ANCC FNP Board Questions and
Answers Updated 2026
AMmiddle-
ageMfemaleMpatientMpresentsMtoMtheMclinicMwithMaMrecurrenceMofMmildMhidradenitisMs
uppurativaMafterMtopicalMtherapiesMfailed.MWhichMfirst-
lineMtreatmentMisMrecommended?M-MAnswerMTetracycline
TwelveMweeksMofMoralMtetracyclineM(Sumycin)MisMtheMrecommendedMfirst-
lineMtreatmentMforMhidradenitisMsuppurativa.
__________________________________________________
HidradenitisMsuppurativaMisMaMdisorderMofMtheMterminalMfollicularMepitheliumMinMapocrin
eMgland-
bearingMskin.MItMisMaMchronic,MdisablingMdisorderMthatMprogresses,MoftenMcausingMkeloi
ds,Mcontractures,MandMimmobility.MItMisMcharacterizedMbyMcomedone-
likeMfollicularMocclusion,MchronicMandMrelapsingMinflammation,MmucopurulentMdischarge,M
andMprogressiveMscarring.
ArthropathyMassociatedMwithMhidradenitisMmayMbeMpresent.MTypicalMpresentationMinclude
sMnodulesMandMsinusMtractsM(inflamedMorMnoninflamed),Mabscesses,MandMscarringMfound
MinMtheMaxilla,MgenitofemoralMarea,Mperineum,MglutealMarea,MandMinframammaryMareaM
inMwomen.
RecommendedMtreatmentsMincludeMantibiotics,Msteroids,Mretinoids,Mdapsone,MandManti-
tumorMnecrosisMfactorMagents.MAMdermatologyMconsultationMshouldMalsoMbeMconsidered.
First-
lineMtreatmentMisMaM12-weekMcourseMofManMoralMtetracyclineM(Sumycin)MsuchMasMdoxy
cycline.MForMpatientsMwhoMdoMnotMrespondMtoMdoxycycline,MtheMnextMrecommendedMs
tepMisMaMcombinationMofMtwice-
dailyMclindamycinM(Cleocin)MandMrifampicinM(Rifadin)MforM10-
12Mweeks.MIfMtreatmentMfails,MacitretinM(Soriatane,MforMmalesMandMnonfertileMfemales)
MorMdapsoneM(Aczone)MmayMbeMconsideredMbyMaMdermatologist.MInMpatientsMwithMmo
derateMtoMsevereMhidradenitisMsuppurativa,MadalimumabM(Humira)MmayMpossiblyMbeMcon
sidered.
WhenMprovidingMculturallyMcompetentMhealthMcareMservicesMtoManMAmericanMIndianMeld
er,MtheMnurseMpractitionerMunderstandsMwhichMisMtraditionallyMtrue?M-
MAnswerMTheM"MedicineMWheel"MisMusedMbyMmanyMforMtheMpurposeMofMhealthMand
Mhealing
TheM"MedicineMWheel"MisMtraditionallyMusedMandMcontainsMfourMdirections;Mnorth,Msout
h,Meast,MandMwest.MTraditionallyMeachMtribeMhasMdifferentMmeaningsMforMeachMdirectio
,nMandMtheyMmayMrepresentMtheMseasonMofMtheMyearMorMstageMofMlife.MItMisMaimed
MatMprovidingMaMholisticMviewMofMlife.
________________________________________
AnMunderstandingMofMdifferentMculturalMpreferencesMleadsMtoMculturalMcompetenceMinM
healthcare.MSomeMpatientsMmayMvalueMtraditionalMcultureMandMpreferencesMasMitMrelate
sMtoMhealthcare.MTheseMindividualMpreferencesMshouldMbeMincludedMinMtheMinterviewMa
ndMtreatmentMplanMforMpatients.
