FNP 654 Midterm Exam Practice – Family Primary Care II |
159 NP Board-Style Questions with Answers & Rationales
(2026) LATEST UPDATED THIS YEAR INSTANT PDF
DOWNLOAD
SECTION 1 – Health Promotion, Screening, and Prevention (Q1–15)
Q1. A 46-year-old average-risk adult asks about colorectal cancer screening. Which option
is appropriate?
A. Colonoscopy every 10 years starting at 45
B. No screening until age 50
C. Annual CT colonography
D. Fecal test only if symptomatic
A. Colonoscopy every 10 years starting at 45
Average-risk screening begins at 45 with several options including colonoscopy q10y.
Q2. A 52-year-old woman with average breast cancer risk asks about mammography. What
is recommended?
A. No screening until 60
B. Biennial mammography starting at 50
C. Annual MRI only
D. Mammography only if symptomatic
B. Biennial mammography starting at 50
Most guidelines support biennial screening mammography beginning at 50 for average risk.
,Q3. A 32-year-old woman with normal prior Pap tests asks about cervical cancer screening.
Which interval is appropriate?
A. Pap every year
B. Pap every 3 years or co-testing every 5 years
C. No screening until 40
D. HPV testing alone every year
B. Pap every 3 years or co-testing every 5 years
Cytology q3y or HPV/cytology co-testing q5y is recommended for ages 30–65.
Q4. A 58-year-old man with a 40 pack-year smoking history asks about lung cancer
screening. Which is indicated if he meets criteria?
A. No screening
B. Annual low-dose CT
C. Chest X-ray every 2 years
D. Sputum cytology annually
B. Annual low-dose CT
High-risk smokers meeting criteria are eligible for annual LDCT.
Q5. A 62-year-old man asks about prostate cancer screening. What is the most appropriate
approach?
A. Routine PSA for all men
B. Shared decision-making about PSA considering risks/benefits
,C. No discussion; screening is never recommended
D. PSA only if urinary symptoms
B. Shared decision-making about PSA considering risks/benefits
Guidelines recommend individualized decisions for men 55–69 after counseling.
Q6. A 23-year-old who never received HPV vaccine presents for care. What is
recommended?
A. No vaccination needed after 21
B. Offer HPV vaccination through age 26 if not previously vaccinated
C. Vaccinate only if sexually active
D. Vaccinate only men
B. Offer HPV vaccination through age 26 if not previously vaccinated
Catch-up HPV vaccination is recommended through age 26.
Q7. A 66-year-old adult with no prior pneumococcal vaccination presents. Which regimen is
appropriate?
A. No vaccination needed
B. PCV20 once, or PCV15 followed by PPSV23
C. PPSV23 only every year
D. PCV13 every 5 years
B. PCV20 once, or PCV15 followed by PPSV23
Current adult pneumococcal recommendations include PCV20 or PCV15→PPSV23.
, Q8. A 42-year-old with BMI 33 kg/m² and no comorbidities asks about weight management.
What is first-line?
A. Immediate bariatric surgery referral
B. Lifestyle modification with diet, activity, and behavioral strategies
C. Start GLP-1 agonist without lifestyle changes
D. No intervention until BMI >35
B. Lifestyle modification with diet, activity, and behavioral strategies
Lifestyle change is first-line for obesity management.
Q9. A 48-year-old with elevated BP on multiple visits but <140/90 mm Hg asks about
diagnosis. Which is accurate?
A. Hypertension is diagnosed at ≥130/80 mm Hg in many guidelines
B. Hypertension is only diagnosed at ≥150/90 mm Hg
C. No diagnosis without symptoms
D. Hypertension is diagnosed only in the hospital
A. Hypertension is diagnosed at ≥130/80 mm Hg in many guidelines
Acc/Aha and others define hypertension at ≥130/80 mm Hg.
Q10. A 38-year-old with no risk factors asks about lipid screening. Which is appropriate?
