FAMILY NURSE PRACTITIONER EXAM |
COMPLETE EXAM WITH CORRECT
ANSWERS AND RATIONALES. A+
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1. A 55-year-old male with a history of hypertension
presents with acute onset of severe, tearing chest
pain radiating to the back. Blood pressure is 160/90
in the right arm and 110/70 in the left arm. Which
diagnosis must be ruled out first?
A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Correct answer: B
Rationale: Tearing chest pain radiating to the back
with unequal blood pressures between arms is
classic for aortic dissection, a life-threatening
emergency requiring immediate CT aortogram.
2. A 45-year-old female presents with episodic
palpitations, headache, sweating, and hypertension.
,Episodes last 15-20 minutes and resolve
spontaneously. Which diagnosis is most likely?
A) Panic disorder
B) Pheochromocytoma
C) Hyperthyroidism
D) Mitral valve prolapse
Correct answer: B
Rationale: Paroxysmal episodes of hypertension,
palpitations, headache, and diaphoresis are classic
for pheochromocytoma, a catecholamine-secreting
tumor.
3. A 60-year-old male with a history of alcohol use
disorder presents with sudden onset of severe
epigastric pain radiating to the back, nausea, and
vomiting. Which diagnosis is most likely?
A) Acute cholecystitis
B) Acute pancreatitis
C) Perforated peptic ulcer
D) Myocardial infarction
Correct answer: B
Rationale: Sudden severe epigastric pain radiating to
the back in a patient with alcohol use disorder is
,classic for acute pancreatitis, confirmed by elevated
lipase.
4. A 55-year-old female presents with progressive
shortness of breath on exertion, non-productive
cough, and digital clubbing. Chest x-ray shows
bilateral interstitial infiltrates. Which diagnosis is
most likely?
A) COPD
B) Idiopathic pulmonary fibrosis (IPF)
C) Asthma
D) Heart failure
Correct answer: B
Rationale: Progressive dyspnea, dry cough, bilateral
interstitial infiltrates, and clubbing suggest IPF.
Velcro crackles are characteristic.
5. A 68-year-old male presents with unilateral vision
loss that occurred suddenly and resolved after 10
minutes. He reports no pain. Which diagnosis is most
likely?
A) Retinal detachment
B) Amaurosis fugax
C) Optic neuritis
, D) Migraine with aura
Correct answer: B
Rationale: Painless, transient monocular vision loss
(amaurosis fugax) suggests transient ischemic attack
of the retinal artery, often due to ipsilateral carotid
stenosis.
6. A 48-year-old female presents with fatigue, cold
intolerance, weight gain, and constipation.
Bradycardia, dry skin, and non-pitting edema are
noted. Which laboratory finding is expected?
A) Elevated free T4 and low TSH
B) Low free T4 and elevated TSH
C) Normal free T4 and elevated TSH
D) Low free T4 and low TSH
Correct answer: B
Rationale: Primary hypothyroidism is characterized
by low free T4 and elevated TSH due to lack of
negative feedback on the pituitary.
7. A 70-year-old male presents with progressive
difficulty walking, urinary incontinence, and cognitive
decline. Wide-based, magnetic gait is noted. Which
diagnosis is most likely?