Traditionally,MtheMAmericanMIndianMcultureMvaluesMaMholisticMapproachMtoMhealthMcare
MintegratingMtheMperson,Mlifestyle,Menvironment,Mfamily,MandMreligion.MPatientsMadhering
MtoMtheseMtraditionalMculturalMpracticesMoftenMfeelMthatMillnessMisMdueMtoMaMlackMof
MharmonyMwithMtheMphysicalMbody,Mmind,Mspirit,MandMemotions.MPatientsMmayMseekMc
areMfromMwesternMmedicineMforMspecificMailmentsMwhileMalsoMconsultingMwithMtradition
alMhealersMforMspiritualMguidance.
HealthcareMprovidersMshouldMseekMtoMunderstandMrelevantMculturalMfactorsMandMassess
MeachMindividual'sMhealthcareMliteracyMinMorderMtoMprovideMculturallyMcompetentMcare.
TheMnurseMpractitionerMseesManMolderMadultMpatientMinMtheMclinicMwithMtheMprimaryM
reportMofMhearingMlossMandMaMsensationMofMfullnessMinMtheMrightMear.MTheMnurseMpr
actitionerMsuspectsMconductiveMhearingMloss.MWhichMcouldMcontributeMtoMthis?M-
MAnswerMCerumen,McommonlyMcalledMearwax,MisMaMcombinationMofMsecretionsMandMsl
oughedMepithelialMcellsMthatMprotectsMtheMearsMfromMinfection,Mwater,MandMinsects.MIt
MisMnormallyMexpelledMfromMtheMearMcanalMthroughMnaturalMjawMmovement.MWhenMt
hisMself-
cleaningMprocessMfails,McerumenMcanMbecomeMimpacted.MCerumenMimpactionMoccludesMt
heMearMcanalMandMcanMpressMagainstMtheMtympanicMmembrane,MresultingMinMconductiv
eMhearingMloss.
_________________________________________
ConductiveMhearingMisMtheMtransitionMofMsoundMfromMtheMexternalMandMmiddleMearMt
oMtheMinnerMear.MConductiveMhearingMlossMisMcausedMbyMproblemsMinMtheMexternalMa
ndMmiddleMearMthatMinterfereMwithMtheMtransmissionMofMsoundMandMitsMconversionMto
MmechanicalMvibration.MCausesMofMconductiveMhearingMlossMincludeMobstructionMofMthe
MexternalMauditoryMcanalMbyMcerumen,MforeignMbodies,MdebrisMfromMotitisMexterna,Man
dMlargeMexocytosisMandMosteomas.
SensorineuralMhearingMlossMinvolvesMdifficultyMconvertingMmechanicalMvibrationsMtoMelectr
icalMpotentialMinMtheMcochleaMorMinMauditoryMnerveMtransmissionMtoMtheMbrain.MItMis
MmostlyMcausedMbyMpermanentMdamageMinMtheMorganMofMCorti.MItMcanMbeMcausedM
byMage-
, relatedMhearingMloss,MnoiseMtrauma,Mmedications,MautoimmuneMdiseases,MmechanicalMtra
uma,MMeniereMdisease,Minfection,MandMneoplasmM(acousticMneuroma).
ApproximatelyMone-
thirdMofMolderMadultsMbetweenMtheMagesMofM61MandM70MyearsMhaveMhearingMloss.M
MoreMthanM90%MofMadultsMolderMthanM85MyearsMofMageMhaveMhearingMloss.MTheMm
ostMcommonMtypeMofMhearingMlossMisMage-
relatedMandMsensorineural.MAllMadultsMolderMthanM60MyearsMofMageMshouldMbeMscreen
edMforMhearingMlossMatMperiodicMhealthMexaminations.
AnMotherwiseMhealthyMadultMpatientMpresentsMtoMtheMclinicMwithMaMdiagnosisMofMcom
munity-
acquiredMpneumoniaMandMnoMrecentMantibioticMtherapy.MWhichMisMtheMbestMoptionMfo
rMtreatment?M-MAnswerMAmoxicillin
High-doseMamoxicillinM(Amoxil)MorMdoxycyclineMareMrecommendedMasMfirst-
lineMtherapyMforMadultsMwithoutMcomorbidities.
