NP Exam 1 Review
Questions and Answers
Updated 2026
A 43-year-old male recently underwent three months worth of lifestyle interventions but
only had a moderate change in overall blood pressure readings at home. At today's visit, his
blood pressure is consistent with his home readings, and is 138/85. The nurse practitioner
knows that according to the AHA guidelines, we should begin initiating medications for a
stage 1 hypertensive patient at what ASCVD cutoff point? - Answer10%
it is appropriate to initiate antihypertensives if their ASCVD risk score is 10% or greater.
(Hint: can think of hyperTENsion to remember!)
A middle-aged female presents to your clinic today. She has a history of smoking,
hypertension, type II diabetes, and osteoporosis. She has been on lisinopril (Prinvil) 10 mg
daily for the past five years and metformin (Glucophage) 500 mg twice daily. Upon your
physical exam you notice asymmetric, non-pitting swelling around her upper lip which the
patient states started yesterday night and is painless. She also reports diffuse abdominal
pain and diarrhea. The rest of the physical exam was benign. Her fasting blood glucose is
130. Her vital signs are as follows: BP: 141/87 mmHg, HR: 92 bpm, RR: 12 breaths per
minute, O2: 96% on room air. What is the most important thing for the nurse practitioner to
do? - AnswerDiscontinue her lisinopril
This patient is experiencing angioedema - ACE Inhibitor induced angioedema can occur
anytime (days, weeks, or years after initiation). In addition to swelling of the lips, tongue,
and face, visceral angioedema due to an ACE inhibitor can occur and cause symptoms
including abdominal pain, diarrhea, and vomiting. She needs to immediately stop the
lisinopril and it needs to be marked as an allergy.
A patient calls the office complaining of a sudden onset of "cobweb like lines" moving in and
out of her central vision in the right eye. She is not in any pain and is asking if she needs to
come in and be seen. What should the nurse practitioner advise her to do? - AnswerRefer to
opthalmogogy immediately
,A group of new nurse practitioners are evaluating the strength of evidence of some new
asthma guidelines. Which of the following would be at the bottom of the hierarchy of
evidence? - AnswerEditorial
A 55-year-old male patient reports increasing issues with erectile dysfunction over the last
six months. He is requesting to be placed on tadalafil (Cialis) for control of this condition.
Which of the following is critical for the nurse practitioner to order prior to prescribing this
medication? - AnswerEKG
You are performing an annual exam and pap smear on a 39-year-old woman who states she
has never had a mammogram before. A close friend of hers was just diagnosed with breast
cancer and she is wanting to know more about her risk and when she should begin
screening. What in her history would be considered a risk factor for breast cancer? -
AnswerHer only child is a step daughter
You recently diagnosed your patient with sciatica. You ask the patient to perform the squat
and rise exam, and you found that there is a diminished knee jerk. Which of the following is
the root cause of his sciatica based on this finding? - AnswerL4
The squat and rise exam with a diminished knee jerk links to the L4 nerve. We can assess L5
with the heel walk and S1 with the toe walk.
You are assessing a patient for acute abdominal pain. With the patient supine and right knee
flexed, you perform inward rotation on the patient's hip. What maneuver is this and what
are you assessing for? - AnswerObturator sign to assess for appendicitis
Obturator- Is inward rOtation of the hip through full ROM and is a pOsitive sign w/
mOvement or flexion of the hip (I think of all the O's). Iliopsoas/psoas sign is performed by
having patients raise their leg against resistance in a supine position, then while on their left
side, extending the right leg from the hip ( When you do leg raises at the gym, your iliopsoas
muscles are sore). Murphy's sign is elicited when deep palpation on the RUQ under the
, costal border produces pain during Midinspiratory arrest (I think M for Murphy's and M for
Midinspiratory).
An 85-year-old woman presents to the clinic today for a follow up x-ray. She states that she
had x-rays completed 11 days after a fall at home but the imaging was negative at that time.
Due to the nature of her fall, she was instructed to come in for an additional set of x-rays if
the pain persisted. The nurse practitioner knows that if this patient has a fracture today, it is
most likely which of the following? - AnswerScaphoid fracture
Your 63-year-old male patient with vague abdominal pain has a triglyceride level of 899.
Which of the following clinical signs would be most concerning given this lab value? -
AnswerCullen's sign
Patients with polycystic ovarian syndrome (PCOS) may develop all of the following except: -
AnswerBreast CA
Upon a digital rectal examination, the nurse practitioner notes a warm and boggy prostate.
This finding is consistent with which diagnosis? - AnswerProstatitis
A 67-year-old male patient is currently being treated for benign prostatic hyperplasia. He is
concerned that his finasteride (Proscar) is not adequately treating his symptoms. Which of
the following questions is most important to ask this patient to do a further assessment? -
AnswerHow long have you been taking this medication?
A 33-year-old female is complaining of dysuria, flank pain and a fever. Her vital signs are as
follows: BP: 112/76, HR: 76, RR: 18, 97% on room air, Temp: 101.6 F. The patient states she
has had a urinary tract infection off and on over the past month and antibiotics never really
helped. Upon your physical exam you elicit CVA tenderness. What is the best plan for this
patient? - AnswerReferral to the emergency room
A 14-year-old male is complaining of scrotal pain. Which of the following descriptions would
warrant immediate referral? - AnswerThe pain is unilateral and when you gently pinch the
inner thigh, the testicle does not elevate
Questions and Answers
Updated 2026
A 43-year-old male recently underwent three months worth of lifestyle interventions but
only had a moderate change in overall blood pressure readings at home. At today's visit, his
blood pressure is consistent with his home readings, and is 138/85. The nurse practitioner
knows that according to the AHA guidelines, we should begin initiating medications for a
stage 1 hypertensive patient at what ASCVD cutoff point? - Answer10%
it is appropriate to initiate antihypertensives if their ASCVD risk score is 10% or greater.