A. No screening until 50
B. Lipid panel every 4–6 years starting in early adulthood
C. Lipid panel every year
D. Lipid panel only if symptomatic
159 NP Board-Style Questions with Answers & Rationales
(2026) LATEST UPDATED THIS YEAR INSTANT PDF
DOWNLOAD
SECTION 1 – Health Promotion, Screening, and Prevention (Q1–15)
Q1. A 46-year-old average-risk adult asks about colorectal cancer screening. Which option
is appropriate?
A. Colonoscopy every 10 years starting at 45
B. No screening until age 50
C. Annual CT colonography
D. Fecal test only if symptomatic
A. Colonoscopy every 10 years starting at 45
Average-risk screening begins at 45 with several options including colonoscopy q10y.
Q2. A 52-year-old woman with average breast cancer risk asks about mammography. What
is recommended?
A. No screening until 60
B. Biennial mammography starting at 50
C. Annual MRI only
D. Mammography only if symptomatic
B. Biennial mammography starting at 50
Most guidelines support biennial screening mammography beginning at 50 for average risk.
,Q3. A 32-year-old woman with normal prior Pap tests asks about cervical cancer screening.
Which interval is appropriate?
A. Pap every year
B. Pap every 3 years or co-testing every 5 years
C. No screening until 40
D. HPV testing alone every year
B. Pap every 3 years or co-testing every 5 years
Cytology q3y or HPV/cytology co-testing q5y is recommended for ages 30–65.
Q4. A 58-year-old man with a 40 pack-year smoking history asks about lung cancer
screening. Which is indicated if he meets criteria?
A. No screening
B. Annual low-dose CT
C. Chest X-ray every 2 years
D. Sputum cytology annually
B. Annual low-dose CT
High-risk smokers meeting criteria are eligible for annual LDCT.
Q5. A 62-year-old man asks about prostate cancer screening. What is the most appropriate
approach?
A. Routine PSA for all men
B. Shared decision-making about PSA considering risks/benefits
,C. No discussion; screening is never recommended
D. PSA only if urinary symptoms
B. Shared decision-making about PSA considering risks/benefits
Guidelines recommend individualized decisions for men 55–69 after counseling.
Q6. A 23-year-old who never received HPV vaccine presents for care. What is
recommended?
A. No vaccination needed after 21
B. Offer HPV vaccination through age 26 if not previously vaccinated
C. Vaccinate only if sexually active
D. Vaccinate only men
B. Offer HPV vaccination through age 26 if not previously vaccinated
Catch-up HPV vaccination is recommended through age 26.
Q7. A 66-year-old adult with no prior pneumococcal vaccination presents. Which regimen is
appropriate?
A. No vaccination needed
B. PCV20 once, or PCV15 followed by PPSV23
C. PPSV23 only every year
D. PCV13 every 5 years
B. PCV20 once, or PCV15 followed by PPSV23
Current adult pneumococcal recommendations include PCV20 or PCV15→PPSV23.
, Q8. A 42-year-old with BMI 33 kg/m² and no comorbidities asks about weight management.
What is first-line?
A. Immediate bariatric surgery referral
B. Lifestyle modification with diet, activity, and behavioral strategies
C. Start GLP-1 agonist without lifestyle changes
D. No intervention until BMI >35
B. Lifestyle modification with diet, activity, and behavioral strategies
Lifestyle change is first-line for obesity management.
Q9. A 48-year-old with elevated BP on multiple visits but <140/90 mm Hg asks about
diagnosis. Which is accurate?
A. Hypertension is diagnosed at ≥130/80 mm Hg in many guidelines
B. Hypertension is only diagnosed at ≥150/90 mm Hg
C. No diagnosis without symptoms
D. Hypertension is diagnosed only in the hospital
A. Hypertension is diagnosed at ≥130/80 mm Hg in many guidelines
Acc/Aha and others define hypertension at ≥130/80 mm Hg.
Q10. A 38-year-old with no risk factors asks about lipid screening. Which is appropriate?
A. No screening until 50
B. Lipid panel every 4–6 years starting in early adulthood
C. Lipid panel every year
D. Lipid panel only if symptomatic
