Family Nurse Practitioner Test Diagnostic Reasoning 3

Question 1

A child presents with a barking cough, stridor, and low-grade fever after a URI. The MOST likely diagnosis is:

Accepted Answer

Croup (laryngotracheobronchitis)

Answer

The classic triad of barking cough, inspiratory stridor, and low-grade fever following URI is diagnostic of croup, caused most often by parainfluenza virus.

Question 2

A 65-year-old with a 30 pack-year smoking history presents with a FEV1/FVC ratio of 0.65 post-bronchodilator. The MOST likely diagnosis is:

Accepted Answer

Chronic obstructive pulmonary disease (COPD)

Answer

A post-bronchodilator FEV1/FVC ratio <0.70 in a smoker confirms the obstructive pattern required for GOLD criteria COPD diagnosis.

Question 3

The FNP notes café-au-lait spots (>6, >15mm) in an adult patient. This finding raises suspicion for:

Accepted Answer

Neurofibromatosis type 1

Answer

Six or more café-au-lait macules larger than 15 mm in adults are a major diagnostic criterion for neurofibromatosis type 1 (NF1).

Question 4

A patient has a positive ANA titer of 1:320 with a butterfly rash across the cheeks and nose. The FNP suspects:

Accepted Answer

Systemic lupus erythematosus (SLE)

Answer

A malar (butterfly) rash sparing the nasolabial folds combined with a high-titer ANA are classic features of SLE.

Question 5

A 45-year-old woman presents with fatigue, weight gain, constipation, cold intolerance, and bradycardia. The BEST initial diagnostic test is:

Accepted Answer

TSH level

Answer

TSH is the most sensitive test for thyroid dysfunction; an elevated TSH confirms primary hypothyroidism before further testing.

Family Nurse Practitioner Test Practice Test

Family Nurse Practitioner Test Practice Test

Family Nurse Practitioner Test Diagnostic Reasoning 3