NP Exam 1 Review NEWEST 2026
ACTUAL EXAM| NURSE
PRACTITIONERS IN PRIMARY CARE I
EXAM 4 REVIEW WITH COMPLETE
100 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST
RECENT!!)
Am43-year-
oldmmalemrecentlymunderwentmthreemmonthsmworthmofmlifestyleminterventionsmbutmonlymhadmamm
oderatemchangeminmoverallmbloodmpressuremreadingsmatmhome.mAtmtoday'smvisit,mhismbloodmpressu
remismconsistentmwithmhismhomemreadings,mandmism138/85.mThemnursempractitionermknowsmthatmac
cordingmtomthemAHAmguidelines,mwemshouldmbeginminitiatingmmedicationsmformamstagem1mhyperten
sivempatientmatmwhatmASCVDmcutoffmpoint?m-
mCORRECTmANSWERm10%mitmismappropriatemtominitiatemantihypertensivesmifmtheirmASCVDmriskmsco
remism10%mormgreater.m(Hint:mcanmthinkmofmhyperTENsionmtomremember!)
Ammiddle-
agedmfemalempresentsmtomyourmclinicmtoday.mShemhasmamhistorymofmsmoking,mhypertension,mtypemI
Imdiabetes,mandmosteoporosis.mShemhasmbeenmonmlisinoprilm(Prinvil)m10mmgmdailymformthempastmfive
myearsmandmmetforminm(Glucophage)m500mmgmtwicemdaily.mUponmyourmphysicalmexammyoumnoticem
asymmetric,mnon-
pittingmswellingmaroundmhermuppermlipmwhichmthempatientmstatesmstartedmyesterdaymnightmandmism
painless.mShemalsomreportsmdiffusemabdominalmpainmandmdiarrhea.mThemrestmofmthemphysicalmexam
mwasmbenign.mHermfastingmbloodmglucosemism130.mHermvitalmsignsmaremasmfollows:mBP:m141/87mmm
Hg,mHR:m92mbpm,mRR:m12mbreathsmpermminute,mO2:m96%monmroommair.mWhatmismthemmostmimporta
ntmthingmformthemnursempractitionermtomdo?m-mCORRECTmANSWERmDiscontinuemhermlisinoprilm
Thismpatientmismexperiencingmangioedemam-
mACEmInhibitorminducedmangioedemamcanmoccurmanytimem(days,mweeks,mormyearsmafterminitiation).
,mInmadditionmtomswellingmofmthemlips,mtongue,mandmface,mvisceralmangioedemamduemtomanmACEminhi
bitormcanmoccurmandmcausemsymptomsmincludingmabdominalmpain,mdiarrhea,mandmvomiting.mShem
needsmtomimmediatelymstopmthemlisinoprilmandmitmneedsmtombemmarkedmasmanmallergy.
Ampatientmcallsmthemofficemcomplainingmofmamsuddenmonsetmofm"cobwebmlikemlines"mmovingminman
dmoutmofmhermcentralmvisionminmthemrightmeye.mShemismnotminmanympainmandmismaskingmifmshemneedsm
tomcomeminmandmbemseen.mWhatmshouldmthemnursempractitionermadvisemhermtomdo?m-
mCORRECTmANSWERmRefermtomopthalmogogymimmediately
Amgroupmofmnewmnursempractitionersmaremevaluatingmthemstrengthmofmevidencemofmsomemnewmast
hmamguidelines.mWhichmofmthemfollowingmwouldmbematmthembottommofmthemhierarchymofmevidence
?m-mCORRECTmANSWERmEditorial
Am55-year-
oldmmalempatientmreportsmincreasingmissuesmwithmerectilemdysfunctionmovermthemlastmsixmmonths.m
Hemismrequestingmtombemplacedmonmtadalafilm(Cialis)mformcontrolmofmthismcondition.mWhichmofmthemf
ollowingmismcriticalmformthemnursempractitionermtomordermpriormtomprescribingmthismmedication?m-
mCORRECTmANSWERmEKG
Youmaremperformingmanmannualmexammandmpapmsmearmonmam39-year-
oldmwomanmwhomstatesmshemhasmnevermhadmammammogrammbefore.mAmclosemfriendmofmhersmwasm
justmdiagnosedmwithmbreastmcancermandmshemismwantingmtomknowmmoremaboutmhermriskmandmwhe
nmshemshouldmbeginmscreening.mWhatminmhermhistorymwouldmbemconsideredmamriskmfactormformbrea
stmcancer?m-mCORRECTmANSWERmHermonlymchildmismamstepmdaughter
Youmrecentlymdiagnosedmyourmpatientmwithmsciatica.mYoumaskmthempatientmtomperformmthemsquatma
ndmrisemexam,mandmyoumfoundmthatmtheremismamdiminishedmkneemjerk.mWhichmofmthemfollowingmism
themrootmcausemofmhismsciaticambasedmonmthismfinding?m-mCORRECTmANSWERmL4
ThemsquatmandmrisemexammwithmamdiminishedmkneemjerkmlinksmtomthemL4mnerve.mWemcanmassessmL5
mwithmthemheelmwalkmandmS1mwithmthemtoemwalk.
