CMN 577 PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS GRADED A+
◍ 124. A 65-year-old African American male reports to your office to
establish care. He reports a PMH of type 2 diabetes and HTN for which he
currently takes Metformin 1,000mg BID and Lisinopril-HCTZ
20mg/12.5mg daily. He reports his father and brother both died of heart
attacks in their 60's. He is a non-smoker. His vital signs are: HR- 72, BP-
135/88, RR- 16, Temp- 98.5, BMI- 31. His lab values are: HgA1C- 6.7,
Glucose- 122, Total Cholesterol- 243, LDL- 165, HDL- 38, and
Triglycerides 225. You calculate his 10-year ASCVD risk score to be
34.8%. Which of the following medications should be started at today's
visit?
A. Atorvastatin 40mg daily.
B. Ozempic 1mg SQ weekly.
C. Aspirin 81mg daily.
D. Metoprolol 50mg daily.
E. A and
C. F. A and
D. G. None of the above..
Answer: A and C: Atorvastatin 40mg PO Qday and Aspirin 81mg PO
QdayRationale: According to Papadakis and McPhee (2018), a high
intensity statin is indicated for individuals 40-75 with the presence of
diabetes, LDL > 70, and a 10-year CVD risk of 7.5% or higher. Papadakis
and McPhee (2018) also states that most patients, whose CVD risk is high
enough to warrant statin therapy for treatment of an elevated LDL, should
receive prophylactic aspirin therapy at 81mg/day unless there are
contraindications such as aspirin sensitivity, active PUD, or bleeding
disorders. Ozempic does not have to be added at this visit because HgA1C is
within range. Metoprolol does not have to be added at this visit because
, blood pressure is at goal. (pg. 1271)
◍ . A patient with right lower quadrant pain, fever, and rebound tenderness
most likely has:
A. GERD
B. Diverticulitis
C. Appendicitis
D. Pancreatitis.
Answer: Appendicitis
◍ A 55-year-old with proximal muscle weakness and elevated CK likely has:
A. Myasthenia gravis
B. Polymyositis
C. ALS
D. Fibromyalgia.
Answer: Polymyositis
◍ A 17-year-old with fever, headache, and photophobia most likely requires:
A. Oral antibiotics
B. Lumbar puncture
C. CT scan only
D. Outpatient observation.
Answer: Lumbar puncture
◍ A newborn with projectile vomiting after feeding likely has:
A. GERD
B. Pyloric stenosis
C. Malrotation
D. Milk protein allergy.
Answer: Pyloric stenosis
◍ 141. A mother brings in her 16-year-old daughter for a wellness check and
has concerns that she has not had her first menstrual period. After a
thorough history and physical exam, the nurse practitioner notices sexual
maturity rating 4 of both breast and pubic hair development. The patient
does not have any acne or hirsutism. What initial tests should be ordered for
, evaluation of amenorrhea?a. CT scan of the headb. Pelvic ultrasoundc.
Urine pregnancy test, TSH, CBC, prolactin, and FSHd. Serum estradiol,
serum Testosterone.
Answer: Urine pregnancy test, TSH, CBC, prolactin, and FSH
◍ According to the World Health Organization, exclusive breast-feeding is
recommended for:a. the first two months of lifeb. the first six months of
lifec. the first ten months of lifed. the first 12 months of life.
Answer: the first six months of lifeRATIONALE: because of optimal
nutrition for a normal, healthy infant, exclusive breast-feeding is
recommended for approximately the first six months of life, then slowly
introducing complementary foods through age two. (Hay, Levin, Deterding,
Abzug. Current Diagnosis and Treatment: Pediatrics, 24th edition. Pg. 288.)
◍ 82. A mother brings her 3-year-old daughter to the clinic for an annual
exam; in regard to vision screening, the nurse practitioner knows which of
the following to be true:A) The patient's visual acuity should be tested using
the Snellen chartB) Visual acuity of 20/30 is acceptable for this patient C) A
funduscopic exam should not be performed until the patient is at least 6
years oldD) An absent red reflex is a normal finding at this age.
