FULL AANP-Style FNP Practice Exam
(Original) — 150 Questions +
Answers/Rationales
Instructions: Choose the single best --Answer-- (A–D).
Timing suggestion: 3 hours.
Questions (1–150)
Cardiology / Vascular (1–20)
1. 64-year-old with exertional chest tightness x 4 months, relieved by rest in 5 minutes. Normal
vitals now. Next best step?
A. Reassure, no testing
B. Outpatient ischemic evaluation and risk-factor management
C. Activate cath lab now
D. Treat as GERD only
--Answer--: B. Rationale: Stable angina warrants ischemic evaluation and prevention.
2. Chest pain + new ST-elevation on ECG in urgent care. Best action?
A. Antibiotics
B. Activate EMS/ED STEMI pathway; give aspirin if not contraindicated
C. Order outpatient echo
D. Send home if improved
--Answer--: B. Rationale: STEMI is time-critical; immediate transfer.
3. Irregularly irregular rhythm; ECG shows absent organized P waves. Diagnosis?
A. Aflutter
B. A-fib
C. VT
D. 1° AV block
--Answer--: B. Rationale: Classic AF ECG/rhythm.
4. Warfarin monitoring (INR) reflects:
A. Platelet function
B. PT/extrinsic pathway (vitamin K factor effect)
, C. Intrinsic pathway only
D. Fibrinogen only
--Answer--: B. Rationale: INR tracks PT pathway affected by warfarin.
5. HTN + diabetes; BP 152/94 repeatedly. Best initial class if no contraindication?
A. ACEi/ARB
B. Loop diuretic only
C. Alpha blocker
D. Hydralazine alone
--Answer--: A. Rationale: Renal/CV benefit in diabetes and HTN.
6. Medication most likely to worsen asthma symptoms?
A. Beta-blocker (esp nonselective; high dose risk)
B. Lisinopril
C. Amlodipine
D. HCTZ
--Answer--: A. Rationale: Beta-blockade can provoke bronchospasm.
7. HF symptom worse lying flat:
A. Dysphagia
B. Orthopnea
C. Hematemesis
D. Otalgia
--Answer--: B. Rationale: Pulmonary congestion increases supine.
8. S3 in adult suggests:
A. Normal in all adults
B. Volume overload/systolic dysfunction
C. Mitral stenosis only
D. COPD
--Answer--: B. Rationale: S3 often indicates HFrEF/overload.
9. Leg edema + hyperpigmentation, worse after standing:
A. Venous insufficiency
B. PAD
C. Acute DVT always
D. Septic arthritis
--Answer--: A. Rationale: Venous stasis changes.
10. PAD screening bedside test:
A. ABI
B. EEG
C. Peak flow
D. Monospot
--Answer--: A. Rationale: ABI screens for PAD.
11. New unilateral leg swelling/tenderness: best initial test?
A. D-dimer only
, B. Compression ultrasound
C. MRI femur
D. BNP
--Answer--: B. Rationale: First-line for suspected DVT.
12. Exertional syncope + harsh systolic murmur RUSB radiating to carotids:
A. Aortic stenosis
B. MR
C. MVP
D. Pericarditis
--Answer--: A. Rationale: Classic AS.
13. Hypertensive emergency is:
A. Any BP >160/100
B. Severe BP + acute end-organ damage
C. BP >140/90 with headache
D. White coat HTN
--Answer--: B. Rationale: Damage defines emergency.
14. High-yield lifestyle BP lowering includes:
A. Potassium restriction for everyone
B. Weight loss + DASH + sodium reduction
C. More caffeine
D. Stop exercise
--Answer--: B. Rationale: Most effective core measures.
15. Pericarditis outpatient stable: best first-line?
A. NSAID + colchicine if appropriate
B. Opioids only
C. Warfarin
D. Routine antibiotics
--Answer--: A. Rationale: Reduces pain/recurrence.
16. Hypotension + JVD + muffled heart sounds after procedure:
A. PE
B. Tamponade
C. Aortic stenosis
D. Stable angina
--Answer--: B. Rationale: Beck triad.
17. Hyperkalemia early ECG change:
A. U waves
B. Peaked T waves
C. Diffuse ST elevation always
D. Short PR always
--Answer--: B. Rationale: Typical early sign.
