NP Certification Q&A

Latest Episodes:

Asymptomatic Bacteriuria Apr 20, 2026

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Which of the following two patients with asymptomatic bacteria, or abbreviated ABS, should receive antimicrobial therapy?

A. An 84‑year‑old woman who is a resident of a long‑term care facility with dementia, no new urinary symptoms, her urine is positive for nitrites, leukocytes, and culture reveals 100,000 colony forming units per ml of E. coli.

B. A 70‑year‑old man with an indwelling Foley catheter, no new urinary symptoms. His urine appears cloudy and foul‑smelling. His culture is 100,000 CFU of mixed flora.

C. A 30‑year‑old woman who is 10 weeks pregnant, no urinary symptoms, culture reveals 100,000 CFU per ml of E. coli.

D. A 72‑year‑old man scheduled for a transurethral prostate resection, a TURP, next week, no urinary symptoms. His culture reveals 100,000 CFU per ml of E. coli.

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YouTube: https://www.youtube.com/watch?v=n1Ze5rIDf8Y&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=139

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Infant Development Question Apr 13, 2026

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A healthy seven‑month‑old boy presents with his parents for a well‑child visit. He was born at 39.5 weeks gestation via spontaneous vaginal delivery. After a pregnancy without complication, he and his mother went home after 24 hours. He is primarily breastfed with a small amount of solids and continues to be at the 50th percentile weight and 40th percentile length. The parents voice no concerns.

Which of the following is the most appropriate developmental milestone for this child's age?

A. sits briefly with support

B. is able to pull to stand

C. rolls front to back

D. uses pincher grasp to pick up a small object

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YouTube: https://www.youtube.com/watch?v=rhH1qyJ5gxw&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=138

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An Adult With a 10 Day History of Cough Apr 06, 2026

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A 28‑year‑old male non‑smoker with no chronic health problems presents with a 10‑day history of persistent cough that's worse at night, stating, "I started with a head cold about two weeks ago. The cold moved into my chest." He reports mild chest discomfort with deep cough, rare production of small amounts of clear to white sputum, and feels tired because, "the cough keeps waking me up." He denies sore throat, fever, ear pain, shortness of breath, or GI symptoms. Objective temp 97.6, heart rate 72, respiratory rate 18, BP 112 over 68, SpO2 is 99%, no acute distress, mild pharyngeal redness, no lymphadenopathy, chest without crackles, occasional dry cough, abdominal exam is within normal limits.

Which of the following is the most appropriate next step?

A. Prescribe one week of oral amoxicillin.

B. Order a chest x-ray

C. Prescribe a five-day course of azithromycin

D. Provide advice about symptomatic care

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YouTube: https://www.youtube.com/watch?v=RlTB1oBGISY&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=137

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36 Year Old Woman With Thyroid Disorder Mar 30, 2026

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A 36 year old woman presents with a three month history of unintended weight loss, sensation of increased anxiety, heat intolerance, and reports, "I feel like my heart is going to beat right out of my chest." In addition, she reports a two-month history of increased frequency and looseness of stools. Physical exam reveals 3-4 plus Achilles and patella reflex response, mild exophthalmosis, bilateral fine tremor, and a diffusely enlarged non-tender thyroid. Heart rate 115 beats per minute at rest without murmur or other cardiac abnormalities.

Considering thyroid disorder as her working diagnosis, which of the following would be her anticipated lab results?

A. Elevated TSH with normal limit free T4

B. Low TSH with elevated free T4

C. Elevated TSH with a low free T4

D. Normal limit TSH

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YouTube: https://www.youtube.com/watch?v=LCbIl606pHM&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=136

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Assessment in Diagnosis of COPD Mar 23, 2026

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A 62 year old man with a 60 pack year cigarette smoking history presents with a chief complaint of progressive dyspnea on exertion and a chronic productive cough over the past eight years. Significant contributing history include two episodes of being seen in urgent care in the past year for "bronchitis" and being told he should follow up with primary care.

When considering the diagnosis of COPD, which of the following is the most important diagnostic parameter?