,Youmaremassessingmampatientmformacutemabdominalmpain.mWithmthempatientmsupinemandmrightmknee
mflexed,myoumperformminwardmrotationmonmthempatient'smhip.mWhatmmaneuvermismthismandmwhatma
remyoumassessingmfor?m-mCORRECTmANSWERmObturatormsignmtomassessmformappendicitis
Obturator-
mIsminwardmrOtationmofmthemhipmthroughmfullmROMmandmismampOsitivemsignmw/mmOvementmormflexi
onmofmthemhipm(ImthinkmofmallmthemO's).mIliopsoas/psoasmsignmismperformedmbymhavingmpatientsmrais
emtheirmlegmagainstmresistanceminmamsupinemposition,mthenmwhilemonmtheirmleftmside,mextendingmth
emrightmlegmfrommthemhipm(mWhenmyoumdomlegmraisesmatmthemgym,myourmiliopsoasmmusclesmaremsor
e).mMurphy'smsignmismelicitedmwhenmdeepmpalpationmonmthemRUQmundermthemcostalmbordermprodu
cesmpainmduringmMidinspiratorymarrestm(ImthinkmMmformMurphy'smandmMmformMidinspiratory).
Anm85-year-oldmwomanmpresentsmtomthemclinicmtodaymformamfollowmupmx-
ray.mShemstatesmthatmshemhadmx-
raysmcompletedm11mdaysmaftermamfallmatmhomembutmthemimagingmwasmnegativematmthatmtime.mDuem
tomthemnaturemofmhermfall,mshemwasminstructedmtomcomeminmformanmadditionalmsetmofmx-
raysmifmthempainmpersisted.mThemnursempractitionermknowsmthatmifmthismpatientmhasmamfracturemtod
ay,mitmismmostmlikelymwhichmofmthemfollowing?m-mCORRECTmANSWERmScaphoidmfracture
Yourm63-year-
oldmmalempatientmwithmvaguemabdominalmpainmhasmamtriglyceridemlevelmofm899.mWhichmofmthemfoll
owingmclinicalmsignsmwouldmbemmostmconcerningmgivenmthismlabmvalue?m-
mCORRECTmANSWERmCullen'smsign
Patientsmwithmpolycysticmovarianmsyndromem(PCOS)mmaymdevelopmallmofmthemfollowingmexcept:m-
mCORRECTmANSWERmBreastmCA
Uponmamdigitalmrectalmexamination,mthemnursempractitionermnotesmamwarmmandmboggymprostate.mT
hismfindingmismconsistentmwithmwhichmdiagnosis?m-mCORRECTmANSWERmProstatitis
, Am67-year-
oldmmalempatientmismcurrentlymbeingmtreatedmformbenignmprostaticmhyperplasia.mHemismconcernedm
thatmhismfinasteridem(Proscar)mismnotmadequatelymtreatingmhismsymptoms.mWhichmofmthemfollowing
mquestionsmismmostmimportantmtomaskmthismpatientmtomdomamfurthermassessment?m-
mCORRECTmANSWERmHowmlongmhavemyoumbeenmtakingmthismmedication?
