TheoryFNP Practice Questions
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FNP Questions
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Q1Your 20-year-old female patient presents with allergic rhinitis symptoms. She reports taking oral antihistamines intermittently but has found them ineffective. She complains of nasal congestion and rhinorrhea almost daily, stating her symptoms are worse in the Spring.<br/><br/>What do you recommend?
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✓ Correct answer: Fluticasone nasal spray daily
The correct answer is C) Fluticasone nasal spray daily.<br/><br/> An intranasal corticosteroid (ICS), such as fluticasone, is the most effective treatment for allergic rhinitis and is the first-line treatment for patients with persistent symptoms (i.e., ≥4 days per week and ≥4 consecutive weeks per year).<strong> </strong><br/><br/><strong>Choice A is incorrect.</strong> Oral antihistamines, such as cetirizine, are recommended for patients with intermittent symptoms or persistent symptoms that are not controlled with an ICS.<br/><br/><strong>Choice B is incorrect.</strong> Antihistamine nasal sprays, such as azelastine, are recommended for patients with intermittent symptoms or whose persistent symptoms are not controlled with an ICS.<br/><br/><strong>Choice D is incorrect.</strong> Intranasal cromolyn may be recommended for use prior to known allergen exposure. For ongoing symptoms, it must be used 3-4 times per day for 1-2 weeks to achieve maximum effect. Cromolyn is not as effective as other medications.
Q2Select the option that includes an example of secondary prevention for elderly individuals.
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✓ Correct answer: Screening lab work
The correct answer is A) Screening lab work.<br/><br/>Lab work is an example of secondary prevention because it detects disease for those at risk.
Q3A patient with supraventricular tachycardia (SVT) receives a 6 mg dose of adenosine after failure on Verapamil.<br/><br/>What EKG change does the cardiovascular nurse anticipate may occur with this medication?
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✓ Correct answer: Transient Asystole
The correct answer is A) Transient Asystole.<br/><br/>Transient Asystole is expected with the administration of Adenosine. Transient asystole is safe and effective in SVT when administered at an average of 0.3-0.4 mg/kg.<br/><br/><strong>Choice B is incorrect. </strong>Adenosine does not produce an atrial fibrillation response.<br/><br/><strong>Choice C is incorrect. </strong>Adenosine does not produce an atrial flutter response.<br/><br/><strong>Choice D is incorrect. </strong>Torsades de Pointes is a specific type of ventricular tachycardia. People who have a long QT interval, certain medications, and genetic abnormalities can cause Torsades de Pointes. Magnesium, beta blockers, and Isoproterenol are used to treat this cardiac arrhythmia.
Q4The 2015 FDA Pregnancy and Lactation Labeling Rule (PLLR) accomplished which of the following?
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✓ Correct answer: Removed the FDA pregnancy categories applied to medications.
The correct answer is B) Removed the FDA pregnancy categories applied to medications.<br/><br/> The 1979 system of pregnancy categories (A, B, C, D, X) was replaced with the PLLR. Pregnancy categories were too simple and were often misinterpreted. The PLLR provides the relevant drug information to allow for informed clinical decision-making.<br/><br/><strong>Choice A is incorrect. </strong>The PLLR does not apply to OTC medication labels. It only applies to prescription drugs and biological products, which are required to be labeled with pregnancy-risk categories.<br/><br/><strong>Choice C is incorrect. </strong>The PLLR replaced the old FDA pregnancy categories with pregnancy-risk categories and subsets of information required under each of the 3 categories: pregnancy (includes through delivery), lactation, and females/males of reproductive potential. The PLLR does not apply to labeling of supplements or OTC products, which is important for patients to understand.<br/><br/><strong>Choice D is incorrect. </strong>The pregnancy subsection established a pregnancy exposure registry that collects data on pregnant women and provides information on risks, clinical considerations, and data. The lactation subsection provides information on risks, clinical considerations, and data. The females and males of the reproductive potential subsection provide information on pregnancy testing, contraception, and infertility.
Q5The Patient Self-Determination Act (PSDA) was passed by the U.S. Congress in 1990.<br/><br/>Which of the following policy changes did it result in?
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✓ Correct answer: Federally funded managed care organizations (MCOs) are required to inform subscribers about their rights under state law to create "advance directives."
The correct answer is A) Federally funded managed care organizations (MCOs) are required to inform subscribers about their rights under state law to create "advance directives."<br/><br/>MCOs are one group of healthcare organizations that are impacted by this law. Now, all subscribers must be provided with the stated information at the time of enrollment. Advance directive documents are never mandatory.
Q6Select the option that includes an example of tertiary prevention for elderly individuals.
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✓ Correct answer: Rehabilitation programs
The correct answer is D) Rehabilitation programs.<br/><br/>Rehabilitation programs (cardiac or stroke) are examples of tertiary prevention.
