nurse practitioner. Final Exam
(Comprehensive) Actual 2025 Questions and
Answers ()(Verified Answers)
1. A 72-year-old male presents with fatigue, DOE, and bilateral ankle
swelling. His JVP is elevated, S3 is present, and BNP is 1,256. What is
the MOST likely diagnosis?
A. COPD exacerbation
B. Heart failure with reduced EF
C. Pulmonary fibrosis
D. Stable angina
Correct Answer: B. Heart failure with reduced EF
Rationale:
• Elevated JVP + S3 + high BNP → classic signs of volume overload
and systolic dysfunction.
• COPD would have wheezing and hyperinflation.
• Pulmonary fibrosis causes dry crackles; no S3.
• Angina has chest pain, not fluid retention.
,2. A 9-year-old presents with rash that began as “slapped cheeks” and
progressed to a lacy, reticular rash on extremities. What is the
diagnosis?
A. Measles
B. Scarlet fever
C. Fifth disease
D. Rubella
Correct Answer: C. Fifth disease (Parvovirus B19)
Rationale:
• “Slapped cheek” + lacy rash = erythema infectiosum.
• Scarlet fever → sandpaper rash + strawberry tongue.
• Rubella → postauricular lymphadenopathy.
• Measles → Koplik spots + confluent rash.
3. Which newborn finding requires urgent evaluation?
A. Acrocyanosis
B. Milia
C. Jaundice within first 12 hours of life
D. Breast buds
Correct Answer: C
Rationale:
• Jaundice <24 hrs is pathologic, often due to hemolysis.
• Acrocyanosis, milia, and breast hypertrophy are benign newborn
variants.
,4. A 54-year-old female has unilateral temporal headache, scalp
tenderness, and jaw claudication. ESR = 110. What is the immediate
management?
A. CT head
B. High-dose prednisone
C. Low-dose aspirin only
D. Indomethacin
Correct Answer: B
Rationale:
• Suspect giant cell arteritis → prevent permanent blindness.
• Start steroids before biopsy.
5. A 22-year-old male presents with knee pain after running. Pain is
anterior, worse descending stairs, and crepitus is present. What is the
diagnosis?
A. Meniscal tear
B. Patellofemoral pain syndrome
C. ACL tear
D. Osteoarthritis
Answer: B
Rationale:
• PFPS = anterior knee pain + stairs + crepitus.
6. Which is the first-line treatment for acute otitis externa?
, A. Oral amoxicillin
B. Ciprofloxacin-HC ear drops
C. Oral cefdinir
D. Corticosteroids alone
Answer: B
Rationale:
Topical antibiotics with steroids are best unless invasive signs.
7. A patient has RUQ pain radiating to right shoulder, fever, positive
Murphy sign. What is the diagnosis?
A. Pancreatitis
B. Cholecystitis
C. Appendicitis
D. GERD
Answer: B
Rationale:
Classic symptoms of gallbladder inflammation.
8. A 40-year-old obese woman presents with amenorrhea, hirsutism,
and acne. Labs show elevated testosterone. What is likely?
A. PCOS
B. Menopause
C. Hyperprolactinemia
D. Hypothyroidism
Answer: A