FNP Board review questions With
Complete Solutions 2024
A 24-year old, otherwise healthy college student presents with c/o cough x 6
weeks. She has tried several OTC cough meds with no improvement. What is
the most important information to consider when building your differential
diagnoses?
A) Her age
B) Family hx
C) Ineffectiveness of OTC cough medicines
D) Length of time she has been coughing - -D) Length of time she has been
coughing
Why? This information helps you build your ddx
Acute cough < 3 weeks: bronchitis, sinusitis, PND, exacerbation of
COPD/asthma, pneumonia, pulmonary embolism
Chronic cough (>8 weeks) GERD and Asthma are most common causes, also
consider infection (e.g. pertussis, atypical pneumonia), ACE inhibitors,
chronic bronchitis, bronchiectasis, lung ca)
-According to the CDC, what drug class is considered first-line treatment for
pertussis?
A) Sulfonamide
B) Tetracycline
C) Macrolide
D) Beta-lactam - -C) Macrolide antiobitic (e.g. Azithromycin, clarithromycin
Sulfonamides are second-line
-Match the antibiotics with the correct drug class:
1. Sulfonamide
2. Tetracycline
3. Macrolide
4. Beta-lactam
A. Doxycyline
B. Azithromycin
C. Penicillins
D.Trimethoprim-Sulfamethoxazole
E. Cephalosporin
,F. Clarithromycin - -1. Sulfonamide - D.Trimethoprim-Sulfamethoxazole
(Bactrim)
2. Tetracycline - A. Doxycycline
3. Macrolide - B & F, Azithromycin and Clarithromycin
4. Beta-lactam - C & E, PCN and cephalosporins
-What are the three most common bugs in community-acquired pneumonia?
- -Streptococcus pneumoniae
Mycoplasma pneuomiae (atypical pathogen)
Chlamydophila pneumoniae (atypical pathogen)
-What is the treatment for CAP caused by Strep pneumo? - -Respiratory
quinolone (e.g. Levofloxacin, moxifloxacin, gemifloxacin) OR high-dose
amoxicillin OR amoxicillin with clavulanate
-What antibiotics are avoided in CAP caused by Strep pneumo due to high
rates of resistance? - -Macrolides
-What is the treatment for CAP caused by Mycoplasma pneumoniae? - -
Macrolide OR doxycycline
-What antibiotics are avoided in CAP caused by atypical pathogens? - -Beta-
lactams (ineffective)
-A 38-year old mother of two teenagers recently recovered from
Mycoplasma pneumonia a couple of weeks ago. She asks if she should get
the "pneumonia shot." She takes levothyroxine 88 mcg daily for
hypothyroidism, but is otherwise healthy. How do you respond?
A) No, it's too soon after your infection
B) No, it's not indicated
C) Yes, you can get it in about a month
D) Yes you can get it today - -B) No, it's not indicated
An otherwise healthy adult without immunocompromise or multiple comorbid
conditions is not a "vulnerable population"
The pneumonia vaccine does not prevent mycoplasma pneumonia
-According to GOLD, what is required to establish the diagnosis of COPD? - -
Spirometry (FEV1/FVC ratio < 70%)
-A 70-year old house painter reports a 4-week history of exertional dyspnea,
chest tightness, and cough for the past 3 months. He has never smoked.
What diagnoses are included in your differential? Select 4.
,A) Asthma
B) Angina
C) COPD
D) GERD
E) Pneumonia
F) Tuberculosis
G) Heart Failure - -B) Angina
C) COPD
F) Tuberculosis
G) Heart failure
-How do inhaled anticholinergics work to treat shortness of breath in COPD?
A) They cause bronchodilation in the lungs
B) They block the action of acetylcholine and prevent bronchoconstriction - -
B) They block the action of acetylcholine and prevent bronchconstriction
-Name a short-acting inhaled anticholinergic: - -Ipratropium (Atrovent)
-Name a long-acting inhaled anticholinergic: - -Tiotropium (Spiriva)
-How do inhaled betá-agonists work to treat shortness of breath in COPD?
A) They cause bronchodilation in the lungs
B) They block the action of acetylcholine and prevent bronchoconstriction - -
A) They cause bronchodilation in the lungs
-What are the only 2 inhaled short-acting beta agonists (SABAs): - -Albuterol
and levalbuterol
-Name an inhaled long-acting beta agonists (LABAs): - -Salmeterol
(Serevent)
-What are the side effects associated with anticholinergic medications? - -
Cognitive impairment, confusion, hallucinations, dry mouth, blurry vision,
urinary retention, constipation, tachycardia, acute angle glaucoma
"Can't see, can't pee, can't spit, can't shit."