_____________________________________________
Community-
acquiredMpneumoniaM(CAP)MisMpneumoniaMnotMacquiredMinMaMhospitalMorMlong-
termMcareMfacility.MPatientsMwithMsuspectedMCAPMshouldMreceiveMaMchestMX-
rayMforMdiagnosis.MTheMPneumoniaMSeverityMIndexMshouldMbeMusedMtoMassistMinMdecis
ionsMregardingMtheMneedMforMhospitalizationMinMpatientsMwithMCAP.
AccordingMtoMtheMAmericanMThoracicMSocietyM(ATS)MandMtheMInfectiousMDiseasesMSociet
yMofMAmericaM(IDSA)M2019Mguidelines,MtheMinitialMtreatmentMofMCAPMforMmostMpatien
tsMisMamoxicillinMorMdoxycycline.MMacrolidesMareManMoptionMforMtreatment,MbutMareMn
oMlongerMrecommendedMroutinelyMasMfirst-
lineMtreatment,MgivenMincreasedMmacrolideMresistance.MThisMisMaMchangeMfromMtheM20
07MATS/IDSAMguidelines.MRespiratoryMfluoroquinolonesMandMamoxicillin/clavulanateMshould
MbeMusedMinMpatientsMwhoMfailMfirst-
lineMmedications,MhaveMsignificantMcomorbidities,MhaveMhadMrecentMantibioticMtherapy,Ma
reMallergicMtoMalternativeMagents,MorMhaveMaMdocumentedMinfectionMwithMhighlyMdrug-
resistantMpneumococci.
AMpatientMpresentsMtoMtheMclinicMforMconceptionMcounseling.MSheMrecentlyMstoppedMta
kingMoralMcontraceptivesMandMwouldMlikeMtoMbecomeMpregnant.MWhichMstatementMabo
utMconceptionMsafetyMafterMstoppingMoralMcontraceptivesMisMcorrect?M-MAnswerM
YouMhaveMaM35-year-
oldMfemaleMpatientMwhoMisMcomplainingMofMwristMpain.MSheMisManMadministrativeMassi
stantMwhoMdoesMaMgreatMdealMofMcomputerMworkMinMherMjob.MYouMwillMtestMherMf
Answers Updated 2026
AMmiddle-
ageMfemaleMpatientMpresentsMtoMtheMclinicMwithMaMrecurrenceMofMmildMhidradenitisMs
uppurativaMafterMtopicalMtherapiesMfailed.MWhichMfirst-
lineMtreatmentMisMrecommended?M-MAnswerMTetracycline
TwelveMweeksMofMoralMtetracyclineM(Sumycin)MisMtheMrecommendedMfirst-
lineMtreatmentMforMhidradenitisMsuppurativa.
__________________________________________________
HidradenitisMsuppurativaMisMaMdisorderMofMtheMterminalMfollicularMepitheliumMinMapocrin
eMgland-
bearingMskin.MItMisMaMchronic,MdisablingMdisorderMthatMprogresses,MoftenMcausingMkeloi
ds,Mcontractures,MandMimmobility.MItMisMcharacterizedMbyMcomedone-
likeMfollicularMocclusion,MchronicMandMrelapsingMinflammation,MmucopurulentMdischarge,M
andMprogressiveMscarring.
ArthropathyMassociatedMwithMhidradenitisMmayMbeMpresent.MTypicalMpresentationMinclude
sMnodulesMandMsinusMtractsM(inflamedMorMnoninflamed),Mabscesses,MandMscarringMfound
MinMtheMaxilla,MgenitofemoralMarea,Mperineum,MglutealMarea,MandMinframammaryMareaM
inMwomen.
RecommendedMtreatmentsMincludeMantibiotics,Msteroids,Mretinoids,Mdapsone,MandManti-
tumorMnecrosisMfactorMagents.MAMdermatologyMconsultationMshouldMalsoMbeMconsidered.
