Chamberlain NP Final Exam
Simulation – 2026 Edition\\questions
and answers with rationales/graded
A+/2026 update/100% correct /instant
download
Course: Nurse Practitioner (Family/Adult-Gerontology)
Total Questions: 85
Format: Multiple Choice, Select All That Apply (SATA), Clinical Judgment
Instructions: Choose the best answer. Correct answers are bolded. Rationales are
provided.
Section 1: Primary Care & Health Promotion (Questions 1–15)
1. A 55-year-old male with hypertension and dyslipidemia asks about aspirin
for primary prevention of cardiovascular disease. Current BP 128/80, LDL
110. What is the best response?
A. Start aspirin 81 mg daily immediately
B. Start aspirin 325 mg daily for better efficacy
C. Not recommended due to increased bleeding risk without clear benefit
D. Use aspirin only if patient develops chest pain
Rationale: Current guidelines advise against routine aspirin for primary prevention
in patients >70 years or with increased bleeding risk. This patient’s 10-year CVD
risk is <10%? No indication.
2. A 28-year-old G0 female presents for preconception counseling. She has no
medical issues. Which vaccine should be prioritized before pregnancy?
A. HPV vaccine
B. MMR (Measles, Mumps, Rubella)
C. Influenza vaccine
D. Tdap
,Rationale: MMR is a live vaccine that must be given ≥4 weeks before conception.
Influenza and Tdap can be given during pregnancy if needed; HPV is not
recommended in pregnancy.
3. A 72-year-old male with osteoporosis has a T-score of -3.0 at the femoral
neck despite 2 years of alendronate. Next best step?
A. Continue alendronate and add calcium
B. Switch to teriparatide
C. Increase alendronate to weekly 140 mg
D. Stop all medications and repeat DEXA in 1 year
Rationale: Lack of response to bisphosphonate (failure to improve or worsening T-
score) warrants switching to an anabolic agent like teriparatide.
4. A 45-year-old female presents with fatigue, weight gain, cold intolerance,
and constipation. TSH is 12.5 mIU/L (ref 0.4–4.0). What is the most
appropriate treatment?
A. Liothyronine (T3) only
B. Levothyroxine 1.6 mcg/kg/day
C. Methimazole 10 mg daily
D. Observation and repeat TSH in 3 months
Rationale: Overt hypothyroidism (TSH >10) requires levothyroxine. Starting dose
is weight-based (1.6 mcg/kg).
5. A 35-year-old male has a BMI of 32, acanthosis nigricans, and fasting
glucose 126 mg/dL confirmed on two occasions. Diagnosis?
A. Prediabetes
B. Type 2 diabetes mellitus
C. Type 1 diabetes mellitus
D. Metabolic syndrome only
Rationale: Fasting glucose ≥126 mg/dL on two separate occasions = diabetes.
Acanthosis suggests insulin resistance.
6. Which statin provides the greatest LDL reduction?
A. Simvastatin 20 mg
B. Atorvastatin 10 mg
C. Rosuvastatin 40 mg
D. Pravastatin 40 mg
, Rationale: Rosuvastatin 40 mg lowers LDL by ~55%; atorvastatin 80 mg is
similar but 40 mg rosuvastatin is more potent.
7. A 62-year-old female with HTN and CKD stage 3 (eGFR 45) has BP 152/90.
Which antihypertensive is preferred?
A. HCTZ
B. Lisinopril
C. Amlodipine
D. Metoprolol
Rationale: ACE inhibitors (or ARBs) are preferred in CKD to slow progression
and reduce proteinuria.
8. A 48-year-old male has an elevated PSA of 5.2 ng/mL. DRE normal. Next
best step?
A. Immediate transrectal ultrasound biopsy
B. Repeat PSA and consider risk calculator
C. Start finasteride immediately
D. Order MRI prostate
Rationale: Elevated PSA requires confirmation and use of risk calculators (e.g.,
PCPT) before invasive testing.
9. A 25-year-old female wants to start hormonal contraception. She has
migraine with aura. Which is contraindicated?
A. Progestin-only pill
B. Copper IUD
C. Combined oral contraceptive
D. Etonogestrel implant
Rationale: Estrogen-containing contraceptives increase stroke risk in migraine
with aura.
10. A 70-year-old male with hx of falls, dementia, and BPH is started on
tamsulosin. Which medication should be avoided?
