
B. Start levothyroxine
C. Order free T4
D. Refer to endocrine
Correct Answer: C. Order free T4
Rationale: Low TSH requires confirmation with T4 to determine hyperthyroidism severity.
5. A child has barky cough, stridor, and hoarse voice.
What is the likely diagnosis?
A. Epiglottitis
B. Croup
C. Pertussis
D. Asthma
Correct Answer: B. Croup
Rationale: Parainfluenza → steeple sign + barky cough.
6. A patient has sudden sharp chest pain that improves
when leaning forward. ECG shows diffuse ST elevations.
Diagnosis?
, A. MI
B. Pericarditis
C. PE
D. Aortic dissection
Correct Answer: B. Pericarditis
Rationale: Positional pain + diffuse ST elevations are classic.
7. Which physical exam finding suggests pneumonia?
A. Hyperresonance
B. Decreased breath sounds
C. Increased tactile fremitus
D. Wheezing
Correct Answer: C. Increased tactile fremitus
Rationale: Consolidation transmits vibrations more efficiently.
8. Treatment of uncomplicated chlamydia?
A. Ciprofloxacin
B. Doxycycline 100 mg BID for 7 days
C. Penicillin G
D. Azithromycin 500 mg daily × 3 days
Correct Answer: B. Doxycycline
Rationale: CDC guidelines recommend doxycycline as first-line.
9. A 44-year-old woman with obesity and RUQ pain after
fatty meals likely has:
A. Peptic ulcer disease
B. Cholelithiasis
C. Appendicitis
D. IBS