A. patient report of progressive dyspnea and chronic productive cough

B. 60-pack year cigarette smoking history

C. FEV1 to FEC ratio of less than 0.7 post bronchodilator

D. FEV1 of less than 50 % of predicted

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YouTube: https://www.youtube.com/watch?v=nzAiWzsDfuM&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=135

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Treatment Choices in Infective Endocarditis Prophylaxis Mar 16, 2026

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A 72-year-old with a prosthetic aortic valve presents stating, "I was told I have to take a medicine before I have a deep dental cleaning." Concurrent health issues include hypertension, type 2 diabetes, and dyslipidemia, currently at treatment goals. Medications include metformin, hydrochlorothiazide, telmisartan, and rosuvastatin. She has no drug allergies. Which of the following is the most appropriate next step in her care?

A. amoxicillin 2 grams PO 30 to 60 minutes prior to the procedure

B. amoxicillin 2 grams PO 1 to 2 hours after the procedure

C. cephalexin 2 grams PO 30 to 60 minutes prior to the procedure

D. inform the patient that no antimicrobial prophylaxis is needed during dental care.

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Infective Endocarditis Prophylaxis Mar 09, 2026

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A patient presents stating, "I've been told I need to take a medicine before I have a deep dental cleaning." Which of the following patients requires antimicrobial prophylaxis prior to this dental visit?

A. A 28-year-old female taking combined oral contraceptives with a history of the murmur of mitral valve prolapse

B. An 18 year old with a physiologic murmur and a history of ACL repair

C. A 64 year old male with hypertension, type 2 diabetes, dyslipidemia, and an A1c of 9.5%

D. A 72-year-old woman with a prosthetic aortic valve

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YouTube: https://www.youtube.com/watch?v=ZJV7mYbaubo&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=133

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Initial Choice of Pharmacologic Therapy in COPD Mar 02, 2026

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A 68-year-old man with a 15-year history of hypertension and dyslipidemia, as well as a 45 pack-year history of cigarette smoking, currently smoking one pack per day, was recently diagnosed with COPD. His FEV1 to FEC ratio is less than 0.7, and his FEV1 is 48% of predicted. He reports two COPD exacerbations in the past year, both treated as an outpatient, and also mentions "I need to pace myself or I get short of breath even if I walk up just a flight of stairs. I can't do any work in the yard anymore." Per current treatment recommendations, which of the following is advised for his COPD maintenance therapy?

A. SABA as needed for shortness of breath

B. Daily use of an ICS LABA

C. As needed use of a LABA for symptoms

D. Scheduled use of an inhaled LABA/LAMA

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YouTube: https://www.youtube.com/watch?v=dazsX-CZk9c&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=132

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Treatment of Carpal Tunnel Syndrome Feb 23, 2026

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A 45 year old woman who works as a professional baker, with a specialty in birthday and wedding cakes, is diagnosed today with carpal tunnel syndrome. Her history of present illness include a four month history of numbness and tingling of the thumb, index and middle finger of her dominant hand. Physical exam reveals normal grip strength and decreased sensation along the median nerve distribution. Thenar atrophy is absent.

Which of the following is the most appropriate next step?

A. referral for carpal tunnel surgical decompression

B. arranging for carpal tunnel corticosteroid injection

C. advice on the use of neutral position wrist splinting

D. obtain a TSH and an A1C

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YouTube: https://www.youtube.com/watch?v=HoPq8PhUVw0&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=131

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Physical Exam in Carpal Tunnel Syndrome Feb 16, 2026

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A 45-year-old woman who works as a professional baker with a specialty in birthday and wedding cakes presents with a six-month history of progressive numbness and tingling in the thumb, index, and middle fingers of her right hand. She noticed that her symptoms are worse at night and are accompanied by hand weakness and reports being right hand dominant. She denies any injury to the area and states "This is getting in the way of my work. I'm having a much harder time holding the tools that I need to use to decorate a cake." Her concurrent health history includes a five-year history of type 2 diabetes, hypertension, and dyslipidemia, obesity with a BMI of 38. Her current meds include Metformin and an SGLT2I, and ARB with a thiazide diuretic and a statin.

When considering the diagnosis of carpal tunnel syndrome, which of the following would be one of the earliest physical exam findings?

A. Pain reproduced with forced wrist flexion held for 60 seconds

B. Diminished radial pulse

C. thenar atrophy

D. tingling of the fingers when tapping on the median nerve

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YouTube: https://www.youtube.com/watch?v=367DAsZ2M9M&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=130

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