NP NP Diagnosis & Clinical Decision-Making

Question 1

A 55-year-old male presents with crushing substernal chest pain radiating to the left arm, diaphoresis, and nausea for 45 minutes.
His ECG shows ST elevations in leads II, III, and aVF.
The NP should suspect:

Accepted Answer

Inferior ST-elevation myocardial infarction (STEMI)

Answer

Stable angina pectoris

Answer

Acute pericarditis

Answer

Pulmonary embolism

Question 2

A patient presents with sudden-onset severe headache described as 'the worst headache of my life.' After ruling out trauma, what is the most critical diagnosis to exclude?

Accepted Answer

Subarachnoid hemorrhage

Answer

Migraine with aura

Answer

Tension headache

Answer

Cluster headache

Question 3

A 28-year-old female presents with dysuria, frequency, and urinary urgency. Urinalysis shows positive nitrites and leukocyte esterase. The most likely diagnosis is:

Accepted Answer

Uncomplicated urinary tract infection

Answer

Pyelonephritis

Answer

Interstitial cystitis

Answer

Urethritis due to STI

Question 4

A 65-year-old with a history of smoking presents with progressive dyspnea, chronic productive cough for 3 years, and barrel chest. Spirometry shows FEV1/FVC ratio of 0.62 post-bronchodilator. The most likely diagnosis is:

Accepted Answer

COPD

Answer

Asthma

Answer

Pulmonary fibrosis

Answer

Congestive heart failure

Question 5

A patient presents with polyuria, polydipsia, polyphagia, and a random blood glucose of 320 mg/dL. What is the appropriate diagnosis?

Accepted Answer

Diabetes mellitus

Answer

Pre-diabetes

Answer

Diabetes insipidus

Answer

Metabolic syndrome

Question 6

An NP evaluates a patient with symmetric joint pain, morning stiffness lasting more than one hour, and positive anti-CCP antibodies. The most likely diagnosis is:

Accepted Answer

Rheumatoid arthritis

Answer

Osteoarthritis

Answer

Gout

Answer

Systemic lupus erythematosus