NRP 531 PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS GRADED A+
◍ The NP is considering erythromycin dosing for a 2-week-old neonate with
Chlamydia pneumoniae conjunctivitis. Recognizing that erythromycin base
is degraded in the stomach by hydrochloric acid prior to absorption, the NP
know the absorption of erythromycin in the neonate is likely to
be________?.
Answer: Decreased
◍ CN 8.
Answer: Acoustic nerve (hearing)Whisper test - whisper words out of
patient's sight & patient repeats words back.Test one ear at a time."one, two,
three" and "four, five, six"--Hearing intact bilaterally
◍ A 41-year-old female presents for evaluation of new onset activity
intolerance; she has times in which she becomes so out of breath she cannot
even talk on the phone without getting out of breath. She has no significant
medical history except for hypertension which resolved after she had gastric
bypass surgery and lost 100 lbs. She currently takes no medications except
for Vitamin D and B12 replacement and has no cardiopulmonary history.
Physical examination reveals a grade II systolic murmur at the 4th ICS LSB
and a loud S2 heart sound. This finding is most consistent with which of the
following?.
Answer: The patient has a remote history of appetite suppressant use.
◍ A 51-year-old woman is complaining of edema of the bilateral lower
extremities from the ankles to mid-calf. She is obese and says that she has
been overweight most of her life. She does not remember when the swelling
started, she just decided that she should come have it checked. The patient
denies any pain but admits that her legs do begin to ache by the end of the
, day. The swelling seems to go down overnight, and it gets better when she
sits with her legs on the ottoman. Physical examination is likely to reveal:.
Answer: Trophic hyperpigmentation.
◍ A 57-year-old woman presents with a 3-day history of fever, dyspnea, and a
purulent cough. Auscultation of the lungs identifies an area of egophony in
the lower left lobe. Palpation reveals increased tactile fremitus. The NP
expects which of the following percussion findings?.
Answer: Dullness
◍ The NP is examining a 15-year-old with an 8-hour history of abdominal
pain progressing to nausea and vomiting. Suspecting acute appendicitis, the
NP checks for the Markle sign that is best described as:.
Answer: RLQ pain when dropping from tiptoe to heels.
◍ The inflammatory response is characterized by three distinctive phases. The
phase of vasoconstriction serves to:.
Answer: Produce acidosis and tissue hypoxia
◍ A morbidly obese 51-year-old male has an LDL of 210 mg/dL. Which best
describes the benefit of weight loss in this individual?.
Answer: Enhances protective mechanisms of endothelial cells
◍ Abdomen: Inspection.
Answer: Contours & symmetryNo distortions
◍ The foundation of medical management for chronic obstructive pulmonary
disease (COPD) includes beta-adrenergic agonist and muscarinic antagonist
inhalers. This is because the pathophysiologic treatment target of COPD is
the:.
Answer: Airflow limitation
◍ Throat & Mouth: Inspection.
Answer: Inspect...-Lips -- pink & moist-Teeth -- no decay or cracks-Gums --
no redness or swelling-Buccal mucosa -- pink & moist-Palate (hard & soft)
-- intact, pink & moist-Tongue -- smooth, pink & moist-Floor of mouth
(under tongue) -- no nodules or drainage; pink & moist-Posterior pharynx -
, pink, no postnasal drainage-Tonsils (grade tonsils if present)
◍ Relative anemia is most likely when the patient’s physiologic state is
characterized by:.
Answer: hypothermia
◍ Patients with early type 2 insulin resistance will often develop which of the
following?.
Answer: Decreased GLP-1 production
◍ Neck: Palpation.
Answer: Palpates trachea - midline, no abnormalitiesPalpates thyroid
gland--Find the cricoid process--One hand in the suprasternal notch--Put
fingers on each side, retract one side--Ask to swallow--Feel thyroid rise, no
nodulesPalpate carotid artery pulsation, one at time--Normal, bounding
◍ A 37-year-old man presents with a complaint of a 3-day history of low back
pain that travels down the buttocks to the lower leg. He mentions tingling
and some muscle weakness on his left leg as well. Suspecting lumbar
radiculopathy, physical assessment can include which of the following?.
Answer: Straight-leg raiseKemp's test
◍ serum levels of LDL cholesterol are correlated with higher risk of
atherosclerotic cardiovascular disease. Which best describes the physiologic
mechanism by which this occurs?.
Answer: Oxidized LDL is endocytosed by macrophages which leads to
atherosclerotic plaque
◍ Creatinine clearance usually:..
Answer: Approximates glomerular filtration rate.
◍ A 54-year-old female presents for a routine wellness examination. She is
without complaints. Her physical reveals a BMI of 14.2. She is being treated
for gastroesophageal reflux, hypothyroidism, and osteoarthritis, and she
reports she is feeling well. A basic metabolic panel shows a Na+ of 117
mEq/dL. What is the next step in the evaluation of this client?.