First-
lineMtreatmentMisMaM12-weekMcourseMofManMoralMtetracyclineM(Sumycin)MsuchMasMdoxy
cycline.MForMpatientsMwhoMdoMnotMrespondMtoMdoxycycline,MtheMnextMrecommendedMs
tepMisMaMcombinationMofMtwice-
dailyMclindamycinM(Cleocin)MandMrifampicinM(Rifadin)MforM10-
12Mweeks.MIfMtreatmentMfails,MacitretinM(Soriatane,MforMmalesMandMnonfertileMfemales)
MorMdapsoneM(Aczone)MmayMbeMconsideredMbyMaMdermatologist.MInMpatientsMwithMmo
derateMtoMsevereMhidradenitisMsuppurativa,MadalimumabM(Humira)MmayMpossiblyMbeMcon
sidered.
WhenMprovidingMculturallyMcompetentMhealthMcareMservicesMtoManMAmericanMIndianMeld
er,MtheMnurseMpractitionerMunderstandsMwhichMisMtraditionallyMtrue?M-
MAnswerMTheM"MedicineMWheel"MisMusedMbyMmanyMforMtheMpurposeMofMhealthMand
Mhealing
TheM"MedicineMWheel"MisMtraditionallyMusedMandMcontainsMfourMdirections;Mnorth,Msout
h,Meast,MandMwest.MTraditionallyMeachMtribeMhasMdifferentMmeaningsMforMeachMdirectio
,nMandMtheyMmayMrepresentMtheMseasonMofMtheMyearMorMstageMofMlife.MItMisMaimed
MatMprovidingMaMholisticMviewMofMlife.
________________________________________
AnMunderstandingMofMdifferentMculturalMpreferencesMleadsMtoMculturalMcompetenceMinM
healthcare.MSomeMpatientsMmayMvalueMtraditionalMcultureMandMpreferencesMasMitMrelate
sMtoMhealthcare.MTheseMindividualMpreferencesMshouldMbeMincludedMinMtheMinterviewMa
ndMtreatmentMplanMforMpatients.
Traditionally,MtheMAmericanMIndianMcultureMvaluesMaMholisticMapproachMtoMhealthMcare
MintegratingMtheMperson,Mlifestyle,Menvironment,Mfamily,MandMreligion.MPatientsMadhering
MtoMtheseMtraditionalMculturalMpracticesMoftenMfeelMthatMillnessMisMdueMtoMaMlackMof
MharmonyMwithMtheMphysicalMbody,Mmind,Mspirit,MandMemotions.MPatientsMmayMseekMc
areMfromMwesternMmedicineMforMspecificMailmentsMwhileMalsoMconsultingMwithMtradition
alMhealersMforMspiritualMguidance.
HealthcareMprovidersMshouldMseekMtoMunderstandMrelevantMculturalMfactorsMandMassess
MeachMindividual'sMhealthcareMliteracyMinMorderMtoMprovideMculturallyMcompetentMcare.
TheMnurseMpractitionerMseesManMolderMadultMpatientMinMtheMclinicMwithMtheMprimaryM
reportMofMhearingMlossMandMaMsensationMofMfullnessMinMtheMrightMear.MTheMnurseMpr
actitionerMsuspectsMconductiveMhearingMloss.MWhichMcouldMcontributeMtoMthis?M-
MAnswerMCerumen,McommonlyMcalledMearwax,MisMaMcombinationMofMsecretionsMandMsl
oughedMepithelialMcellsMthatMprotectsMtheMearsMfromMinfection,Mwater,MandMinsects.MIt
MisMnormallyMexpelledMfromMtheMearMcanalMthroughMnaturalMjawMmovement.MWhenMt
hisMself-
cleaningMprocessMfails,McerumenMcanMbecomeMimpacted.MCerumenMimpactionMoccludesMt
heMearMcanalMandMcanMpressMagainstMtheMtympanicMmembrane,MresultingMinMconductiv
eMhearingMloss.
_________________________________________
ConductiveMhearingMisMtheMtransitionMofMsoundMfromMtheMexternalMandMmiddleMearMt
oMtheMinnerMear.MConductiveMhearingMlossMisMcausedMbyMproblemsMinMtheMexternalMa
ndMmiddleMearMthatMinterfereMwithMtheMtransmissionMofMsoundMandMitsMconversionMto
MmechanicalMvibration.MCausesMofMconductiveMhearingMlossMincludeMobstructionMofMthe
MexternalMauditoryMcanalMbyMcerumen,MforeignMbodies,MdebrisMfromMotitisMexterna,Man
dMlargeMexocytosisMandMosteomas.
