⚕️ Ace Your ANCC FNP Board Exam: 2023 Edition PDF!
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ANCC FNP Board Exam 2023-2024 Real
Exam Questions and Correct Answers with
Rationales Rated +
A middle-age female patient presents to the clinic with a recurrence of mild hidradenitis
suppurativa after topical therapies failed. Which first-line treatment is recommended? -
ANSWER-Tetracycline
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line treatment for
hidradenitis suppurativa.
Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in apocrine gland-
bearing skin. It is a chronic, disabling disorder that progresses, often causing keloids,
contractures, and immobility. It is characterized by comedone-like follicular occlusion, chronic
and relapsing inflammation, mucopurulent discharge, and progressive scarring.
Arthropathy associated with hidradenitis may be present. Typical presentation includes nodules
and sinus tracts (inflamed or noninflamed), abscesses, and scarring found in the axilla,
genitofemoral area, perineum, gluteal area, and inframammary area in women.
Recommended treatments include antibiotics, steroids, retinoids, dapsone, and anti-tumor
necrosis factor agents. A dermatology consultation should also be considered.
First-line treatment is a 12-week course of an oral tetracycline (Sumycin) such as doxycycline.
For patients who do not respond to doxycycline, the next recommended step is a combination of
twice-daily clindamycin (Cleocin) and rifampicin (Rifadin) for 10-12 weeks. If treatment fails,
acitretin (Soriatane, for males and nonfertile females) or dapsone (Aczone) may be considered by
a dermatologist. In patients with moderate to severe hidradenitis suppurativa, adalimumab
(Humira) may possibly be considered.
When providing culturally competent health care services to an American Indian elder, the nurse
practitioner understands which is traditionally true? - ANSWER-The "Medicine Wheel" is used
by many for the purpose of health and healing
The "Medicine Wheel" is traditionally used and contains four directions; north, south, east, and
west. Traditionally each tribe has different meanings for each direction and they may represent
the season of the year or stage of life. It is aimed at providing a holistic view of life.
________________________________________
An understanding of different cultural preferences leads to cultural competence in healthcare.
Some patients may value traditional culture and preferences as it relates to healthcare. These
individual preferences should be included in the interview and treatment plan for patients.
Traditionally, the American Indian culture values a holistic approach to health care integrating
the person, lifestyle, environment, family, and religion. Patients adhering to these traditional
cultural practices often feel that illness is due to a lack of harmony with the physical body, mind,
,spirit, and emotions. Patients may seek care from western medicine for specific ailments while
also consulting with traditional healers for spiritual guidance.
Healthcare providers should seek to understand relevant cultural factors and assess each
individual's healthcare literacy in order to provide culturally competent care.
The nurse practitioner sees an older adult patient in the clinic with the primary report of hearing
loss and a sensation of fullness in the right ear. The nurse practitioner suspects conductive
hearing loss. Which could contribute to this? - ANSWER-Cerumen, commonly called earwax, is
a combination of secretions and sloughed epithelial cells that protects the ears from infection,
water, and insects. It is normally expelled from the ear canal through natural jaw movement.
When this self-cleaning process fails, cerumen can become impacted. Cerumen impaction
occludes the ear canal and can press against the tympanic membrane, resulting in conductive
hearing loss.
_________________________________________
Conductive hearing is the transition of sound from the external and middle ear to the inner ear.
Conductive hearing loss is caused by problems in the external and middle ear that interfere with
the transmission of sound and its conversion to mechanical vibration. Causes of conductive
hearing loss include obstruction of the external auditory canal by cerumen, foreign bodies, debris
from otitis externa, and large exocytosis and osteomas.
Sensorineural hearing loss involves difficulty converting mechanical vibrations to electrical
potential in the cochlea or in auditory nerve transmission to the brain. It is mostly caused by
permanent damage in the organ of Corti. It can be caused by age-related hearing loss, noise
trauma, medications, autoimmune diseases, mechanical trauma, Meniere disease, infection, and
neoplasm (acoustic neuroma).
Approximately one-third of older adults between the ages of 61 and 70 years have hearing loss.
More than 90% of adults older than 85 years of age have hearing loss. The most common type of
hearing loss is age-related and sensorineural. All adults older than 60 years of age should be
screened for hearing loss at periodic health examinations.
An otherwise healthy adult patient presents to the clinic with a diagnosis of community-acquired
pneumonia and no recent antibiotic therapy. Which is the best option for treatment? - ANSWER-
Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-line therapy for adults
without comorbidities.
_____________________________________________
Community-acquired pneumonia (CAP) is pneumonia not acquired in a hospital or long-term
care facility. Patients with suspected CAP should receive a chest X-ray for diagnosis. The
Pneumonia Severity Index should be used to assist in decisions regarding the need for
hospitalization in patients with CAP.
According to the American Thoracic Society (ATS) and the Infectious Diseases Society of
America (IDSA) 2019 guidelines, the initial treatment of CAP for most patients is amoxicillin or
doxycycline. Macrolides are an option for treatment, but are no longer recommended routinely as
, first-line treatment, given increased macrolide resistance. This is a change from the 2007
ATS/IDSA guidelines. Respiratory fluoroquinolones and amoxicillin/clavulanate should be used
in patients who fail first-line medications, have significant comorbidities, have had recent
antibiotic therapy, are allergic to alternative agents, or have a documented infection with highly
drug-resistant pneumococci.
A patient presents to the clinic for conception counseling. She recently stopped taking oral
contraceptives and would like to become pregnant. Which statement about conception safety
after stopping oral contraceptives is correct? - ANSWER-
You have a 35-year-old female patient who is complaining of wrist pain. She is an administrative
assistant who does a great deal of computer work in her job. You will test her for carpal tunnel
syndrome. When you tap at the volar surface of the wrist you are performing which of the
following tests? - ANSWER-Tinel's sign
A gastrinoma located on the pancreas or the stomach which secretes gastrin, stimulating high
levels of acid production in the stomach is which of the following? - ANSWER-Zollinger-
Ellison syndrome
A 16-year-old male is in the office. He has a insect bite on his left forearm and you suspect a
brown recluse spider bite. What medical management would you provide? - ANSWER-ice pack
and elevation of the area
In addition to being overweight, the American Diabetes Association recommends type 2 diabetes
mellitus testing in adults who: - ANSWER-have an HDL level of < 35 mg/dL
Which of the following found on an ECG would confirm atrial fibrillation? - ANSWER--absent
P waves
-irregular ventricular rate
As an FNP you understand that all of the following statements about chronic heart failure are
accurate EXCEPT: - ANSWER--The preponderance is in females until the age of 75, then there
is equal occurrence in males and females.
-Patients who are underweight have a greater risk of CHF.
The FNP has a 45-year-old male patient with BPH who has poison ivy. The FNP plans to
prescribe Benadryl for this. What is a possible adverse effect with the use of Benadryl for this
patient? - ANSWER-urinary retention
You are testing a client suspected of having Parkinson's disease. You support the client's elbow
with his forearm extended in your hand and grasp his wrist, flexing the forearm. You find rigid
resistance to this motion. This is considered which of the following? - ANSWER-cogwheeling
The complex network of nerve fibers that innervate the organs within the abdomen like the
gastrointestinal tract, pancreas, and gall bladder is the - ANSWER-enteric nervous system
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