Education That
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Available on our partner site, BoardVitals, this course is specifically targeted to the ANCC FNP Examination. Questions come in all formats that are seen on the exam: multiple choice, multiple response, drag & drop and hot post.

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Earn up to 90 contact hours quickly and easily.

Detailed Questions
& Explanations

Test your knowledge by answering more than 2,000 family nurse practitioner board review questions that have been reviewed and vetted by recent FNP exam takers. Then review detailed rationales for every question and correct your answers as you go to receive credit.


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Whether testing from your iPad in the hospital between cases, or at home on your couch, you have twenty-four hours a day access for 3 months.


ClinicIan Feedback:

Excellent Resource. Questions created around major Nursing topics are a plus for this review site. The explanations are unmatched; I had more notes from the explanations and better understanding of why a particular choice is the best and correct answer. An excellent resource, I will recommend this to anybody preparing to take Boards.

Gabriel Ohiani-Jegede, Family Nurse Practitioner


ANCC Family Nurse Practitioner Sample Questions:

Question 1

A 14-year-old afebrile male presents to clinic with sudden onset of a painful and swollen testicle that appears to lie transversely. The pain began 6 hours ago, has been persistent, and does not fluctuate with activity. He denies any dysuria or sexual activity. Which of the following is the most appropriate next step in management?

A) Obtain blood counts and prothrombin time
B) Immediate urology consult for surgery
C) Doppler abdominal ultrasound
D) Non-Doppler scrotal ultrasound
E) Hernia exam

Answer
B) Immediate urology consult for surgery


Explanation
Correct: (B) Immediate urology consult for surgery. Explanation: If a male presents with sudden onset of a painful and swollen testicle and does not have history or symptoms consistent with infection, emergent urological consultation is needed. There is a 4- to 8-hour window before permanent damage occurs. Obtaining labs or imaging should not delay a referral to urology. A. FALSE: Labs may be obtained prior to surgery by the urologist, but prompt referral is needed to avoid permanent damage. C and D. FALSE: Doppler scrotal ultrasound is the imaging study of choice for testicular torsion. E. FALSE: An incarcerated hernia may cause a swollen and painful testicle, but it does not cause a transverse testicle.

Reference
Sharp et al. Testicular Torsion: Diagnosis, Evaluation and Management. American Family Physician. 2013;88(12):835-840.


Question 2

A 52-year-old hypertensive male has had two previous myocardial infarctions. In spite of his best efforts, he has not achieved significant weight loss, and he finds it difficult to follow a heart-healthy diet. He takes rosuvastatin at 20mg/day, and his last lipid profile showed a total cholesterol level of 218mg/dL, a triglyceride level of 190mg/dL, an HDL-cholesterol level of 45mg/dL, and an LDL-cholesterol level of 118mg/dL. Which of the following would be the most appropriate change in management?

A) Maintain the same rosuvastatin dosage
B) Add atorvastatin
C) Add niacin
D) Add fenofibrate
E) Add ezetimibe

Answer
A) Maintain the same rosuvastatin dosage


Explanation
Correct: (A) Maintain the same rosuvastatin dosage. Explanation: According to the new lipid guidelines released in 2014, there is no specific treatment goal for LDL. Therefore, tailoring management to reach a specific lipid goal for LDL is not appropriate. Instead, there are 4 groups that should be treated with statins. Statin treatment groups are divided into low-intensity, medium-intensity, and high-intensity. The 4 groups most likely to benefit from statin therapy are identified as patients with any form of clinical ASCVD such as cardiovascular disease, stroke, peripheral artery disease, history of myocardial infarction, or aortic aneurysm; patients with primary LDL-C levels of 190mg/dL or greater; patients with diabetes mellitus, ages 40-75, or with LDL-C levels of 70-189 mg/dL; and patients without diabetes ages 40-75, with an estimated 10-year ASCVD risk ≥ 7.5%. In those with atherosclerotic cardiovascular disease, high-intensity statin therapy, such as rosuvastatin 20-40mg or atorvastatin 80mg, should be used to achieve at least a 50% reduction in LDL cholesterol unless otherwise contraindicated or when statin-associated adverse events are present. Similarly, for those with LDL cholesterol levels >190mg/dL, a high-intensity statin should be used with the goal of achieving at least a 50% reduction in LDL-cholesterol levels. This patient is on a high-intensity statin, the correct regimen for a patient that has had a myocardial infarction. B. FALSE: Adding another type of statin is not recommended until the first medication is maxed out. In this case, rosuvastatin could potentially be increased to 40mg. C. FALSE: Three classes of medications are appropriate for the management of major triglyceride elevations: fibric acid derivatives, niacin, and omega-3 fatty acids. Niacin is indicated as adjunctive therapy for treatment of adult patients with severe hypertriglyceridemia who present a risk of pancreatitis and who do not respond adequately to a determined dietary regimen. Extended-release niacin does not reduce cardiovascular morbidity or mortality among patients treated with statins. D. FALSE: Fibrates raise HDL and may also increase LDL, particularly if the triglyceride level is greater than 400mg/dL. E. FALSE: Ezetimibe is not a first-line agent for lowering cholesterol and should not be used in this patient.

Reference
Practice Guidelines: ACC/AHA Release Updated Guideline on the Treatment of Blood Cholesterol to Reduce ASCVD Risk Am Fam Physician. 2014 Aug 15;90(4):260-265.

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