Family Nurse Practitioner Test Diagnostic Reasoning 2

Question 1

A patient has a fasting plasma glucose of 128 mg/dL on two separate occasions. The FNP diagnoses:

Accepted Answer

Diabetes mellitus

Answer

A fasting plasma glucose ≥126 mg/dL on two separate tests meets the ADA diagnostic criteria for diabetes mellitus.

Question 2

Which finding on urinalysis is MOST specific for a urinary tract infection?

Accepted Answer

Positive nitrites

Answer

Positive nitrites indicate bacterial conversion of nitrates, which is highly specific for gram-negative bacteriuria such as E. coli.

Question 3

A patient is found to have TSH of 0.1 mIU/L with elevated free T4. The FNP interprets this as:

Accepted Answer

Primary hyperthyroidism

Answer

Low TSH with elevated free T4 indicates primary hyperthyroidism, where excess thyroid hormone suppresses pituitary TSH secretion.

Question 4

A patient with recurrent nephrolithiasis is found to have hypercalcemia, elevated PTH, and low phosphorus. The MOST likely diagnosis is:

Accepted Answer

Primary hyperparathyroidism

Answer

High PTH with hypercalcemia and hypophosphatemia is the classic triad of primary hyperparathyroidism, the most common cause of outpatient hypercalcemia.

Question 5

Which EKG finding is the EARLIEST sign of hyperkalemia?

Accepted Answer

Peaked (tall, narrow, symmetric) T waves

Answer

Peaked T waves are the earliest EKG manifestation of hyperkalemia, preceding the PR prolongation, wide QRS, and eventually sine wave pattern.

Family Nurse Practitioner Test Practice Test

Family Nurse Practitioner Test Practice Test

Family Nurse Practitioner Test Diagnostic Reasoning 2