Answer: Visual acuity of 20/30 is acceptable for this patient [Rationale: A)
visual acuity testing does begin at 3; however, a 3-year-old does not know
letters at this time. The correct vision tests would be the Tumbling E chart or
Allen cards; B) Minimal acceptable acuity for 3-5yo is 20/40; C)
Funduscopic exams begin at age 3; D) an absent red reflex is not a normal
finding at any age]
◍ 33. A 6-month-old female with a history of allergic rhinitis & a mother with
asthma presents to the clinic with pruritis and dry skin patches in the
antecubital skin creases over the last month. The NP knows that the likely
diagnosis is:
A. Tinea Versicolor
B. Varicella-Zoster Infection
C. Folliculitis
, D. Atopic Dermatitis.
Answer: Atopic DermatitisD. Rationale: The essential clinical Signs and
Symptoms of atopic dermatitis are pruritis in the past 12 months, plus three
of the following: history of dry skin in the past 12 months, personal history
of asthma, if <4 years of age has a first-degree family member with
diagnosis of asthma or allergic rhinitis, onset of signs and symptoms prior to
2 years of age, visual flexural dermatitis, or skin crease involvement. This
infant has pruritis plus three of the other features making this the correct
diagnosis (Hay, Deterding, Levin, & Abzug, 2018, p.412).
◍ A 60-year-old chronic smoker presents with hemoptysis and weight loss.
First diagnostic step?
A. Chest X-ray
B. Spirometry
C. MRI
D. D-dimer.
Answer: Chest X-ray
◍ A neonate with a harsh holosystolic murmur at the left lower sternal border
likely has:
A. ASD
B. VSD
C. PDA
D. Tetralogy of Fallot.
Answer: VSD
◍ A 15-year-old female who has never been sexually active, complains she
has lower abdominal cramps with associated symptoms of nausea and
diarrhea. She states the onset occurs a few days before her period and go
away in about 2 days. She states this is new within the last few periods, and
her cycle has been more regular and predictable. She admits to starting her
cycle when she was 13.5 years old and up until now, they have been very
irregular. The NP knows which of the following?
A. Other characteristics of Primary Dysmenorrhea is chronic pelvic pain,
QUESTIONS WITH ANSWERS GRADED A+
◍ 124. A 65-year-old African American male reports to your office to
establish care. He reports a PMH of type 2 diabetes and HTN for which he
currently takes Metformin 1,000mg BID and Lisinopril-HCTZ
20mg/12.5mg daily. He reports his father and brother both died of heart
attacks in their 60's. He is a non-smoker. His vital signs are: HR- 72, BP-
135/88, RR- 16, Temp- 98.5, BMI- 31. His lab values are: HgA1C- 6.7,
Glucose- 122, Total Cholesterol- 243, LDL- 165, HDL- 38, and
Triglycerides 225. You calculate his 10-year ASCVD risk score to be
34.8%. Which of the following medications should be started at today's
visit?
A. Atorvastatin 40mg daily.
B. Ozempic 1mg SQ weekly.
C. Aspirin 81mg daily.
D. Metoprolol 50mg daily.
E. A and
C. F. A and
D. G. None of the above..
Answer: A and C: Atorvastatin 40mg PO Qday and Aspirin 81mg PO
QdayRationale: According to Papadakis and McPhee (2018), a high
intensity statin is indicated for individuals 40-75 with the presence of
diabetes, LDL > 70, and a 10-year CVD risk of 7.5% or higher. Papadakis
and McPhee (2018) also states that most patients, whose CVD risk is high
enough to warrant statin therapy for treatment of an elevated LDL, should
receive prophylactic aspirin therapy at 81mg/day unless there are
contraindications such as aspirin sensitivity, active PUD, or bleeding
disorders. Ozempic does not have to be added at this visit because HgA1C is
within range. Metoprolol does not have to be added at this visit because
, blood pressure is at goal. (pg. 1271)
◍ . A patient with right lower quadrant pain, fever, and rebound tenderness
most likely has:
A. GERD
B. Diverticulitis
C. Appendicitis
D. Pancreatitis.
Answer: Appendicitis
◍ A 55-year-old with proximal muscle weakness and elevated CK likely has:
