2026 Barkley FNP Review – Family Nurse Practitioner
Board Certification Practice Questions Orthopedics &
Musculoskeletal Disorders | Latest Exam with 100%
Verified Solutions, Study Guide, Test Bank &
2026/2027 Prep Material
Introduction
This comprehensive Barkley FNP Review Practice Examination contains exactly 210
original items aligned to the Family Nurse Practitioner Board Certification blueprint for
Orthopedics and Musculoskeletal Disorders. Content is organized across ten essential
domains: Inflammatory Arthritis, Degenerative Joint Disease, Crystal Arthropathies,
Infectious Bone and Joint Disorders, Metabolic Bone Disease, Spinal Disorders, Upper
Extremity Disorders, Lower Extremity Disorders, Pediatric Orthopedics, and Fractures and
Trauma.
This Evaluation offers original content designed to reinforce FNP certification objectives for
exam readiness and clinical success, referencing current evidence-based guidelines and
best practices in orthopedics and rheumatology. Each question includes detailed rationales
to support deep understanding of pathophysiology, clinical presentation, differential
diagnosis, diagnostic strategies, and evidence-based management.
Content Area Overview - FNP Orthopedics Exam Blueprint
Content Area Questions Key Topics Weight
Rheumatoid arthritis, psoriatic arthritis,
Inflammatory
1–21 ankylosing spondylitis, reactive arthritis, 10%
Arthritis
systemic lupus erythematosus
,Content Area Questions Key Topics Weight
Osteoarthritis, cervical/lumbar
Degenerative
22–42 spondylosis, degenerative disc disease, 10%
Joint Disease
joint replacement
Gout, pseudogout, calcium
Crystal
43–63 pyrophosphate deposition disease, uric 10%
Arthropathies
acid management
Infectious Bone
Septic arthritis, osteomyelitis, Lyme
and Joint 64–84 10%
disease, reactive arthritis, discitis
Disorders
Osteoporosis, Paget's disease,
Metabolic Bone
85–105 osteomalacia, hyperparathyroidism, 10%
Disease
vitamin D deficiency
Herniated disc, spinal stenosis,
Spinal Disorders 106–126 10%
spondylolisthesis, scoliosis, back pain
Rotator cuff injury, carpal tunnel
Upper Extremity
127–147 syndrome, epicondylitis, trigger finger, 10%
Disorders
De Quervain's
Hip and knee OA, meniscal tears, ACL
Lower Extremity
148–168 injury, plantar fasciitis, Achilles 10%
Disorders
tendinopathy
,Content Area Questions Key Topics Weight
Developmental dysplasia of the hip,
Pediatric
169–189 scoliosis, Osgood-Schlatter, Legg- 10%
Orthopedics
Calvé-Perthes, clubfoot
Fracture types, management,
Fractures and
190–210 complications, stress fractures, 10%
Trauma
pediatric fractures
DOMAIN 1: INFLAMMATORY ARTHRITIS – Questions 1–21
1. A 65-year-old carpenter complains of morning stiffness and pain in both hands that
improves with activity throughout the day. On examination, you note bony
enlargement of the distal interphalangeal (DIP) joints. Which of the following is the
most likely diagnosis?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Psoriatic arthritis
Rationale: Osteoarthritis is characterized by pain that worsens with activity and improves
with rest, morning stiffness lasting less than 30 minutes, and bony enlargements such as
Heberden's nodes (DIP joints) and Bouchard's nodes (PIP joints). Rheumatoid arthritis
typically presents with joint pain, swelling, and stiffness lasting >1 hour.
2. A 45-year-old woman presents with symmetric pain, swelling, and stiffness in her
hands, wrists, and knees. She reports morning stiffness lasting over 2 hours.
Laboratory studies show positive rheumatoid factor and anti-CCP antibodies. Which
of the following is the most likely diagnosis?
, A. Osteoarthritis
B. Rheumatoid arthritis
C. Gout
D. Systemic lupus erythematosus
Rationale: Rheumatoid arthritis presents with symmetric, polyarticular joint pain, swelling,
and prolonged morning stiffness (>1 hour). Positive rheumatoid factor and anti-CCP
antibodies are highly specific for RA. Osteoarthritis lacks systemic inflammation and
typically involves fewer joints.
3. A patient with rheumatoid arthritis is on methotrexate. Which laboratory test
should be monitored regularly?
A. Serum uric acid
B. Liver function tests and complete blood count
C. Renal function tests
D. Serum calcium
Rationale: Methotrexate is hepatotoxic and can cause bone marrow suppression. Liver
function tests (AST, ALT) and complete blood count (CBC) should be monitored regularly.
Patients should also be counseled to avoid alcohol.
4. A 35-year-old man presents with inflammatory back pain, morning stiffness, and
improvement with exercise. He has a history of uveitis. Which of the following is the
most likely diagnosis?
A. Rheumatoid arthritis
B. Ankylosing spondylitis
C. Osteoarthritis
D. Fibromyalgia
Rationale: Ankylosing spondylitis presents with inflammatory back pain (improves with
exercise, worse with rest), morning stiffness, and is associated with uveitis. Rheumatoid
arthritis typically affects peripheral joints, not the spine.