Answer: Calculate a serum osmolality
QUESTIONS WITH ANSWERS GRADED A+
◍ The NP is considering erythromycin dosing for a 2-week-old neonate with
Chlamydia pneumoniae conjunctivitis. Recognizing that erythromycin base
is degraded in the stomach by hydrochloric acid prior to absorption, the NP
know the absorption of erythromycin in the neonate is likely to
be________?.
Answer: Decreased
◍ CN 8.
Answer: Acoustic nerve (hearing)Whisper test - whisper words out of
patient's sight & patient repeats words back.Test one ear at a time."one, two,
three" and "four, five, six"--Hearing intact bilaterally
◍ A 41-year-old female presents for evaluation of new onset activity
intolerance; she has times in which she becomes so out of breath she cannot
even talk on the phone without getting out of breath. She has no significant
medical history except for hypertension which resolved after she had gastric
bypass surgery and lost 100 lbs. She currently takes no medications except
for Vitamin D and B12 replacement and has no cardiopulmonary history.
Physical examination reveals a grade II systolic murmur at the 4th ICS LSB
and a loud S2 heart sound. This finding is most consistent with which of the
following?.
Answer: The patient has a remote history of appetite suppressant use.
◍ A 51-year-old woman is complaining of edema of the bilateral lower
extremities from the ankles to mid-calf. She is obese and says that she has
been overweight most of her life. She does not remember when the swelling
started, she just decided that she should come have it checked. The patient
denies any pain but admits that her legs do begin to ache by the end of the
, day. The swelling seems to go down overnight, and it gets better when she
sits with her legs on the ottoman. Physical examination is likely to reveal:.
Answer: Trophic hyperpigmentation.
◍ A 57-year-old woman presents with a 3-day history of fever, dyspnea, and a
purulent cough. Auscultation of the lungs identifies an area of egophony in
the lower left lobe. Palpation reveals increased tactile fremitus. The NP
expects which of the following percussion findings?.
Answer: Dullness
◍ The NP is examining a 15-year-old with an 8-hour history of abdominal
pain progressing to nausea and vomiting. Suspecting acute appendicitis, the
NP checks for the Markle sign that is best described as:.
Answer: RLQ pain when dropping from tiptoe to heels.
◍ The inflammatory response is characterized by three distinctive phases. The
phase of vasoconstriction serves to:.
Answer: Produce acidosis and tissue hypoxia
◍ A morbidly obese 51-year-old male has an LDL of 210 mg/dL. Which best
describes the benefit of weight loss in this individual?.
Answer: Enhances protective mechanisms of endothelial cells
◍ Abdomen: Inspection.
Answer: Contours & symmetryNo distortions
◍ The foundation of medical management for chronic obstructive pulmonary
disease (COPD) includes beta-adrenergic agonist and muscarinic antagonist
inhalers. This is because the pathophysiologic treatment target of COPD is
the:.
Answer: Airflow limitation
◍ Throat & Mouth: Inspection.
Answer: Inspect...-Lips -- pink & moist-Teeth -- no decay or cracks-Gums --
no redness or swelling-Buccal mucosa -- pink & moist-Palate (hard & soft)
-- intact, pink & moist-Tongue -- smooth, pink & moist-Floor of mouth
(under tongue) -- no nodules or drainage; pink & moist-Posterior pharynx -
, pink, no postnasal drainage-Tonsils (grade tonsils if present)
◍ Relative anemia is most likely when the patient’s physiologic state is
characterized by:.
Answer: hypothermia
◍ Patients with early type 2 insulin resistance will often develop which of the
following?.
Answer: Decreased GLP-1 production
◍ Neck: Palpation.
Answer: Palpates trachea - midline, no abnormalitiesPalpates thyroid
gland--Find the cricoid process--One hand in the suprasternal notch--Put
fingers on each side, retract one side--Ask to swallow--Feel thyroid rise, no
nodulesPalpate carotid artery pulsation, one at time--Normal, bounding
◍ A 37-year-old man presents with a complaint of a 3-day history of low back
pain that travels down the buttocks to the lower leg. He mentions tingling
and some muscle weakness on his left leg as well. Suspecting lumbar
radiculopathy, physical assessment can include which of the following?.
Answer: Straight-leg raiseKemp's test
◍ serum levels of LDL cholesterol are correlated with higher risk of
atherosclerotic cardiovascular disease. Which best describes the physiologic
mechanism by which this occurs?.
Answer: Oxidized LDL is endocytosed by macrophages which leads to
atherosclerotic plaque
◍ Creatinine clearance usually:..
Answer: Approximates glomerular filtration rate.
◍ A 54-year-old female presents for a routine wellness examination. She is
without complaints. Her physical reveals a BMI of 14.2. She is being treated
for gastroesophageal reflux, hypothyroidism, and osteoarthritis, and she
reports she is feeling well. A basic metabolic panel shows a Na+ of 117
mEq/dL. What is the next step in the evaluation of this client?.
Answer: Calculate a serum osmolality