Am33-year-
oldmfemalemismcomplainingmofmdysuria,mflankmpainmandmamfever.mHermvitalmsignsmaremasmfollows:mBP
:m112/76,mHR:m76,mRR:m18,m97%monmroommair,mTemp:m101.6mF.mThempatientmstatesmshemhasmhadmam
urinarymtractminfectionmoffmandmonmovermthempastmmonthmandmantibioticsmnevermreallymhelped.mU
ponmyourmphysicalmexammyoumelicitmCVAmtenderness.mWhatmismthembestmplanmformthismpatient?m-
mCORRECTmANSWERmReferralmtomthememergencymroom
Am14-year-
oldmmalemismcomplainingmofmscrotalmpain.mWhichmofmthemfollowingmdescriptionsmwouldmwarrantmi
mmediatemreferral?m-
mCORRECTmANSWERmThempainmismunilateralmandmwhenmyoumgentlympinchmtheminnermthigh,mthemtes
ticlemdoesmnotmelevate
Anmelderlympatientmwhomlivesmwithmhismdaughtermismdiagnosedmwithmterminalmcancermandmasksmyo
umtomnotmsharemtheminformationmwithmhismdaughter.mNotmsharingmthisminformationmwithoutmthemp
atient'smconsentmupholdsmwhichmethicalmprinciple?m-mCORRECTmANSWERmFidelity
Youmaremconcernedmthatmyourmdiabeticmpatientmmaymbemdevelopingmchronicmkidneymdisease.mWhi
chmlabmwouldmbemthembestmevaluationmofmthempatient'smkidneymfunction?m-
mCORRECTmANSWERmGlomerularmFiltrationmRate
Am67-year-
oldmfemalempatientmcomesmintomthemclinicmtodaymwithmamchiefmcomplaintmofmjointmpainmandmstiffn
ess.mWhichmofmthemfollowingmsymptomsmwouldmleadmyoumtomincludemosteoarthritismasmampossiblem
differential?m-mCORRECTmANSWERmMorningmstiffnessmlastingm<1mhour
ACTUAL EXAM| NURSE
PRACTITIONERS IN PRIMARY CARE I
EXAM 4 REVIEW WITH COMPLETE
100 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST
RECENT!!)
Am43-year-
oldmmalemrecentlymunderwentmthreemmonthsmworthmofmlifestyleminterventionsmbutmonlymhadmamm
oderatemchangeminmoverallmbloodmpressuremreadingsmatmhome.mAtmtoday'smvisit,mhismbloodmpressu
remismconsistentmwithmhismhomemreadings,mandmism138/85.mThemnursempractitionermknowsmthatmac
cordingmtomthemAHAmguidelines,mwemshouldmbeginminitiatingmmedicationsmformamstagem1mhyperten
sivempatientmatmwhatmASCVDmcutoffmpoint?m-
mCORRECTmANSWERm10%mitmismappropriatemtominitiatemantihypertensivesmifmtheirmASCVDmriskmsco
remism10%mormgreater.m(Hint:mcanmthinkmofmhyperTENsionmtomremember!)
Ammiddle-
agedmfemalempresentsmtomyourmclinicmtoday.mShemhasmamhistorymofmsmoking,mhypertension,mtypemI
Imdiabetes,mandmosteoporosis.mShemhasmbeenmonmlisinoprilm(Prinvil)m10mmgmdailymformthempastmfive
myearsmandmmetforminm(Glucophage)m500mmgmtwicemdaily.mUponmyourmphysicalmexammyoumnoticem
asymmetric,mnon-
pittingmswellingmaroundmhermuppermlipmwhichmthempatientmstatesmstartedmyesterdaymnightmandmism
painless.mShemalsomreportsmdiffusemabdominalmpainmandmdiarrhea.mThemrestmofmthemphysicalmexam
mwasmbenign.mHermfastingmbloodmglucosemism130.mHermvitalmsignsmaremasmfollows:mBP:m141/87mmm
Hg,mHR:m92mbpm,mRR:m12mbreathsmpermminute,mO2:m96%monmroommair.mWhatmismthemmostmimporta
ntmthingmformthemnursempractitionermtomdo?m-mCORRECTmANSWERmDiscontinuemhermlisinoprilm
Thismpatientmismexperiencingmangioedemam-
mACEmInhibitorminducedmangioedemamcanmoccurmanytimem(days,mweeks,mormyearsmafterminitiation).
