ANCC FNP BOARD EXAM
- 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
Rationale
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 longterm 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. - 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?
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?
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?
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:
Have an HDL level of < 35 mg/dL - Which of the following found on an ECG would confirm atrial fibrillation?
-absent P waves
-irregular ventricular rate - As an FNP you understand that all of the following statements about chronic heart
failure are accurate EXCEPT:
-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?
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?
Cog wheeling
- The complex network of nerve fibers that innervate the organs within the abdomen
like the gastrointestinal tract, pancreas, and gall bladder is the
Enteric nervous system - Aplastic anemia would be classified as which of the following?
Normocytic anemia - Charles Darwin wrote On the Origin of Species about human evolution. He also is
known for which of the following?
Developing the “baby journal” as a systematic method to document observed behavioral
development. - Your patient has AIDS. He is in the hospital suffering from an infection. He
presented with severe watery diarrhea, abdominal cramps, nausea, malaise and has an
electrolyte imbalance. Which of the following opportunistic infections do these
symptoms best describe?
Cryptosporidiosis
Rationale:
Cryptosporidiosis presents with severe watery diarrhea – sometimes as many as 30-40
stools per day. The patient also has abdominal cramps, nausea, malaise and tests will
show an electrolyte balance. - A patient with sensitive skin had a TB skin test but has no symptoms. He returns
with redness and swelling that appears positive. What is the next step?
Schedule a CXR - The nurse practitioner should not cross certain boundaries with patients. Which of
the following would not be considered crossing one of these boundaries?