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FNP Certification Exam Questions EXAM
2025 | ACTUAL REAL EXAM ACCURATE
QUESTIONS AND ANSWERS WITH
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1. A new FNP questions whether an iPhone® app caused 10% weight loss in a study of 30 women. What aspect of the study is most questionable? A. Reliability B. Power C. Confidence level D. External validity ✅ Rationale: External validity refers to whether the results can be generalized beyond the study population. The FNP questions if the app would work for other people, which reflects concerns about external validity. 2. The most likely diagnosis for a red, protruding mass under a newborn’s ear that appeared after birth is: A. Port wine lesion B. Melanoma C. Erythema toxicum neonatorum D. Hemangioma ✅ Rationale: Hemangiomas often appear within weeks after birth and present as raised, red lesions. 3. For the newborn described above, the appropriate advice to parents is: A. Refer to dermatologist for laser therapy B. Monitor at 6-month intervals due to malignancy risk C. Apply corticosteroid cream D. These lesions will likely lighten over time and disappear during childhood ✅
Rationale: Most infantile hemangiomas resolve on their own without intervention.
4. In a population of 1 million, 10,000 have PAD and 500 new cases occur yearly. What is the prevalence? A. 1% ✅ B. 10% C. 500 D. 1/2000 persons Rationale: Prevalence = (10,000 / 1,000,000) × 100 = 1%. 5. A 21-year-old pregnant woman with low weight gain after 28 weeks is most likely to affect the baby’s: A. Head circumference B. Birth length C. Apgar scores D. Birth weight ✅ Rationale: Inadequate maternal weight gain in late pregnancy is most strongly associated with low birth weight. 6. A 2-week-old boy has a red, spongy mass under the ear. What is the best initial treatment? A. Corticosteroid injection B. Mohs surgery C. Laser therapy D. Oral propranolol ✅ Rationale: Oral propranolol is the first-line treatment for problematic infantile hemangiomas. 7. A 1-month-old Asian infant has blue-black macules on the back and buttocks. Likely diagnosis? A. Port wine lesion B. Milia C. Keratosis pilaris D. Mongolian spot ✅
- Headaches waking him at night, behind eye – D
- Pulsating, visual aura, nausea – B
- Bilateral, pressing, no photophobia – C
- Headache worse in morning, improves during day – A Correct match: 1-D, 2-B, 3-C, 4-A ✅ 11. Type 2 diabetes mellitus is best described as: A. A genetically-based autoimmune process B. A consequence of obesity C. Environmentally dictated condition D. A disorder of insulin resistance with eventual insulin deficiency ✅ Rationale: Type 2 diabetes is primarily caused by insulin resistance with eventual β-cell dysfunction. 12. What is the most likely finding in low back pain without radiculopathy? A. Positive straight leg raise B. Abnormal lower extremity DTR C. Pain relief with lumbar flexion D. Discomfort to direct palpation of paraspinal muscles ✅ Rationale: Mechanical back pain typically involves muscle tenderness without neurologic signs. 13. A 33-year-old man reports a 3-week history of recurrent headaches that awaken him during the night, lasting up to 2 hours and located behind the right eye. Likely diagnosis? A. Increased intracranial pressure B. Migraine with aura C. Tension-type headache D. Cluster headache ✅ Rationale: Cluster headaches are often unilateral, severe, and occur at night with orbital pain. 14. A 29-year-old woman has recurrent, unilateral, pulsating headaches with nausea and visual aura. Likely diagnosis?
A. Increased intracranial pressure B. Migraine with aura ✅ C. Tension-type headache D. Cluster headache Rationale: Migraines with aura include visual disturbances before the headache and are often associated with nausea and photophobia.
15. A 54-year-old man has occasional, bilateral, non-pulsatile headaches without nausea, photophobia, or phonophobia. Likely diagnosis? A. Increased intracranial pressure B. Migraine with aura C. Tension-type headache ✅ D. Cluster headache Rationale: Tension-type headaches are pressing, bilateral, and not associated with sensory sensitivities or nausea. 16. A 45-year-old man reports headaches worst in the morning, improving as the day progresses. Likely diagnosis? A. Increased intracranial pressure ✅ B. Migraine with aura C. Tension-type headache D. Cluster headache Rationale: Morning headaches that improve over the day can be a sign of elevated intracranial pressure. 17. When evaluating a patient with low back pain without radiculopathy, which of the following findings is most likely? A. A positive straight leg raise B. Abnormal lower extremity deep tendon reflexes (DTRs) C. Pain relief with lumbar flexion D. Discomfort to direct palpation of paraspinal muscles ✅ Rationale: In mechanical or non-radicular low back pain, the most common finding is localized tenderness over the paraspinal muscles. Neurological findings like positive straight leg raise or abnormal DTRs are typically absent.