A. Myasthenia gravis
B. Polymyositis
C. ALS
D. Fibromyalgia.
Answer: Polymyositis
◍ A 17-year-old with fever, headache, and photophobia most likely requires:
A. Oral antibiotics
B. Lumbar puncture
C. CT scan only
D. Outpatient observation.
Answer: Lumbar puncture
◍ A newborn with projectile vomiting after feeding likely has:
A. GERD
B. Pyloric stenosis
C. Malrotation
D. Milk protein allergy.
Answer: Pyloric stenosis
◍ 141. A mother brings in her 16-year-old daughter for a wellness check and
has concerns that she has not had her first menstrual period. After a
thorough history and physical exam, the nurse practitioner notices sexual
maturity rating 4 of both breast and pubic hair development. The patient
does not have any acne or hirsutism. What initial tests should be ordered for
, evaluation of amenorrhea?a. CT scan of the headb. Pelvic ultrasoundc.
Urine pregnancy test, TSH, CBC, prolactin, and FSHd. Serum estradiol,
serum Testosterone.
Answer: Urine pregnancy test, TSH, CBC, prolactin, and FSH
◍ According to the World Health Organization, exclusive breast-feeding is
recommended for:a. the first two months of lifeb. the first six months of
lifec. the first ten months of lifed. the first 12 months of life.
Answer: the first six months of lifeRATIONALE: because of optimal
nutrition for a normal, healthy infant, exclusive breast-feeding is
recommended for approximately the first six months of life, then slowly
introducing complementary foods through age two. (Hay, Levin, Deterding,
Abzug. Current Diagnosis and Treatment: Pediatrics, 24th edition. Pg. 288.)
◍ 82. A mother brings her 3-year-old daughter to the clinic for an annual
exam; in regard to vision screening, the nurse practitioner knows which of
the following to be true:A) The patient's visual acuity should be tested using
the Snellen chartB) Visual acuity of 20/30 is acceptable for this patient C) A
funduscopic exam should not be performed until the patient is at least 6
years oldD) An absent red reflex is a normal finding at this age.
Answer: Visual acuity of 20/30 is acceptable for this patient [Rationale: A)
visual acuity testing does begin at 3; however, a 3-year-old does not know
letters at this time. The correct vision tests would be the Tumbling E chart or
Allen cards; B) Minimal acceptable acuity for 3-5yo is 20/40; C)
Funduscopic exams begin at age 3; D) an absent red reflex is not a normal
finding at any age]
◍ 33. A 6-month-old female with a history of allergic rhinitis & a mother with
asthma presents to the clinic with pruritis and dry skin patches in the
antecubital skin creases over the last month. The NP knows that the likely
diagnosis is:
A. Tinea Versicolor
B. Varicella-Zoster Infection
C. Folliculitis
, D. Atopic Dermatitis.
Answer: Atopic DermatitisD. Rationale: The essential clinical Signs and
Symptoms of atopic dermatitis are pruritis in the past 12 months, plus three
of the following: history of dry skin in the past 12 months, personal history
of asthma, if <4 years of age has a first-degree family member with
diagnosis of asthma or allergic rhinitis, onset of signs and symptoms prior to
2 years of age, visual flexural dermatitis, or skin crease involvement. This
infant has pruritis plus three of the other features making this the correct
diagnosis (Hay, Deterding, Levin, & Abzug, 2018, p.412).
◍ A 60-year-old chronic smoker presents with hemoptysis and weight loss.
First diagnostic step?
A. Chest X-ray
B. Spirometry
C. MRI
D. D-dimer.
Answer: Chest X-ray
◍ A neonate with a harsh holosystolic murmur at the left lower sternal border
likely has:
A. ASD
B. VSD
C. PDA
D. Tetralogy of Fallot.
Answer: VSD
◍ A 15-year-old female who has never been sexually active, complains she
has lower abdominal cramps with associated symptoms of nausea and
diarrhea. She states the onset occurs a few days before her period and go
away in about 2 days. She states this is new within the last few periods, and
her cycle has been more regular and predictable. She admits to starting her
cycle when she was 13.5 years old and up until now, they have been very
irregular. The NP knows which of the following?
A. Other characteristics of Primary Dysmenorrhea is chronic pelvic pain,
