FNP-BC sample questions

Question 1

A 38-year-old female presents to the primary care clinic for an annual preventive visit. Her body mass index (BMI) is 28.4 kg/m², blood pressure is 124/78 mm Hg, and she reports no symptoms of polyuria, polydipsia, or unexplained weight loss. Her last clinical evaluation was three years ago. According to USPSTF screening guidelines, which screening intervention is indicated for this patient?

Accepted Answer

Screening for prediabetes and type 2 diabetes mellitus using fasting plasma glucose or glycated hemoglobin.

Answer

Universal screening for asymptomatic bacteriuria using a clean-catch urine culture.

Answer

Deferral of all metabolic screening until age 45 unless stage 2 hypertension develops.

Answer

Baseline coronary artery disease screening using a resting 12-lead electrocardiogram.

Question 2

A 42-year-old male who emigrated from Vietnam 12 years ago presents to an outpatient family practice clinic to establish care. He reports feeling healthy with no chronic medical complaints. During the social and family history, the patient notes that his father died in his late 40s from primary liver cancer, and several extended relatives in his country of origin were treated for chronic liver disorders.

Physical examination reveals an alert, well-nourished adult in no acute distress. Vital signs are normal. The abdomen is soft and non-tender, without hepatosplenomegaly, spider angiomas, palmar erythema, or ascites. Routine laboratory tests from an employee health fair 6 months ago showed normal complete blood counts and renal function.

Considering the patient's geographic origin, familial history, and risk profile, which diagnostic screening strategy should the family nurse practitioner prioritize?

Accepted Answer

Screen for chronic hepatitis B infection using the hepatitis B surface antigen, core antibody, and surface antibody triple panel.

Answer

Reassure the patient that the absence of jaundice and normal physical examination exclude significant viral hepatopathy.

Answer

Initiate prophylactic low-dose oral antiviral therapy immediately based on strong family history.

Answer

Order an empirical contrast-enhanced abdominal computed tomography scan to evaluate for occult intrahepatic mass lesions.

Question 3

A 66-year-old retired industrial pipefitter presents with progressive exertional dyspnea and a nonproductive cough. When conducting a comprehensive occupational risk assessment for suspected occupational interstitial pulmonary disease, which characteristic feature of toxic mineral exposure most frequently obscures the causal link between workplace hazards and clinical disease onset?

Accepted Answer

The prolonged latency period spanning decades between initial exposure and clinical manifestation.

Answer

The rapid clearance of fibrogenic mineral particles by alveolar macrophages within weeks of inhalation.

Answer

The strict restriction of mineral toxicities to acute type I IgE-mediated immediate hypersensitivity reactions.

Answer

The complete reversibility of toxic pneumoconioses once the worker leaves the industrial environment.

Question 4

A 58-year-old Chinese American male arrives for a post-surgical follow-up visit accompanied by his elderly parents and adult daughter. The patient quietly nods when addressed, while his father steps forward to speak and actively inquires about surgical recovery, medications, and wound care. To demonstrate ethnically and culturally sensitive risk assessment and family engagement within a collectivist framework, how should the family nurse practitioner respond?

Accepted Answer

Directly acknowledge and answer the father's questions while maintaining inclusive, respectful communication with the entire family unit.

Answer

Request that all family members leave the examination room to enforce individual autonomy and Western communication norms.

Answer

Advise the father that extended family members are prohibited from participating in post-surgical outpatient visits.

Answer

Direct all medical inquiries exclusively to the adult daughter under the assumption that younger relatives possess superior health literacy.

Question 5

A 44-year-old warehouse worker presents with sharp lower back pain radiating down the posterolateral aspect of his right thigh and calf to the lateral foot. Physical examination demonstrates a positive straight-leg raise at 35 degrees on the right and decreased sensation over the S1 dermatome. What primary mechanical pathophysiology underlies this patient's clinical presentation?

Accepted Answer

Herniation of the nucleus pulposus causing mechanical compression and chemical irritation of the traversing nerve root.

Answer

Microvascular ischemia of the sciatic nerve trunk secondary to piriformis tendon avulsion.

Answer

Autoimmune enthesopathy producing symmetric inflammation of the bilateral sacroiliac joint capsules.

Answer

Acute calcification and hypertrophy of the anterior longitudinal ligament across the lower thoracic spine.

Question 6

A 55-year-old female presents for evaluation of progressive exertional dyspnea and orthopnea. On cardiovascular auscultation at the cardiac apex, the family nurse practitioner identifies a soft first heart sound (S1) followed immediately by a blowing, high-pitched holosystolic murmur that radiates into the left axilla. Which valvular lesion is responsible for this physical finding?

Accepted Answer

Mitral regurgitation.

Answer

Tricuspid stenosis.

Answer

Aortic stenosis.

Answer

Pulmonic regurgitation.

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