FNP ANCC BOARDS EXAM 2025/2026 QUESTIONS AND
ANSWERS GRADED A+
Dose of Tetanus Immune Globulin (TIG) - correct answer✨✔✔ 250 units IM
How many doses of Tdap or Td IM needed for protection after clean minor wounds. - correct
answer✨✔✔ Three doses needed. If <3, unknown, or >10 years since last dose give dose of Tdap or Td
for clean minor wounds. No need to give TIG.
Non-"clean" minor wounds given both of these if unknown tetanus hx or <3 doses of Tdap/Td. - correct
answer✨✔✔ Tdap or Td IM & TIG
Dirty wounds (puncture, crush injury, soil, saliva, feces, dirt, avulsions, missiles, burns, frostbite) -
correct answer✨✔✔ If <3 doses Tdap or Td give both Tdap and TIG 250 units. If 3 doses in past, but
none in the last 5 years then given Tdap or Td. No need to give TIG If 3 or > doses in the past
When to switch from DTap to Tdap in children - correct answer✨✔✔ Age 7 or > given Tdap
A woman becomes pregnant and received Tdap during her last pregnancy 1 year ago. When should she
receive her next dose. - correct answer✨✔✔ Tdap is recommended for each pregnancy.
"Getting Tdap between 27 through 36 weeks of pregnancy is 78% more effective at preventing
whooping cough in babies younger than 2 months old (CDC)".
A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)? - correct
answer✨✔✔ IPV, MMR, varicella
A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)? - correct
answer✨✔✔ IPV, vaccinia (smallpox)
,A person with a hx of anaphylaxis to bakers yeast should avoid which immunizations (IZ)? - correct
answer✨✔✔ Hepatitis B
A person with a hx of anaphylaxis to gelatin should avoid which immunizations (IZ)? - correct
answer✨✔✔ varicella zoster (zostavax) and MMR
Epinephrine needs to be on hand for potential anaphylaxis r/t immunization rxn. What other
interventions/meds should be considered during anaphylaxis? - correct answer✨✔✔ Supine, 911,
give epinephrine:
7.5-15kg: give 0.1 mg IM x1
15 to <30 kg: give 0.15mg IM; may repeat in 5-15 min x1
>30 kg or Adult: Epipen 0.3mg/0.3mL IM; may repeat in 5-15 min
H1/H2 blocker po (diphenhydramine, ranitidine)
IV access for fluids, Oxygen.
Anticipate ED might give glucagon (if on beta blocker), systemic corticosteroids, bronchodilators
s/s anaphylaxis - correct answer✨✔✔ Skin: pruritus, urticaria, angioedema
Resp: dyspnea, wheezing (bronchospasm), stridor
End-organ dysfunction: hypotension, collapse, syncope, incontinence
PCV-13 - correct answer✨✔✔ Prevnar. Greater protection, Narrower coverage. Pneumococcal
conjugate.
, PCV23 - correct answer✨✔✔ lesser protection, broader coverage
Which type of vaccine boosts immune response better? conjugate vs. polysaccharide - correct
answer✨✔✔ conjugate (example: prevnar)
Live attenuated (weaned) vaccines - correct answer✨✔✔ MMR, Varicella and intranasal Flu-mist.
Zostavax is also live. Shingrix is NOT live.
When is rotavirus vaccine contraindicated? - correct answer✨✔✔ SCID (severe combined
immunodeficiency) or hx intussusception
Precautions after rotavirus - correct answer✨✔✔ hand washing!; viral shed in stool in first week
post-vaccination
Shingrix: timing and dosing - correct answer✨✔✔ =/> 50 y/o, 2 doses, 2nd dose two to six months
after 1st dose.
Under age 50 y/o gets shingles; think immunocompromise vs. stress.
What month does the CDC release a new vaccination schedule each year? - correct answer✨✔✔ Feb
What s/s are associated with leukemia? - correct answer✨✔✔ fever, wt loss, fatigue, bone pain,
bleeding, bruising.
What bloodwork should be obtained in suspected leukemia? - correct answer✨✔✔ WBCs >20,000
(think through common causes of leukocytosis: infection, stress, inflammation) --> get a peripheral
smear (AKA manual diff)
if WBCs >20,000 and with associated anemia; thrombocytopenia; thrombocytosis; enlarged liver, spleen,
or lymph nodes; or constitutional symptoms.