-Name a inhaled combined short-acting anticholinergic/short-acting beta
agonist: - -Ipratropium/albuterol (Combivent)
-Name a inhaled combined long-acting beta-agonist/corticosteroid - -
Fluticasone/salmeterol (Advair)
Fluticasone/vilanterol (Breo)
Budesonide/formoterol (Symbicort)
Mometasone/frmoterol (Dulera)
, -Name an inhaled steroid: - -Fluticasone (Flovent)
Budesonide (Pulmicort)
Mometasone (Asmanex)
-Put the following in the correct order for COPD prescribing strategy:
A) Long-acting anticholinergic or LABA, plus rescue med
B) Inhaled corticosteroid +LABA or LA anticholinergic, plus rescue med
C) Short-acting anticholinergic or SABA PRN
D) Inhaled corticosteroid +LABA and/or LA anticholinergic, plus rescue med -
-C, A, B, D
1. Short-acting anticholinergic or SABA PRN
THEN
2. Long-acting anticholinergic or LABA, plus rescue med
THEN
3. Inhaled corticosteroid +LABA or LA anticholinergic, plus rescue med
THEN
4. Inhaled corticosteroid +LABA and/or LA anticholinergic, plus rescue med
-There is good evidence in support of oral steroids for COPD exacerbations
to shorten recovery time and improve lung function. What is the correct
recommended dose?
A) Medrol dose-pack
B) 10-day course of Prednisone 20 mg, followed by a taper
C) 5-day course of Prednisone 40 mg - -C) 5-day course of Prednisone 40 mg
Chronic use should be avoided - associated with an unfavorable risk-to-
benefit ratio
-A patient with asthma symptoms daily with occasional nighttime
awakenings has
A) Intermittent asthma
B) Mild persistent asthma
C) Moderate persistent asthma
D) Severe persistent asthma - -C) Moderate persistent asthma
-A patient with asthma symptoms more than twice a week, but not daily
with occasional nighttime awakenings has
A) Intermittent asthma
B) Mild persistent asthma
C) Moderate persistent asthma
D) Severe persistent asthma - -B) Mild persistent asthma
Complete Solutions 2024
A 24-year old, otherwise healthy college student presents with c/o cough x 6
weeks. She has tried several OTC cough meds with no improvement. What is
the most important information to consider when building your differential
diagnoses?
A) Her age
B) Family hx
C) Ineffectiveness of OTC cough medicines
D) Length of time she has been coughing - -D) Length of time she has been
coughing
Why? This information helps you build your ddx
Acute cough < 3 weeks: bronchitis, sinusitis, PND, exacerbation of
COPD/asthma, pneumonia, pulmonary embolism
Chronic cough (>8 weeks) GERD and Asthma are most common causes, also
consider infection (e.g. pertussis, atypical pneumonia), ACE inhibitors,
chronic bronchitis, bronchiectasis, lung ca)
-According to the CDC, what drug class is considered first-line treatment for
pertussis?
A) Sulfonamide
B) Tetracycline
C) Macrolide
D) Beta-lactam - -C) Macrolide antiobitic (e.g. Azithromycin, clarithromycin
Sulfonamides are second-line
-Match the antibiotics with the correct drug class:
1. Sulfonamide
2. Tetracycline
3. Macrolide
4. Beta-lactam
A. Doxycyline
B. Azithromycin
C. Penicillins
D.Trimethoprim-Sulfamethoxazole
E. Cephalosporin
,F. Clarithromycin - -1. Sulfonamide - D.Trimethoprim-Sulfamethoxazole
(Bactrim)
2. Tetracycline - A. Doxycycline
3. Macrolide - B & F, Azithromycin and Clarithromycin
4. Beta-lactam - C & E, PCN and cephalosporins
-What are the three most common bugs in community-acquired pneumonia?
- -Streptococcus pneumoniae
Mycoplasma pneuomiae (atypical pathogen)
Chlamydophila pneumoniae (atypical pathogen)
-What is the treatment for CAP caused by Strep pneumo? - -Respiratory
quinolone (e.g. Levofloxacin, moxifloxacin, gemifloxacin) OR high-dose
amoxicillin OR amoxicillin with clavulanate
-What antibiotics are avoided in CAP caused by Strep pneumo due to high
rates of resistance? - -Macrolides
-What is the treatment for CAP caused by Mycoplasma pneumoniae? - -
Macrolide OR doxycycline
-What antibiotics are avoided in CAP caused by atypical pathogens? - -Beta-
lactams (ineffective)
-A 38-year old mother of two teenagers recently recovered from
Mycoplasma pneumonia a couple of weeks ago. She asks if she should get
the "pneumonia shot." She takes levothyroxine 88 mcg daily for
hypothyroidism, but is otherwise healthy. How do you respond?