,mInmadditionmtomswellingmofmthemlips,mtongue,mandmface,mvisceralmangioedemamduemtomanmACEminhi
bitormcanmoccurmandmcausemsymptomsmincludingmabdominalmpain,mdiarrhea,mandmvomiting.mShem
needsmtomimmediatelymstopmthemlisinoprilmandmitmneedsmtombemmarkedmasmanmallergy.
Ampatientmcallsmthemofficemcomplainingmofmamsuddenmonsetmofm"cobwebmlikemlines"mmovingminman
dmoutmofmhermcentralmvisionminmthemrightmeye.mShemismnotminmanympainmandmismaskingmifmshemneedsm
tomcomeminmandmbemseen.mWhatmshouldmthemnursempractitionermadvisemhermtomdo?m-
mCORRECTmANSWERmRefermtomopthalmogogymimmediately
Amgroupmofmnewmnursempractitionersmaremevaluatingmthemstrengthmofmevidencemofmsomemnewmast
hmamguidelines.mWhichmofmthemfollowingmwouldmbematmthembottommofmthemhierarchymofmevidence
?m-mCORRECTmANSWERmEditorial
Am55-year-
oldmmalempatientmreportsmincreasingmissuesmwithmerectilemdysfunctionmovermthemlastmsixmmonths.m
Hemismrequestingmtombemplacedmonmtadalafilm(Cialis)mformcontrolmofmthismcondition.mWhichmofmthemf
ollowingmismcriticalmformthemnursempractitionermtomordermpriormtomprescribingmthismmedication?m-
mCORRECTmANSWERmEKG
Youmaremperformingmanmannualmexammandmpapmsmearmonmam39-year-
oldmwomanmwhomstatesmshemhasmnevermhadmammammogrammbefore.mAmclosemfriendmofmhersmwasm
justmdiagnosedmwithmbreastmcancermandmshemismwantingmtomknowmmoremaboutmhermriskmandmwhe
nmshemshouldmbeginmscreening.mWhatminmhermhistorymwouldmbemconsideredmamriskmfactormformbrea
stmcancer?m-mCORRECTmANSWERmHermonlymchildmismamstepmdaughter
Youmrecentlymdiagnosedmyourmpatientmwithmsciatica.mYoumaskmthempatientmtomperformmthemsquatma
ndmrisemexam,mandmyoumfoundmthatmtheremismamdiminishedmkneemjerk.mWhichmofmthemfollowingmism
themrootmcausemofmhismsciaticambasedmonmthismfinding?m-mCORRECTmANSWERmL4
ThemsquatmandmrisemexammwithmamdiminishedmkneemjerkmlinksmtomthemL4mnerve.mWemcanmassessmL5
mwithmthemheelmwalkmandmS1mwithmthemtoemwalk.
,Youmaremassessingmampatientmformacutemabdominalmpain.mWithmthempatientmsupinemandmrightmknee
mflexed,myoumperformminwardmrotationmonmthempatient'smhip.mWhatmmaneuvermismthismandmwhatma
remyoumassessingmfor?m-mCORRECTmANSWERmObturatormsignmtomassessmformappendicitis
Obturator-
mIsminwardmrOtationmofmthemhipmthroughmfullmROMmandmismampOsitivemsignmw/mmOvementmormflexi
onmofmthemhipm(ImthinkmofmallmthemO's).mIliopsoas/psoasmsignmismperformedmbymhavingmpatientsmrais
emtheirmlegmagainstmresistanceminmamsupinemposition,mthenmwhilemonmtheirmleftmside,mextendingmth
emrightmlegmfrommthemhipm(mWhenmyoumdomlegmraisesmatmthemgym,myourmiliopsoasmmusclesmaremsor
e).mMurphy'smsignmismelicitedmwhenmdeepmpalpationmonmthemRUQmundermthemcostalmbordermprodu
cesmpainmduringmMidinspiratorymarrestm(ImthinkmMmformMurphy'smandmMmformMidinspiratory).