- Ans - Ans: 1/2000 persons if there 500 new cases out of 10,000 people with PAD are diagnosed each year. Calculation : 1,000,000 / 500 = 2000 persons Felicia is 18-weeks pregnant with her first child. Which of the following is most consistent with her gestational age? Uterine fundus palpable through the abdominal wall Nausea and breast tenderness Report of quickening Fetal heart tones detectable by abdominal Doppler
- Ans - Ans: Report of quickening Treatment options for uncomplicated Chlamydiatrachomatis infection in pregnancy include: Clarithromycin. Doxycycline. Azithromycin. Ofloxacin.
- Ans - Ans: Azithromycin
When a pregnant woman takes a teratogenic drug, the fetal effects are usually seen in: Certain target organs in a predictable manner. Random body systems without a predictable pattern. Select organ systems with random outcomes. A pattern of systemic injury.
- Ans - Ans: Certain target organs in a predictable manner. Treatment of atopic dermatitis present on the cheeks of an otherwise healthy 4-month-old infant can include all of the following except: Moisturizing cream to hydrate the skin. Antihistamines to reduce itching. Alcohol-based lotion to prevent infection. Topical corticosteroid to control flares.
- Ans - Ans: Alcohol-based lotion to prevent infection. When a patient is seen by a nurse practitioner, the visit can be charged to Medicare using "incident-to" billing. If the criteria for this type of visit are fulfilled, then anticipated reimbursement is at what percentage of the physician rate? 75
Moxifloxacin (Avelox®). - Ans - Ans: Doxycycline (Doryx®). While evaluating a patient with psoriasis vulgaris, the nurse practitioner expects to find: Lichenification in the post-auricular region. Maculopapular lesions over the upper thorax. Scaling lesions within the nasolabial folds. Well-demarcated plaques and coalescing papules on the knees. - Ans - Ans: Well-demarcated plaques and coalescing papules on the knees. When initiating pharmacologic therapy for the patient with first diagnosis of major depression disorder, the nurse practitioner advises the patient that treatment should: Generally be given for about 4-6 months before improvement is noted. Continue for at least 6 months after remission is achieved. Be continued indefinitely after therapeutic goals are met. Be started at a higher dose then titrated to a lower dose once symptom relief is achieved. - Ans - Ans: Continue for at least 6 months after remission is achieved. our neighbor asks you to refill her high blood pressure medicine as she could not make her last office visit to her provider due to a family emergency. You are aware that she is going through a difficult time personally and agree to call in the prescription. As a result:
A healthcare provider-patient relationship has been formed. The Good Samaritan Act will protect you from liability since you volunteered to help her out. You should charge your neighbor for a standard office visit in order to keep your relationship with her on a professional level. You realize this action is acceptable as her antihypertensive medication is not a controlled substance. - Ans - Ans: A healthcare provider-patient relationship has been formed. Gary is a 26-year-old graduate student who is diagnosed with major depressive disorder (MDD) without psychotic features. His medical history is unremarkable and he states that he does not wish to undergo psychotherapy. An appropriate first-line medication is: Sertraline (Zoloft®). Bupropion (Wellbutrin®). Amitriptyline (Elavil®). Trazodone (Oleptro®). - Ans - Ans: Sertraline (Zoloft®). Which of the following is a typical physical finding in a patient with carpal tunnel syndrome? Decreased vibratory sense of distal phalanges Hyperactive radial reflex
I - oldfactory nerve - smell - SENSORY II - optic (vision) - MOTOR- test for accommodation, visual field, pupillary reaction III- oculomotor nerve - eye move up or down; outward or inward; drooping lid-reflag. MOTOR IV- trochlear nerve- eye movement down and inward - MOTOR V- trigeminal nerve - corneal blink reflex, sensation (wisp of cotton, light vs. dull touch) BOTH VI- Aducens nerve- eye movements (ability to move eyes bilaterally) MOTOR VII- Facial nerve - facial expression, clench teeth, puff cheeks out, production of saliva and tears, raise eyebrown, close eyes against resistance- MOTOR Usually V and VII are tested together. VIII- Acoustic nerve- hearing - Wiber test (lateralization) Rinne test (air vs bone conduction) SENSORY IX- glossaphareangeal - test gag reflex (say Ahh)- BOTH X- Vagus nerve- swallowing or gag reflex, voice - BOTH XI- Spinal accessory - test shoulder movements like shrugging, push up against resistance - MOTOR XII- Hypoglossal - tongue movements (sticks tongue out, move tongue side-to-side) MOTOR A 37-year-old female presents with flank pain, fever, and vomiting. Physical examination is significant for costovertebral angle tenderness. A urinalysis is likely to reveal: Urobilinogen. Specific gravity <1.010. White blood cell (WBC) casts. Ketones. - Ans - Ans: White blood cell (WBC) casts.
