Fitzgerald NP Post Test 2026| Actual 150
Questions and Correct Answers with
Explanations for Guaranteed Pass
Question
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:
A) Oral isotretinoin
B) Topical benzoyl peroxide plus topical antimicrobial
C) Oral tetracycline monotherapy
D) Topical retinoid alone
Correct Answer: B) Topical benzoyl peroxide plus topical antimicrobial
Explanation: Moderate inflammatory acne (predominantly papules/pustules) is best managed
initially with combination topical therapy per AAD guidelines. Benzoyl peroxide (BPO) reduces
Cutibacterium acnes and inflammation while a topical antibiotic (e.g., clindamycin) adds
antibacterial synergy and helps prevent resistance. Oral isotretinoin is reserved for
severe/nodular acne; monotherapy (oral or topical) is less effective and increases resistance risk.
Question
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?
A) Friable cervix
B) Negative cervical motion tenderness
C) Clear vaginal discharge
D) Normal cervical appearance
Correct Answer: A) Friable cervix
,Explanation: Chlamydial cervicitis classically presents with mucopurulent endocervical
discharge, dysuria, and a friable (easily bleeding when touched) cervix on speculum exam.
Friable cervix is a hallmark physical finding supporting Chlamydia trachomatis infection. Clear
discharge or lack of cervical motion tenderness would be less suggestive.
Question
The NAAT assay is performed for Lisa and chlamydia infection is confirmed. Which of the
following is the most appropriate treatment choice?
A) Oral doxycycline 100 mg BID for 7 days
B) Oral azithromycin 1 g single dose
C) IM ceftriaxone 500 mg single dose
D) Oral metronidazole 500 mg BID for 7 days
Correct Answer: B) Oral azithromycin 1 g single dose
Explanation: CDC-recommended first-line treatment for uncomplicated urogenital chlamydia in
non-pregnant adults is azithromycin 1 g orally as a single dose (preferred for adherence) or
doxycycline 100 mg BID × 7 days. Single-dose azithromycin is equally effective and often
chosen for simplicity. Ceftriaxone is for gonorrhea; metronidazole is for trichomoniasis or BV.
Question
Which of the following is recommended prior to Lisa leaving the clinic?
A) Prescribe expedited partner therapy only
B) Encourage screening for HIV and other STIs
C) Schedule a follow-up Pap smear immediately
D) Recommend abstinence for 6 months
Correct Answer: B) Encourage screening for HIV and other STIs
Explanation: Patients diagnosed with chlamydia should be offered comprehensive STI screening
(HIV, gonorrhea, syphilis, hepatitis B/C) per CDC guidelines due to high co-infection risk.
Expedited partner therapy is also recommended, but broad STI screening is a key action before
discharge. Pap smear is not urgent here; abstinence is advised until treatment completion and
symptom resolution.
,Question
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:
A) Oral azithromycin 1 g single dose
B) IM ceftriaxone 500 mg single dose
C) Oral doxycycline 100 mg BID for 7 days
D) Oral cefixime 400 mg single dose
Correct Answer: B) IM ceftriaxone 500 mg single dose
Explanation: Uncomplicated gonorrhea treatment (CDC 2024 update): ceftriaxone 500 mg IM
single dose (1 g if body weight ≥150 kg). Dual therapy with azithromycin/doxycycline is no
longer routinely recommended unless chlamydia co-infection is confirmed or suspected.
Cefixime is no longer first-line due to resistance concerns.
Question
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) A prescription is not needed for levonorgestrel emergency contraception
B) Ulipristal acetate is available over-the-counter
C) Copper IUD is not effective after 72 hours
D) Emergency contraception requires a negative pregnancy test first
Correct Answer: A) A prescription is not needed for levonorgestrel emergency contraception
Explanation: Levonorgestrel (Plan B One-Step or generics) is available OTC without age
restriction or prescription in the U.S. It is most effective within 72 hours but can be used up to 5
days. Ulipristal (ella) requires a prescription; copper IUD is effective up to 5 days and requires
insertion; pregnancy test is not required before use but recommended if delayed menses occur.
Question
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:
, A) Taking a pregnancy test
B) Starting combined oral contraceptives immediately
C) Repeating emergency contraception
D) Scheduling a pelvic ultrasound
Correct Answer: A) Taking a pregnancy test
Explanation: Emergency contraception can delay menses by up to 1 week due to hormonal
disruption. If menses are >1 week late, a pregnancy test is the first step to rule out pregnancy. If
negative and no menses, re-evaluate in 1 week or consider hormonal contraception restart.
Question
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:
A) Basal cell carcinoma
B) Squamous cell carcinoma
C) Seborrheic keratosis
D) Actinic keratosis
Correct Answer: B) Squamous cell carcinoma
Explanation: Chronic UV exposure (roofing) + ulcerated, opaque nodule with irregular borders
on sun-exposed skin (nose) is highly suggestive of squamous cell carcinoma (SCC). Basal cell is
typically pearly/nodular with telangiectasia; actinic keratosis is rough/scaly; seborrheic keratosis
is waxy/stuck-on.