Anm85-year-oldmwomanmpresentsmtomthemclinicmtodaymformamfollowmupmx-
ray.mShemstatesmthatmshemhadmx-
raysmcompletedm11mdaysmaftermamfallmatmhomembutmthemimagingmwasmnegativematmthatmtime.mDuem
tomthemnaturemofmhermfall,mshemwasminstructedmtomcomeminmformanmadditionalmsetmofmx-
raysmifmthempainmpersisted.mThemnursempractitionermknowsmthatmifmthismpatientmhasmamfracturemtod
ay,mitmismmostmlikelymwhichmofmthemfollowing?m-mCORRECTmANSWERmScaphoidmfracture
Yourm63-year-
oldmmalempatientmwithmvaguemabdominalmpainmhasmamtriglyceridemlevelmofm899.mWhichmofmthemfoll
owingmclinicalmsignsmwouldmbemmostmconcerningmgivenmthismlabmvalue?m-
mCORRECTmANSWERmCullen'smsign
Patientsmwithmpolycysticmovarianmsyndromem(PCOS)mmaymdevelopmallmofmthemfollowingmexcept:m-
mCORRECTmANSWERmBreastmCA
Uponmamdigitalmrectalmexamination,mthemnursempractitionermnotesmamwarmmandmboggymprostate.mT
hismfindingmismconsistentmwithmwhichmdiagnosis?m-mCORRECTmANSWERmProstatitis
, Am67-year-
oldmmalempatientmismcurrentlymbeingmtreatedmformbenignmprostaticmhyperplasia.mHemismconcernedm
thatmhismfinasteridem(Proscar)mismnotmadequatelymtreatingmhismsymptoms.mWhichmofmthemfollowing
mquestionsmismmostmimportantmtomaskmthismpatientmtomdomamfurthermassessment?m-
mCORRECTmANSWERmHowmlongmhavemyoumbeenmtakingmthismmedication?
Am33-year-
oldmfemalemismcomplainingmofmdysuria,mflankmpainmandmamfever.mHermvitalmsignsmaremasmfollows:mBP
:m112/76,mHR:m76,mRR:m18,m97%monmroommair,mTemp:m101.6mF.mThempatientmstatesmshemhasmhadmam
urinarymtractminfectionmoffmandmonmovermthempastmmonthmandmantibioticsmnevermreallymhelped.mU
ponmyourmphysicalmexammyoumelicitmCVAmtenderness.mWhatmismthembestmplanmformthismpatient?m-
mCORRECTmANSWERmReferralmtomthememergencymroom
Am14-year-
oldmmalemismcomplainingmofmscrotalmpain.mWhichmofmthemfollowingmdescriptionsmwouldmwarrantmi
mmediatemreferral?m-
mCORRECTmANSWERmThempainmismunilateralmandmwhenmyoumgentlympinchmtheminnermthigh,mthemtes
ticlemdoesmnotmelevate
Anmelderlympatientmwhomlivesmwithmhismdaughtermismdiagnosedmwithmterminalmcancermandmasksmyo
umtomnotmsharemtheminformationmwithmhismdaughter.mNotmsharingmthisminformationmwithoutmthemp
atient'smconsentmupholdsmwhichmethicalmprinciple?m-mCORRECTmANSWERmFidelity
Youmaremconcernedmthatmyourmdiabeticmpatientmmaymbemdevelopingmchronicmkidneymdisease.mWhi
chmlabmwouldmbemthembestmevaluationmofmthempatient'smkidneymfunction?m-
mCORRECTmANSWERmGlomerularmFiltrationmRate
Am67-year-
oldmfemalempatientmcomesmintomthemclinicmtodaymwithmamchiefmcomplaintmofmjointmpainmandmstiffn
ess.mWhichmofmthemfollowingmsymptomsmwouldmleadmyoumtomincludemosteoarthritismasmampossiblem
differential?m-mCORRECTmANSWERmMorningmstiffnessmlastingm<1mhour
