Download FNP Certification Questions EXAM 2025 | ACTUAL REAL EXAM ACCURATE QUESTIONS AND ANSWERS and more Exams Pharmacology in PDF only on Docsity!
FNP Certification Questions EXAM 2025 |
ACTUAL REAL EXAM ACCURATE QUESTIONS
AND ANSWERS WITH RATIONALES |
VERIFIED AND LATEST UPDATED |
GUARANTEED PASS
1. Treatment for acute COPD exacerbation in a 78-year-old woman with worsening symptoms: Which of the following is the most appropriate pharmacologic treatment? A. Oral cefpodoxime and injectable sustained-release corticosteroid B. Oral doxycycline with a short-course of an oral corticosteroid C. Increase the dose of inhaled corticosteroid D. Add oral montelukast Correct Answer: B. Oral doxycycline with a short-course of an oral corticosteroid Rationale: For acute exacerbations of COPD with symptoms of increased sputum production and dyspnea, a short course of antibiotics (such as doxycycline) and systemic corticosteroids is appropriate. Doxycycline covers common pathogens, and corticosteroids reduce airway inflammation. 2. Agent with the longest bronchodilation duration in COPD: Which class of agents provides a protracted duration of bronchodilation in COPD? A. Short-acting beta2-agonists (SABA) B. Inhaled corticosteroids C. PDE-4 inhibitors D. Long-acting beta2-agonists (LABA) Correct Answer: D. Long-acting beta2-agonists (LABA) Rationale: LABAs provide bronchodilation for up to 12–24 hours, making them ideal for long- term control in COPD. SABAs are shorter-acting and ICS do not directly cause bronchodilation. 3. First-line agent to reduce risk of COPD exacerbations: Which of the following is a first-line therapy to reduce exacerbation risk in COPD? A. Oral xanthine (e.g., theophylline) B. Inhaled long-acting muscarinic antagonists (LAMA) C. Inhaled short-acting beta2-agonist (SABA) D. Oral PDE-4 inhibitor
Correct Answer: B. Inhaled long-acting muscarinic antagonists (LAMA) Rationale: LAMAs like tiotropium are first-line for reducing exacerbations and improving symptoms in moderate to severe COPD.
4. Effective duration for long-term oxygen therapy in COPD: What is the recommended minimum duration of daily oxygen therapy to achieve benefits in severe COPD? A. Oxygen therapy can replace ICS B. 4–6 hours per day C. At least 15 hours per day D. Improves FEV1 to near normal Correct Answer: C. At least 15 hours per day Rationale: To improve survival in severe COPD, long-term oxygen therapy must be used for at least 15 hours daily. 5. Asthma control assessment in an asymptomatic 30-year-old patient: Which of the following is the most appropriate next step? A. Continue current treatment B. Asthma appears well-controlled C. Intensify therapy D. More information is needed to determine level of asthma control Correct Answer: D. More information is needed to determine level of asthma control Rationale: Even if the patient is asymptomatic, control should be assessed using objective criteria like frequency of rescue inhaler use, night-time symptoms, and activity limitation. 6. Skin changes with insulin resistance: What is the most likely diagnosis? A. Acanthosis nigricans B. Lichen planus C. Actinic keratosis D. Erythema migrans Correct Answer: A. Acanthosis nigricans Rationale: This condition presents as velvety, hyperpigmented plaques in intertriginous areas and is commonly associated with insulin resistance and obesity. 7. Hypertension management in a physically active 68-year-old woman: Which of the following should be recommended? (Select all that apply) A. Start a beta-blocker B. Initiate a thiazide diuretic
C. "What barriers do you see to losing weight?" D. "Your blood sugar control will improve if you lose weight." Correct Answer: C. "What barriers do you see to losing weight?" Rationale: This open-ended, nonjudgmental question promotes patient engagement and identifies obstacles, which is key in behavior change strategies.