(Hint: can think of hyperTENsion to remember!)
A middle-aged female presents to your clinic today. She has a history of smoking,
hypertension, type II diabetes, and osteoporosis. She has been on lisinopril (Prinvil) 10 mg
daily for the past five years and metformin (Glucophage) 500 mg twice daily. Upon your
physical exam you notice asymmetric, non-pitting swelling around her upper lip which the
patient states started yesterday night and is painless. She also reports diffuse abdominal
pain and diarrhea. The rest of the physical exam was benign. Her fasting blood glucose is
130. Her vital signs are as follows: BP: 141/87 mmHg, HR: 92 bpm, RR: 12 breaths per
minute, O2: 96% on room air. What is the most important thing for the nurse practitioner to
do? - AnswerDiscontinue her lisinopril
This patient is experiencing angioedema - ACE Inhibitor induced angioedema can occur
anytime (days, weeks, or years after initiation). In addition to swelling of the lips, tongue,
and face, visceral angioedema due to an ACE inhibitor can occur and cause symptoms
including abdominal pain, diarrhea, and vomiting. She needs to immediately stop the
lisinopril and it needs to be marked as an allergy.
A patient calls the office complaining of a sudden onset of "cobweb like lines" moving in and
out of her central vision in the right eye. She is not in any pain and is asking if she needs to
come in and be seen. What should the nurse practitioner advise her to do? - AnswerRefer to
opthalmogogy immediately
,A group of new nurse practitioners are evaluating the strength of evidence of some new
asthma guidelines. Which of the following would be at the bottom of the hierarchy of
evidence? - AnswerEditorial
A 55-year-old male patient reports increasing issues with erectile dysfunction over the last
six months. He is requesting to be placed on tadalafil (Cialis) for control of this condition.
Which of the following is critical for the nurse practitioner to order prior to prescribing this
medication? - AnswerEKG
You are performing an annual exam and pap smear on a 39-year-old woman who states she
has never had a mammogram before. A close friend of hers was just diagnosed with breast
cancer and she is wanting to know more about her risk and when she should begin
screening. What in her history would be considered a risk factor for breast cancer? -
AnswerHer only child is a step daughter
You recently diagnosed your patient with sciatica. You ask the patient to perform the squat
and rise exam, and you found that there is a diminished knee jerk. Which of the following is
the root cause of his sciatica based on this finding? - AnswerL4
The squat and rise exam with a diminished knee jerk links to the L4 nerve. We can assess L5
with the heel walk and S1 with the toe walk.
You are assessing a patient for acute abdominal pain. With the patient supine and right knee
flexed, you perform inward rotation on the patient's hip. What maneuver is this and what
are you assessing for? - AnswerObturator sign to assess for appendicitis
Obturator- Is inward rOtation of the hip through full ROM and is a pOsitive sign w/
mOvement or flexion of the hip (I think of all the O's). Iliopsoas/psoas sign is performed by
having patients raise their leg against resistance in a supine position, then while on their left
side, extending the right leg from the hip ( When you do leg raises at the gym, your iliopsoas
muscles are sore). Murphy's sign is elicited when deep palpation on the RUQ under the
, costal border produces pain during Midinspiratory arrest (I think M for Murphy's and M for
Midinspiratory).
An 85-year-old woman presents to the clinic today for a follow up x-ray. She states that she
had x-rays completed 11 days after a fall at home but the imaging was negative at that time.
Due to the nature of her fall, she was instructed to come in for an additional set of x-rays if
the pain persisted. The nurse practitioner knows that if this patient has a fracture today, it is
most likely which of the following? - AnswerScaphoid fracture
Your 63-year-old male patient with vague abdominal pain has a triglyceride level of 899.
Which of the following clinical signs would be most concerning given this lab value? -
AnswerCullen's sign
Patients with polycystic ovarian syndrome (PCOS) may develop all of the following except: -
AnswerBreast CA
Upon a digital rectal examination, the nurse practitioner notes a warm and boggy prostate.
This finding is consistent with which diagnosis? - AnswerProstatitis
A 67-year-old male patient is currently being treated for benign prostatic hyperplasia. He is
concerned that his finasteride (Proscar) is not adequately treating his symptoms. Which of
the following questions is most important to ask this patient to do a further assessment? -
AnswerHow long have you been taking this medication?
A 33-year-old female is complaining of dysuria, flank pain and a fever. Her vital signs are as
follows: BP: 112/76, HR: 76, RR: 18, 97% on room air, Temp: 101.6 F. The patient states she
has had a urinary tract infection off and on over the past month and antibiotics never really
helped. Upon your physical exam you elicit CVA tenderness. What is the best plan for this
patient? - AnswerReferral to the emergency room
A 14-year-old male is complaining of scrotal pain. Which of the following descriptions would
warrant immediate referral? - AnswerThe pain is unilateral and when you gently pinch the
inner thigh, the testicle does not elevate