A) No, it's too soon after your infection
B) No, it's not indicated
C) Yes, you can get it in about a month
D) Yes you can get it today - -B) No, it's not indicated
An otherwise healthy adult without immunocompromise or multiple comorbid
conditions is not a "vulnerable population"
The pneumonia vaccine does not prevent mycoplasma pneumonia
-According to GOLD, what is required to establish the diagnosis of COPD? - -
Spirometry (FEV1/FVC ratio < 70%)
-A 70-year old house painter reports a 4-week history of exertional dyspnea,
chest tightness, and cough for the past 3 months. He has never smoked.
What diagnoses are included in your differential? Select 4.
,A) Asthma
B) Angina
C) COPD
D) GERD
E) Pneumonia
F) Tuberculosis
G) Heart Failure - -B) Angina
C) COPD
F) Tuberculosis
G) Heart failure
-How do inhaled anticholinergics work to treat shortness of breath in COPD?
A) They cause bronchodilation in the lungs
B) They block the action of acetylcholine and prevent bronchoconstriction - -
B) They block the action of acetylcholine and prevent bronchconstriction
-Name a short-acting inhaled anticholinergic: - -Ipratropium (Atrovent)
-Name a long-acting inhaled anticholinergic: - -Tiotropium (Spiriva)
-How do inhaled betá-agonists work to treat shortness of breath in COPD?
A) They cause bronchodilation in the lungs
B) They block the action of acetylcholine and prevent bronchoconstriction - -
A) They cause bronchodilation in the lungs
-What are the only 2 inhaled short-acting beta agonists (SABAs): - -Albuterol
and levalbuterol
-Name an inhaled long-acting beta agonists (LABAs): - -Salmeterol
(Serevent)
-What are the side effects associated with anticholinergic medications? - -
Cognitive impairment, confusion, hallucinations, dry mouth, blurry vision,
urinary retention, constipation, tachycardia, acute angle glaucoma
"Can't see, can't pee, can't spit, can't shit."
-Name a inhaled combined short-acting anticholinergic/short-acting beta
agonist: - -Ipratropium/albuterol (Combivent)
-Name a inhaled combined long-acting beta-agonist/corticosteroid - -
Fluticasone/salmeterol (Advair)
Fluticasone/vilanterol (Breo)
Budesonide/formoterol (Symbicort)
Mometasone/frmoterol (Dulera)
, -Name an inhaled steroid: - -Fluticasone (Flovent)
Budesonide (Pulmicort)
Mometasone (Asmanex)
-Put the following in the correct order for COPD prescribing strategy:
A) Long-acting anticholinergic or LABA, plus rescue med
B) Inhaled corticosteroid +LABA or LA anticholinergic, plus rescue med
C) Short-acting anticholinergic or SABA PRN
D) Inhaled corticosteroid +LABA and/or LA anticholinergic, plus rescue med -
-C, A, B, D
1. Short-acting anticholinergic or SABA PRN
THEN
2. Long-acting anticholinergic or LABA, plus rescue med
THEN
3. Inhaled corticosteroid +LABA or LA anticholinergic, plus rescue med
THEN
4. Inhaled corticosteroid +LABA and/or LA anticholinergic, plus rescue med
-There is good evidence in support of oral steroids for COPD exacerbations
to shorten recovery time and improve lung function. What is the correct
recommended dose?
A) Medrol dose-pack
B) 10-day course of Prednisone 20 mg, followed by a taper
C) 5-day course of Prednisone 40 mg - -C) 5-day course of Prednisone 40 mg
Chronic use should be avoided - associated with an unfavorable risk-to-
benefit ratio
-A patient with asthma symptoms daily with occasional nighttime
awakenings has
A) Intermittent asthma
B) Mild persistent asthma
C) Moderate persistent asthma
D) Severe persistent asthma - -C) Moderate persistent asthma
-A patient with asthma symptoms more than twice a week, but not daily
with occasional nighttime awakenings has
A) Intermittent asthma
B) Mild persistent asthma
C) Moderate persistent asthma
D) Severe persistent asthma - -B) Mild persistent asthma