12. Appropriate diabetes medication for older adult with reduced GFR and risk for hypoglycemia: Which statement is true regarding glycemic management in older adults with reduced kidney function? A. Metformin should always be discontinued in older adults B. Glyburide is a safer sulfonylurea option than glipizide in the elderly C. Glipizide is preferred over glyburide as a sulfonylurea in the older adult D. An A1C target of <6.5% should be pursued aggressively Correct Answer: C. Glipizide is preferred over glyburide as a sulfonylurea in the older adult Rationale: Glyburide has a higher risk of prolonged hypoglycemia, especially in renal impairment. Glipizide has a safer profile for older adults with kidney dysfunction. 13. Risk of hyperkalemia in older diabetic patients with ACE inhibitor and impaired renal function: Which of the following contributes to increased risk of hyperkalemia? A. Use of simvastatin with metformin B. Poor hydration in a patient on lisinopril C. Combination of metformin and glyburide D. Elevated GFR values Correct Answer: B. Poor hydration in a patient on lisinopril Rationale: ACE inhibitors like lisinopril can increase potassium levels. When combined with dehydration, the risk of hyperkalemia is higher, especially in older adults with reduced renal reserve. 14. Metformin use in elderly patients with renal impairment: Why is metformin use concerning in older adults with impaired renal function? A. It causes direct nephrotoxicity B. It increases risk for liver failure C. It increases the risk of lactic acidosis D. It significantly raises blood pressure Correct Answer: C. It increases the risk of lactic acidosis Rationale: Metformin is renally excreted, and accumulation due to impaired GFR can lead to lactic acidosis, especially in elderly patients. 15. Goal A1C in functionally independent older adults with diabetes:
Which of the following best represents the recommended A1C goal? A. <6.0% B. <6.5% C. <7.0% D. <8.5% Correct Answer: C. <7.0% Rationale: For healthy, functionally independent older adults, an A1C goal of <7% is appropriate. Less strict goals may be considered if comorbidities or frailty are present. Michelle's physical examination is consistent with an asthma flare triggered by viral RTI. Her medication regimen should be adjusted to include which of the following? Choose all that apply. Based on the scenario below: You see Michelle, a 38-year-old woman with moderate persistent asthma who is using mediumdose inhaled fluticasone daily and albuterol via MDI as needed. In a typical month, she uses albuterol 2 puffs "about 2 times, when I feel my chest getting a little tight, and it works right away." In an average month, she has no episodes of nocturnal awakening with cough or wheeze, typically has excellent activity tolerance. An oral systemic bronchodilator titrated to therapeutic level A short course of oral corticosteroid An oral macrolide antimicrobial A single dose of injectable corticosteroid
- Ans - Ans: A short course of oral corticosteroid A 76-year-old man with COPD, who uses an inhaled LAMA daily on a set schedule and SABA via MDI as needed for symptom relief, presents with a COPD exacerbation. Which of the following describes the role of imaging in the evaluation of COPD exacerbation? Chest x-ray is a routine part of the evaluation of a person with COPD exacerbation
A. 8:30AM-10:30AM
B. 10:00AM-11:00AM
C. 2:00 PM-10:00 PM
- Lispro (Humalog®) __
- Regular insulin (Humulin R®) __
- NPH (Novolin N®, Humulin N®) __ 1 - A 2-B 3-C 1 - C 2-A 3-B 1 - B 2-A 3-C 1 - A 2-C 3-B - Ans - Ans: 1-A (onset: 30 mins, peak: 1-2 hr) 2-B ( onset: 1hr peak: 1-3 hrs 3-C (onset: 1-2 hrs; peak: 3-14hrs) Mr. Jones, a 52-year-old African-American man, presents for treatment of hypertension. He is currently taking a calcium channel blocker for the past 2 months. He is feeling well with no complaint and physical examination is within normal limits. His blood pressure today is 160/ mm Hg bilaterally. The next best step is to: Add an ACEI and have the patient follow-up in 2 weeks Discontinue the calcium channel blocker and start an aldosterone antagonist Advise Mr. Jones that his blood pressure is in an acceptable range and he should follow-up in approximately 2 months
Prescribe a thiazide diuretic and advise a 1-month follow-up - Ans - Ans: Prescribe a thiazide diuretic and advise a 1-month follow-up Mr. Kelly is a 66-year-old man with type 2 DM and HTN who presents with the following lipid profile: HDL=35 mg/dL (0.9 mmol/L) LDL=150 mg/dL (3.9 mmol/L) Triglycerides=210 mg/dL (2.4 mmol/L) Which of the following represents the best choice of dyslipidemia therapy for Mr. Kelly? Optimized oral selective cholesterol absorption inhibitor therapy Moderate-intensity oral statin therapy Injectable PCSK9 therapy High-intensity oral omega-3 fatty acid therapy
- Ans - Ans: Moderate-intensity oral statin therapy Which of the following medications should be avoided in a 45-year-old man with poorlycontrolled hypertension who asks, "What medications can I take when I have a cold?" Dextromethorphan Chlorpheniramine
Calcium channel blockers are appropriate to use in the presence of heart failure. - Ans - Ans: Calcium channel blockers are appropriate to use in the presence of heart failure. The typical international normalized ratio (INR) goal during warfarin therapy for a 65-year-old woman with atrial fibrillation is: 1.0‒2.0. 1.5‒2.5. 2.0‒3.0. 2.5‒3.5. - Ans - ans: 2.0‒3.0. Which of the following drug classes will yield the greatest decrease in blood pressure for a middle-aged African American male? Calcium channel blocker Beta-blocker ACE inhibitor Angiotensin receptor blocker - Ans - ans: Calcium channel blocker You see a 56-year-old male who is newly diagnosed with dyslipidemia. Prior to initiating statin treatment, his hepatic enzyme levels are measured to establish baseline values. In the absence
