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ANCC FNP Board 149 Questions With All Correct Answers 100% Solved.
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ANCC FNP BOARDANCC FNP Board 149 Questions With All
Correct Answers 100% Solved.
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? - ✔✔✔ -
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? - ✔✔✔ - 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.
________________________________________
149 QUESTIONS
,ANCC FNP BOARD
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? - ✔✔✔ - 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
149 QUESTIONS
, ANCC FNP BOARD
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? -
✔✔✔ - 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? - ✔✔✔ -
149 QUESTIONS
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