(Original) — 150 Questions +
Answers/Rationales
Instructions: Choose the single best --Answer-- (A–D).
Timing suggestion: 3 hours.
Questions (1–150)
Cardiology / Vascular (1–20)
1. 64-year-old with exertional chest tightness x 4 months, relieved by rest in 5 minutes. Normal
vitals now. Next best step?
A. Reassure, no testing
B. Outpatient ischemic evaluation and risk-factor management
C. Activate cath lab now
D. Treat as GERD only
--Answer--: B. Rationale: Stable angina warrants ischemic evaluation and prevention.
2. Chest pain + new ST-elevation on ECG in urgent care. Best action?
A. Antibiotics
B. Activate EMS/ED STEMI pathway; give aspirin if not contraindicated
C. Order outpatient echo
D. Send home if improved
--Answer--: B. Rationale: STEMI is time-critical; immediate transfer.
3. Irregularly irregular rhythm; ECG shows absent organized P waves. Diagnosis?
A. Aflutter
B. A-fib
C. VT
D. 1° AV block
--Answer--: B. Rationale: Classic AF ECG/rhythm.
4. Warfarin monitoring (INR) reflects:
A. Platelet function
B. PT/extrinsic pathway (vitamin K factor effect)
, C. Intrinsic pathway only
D. Fibrinogen only
--Answer--: B. Rationale: INR tracks PT pathway affected by warfarin.
5. HTN + diabetes; BP 152/94 repeatedly. Best initial class if no contraindication?
A. ACEi/ARB
B. Loop diuretic only
C. Alpha blocker
D. Hydralazine alone
--Answer--: A. Rationale: Renal/CV benefit in diabetes and HTN.
6. Medication most likely to worsen asthma symptoms?
A. Beta-blocker (esp nonselective; high dose risk)
B. Lisinopril
C. Amlodipine
D. HCTZ
--Answer--: A. Rationale: Beta-blockade can provoke bronchospasm.
7. HF symptom worse lying flat:
A. Dysphagia
B. Orthopnea
C. Hematemesis
D. Otalgia
--Answer--: B. Rationale: Pulmonary congestion increases supine.
8. S3 in adult suggests:
A. Normal in all adults
B. Volume overload/systolic dysfunction
C. Mitral stenosis only
D. COPD
--Answer--: B. Rationale: S3 often indicates HFrEF/overload.
9. Leg edema + hyperpigmentation, worse after standing:
A. Venous insufficiency
B. PAD
C. Acute DVT always
D. Septic arthritis
--Answer--: A. Rationale: Venous stasis changes.
10. PAD screening bedside test:
A. ABI
B. EEG
C. Peak flow
D. Monospot
--Answer--: A. Rationale: ABI screens for PAD.
11. New unilateral leg swelling/tenderness: best initial test?
A. D-dimer only
, B. Compression ultrasound
C. MRI femur
D. BNP
--Answer--: B. Rationale: First-line for suspected DVT.
12. Exertional syncope + harsh systolic murmur RUSB radiating to carotids:
A. Aortic stenosis
B. MR
C. MVP
D. Pericarditis
--Answer--: A. Rationale: Classic AS.
13. Hypertensive emergency is:
A. Any BP >160/100
B. Severe BP + acute end-organ damage
C. BP >140/90 with headache
D. White coat HTN
--Answer--: B. Rationale: Damage defines emergency.
14. High-yield lifestyle BP lowering includes:
A. Potassium restriction for everyone
B. Weight loss + DASH + sodium reduction
C. More caffeine
D. Stop exercise
--Answer--: B. Rationale: Most effective core measures.
15. Pericarditis outpatient stable: best first-line?
A. NSAID + colchicine if appropriate
B. Opioids only
C. Warfarin
D. Routine antibiotics
--Answer--: A. Rationale: Reduces pain/recurrence.
16. Hypotension + JVD + muffled heart sounds after procedure:
A. PE
B. Tamponade
C. Aortic stenosis
D. Stable angina
--Answer--: B. Rationale: Beck triad.
17. Hyperkalemia early ECG change:
A. U waves
B. Peaked T waves
C. Diffuse ST elevation always
D. Short PR always
--Answer--: B. Rationale: Typical early sign.