A. Finasteride
B. Doxazosin
C. Oxybutynin
D. Mirabegron
Simulation – 2026 Edition\\questions
and answers with rationales/graded
A+/2026 update/100% correct /instant
download
Course: Nurse Practitioner (Family/Adult-Gerontology)
Total Questions: 85
Format: Multiple Choice, Select All That Apply (SATA), Clinical Judgment
Instructions: Choose the best answer. Correct answers are bolded. Rationales are
provided.
Section 1: Primary Care & Health Promotion (Questions 1–15)
1. A 55-year-old male with hypertension and dyslipidemia asks about aspirin
for primary prevention of cardiovascular disease. Current BP 128/80, LDL
110. What is the best response?
A. Start aspirin 81 mg daily immediately
B. Start aspirin 325 mg daily for better efficacy
C. Not recommended due to increased bleeding risk without clear benefit
D. Use aspirin only if patient develops chest pain
Rationale: Current guidelines advise against routine aspirin for primary prevention
in patients >70 years or with increased bleeding risk. This patient’s 10-year CVD
risk is <10%? No indication.
2. A 28-year-old G0 female presents for preconception counseling. She has no
medical issues. Which vaccine should be prioritized before pregnancy?
A. HPV vaccine
B. MMR (Measles, Mumps, Rubella)
C. Influenza vaccine
D. Tdap
,Rationale: MMR is a live vaccine that must be given ≥4 weeks before conception.
Influenza and Tdap can be given during pregnancy if needed; HPV is not
recommended in pregnancy.
3. A 72-year-old male with osteoporosis has a T-score of -3.0 at the femoral
neck despite 2 years of alendronate. Next best step?
A. Continue alendronate and add calcium
B. Switch to teriparatide
C. Increase alendronate to weekly 140 mg
D. Stop all medications and repeat DEXA in 1 year
Rationale: Lack of response to bisphosphonate (failure to improve or worsening T-
score) warrants switching to an anabolic agent like teriparatide.
4. A 45-year-old female presents with fatigue, weight gain, cold intolerance,
and constipation. TSH is 12.5 mIU/L (ref 0.4–4.0). What is the most
appropriate treatment?
A. Liothyronine (T3) only
B. Levothyroxine 1.6 mcg/kg/day
C. Methimazole 10 mg daily
D. Observation and repeat TSH in 3 months
Rationale: Overt hypothyroidism (TSH >10) requires levothyroxine. Starting dose
is weight-based (1.6 mcg/kg).
5. A 35-year-old male has a BMI of 32, acanthosis nigricans, and fasting
glucose 126 mg/dL confirmed on two occasions. Diagnosis?
A. Prediabetes
B. Type 2 diabetes mellitus
C. Type 1 diabetes mellitus
D. Metabolic syndrome only
Rationale: Fasting glucose ≥126 mg/dL on two separate occasions = diabetes.
Acanthosis suggests insulin resistance.
6. Which statin provides the greatest LDL reduction?
A. Simvastatin 20 mg
B. Atorvastatin 10 mg
C. Rosuvastatin 40 mg
D. Pravastatin 40 mg
, Rationale: Rosuvastatin 40 mg lowers LDL by ~55%; atorvastatin 80 mg is
similar but 40 mg rosuvastatin is more potent.
7. A 62-year-old female with HTN and CKD stage 3 (eGFR 45) has BP 152/90.
Which antihypertensive is preferred?
A. HCTZ
B. Lisinopril
C. Amlodipine
D. Metoprolol
Rationale: ACE inhibitors (or ARBs) are preferred in CKD to slow progression
and reduce proteinuria.
8. A 48-year-old male has an elevated PSA of 5.2 ng/mL. DRE normal. Next
best step?
A. Immediate transrectal ultrasound biopsy
B. Repeat PSA and consider risk calculator
C. Start finasteride immediately
D. Order MRI prostate
Rationale: Elevated PSA requires confirmation and use of risk calculators (e.g.,
PCPT) before invasive testing.
9. A 25-year-old female wants to start hormonal contraception. She has
migraine with aura. Which is contraindicated?
A. Progestin-only pill
B. Copper IUD
C. Combined oral contraceptive
D. Etonogestrel implant
Rationale: Estrogen-containing contraceptives increase stroke risk in migraine
with aura.
10. A 70-year-old male with hx of falls, dementia, and BPH is started on
tamsulosin. Which medication should be avoided?
A. Finasteride
B. Doxazosin
C. Oxybutynin
D. Mirabegron