Board Certification Practice Questions Orthopedics &
Musculoskeletal Disorders | Latest Exam with 100%
Verified Solutions, Study Guide, Test Bank &
2026/2027 Prep Material
Introduction
This comprehensive Barkley FNP Review Practice Examination contains exactly 210
original items aligned to the Family Nurse Practitioner Board Certification blueprint for
Orthopedics and Musculoskeletal Disorders. Content is organized across ten essential
domains: Inflammatory Arthritis, Degenerative Joint Disease, Crystal Arthropathies,
Infectious Bone and Joint Disorders, Metabolic Bone Disease, Spinal Disorders, Upper
Extremity Disorders, Lower Extremity Disorders, Pediatric Orthopedics, and Fractures and
Trauma.
This Evaluation offers original content designed to reinforce FNP certification objectives for
exam readiness and clinical success, referencing current evidence-based guidelines and
best practices in orthopedics and rheumatology. Each question includes detailed rationales
to support deep understanding of pathophysiology, clinical presentation, differential
diagnosis, diagnostic strategies, and evidence-based management.
Content Area Overview - FNP Orthopedics Exam Blueprint
Content Area Questions Key Topics Weight
Rheumatoid arthritis, psoriatic arthritis,
Inflammatory
1–21 ankylosing spondylitis, reactive arthritis, 10%
Arthritis
systemic lupus erythematosus
,Content Area Questions Key Topics Weight
Osteoarthritis, cervical/lumbar
Degenerative
22–42 spondylosis, degenerative disc disease, 10%
Joint Disease
joint replacement
Gout, pseudogout, calcium
Crystal
43–63 pyrophosphate deposition disease, uric 10%
Arthropathies
acid management
Infectious Bone
Septic arthritis, osteomyelitis, Lyme
and Joint 64–84 10%
disease, reactive arthritis, discitis
Disorders
Osteoporosis, Paget's disease,
Metabolic Bone
85–105 osteomalacia, hyperparathyroidism, 10%
Disease
vitamin D deficiency
Herniated disc, spinal stenosis,
Spinal Disorders 106–126 10%
spondylolisthesis, scoliosis, back pain
Rotator cuff injury, carpal tunnel
Upper Extremity
127–147 syndrome, epicondylitis, trigger finger, 10%
Disorders
De Quervain's
Hip and knee OA, meniscal tears, ACL
Lower Extremity
148–168 injury, plantar fasciitis, Achilles 10%
Disorders
tendinopathy
,Content Area Questions Key Topics Weight
Developmental dysplasia of the hip,
Pediatric
169–189 scoliosis, Osgood-Schlatter, Legg- 10%
Orthopedics
Calvé-Perthes, clubfoot
Fracture types, management,
Fractures and
190–210 complications, stress fractures, 10%
Trauma
pediatric fractures
DOMAIN 1: INFLAMMATORY ARTHRITIS – Questions 1–21
1. A 65-year-old carpenter complains of morning stiffness and pain in both hands that
improves with activity throughout the day. On examination, you note bony
enlargement of the distal interphalangeal (DIP) joints. Which of the following is the
most likely diagnosis?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Psoriatic arthritis
Rationale: Osteoarthritis is characterized by pain that worsens with activity and improves
with rest, morning stiffness lasting less than 30 minutes, and bony enlargements such as
Heberden's nodes (DIP joints) and Bouchard's nodes (PIP joints). Rheumatoid arthritis
typically presents with joint pain, swelling, and stiffness lasting >1 hour.
2. A 45-year-old woman presents with symmetric pain, swelling, and stiffness in her
hands, wrists, and knees. She reports morning stiffness lasting over 2 hours.
Laboratory studies show positive rheumatoid factor and anti-CCP antibodies. Which
of the following is the most likely diagnosis?
, A. Osteoarthritis
B. Rheumatoid arthritis
C. Gout
D. Systemic lupus erythematosus
Rationale: Rheumatoid arthritis presents with symmetric, polyarticular joint pain, swelling,
and prolonged morning stiffness (>1 hour). Positive rheumatoid factor and anti-CCP
antibodies are highly specific for RA. Osteoarthritis lacks systemic inflammation and
typically involves fewer joints.
3. A patient with rheumatoid arthritis is on methotrexate. Which laboratory test
should be monitored regularly?
A. Serum uric acid
B. Liver function tests and complete blood count
C. Renal function tests
D. Serum calcium
Rationale: Methotrexate is hepatotoxic and can cause bone marrow suppression. Liver
function tests (AST, ALT) and complete blood count (CBC) should be monitored regularly.
Patients should also be counseled to avoid alcohol.
4. A 35-year-old man presents with inflammatory back pain, morning stiffness, and
improvement with exercise. He has a history of uveitis. Which of the following is the
most likely diagnosis?
A. Rheumatoid arthritis
B. Ankylosing spondylitis
C. Osteoarthritis
D. Fibromyalgia
Rationale: Ankylosing spondylitis presents with inflammatory back pain (improves with
exercise, worse with rest), morning stiffness, and is associated with uveitis. Rheumatoid
arthritis typically affects peripheral joints, not the spine.