Q7A 1-month-old female presents to the clinic for a follow-up appointment. The infant was recently diagnosed with spina bifida at birth. During physical assessment, the nurse practitioner measures the infant’s head circumference to assess for:
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✓ Correct answer: Hydrocephalus
The correct answer is C) Hydrocephalus.<br/><br/>Spina bifida is a midline neural tube defect where the osseous spine fails to close. Spina bifida is categorized by spina bifida occulta and spina bifida cystica. Spina bifida occulta is when the spinal defect is not externally visible. Spina bifida cystica is when the spinal defect forms an external saclike protrusion<strong>.</strong> Children with minor defects of spina bifida are asymptomatic. However, neurological complications of spina bifida include hydrocephalus, differing degrees of paralysis and sensory deficits, and decreased rectal tone.<br/><br/><img src="asset:assets/questions/b7979320fde99b10.png"><br/><br/><strong><em>Spina bifida</em></strong><em> Image Source: https://en.wikipedia.org/wiki/Spina_bifida#/media/File:Spina-bifida.jpg</em><br/><br/>Hydrocephalus is an accumulation of excessive amounts of CSF in the ventricular system of the brain. It can cause cerebral ventricular enlargement and/or increased intracranial pressure. Head circumference is measured to check for the development of hydrocephalus. Cranial imaging such as CT scan, MRI, or ultrasound is used to further monitor the progression of hydrocephalus.<br/><br/><img src="asset:assets/questions/d7c38ac319bd64e5.png"><br/><br/><strong><em>Hydrocephalus </em></strong><em>Image Source: </em><a href="https://en.wikipedia.org/wiki/Hydrocephalus#/media/File:Hydrocephalus_CDC.png" style="color: rgb(5, 99, 193);"><em>https://en.wikipedia.org/wiki/Hydrocephalus#/media/File:Hydrocephalus_CDC.png</em></a><br/><br/><strong>Choice A is incorrect.</strong> Microcephaly is defined as the head being disproportionately smaller compared to the rest of the body. Microcephaly is caused by chromosomal disorders and environmental causes such as prenatal alcohol, drug, or radiation exposure and prenatal infections.<br/><br/>Macrocephaly can be seen in hydrocephalus.<br/><br/><strong>Choice B is incorrect.</strong> Subdural hematoma is intracranial bleeding that occurs under the dura matter. In infants, subdural hematomas can occur due to falls, assaults, birth trauma, or violent shaking. Subdural hematomas develop slowly in a span of days or weeks after the injury.<br/><br/><strong>Choice C is incorrect. </strong>Spina bifida cystica<strong> </strong>is when the spinal defect forms an external saclike protrusion<strong>. </strong>Spina bifida cystica refers to two forms: myelomeningocele (can also be referred to as meningomyelocele) and meningocele. Myelomeningocele contains meninges, spinal fluid, and nerves. Meningocele contains meninges and spinal fluid.<br/><br/>Spina bifida occulta is when the spinal defect is not outwardly visible. It occurs more commonly in the lumbosacral area. Physical examination of spina bifida occulta includes asymmetry of the gluteal cleft, hyperpigmented areas, and tufts of hair at the site.<br/><br/><img src="asset:assets/questions/faa139783bf2916c.png"><br/><br/><strong><em>Forms of spina bifida </em></strong><em>Image Source: </em><em>https://en.wikipedia.org/wiki/Spina_bifida#/media/File:Typesofspinabifida.jpg</em>
Q8A 12-year-old patient presents for a yearly examination. You decide to perform a Rinne test.<br/><br/>Which of the following cranial nerves does the Rinne test assess?
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✓ Correct answer: CN VIII
The correct answer is B) CN VIII.<br/><br/>CN VIII is the auditory nerve, which is responsible for hearing. The Rinne test, which evaluates conductive hearing loss, is performed by striking a tuning fork at 256 or 512 Hz and placing it on the mastoid process. A normal test will show that air conduction is twice the time of bone conduction. If conductive hearing loss is present, bone conduction will be longer than air conduction.<br/><br/><strong>Choice A is incorrect. </strong>CN VI innervates the abducens nerve which is responsible for the movement of the lateral rectus eye muscle.<br/><br/><strong>Choice C is incorrect. </strong>CN VII innervates the facial nerve which is responsible for facial expression and taste.<br/><br/><strong>Choice D is incorrect. </strong>CN V innervates the trigeminal nerve which is responsible for facial movement and touch sensation.
Q9The majority of breast cancers occur in which area of the breast?
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✓ Correct answer: Upper outer quadrant
The correct answer is B) Upper outer quadrant.<br/><br/>The upper outer quadrant is the most common site for breast cancer. The second most common site for breast cancer is beneath the nipple and areola.
Q10Which procedure is most helpful in screening for impotence?
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✓ Correct answer: Sexual history and physical examination
The correct answer is A) Sexual history and physical examination.<br/><br/>It is important to take a thorough history of sexual activity and a psychiatric history of the patient before undergoing different and expensive laboratory tests.<br/><br/>By interviewing the patient’s wife or partner, you are narrowing down possible causes of the condition and determining whether the symptoms reported are just an exaggeration of the patient.<br/><br/>Physical examination is important to gather evidence of overt testicular atrophy or penile disease.<br/><br/>And the laboratory and diagnostic test would be used to form a definitive diagnosis.
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