Hesi Exit Family Nurse
Practitionerquestions for FNP review
Latest 2026- 2027 Updated
1. A 55-year-old female asks about routine health screening. According to
USPSTF grade A recommendations, which test should the nurse practitioner
order?
• A) Annual ECG
• B) Mammography every 2 years for women aged 50–74
• C) PSA for prostate cancer
• D) CT scan for lung cancer in all adults
Answer: B
Rationale: The USPSTF recommends biennial screening mammography for women
aged 50–74 years (Grade B). PSA is not recommended for routine screening (Grade
C/D). Lung CT is only for high-risk adults aged 50–80 with a 20-pack-year smoking
history.
2. A 45-year-old man has a blood pressure of 138/86 mm Hg on two occasions.
What is the most appropriate next step?
• A) Start hydrochlorothiazide
• B) Recommend lifestyle modifications and recheck in 6 months
• C) Order an echocardiogram
• D) Diagnose hypertension and start amlodipine
,Answer: B
Rationale: According to ACC/AHA guidelines, stage 1 hypertension (130-139/80-
89) with low ASCVD risk should first be managed with lifestyle changes for 3-6
months before initiating medication.
3. A 65-year-old woman with a 30-pack-year smoking history asks about lung
cancer screening. Which test is recommended?
• A) Chest X-ray annually
• B) Low-dose CT scan annually if she meets age and pack-year criteria
• C) Sputum cytology
• D) No screening because she quit 5 years ago
Answer: B
Rationale: USPSTF recommends annual low-dose CT for adults aged 50–80 with a
20-pack-year smoking history who currently smoke or quit within the past 15 years.
4. A 30-year-old woman desires contraception. Which method is most
effective (>99%) with perfect use?
• A) Oral contraceptive pills
• B) Copper intrauterine device (IUD)
• C) Male condoms
• D) Fertility awareness
Answer: B
Rationale: Long-acting reversible contraceptives (IUDs, implant) have failure rates
<1% with typical use. Pills and condoms have higher typical-use failure rates.
,5. A 50-year-old man has a body mass index (BMI) of 32 kg/m² with no other
comorbidities. Which intervention is first-line for weight loss?
• A) Bariatric surgery referral
• B) Prescribe phentermine
• C) Intensive behavioral counseling and lifestyle modification
• D) Orlistat prescription
Answer: C
Rationale: USPSTF recommends intensive, multicomponent behavioral
interventions for adults with obesity. Medications or surgery are considered after
lifestyle intervention failure.
6. Which immunization is recommended annually for adults with chronic heart
disease?
• A) Pneumococcal
• B) Tdap
• C) Influenza
• D) Hepatitis B
Answer: C
Rationale: Annual influenza vaccination is recommended for adults with chronic
conditions, including heart disease, to reduce morbidity and mortality.
, 7. A 65-year-old man with no history of colorectal cancer screening asks about
options. Which screening test is recommended by USPSTF for average-risk
adults aged 50–75?
• A) Colonoscopy every 5 years
• B) Fecal immunochemical test (FIT) annually
• C) CT colonography every 10 years
• D) Flexible sigmoidoscopy every 15 years
Answer: B
Rationale: USPSTF recommends screening for colorectal cancer in adults aged
50–75 years. Options include annual FIT, colonoscopy every 10 years, or flexible
sigmoidoscopy every 5 years with FIT every 3 years. FIT annually is Grade A
recommended.
8. A 60-year-old woman with osteoporosis is prescribed alendronate. What
instruction is most important regarding administration?
• A) Take with food to prevent GI upset
• B) Take on an empty stomach with a full glass of water and remain upright for
30 minutes
• C) Take with calcium supplements
• D) Take at bedtime
Answer: B
Rationale: Alendronate must be taken on an empty stomach with a full glass of
water, and the patient must remain upright for 30 minutes to prevent esophageal
irritation and ulcers.
Practitionerquestions for FNP review
Latest 2026- 2027 Updated
1. A 55-year-old female asks about routine health screening. According to
USPSTF grade A recommendations, which test should the nurse practitioner
order?
• A) Annual ECG
• B) Mammography every 2 years for women aged 50–74
• C) PSA for prostate cancer
• D) CT scan for lung cancer in all adults
Answer: B
Rationale: The USPSTF recommends biennial screening mammography for women
aged 50–74 years (Grade B). PSA is not recommended for routine screening (Grade
C/D). Lung CT is only for high-risk adults aged 50–80 with a 20-pack-year smoking
history.
2. A 45-year-old man has a blood pressure of 138/86 mm Hg on two occasions.
What is the most appropriate next step?
• A) Start hydrochlorothiazide
• B) Recommend lifestyle modifications and recheck in 6 months
• C) Order an echocardiogram
• D) Diagnose hypertension and start amlodipine
,Answer: B
Rationale: According to ACC/AHA guidelines, stage 1 hypertension (130-139/80-
89) with low ASCVD risk should first be managed with lifestyle changes for 3-6
months before initiating medication.
3. A 65-year-old woman with a 30-pack-year smoking history asks about lung
cancer screening. Which test is recommended?
• A) Chest X-ray annually
• B) Low-dose CT scan annually if she meets age and pack-year criteria
• C) Sputum cytology
• D) No screening because she quit 5 years ago
Answer: B
Rationale: USPSTF recommends annual low-dose CT for adults aged 50–80 with a
20-pack-year smoking history who currently smoke or quit within the past 15 years.
4. A 30-year-old woman desires contraception. Which method is most
effective (>99%) with perfect use?
• A) Oral contraceptive pills
• B) Copper intrauterine device (IUD)
• C) Male condoms
• D) Fertility awareness
Answer: B
Rationale: Long-acting reversible contraceptives (IUDs, implant) have failure rates
<1% with typical use. Pills and condoms have higher typical-use failure rates.
,5. A 50-year-old man has a body mass index (BMI) of 32 kg/m² with no other
comorbidities. Which intervention is first-line for weight loss?
• A) Bariatric surgery referral
• B) Prescribe phentermine
• C) Intensive behavioral counseling and lifestyle modification
• D) Orlistat prescription
Answer: C
Rationale: USPSTF recommends intensive, multicomponent behavioral
interventions for adults with obesity. Medications or surgery are considered after
lifestyle intervention failure.
6. Which immunization is recommended annually for adults with chronic heart
disease?
• A) Pneumococcal
• B) Tdap
• C) Influenza
• D) Hepatitis B
Answer: C
Rationale: Annual influenza vaccination is recommended for adults with chronic
conditions, including heart disease, to reduce morbidity and mortality.
, 7. A 65-year-old man with no history of colorectal cancer screening asks about
options. Which screening test is recommended by USPSTF for average-risk
adults aged 50–75?
• A) Colonoscopy every 5 years
• B) Fecal immunochemical test (FIT) annually
• C) CT colonography every 10 years
• D) Flexible sigmoidoscopy every 15 years
Answer: B
Rationale: USPSTF recommends screening for colorectal cancer in adults aged
50–75 years. Options include annual FIT, colonoscopy every 10 years, or flexible
sigmoidoscopy every 5 years with FIT every 3 years. FIT annually is Grade A
recommended.
8. A 60-year-old woman with osteoporosis is prescribed alendronate. What
instruction is most important regarding administration?
• A) Take with food to prevent GI upset
• B) Take on an empty stomach with a full glass of water and remain upright for
30 minutes
• C) Take with calcium supplements
• D) Take at bedtime
Answer: B
Rationale: Alendronate must be taken on an empty stomach with a full glass of
water, and the patient must remain upright for 30 minutes to prevent esophageal
irritation and ulcers.