Question
The next-best course of action for Wellman is:
A) Apply topical 5-fluorouracil
B) Schedule a biopsy of the lesion
C) Prescribe oral antibiotics
D) Observe for 3 months
Questions and Correct Answers with
Explanations for Guaranteed Pass
Question
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:
A) Oral isotretinoin
B) Topical benzoyl peroxide plus topical antimicrobial
C) Oral tetracycline monotherapy
D) Topical retinoid alone
Correct Answer: B) Topical benzoyl peroxide plus topical antimicrobial
Explanation: Moderate inflammatory acne (predominantly papules/pustules) is best managed
initially with combination topical therapy per AAD guidelines. Benzoyl peroxide (BPO) reduces
Cutibacterium acnes and inflammation while a topical antibiotic (e.g., clindamycin) adds
antibacterial synergy and helps prevent resistance. Oral isotretinoin is reserved for
severe/nodular acne; monotherapy (oral or topical) is less effective and increases resistance risk.
Question
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?
A) Friable cervix
B) Negative cervical motion tenderness
C) Clear vaginal discharge
D) Normal cervical appearance
Correct Answer: A) Friable cervix
,Explanation: Chlamydial cervicitis classically presents with mucopurulent endocervical
discharge, dysuria, and a friable (easily bleeding when touched) cervix on speculum exam.
Friable cervix is a hallmark physical finding supporting Chlamydia trachomatis infection. Clear
discharge or lack of cervical motion tenderness would be less suggestive.
Question
The NAAT assay is performed for Lisa and chlamydia infection is confirmed. Which of the
following is the most appropriate treatment choice?
A) Oral doxycycline 100 mg BID for 7 days
B) Oral azithromycin 1 g single dose
C) IM ceftriaxone 500 mg single dose
D) Oral metronidazole 500 mg BID for 7 days
Correct Answer: B) Oral azithromycin 1 g single dose
Explanation: CDC-recommended first-line treatment for uncomplicated urogenital chlamydia in
non-pregnant adults is azithromycin 1 g orally as a single dose (preferred for adherence) or
doxycycline 100 mg BID × 7 days. Single-dose azithromycin is equally effective and often
chosen for simplicity. Ceftriaxone is for gonorrhea; metronidazole is for trichomoniasis or BV.
Question
Which of the following is recommended prior to Lisa leaving the clinic?
A) Prescribe expedited partner therapy only
B) Encourage screening for HIV and other STIs
C) Schedule a follow-up Pap smear immediately
D) Recommend abstinence for 6 months
Correct Answer: B) Encourage screening for HIV and other STIs
Explanation: Patients diagnosed with chlamydia should be offered comprehensive STI screening
(HIV, gonorrhea, syphilis, hepatitis B/C) per CDC guidelines due to high co-infection risk.
Expedited partner therapy is also recommended, but broad STI screening is a key action before
discharge. Pap smear is not urgent here; abstinence is advised until treatment completion and
symptom resolution.
,Question
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:
A) Oral azithromycin 1 g single dose
B) IM ceftriaxone 500 mg single dose
C) Oral doxycycline 100 mg BID for 7 days
D) Oral cefixime 400 mg single dose
Correct Answer: B) IM ceftriaxone 500 mg single dose
Explanation: Uncomplicated gonorrhea treatment (CDC 2024 update): ceftriaxone 500 mg IM
single dose (1 g if body weight ≥150 kg). Dual therapy with azithromycin/doxycycline is no
longer routinely recommended unless chlamydia co-infection is confirmed or suspected.
Cefixime is no longer first-line due to resistance concerns.
Question
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) A prescription is not needed for levonorgestrel emergency contraception
B) Ulipristal acetate is available over-the-counter
C) Copper IUD is not effective after 72 hours
D) Emergency contraception requires a negative pregnancy test first
Correct Answer: A) A prescription is not needed for levonorgestrel emergency contraception
Explanation: Levonorgestrel (Plan B One-Step or generics) is available OTC without age
restriction or prescription in the U.S. It is most effective within 72 hours but can be used up to 5
days. Ulipristal (ella) requires a prescription; copper IUD is effective up to 5 days and requires
insertion; pregnancy test is not required before use but recommended if delayed menses occur.
Question
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:
, A) Taking a pregnancy test
B) Starting combined oral contraceptives immediately
C) Repeating emergency contraception
D) Scheduling a pelvic ultrasound
Correct Answer: A) Taking a pregnancy test
Explanation: Emergency contraception can delay menses by up to 1 week due to hormonal
disruption. If menses are >1 week late, a pregnancy test is the first step to rule out pregnancy. If
negative and no menses, re-evaluate in 1 week or consider hormonal contraception restart.
Question
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:
A) Basal cell carcinoma
B) Squamous cell carcinoma
C) Seborrheic keratosis
D) Actinic keratosis
Correct Answer: B) Squamous cell carcinoma
Explanation: Chronic UV exposure (roofing) + ulcerated, opaque nodule with irregular borders
on sun-exposed skin (nose) is highly suggestive of squamous cell carcinoma (SCC). Basal cell is
typically pearly/nodular with telangiectasia; actinic keratosis is rough/scaly; seborrheic keratosis
is waxy/stuck-on.
Question
The next-best course of action for Wellman is:
A) Apply topical 5-fluorouracil
B) Schedule a biopsy of the lesion
C) Prescribe oral antibiotics
D) Observe for 3 months