ANSWERS GRADED A+
Dose of Tetanus Immune Globulin (TIG) - correct answer✨✔✔ 250 units IM
How many doses of Tdap or Td IM needed for protection after clean minor wounds. - correct
answer✨✔✔ Three doses needed. If <3, unknown, or >10 years since last dose give dose of Tdap or Td
for clean minor wounds. No need to give TIG.
Non-"clean" minor wounds given both of these if unknown tetanus hx or <3 doses of Tdap/Td. - correct
answer✨✔✔ Tdap or Td IM & TIG
Dirty wounds (puncture, crush injury, soil, saliva, feces, dirt, avulsions, missiles, burns, frostbite) -
correct answer✨✔✔ If <3 doses Tdap or Td give both Tdap and TIG 250 units. If 3 doses in past, but
none in the last 5 years then given Tdap or Td. No need to give TIG If 3 or > doses in the past
When to switch from DTap to Tdap in children - correct answer✨✔✔ Age 7 or > given Tdap
A woman becomes pregnant and received Tdap during her last pregnancy 1 year ago. When should she
receive her next dose. - correct answer✨✔✔ Tdap is recommended for each pregnancy.
"Getting Tdap between 27 through 36 weeks of pregnancy is 78% more effective at preventing
whooping cough in babies younger than 2 months old (CDC)".
A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)? - correct
answer✨✔✔ IPV, MMR, varicella
A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)? - correct
answer✨✔✔ IPV, vaccinia (smallpox)
,A person with a hx of anaphylaxis to bakers yeast should avoid which immunizations (IZ)? - correct
answer✨✔✔ Hepatitis B
A person with a hx of anaphylaxis to gelatin should avoid which immunizations (IZ)? - correct
answer✨✔✔ varicella zoster (zostavax) and MMR
Epinephrine needs to be on hand for potential anaphylaxis r/t immunization rxn. What other
interventions/meds should be considered during anaphylaxis? - correct answer✨✔✔ Supine, 911,
give epinephrine:
7.5-15kg: give 0.1 mg IM x1
15 to <30 kg: give 0.15mg IM; may repeat in 5-15 min x1
>30 kg or Adult: Epipen 0.3mg/0.3mL IM; may repeat in 5-15 min
H1/H2 blocker po (diphenhydramine, ranitidine)
IV access for fluids, Oxygen.
Anticipate ED might give glucagon (if on beta blocker), systemic corticosteroids, bronchodilators
s/s anaphylaxis - correct answer✨✔✔ Skin: pruritus, urticaria, angioedema
Resp: dyspnea, wheezing (bronchospasm), stridor
End-organ dysfunction: hypotension, collapse, syncope, incontinence
PCV-13 - correct answer✨✔✔ Prevnar. Greater protection, Narrower coverage. Pneumococcal
conjugate.
, PCV23 - correct answer✨✔✔ lesser protection, broader coverage
Which type of vaccine boosts immune response better? conjugate vs. polysaccharide - correct
answer✨✔✔ conjugate (example: prevnar)
Live attenuated (weaned) vaccines - correct answer✨✔✔ MMR, Varicella and intranasal Flu-mist.
Zostavax is also live. Shingrix is NOT live.
When is rotavirus vaccine contraindicated? - correct answer✨✔✔ SCID (severe combined
immunodeficiency) or hx intussusception
Precautions after rotavirus - correct answer✨✔✔ hand washing!; viral shed in stool in first week
post-vaccination
Shingrix: timing and dosing - correct answer✨✔✔ =/> 50 y/o, 2 doses, 2nd dose two to six months
after 1st dose.
Under age 50 y/o gets shingles; think immunocompromise vs. stress.
What month does the CDC release a new vaccination schedule each year? - correct answer✨✔✔ Feb
What s/s are associated with leukemia? - correct answer✨✔✔ fever, wt loss, fatigue, bone pain,
bleeding, bruising.
What bloodwork should be obtained in suspected leukemia? - correct answer✨✔✔ WBCs >20,000
(think through common causes of leukocytosis: infection, stress, inflammation) --> get a peripheral
smear (AKA manual diff)
if WBCs >20,000 and with associated anemia; thrombocytopenia; thrombocytosis; enlarged liver, spleen,
or lymph nodes; or constitutional symptoms.