The nurse practitioner is seeing a patient who is starting on an HMG-CoA reductase inhibitor. Laboratory assessment should include an initial measurement of: LDH. ALT. ALP. GGT. - Ans - Ans: ALT. The most important option for the primary prevention of shingles is the use of: Varicella zoster immune globulin. Zoster vaccine. High-dose acyclovir at the onset of an outbreak. A tricyclic antidepressant post zoster episode. - Ans - ans: Zoster vaccine. Mr. Woods is a 63-year-old man who presents for initial evaluation at your practice. He has a 45 pack-year smoking history and COPD that is currently being treated with daily oral theophylline and albuterol via MDI prn. He complains of shortness of breath and chronic cough with sputum production. He states, "I can barely walk to my car without getting out of breath." Spirometric assessment reveals an FEV1 of 45% predicted and a FEV1:FVC of 62%. His health history reveals 3 exacerbations in the past year. The best course of action for Mr. Woods to minimize COPD exacerbation risk is to:
Dysphonia. Hematemesis. - Ans - Ans: Hematemesis. While counseling a patient about the adverse effects of first-generation antihistamines, the nurse practitioner advises that all of the following usually occur except: Sedation. Dry mouth. Pruritus. Urinary retention. - Ans - Ans: Pruritus. A 20-year-old male complains of being fatigued for the past week. The physical examination is significant for anterior and posterior cervical lymphadenopathy and right and left upper quadrant abdominal tenderness. A white blood cell differential is significant for lymphocytosis with reactive forms. Which of the following additional findings does the nurse practitioner anticipate? Pharyngitis with exudate Supraclavicular lymphadenopathy Diffuse maculopapular rash Marked sinus tenderness - Ans - Ans: Pharyngitis with exudate
A 33-year-old woman comes to your office and reports that she is "having a stroke." She has no medical history and no significant risk factors for cerebrovascular disease, but today she has sudden onset of inability to tightly close her eyelid and to frown or smile on the right side of her face. Her physical examination is otherwise unremarkable. The nurse practitioner recognizes that this likely represents paralysis of cranial nerve (CN): IV. V. VI. VII. - Ans - Ans: VII. Laboratory assessment of a patient with Hashimoto's thyroiditis typically includes the presence of: Polycythemia. TPO antibodies. Leukocytosis. Hypokalemia. - Ans - Ans: TPO antibodies. (thyroid protease antibodies) The nurse practitioner knows that all patients with an acute eye complaint should have:
Profound vaginal odor. - Ans - ans: Profound vaginal odor. The Federal Drug Enforcement Administration (DEA) provides registration numbers for prescription of controlled substances to which of the following groups? NPs with federal prescription authority Physicians, veterinarians, dentists, and NPs who practice in oncology or palliative care NPs with state-determined controlled substance prescriptive authority Nationally-certified APRNs with state licensure - Ans - Ans: NPs with state-determined controlled substance prescriptive authority In initial prescription of thyroxine therapy, which of the following statements is true? TSH should be checked about 2 days after dose adjustment. The anticipated thyroxine dose is usually calculated using an age- and weight-based formula. TSH should be suppressed to undetectable measures when seeking therapeutic effect. The therapeutic dose of thyroxine needed by the elderly is approximately the same as that needed by the younger adult and child. - Ans - Ans: The anticipated thyroxine dose is usually calculated using an age- and weight-based formula.
A 38-year-old woman presents complaining of weight loss, agitation, and new-onset tremor. The nurse practitioner suspects hyperthyroidism. Laboratory assessment will most likely include: TSH=8.9 mIU/L (0.4-4.0 mIU/L), free T4 =15 pmol/L (10-27 pmol/L). TSH<0.15 mIU/L (0.4-4.0 mIU/L), free T4 =79 pmol/L (10-27 pmol/L). TSH=24 mIU/L (0.4-4.0 mIU/L), free T4 =3 pmol/L (10-27 pmol/L). TSH=1.9 mIU/L (0.4-4.0 mIU/L), free T4 =22 pmol/L (10-27 pmol/L). - Ans - Ans: TSH<0.15 mIU/L (0.4-4.0 mIU/L), free T4 =79 pmol/L (10-27 pmol/L). Clinical evaluation of a 43-year-old man with a BMI=42 kg/m2 who presents with recurrent genital Candida albicans infection should include all of the following except: Treatment with oral or topical antifungals. Offering testing for HIV antibodies. Avoidance of soap on the genitals. Checking A1C. - Ans - Ans: Avoidance of soap on the genitals. Primary care of a person with alpha thalassemia minor should include: Routine iron supplementation. Offering genetic counseling prior to pregnancy.