SensorineuralMhearingMlossMinvolvesMdifficultyMconvertingMmechanicalMvibrationsMtoMelectr
icalMpotentialMinMtheMcochleaMorMinMauditoryMnerveMtransmissionMtoMtheMbrain.MItMis
MmostlyMcausedMbyMpermanentMdamageMinMtheMorganMofMCorti.MItMcanMbeMcausedM
byMage-
, relatedMhearingMloss,MnoiseMtrauma,Mmedications,MautoimmuneMdiseases,MmechanicalMtra
uma,MMeniereMdisease,Minfection,MandMneoplasmM(acousticMneuroma).
ApproximatelyMone-
thirdMofMolderMadultsMbetweenMtheMagesMofM61MandM70MyearsMhaveMhearingMloss.M
MoreMthanM90%MofMadultsMolderMthanM85MyearsMofMageMhaveMhearingMloss.MTheMm
ostMcommonMtypeMofMhearingMlossMisMage-
relatedMandMsensorineural.MAllMadultsMolderMthanM60MyearsMofMageMshouldMbeMscreen
edMforMhearingMlossMatMperiodicMhealthMexaminations.
AnMotherwiseMhealthyMadultMpatientMpresentsMtoMtheMclinicMwithMaMdiagnosisMofMcom
munity-
acquiredMpneumoniaMandMnoMrecentMantibioticMtherapy.MWhichMisMtheMbestMoptionMfo
rMtreatment?M-MAnswerMAmoxicillin
High-doseMamoxicillinM(Amoxil)MorMdoxycyclineMareMrecommendedMasMfirst-
lineMtherapyMforMadultsMwithoutMcomorbidities.
_____________________________________________
Community-
acquiredMpneumoniaM(CAP)MisMpneumoniaMnotMacquiredMinMaMhospitalMorMlong-
termMcareMfacility.MPatientsMwithMsuspectedMCAPMshouldMreceiveMaMchestMX-
rayMforMdiagnosis.MTheMPneumoniaMSeverityMIndexMshouldMbeMusedMtoMassistMinMdecis
ionsMregardingMtheMneedMforMhospitalizationMinMpatientsMwithMCAP.
AccordingMtoMtheMAmericanMThoracicMSocietyM(ATS)MandMtheMInfectiousMDiseasesMSociet
yMofMAmericaM(IDSA)M2019Mguidelines,MtheMinitialMtreatmentMofMCAPMforMmostMpatien
tsMisMamoxicillinMorMdoxycycline.MMacrolidesMareManMoptionMforMtreatment,MbutMareMn
oMlongerMrecommendedMroutinelyMasMfirst-
lineMtreatment,MgivenMincreasedMmacrolideMresistance.MThisMisMaMchangeMfromMtheM20
07MATS/IDSAMguidelines.MRespiratoryMfluoroquinolonesMandMamoxicillin/clavulanateMshould
MbeMusedMinMpatientsMwhoMfailMfirst-
lineMmedications,MhaveMsignificantMcomorbidities,MhaveMhadMrecentMantibioticMtherapy,Ma
reMallergicMtoMalternativeMagents,MorMhaveMaMdocumentedMinfectionMwithMhighlyMdrug-
resistantMpneumococci.
AMpatientMpresentsMtoMtheMclinicMforMconceptionMcounseling.MSheMrecentlyMstoppedMta
kingMoralMcontraceptivesMandMwouldMlikeMtoMbecomeMpregnant.MWhichMstatementMabo
utMconceptionMsafetyMafterMstoppingMoralMcontraceptivesMisMcorrect?M-MAnswerM
YouMhaveMaM35-year-
oldMfemaleMpatientMwhoMisMcomplainingMofMwristMpain.MSheMisManMadministrativeMassi
stantMwhoMdoesMaMgreatMdealMofMcomputerMworkMinMherMjob.MYouMwillMtestMherMf