of symptoms of liver injury, which of the following is the recommended schedule for hepatic enzyme monitoring during statin use? Every 3 months Every 6 months Every 12 months No additional hepatic enzyme monitoring is needed - Ans - Ans: No additional hepatic enzyme monitoring is needed You start a patient on spironolactone who is also on an angiotensin-converting enzyme inhibitor. You advise the patient to return in 4 weeks to check which of the following laboratory parameters? Sodium Calcium Potassium Chloride - Ans - Ans: Potassium Match each medication used to manage dyslipidemia with its major anticipated change in the lipid profile. An answer can be used more than once. A. Decreases triglycerides
The routine use of diuretics can be considered for patients with heart failure beginning at: Stage A. Stage B. Stage C. Stage D. - Ans - Ans: Stage C. Genital Candida albicans infection in men typically presents with all of the following except: Penile discharge. Balanitis. Groin-fold involvement. Scrotal excoriation. - Ans - Ans: Penile discharge. Which of the following medications can be considered for patients at risk for heart failure but without structural heart disease (Stage A)? Beta-blockers
Thiazide diuretics ARB or ACEI Digitalis - Ans - ans: ARB or ACEI Choose from the following: A. Bacterial vaginosis B. Candida vulvovaginitis C. Nongonococcal cervicitis/vaginitis
- Clue cells with alkaline pH __
- Pseudohyphae __
- Abundant WBCs __ 1 - A 2 - B 3-C 1 - B 2 - A 3-C 1 - C 2 - B 3-A 1 - A 2-C 3-B - Ans - Ans: 1-A (clue cells with alkaline pH) 2-B (pseudohyphae) 3-C (WBC's) Choose from the following (an option can be used more than once):
- External genital warts in a 25-year-old man __
- Gonococcal urethritis in a 22-year-old man __
- Syphilis in a 45-year-old man __
- External genital warts in a 28-year-old pregnant woman __ 1 - C 2 - A 3-B 4-D 1 - D 2 - A 3-B 4-C 1 - A 2 - B 3-C 4-D 1 - B 2 - D 3-A 4-C - Ans - Ans: 1-C (use Imiquimod cream to treats external genital warts ) 2 - A (Ceftriaxone 2 gr IM treats gonococcal urethritis ) 3-B (Injectable Penicillin 2 Mill VK treats Syphillis) 4-D (Trichloacetic acid uses to treat external genital warts for 28yr pregnant woman) considerations in caring for a 68-year-old man with a BMI=38 kg/m2 who is otherwise well and presents with genital candidiasis includes which of two most helpful measures? Advice on the use of antibacterial soap to the region. Obtain an in-office blood glucose. Prescribing topical miconazole. Order a medium-potency topical corticosteroid to the affected region to help with symptom control. - Ans - Ans: Obtain an in-office blood glucose.
Prescribing topical miconazole. Which of the following is inconsistent with benign prostatic hyperplasia? Obliterated median sulcus Size ≥2.5 cm × 3 cm Symptoms improved with use of an alpha-1 receptor blockade such as tamsulosin. Surgical intervention should be offered early in the disease process. - Ans - Ans: Surgical intervention should be offered early in the disease process. Which of the following is least likely to be noted in the 55-year-old man who presents with bladder cancer? Textile worker for the past 25 years 60 pack-year cigarette smoking history Report of intermittent painless gross hematuria Report of recent-onset intermittent acute urinary retention - Ans - Ans: Report of recent-onset intermittent acute urinary retention Which of the following is a worrisome finding noted during pelvic examination on a 62-year-old woman?
- Associated with lifting __
- Occurs during an acute illness __
- Reports of strong sensation of needing to void __
- Often occurs in presence of mobility problems __ 1 - D 2-A 3-B 4-C 1 - B 2 - A 3-D 4-C 1 - C 2 - D 3-B 4-A 1 - B 2-D 3-A 4-C - Ans - ans: 1 - B (stress incontinence/associated with lifting) 2-D (transient incontinence occurs during in an acute illness) 3-A(urge incontinence/reports strong sensation of needing to void) 4-C (functional incontinence/often occurs in presence of mobility problems) Which of the following patients should have screening for HPV-associated cancer? An annual Pap test for cervical cancer screening in a 21-year-old woman A cervical Pap test every 3 years for a 40-year-old woman who has undergone a total hysterectomy for uterine fibroids An anal Pap in a 45-year-old man with a history of anal and genital warts An anal Pap in a 21-year-old woman who has received HPV-9 vaccine - Ans - Ans: An anal Pap in a 45-year-old man with a history of anal and genital warts
Samantha, a healthy 32-year-old woman who is taking combined oral contraceptives, is here to review the results of her recent liquid-based Pap screening that revealed atypical squamous cells of unknown significance (ASCUS) and high-risk HPV positive. She has no history of previous abnormal cervical cytology, with her last screening obtained approximately 2 years ago. After explaining the significance of these findings, the most appropriate next step is to: Advise that she return in 6-12 months for a repeat Pap with HPV cotesting. Obtain screening tests for N. gonorrhoeae and C. trachomatis infection. Referral for colposcopy. Counsel that the usual cervical cancer screening guidelines should be followed. - Ans - Ans: Referral for colposcopy. Which of the following is demonstrated to provide the most symptom relief in treating vasomotor symptoms? Clonidine Paroxetine Conjugated estrogen Venlafaxine - Ans - Ans: conjugated estrogen Match the following cancer types:
