FNP Certification Review: Practice
Questions & Answers (2026)
special considerations for Thiazides - correct answersChlorthalidone is preferred on the basis of prolonged
e e e e e e e e e e e e e e
half-life and proven trial reduction of CVD.
e e e e e e
Monitor for hyponatremia and hypokalemia, monitor uric acid and calcium levels.
e e e e e e e e e e
Use with caution in patients with history of acute gout unless patient is on uric acid-lowering therapy.
e e e e e e e e e e e e e e e e
special considerations for ACE inhibitors - correct answersDo not use in combination with ARBs or direct renin
e e e e e e e e e e e e e e e e e
inhibitor.
There is an increased risk of hyperkalemia, especially in patients with CKD or in those on K+ supplements or K+-
e e e e e e e e e e e e e e e e e e e
sparing drugs. e
There is a risk of acute renal failure in patients with severe bilateral renal artery stenosis.
e e e e e e e e e e e e e e e
,Do not use if patient has history of angioedema with ACE inhibitors.
e e e e e e e e e e e
ACE inhibitor cough is common, in 5 to 20 percent of patients, due to bradykinin production.
e e e e e e e e e e e e e e e
Avoid in pregnant females or females of reproductive age without adequate contraception
e e e e e e e e e e e
special considerations for Angiotensin receptor blockers - correct answersDo not use in combination with
e e e e e e e e e e e e e e
ACE inhibitors or direct renin inhibitor.
e e e e e
There is an increased risk of hyperkalemia in CKD or in those on K+ supplements or K+-sparing drugs.
e e e e e e e e e e e e e e e e e
There is a risk of acute renal failure in patients with severe bilateral renal artery stenosis.
e e e e e e e e e e e e e e e
Do not use if patient has history of angioedema with ARBs. Patients with a history of angioedema with an ACE
e e e e e e e e e e e e e e e e e e e e
inhibitor can receive an ARB beginning 6 weeks after ACE inhibitor is discontinued.
e e e e e e e e e e e e
Avoid in pregnant females or females of reproductive age without adequate contraception.
e e e e e e e e e e e
Lower risk of cough than ACE-Is.
e e e e e
special considerations for Calcium channel blockers - correct answersAssociated with dose-related pedal
e e e e e e e e e e e e
edema, which is more common in females than men.
e e e e e e e e
When should you Refer to a Nephrologist or Cardiologist in a hypertensive patient? - correct answers-signs of
e e e e e e e e e e e e e e e e e
end-organ damage e
-evidence of a secondary cause of hypertension e e e e e e
-only on one to two medications
e e e e e
Generally, failure to achieve blood pressure goal in patients who are adhering to full doses of an appropriate
e e e e e e e e e e e e e e e e e e
three to four drug regimen that includes a diuretic may warrant referral to a nephrologist or cardiologist
e e e e e e e e e e e e e e e e
,Before referring, clinicians should first review other causes of inadequate hypertension control such as:
e e e e e e e e e e e e e
-Improper blood pressure measurement e e e
-White coat hypertension e e
-Excess sodium intake e e
-Medication issues (e.g., nonsteroidal anti-inflammatory drugs (NSAIDs), illicit drugs, sympathomimetics,
e e e e e e e e e e
oral contraceptives) e
-Excess alcohol intake e e
-Underlying identifiable causes of hypertension (secondary hypertension) e e e e e e
A researcher is studying potential risk factors for obesity. She sends a questionnaire to 5000 patients who
e e e e e e e e e e e e e e e e e
meet the CDC criteria for obesity that asks them about sedentary lifestyle factors, consumption of processed
e e e e e e e e e e e e e e e e
food, and family history of obesity. The researcher sends the same questionnaire to 5000 patients who are not
e e e e e e e e e e e e e e e e e
obese. Which of the following best describes the design of the study?
e e e e e e e e e e e e
A. Cross-sectional study
e e
B. Randomized controlled trial
e e e e
C. Meta-analysis
e
e D. Case-control study - correct answersCorrect Answer: D. Case-control study
e e e e e e e e e
This is a retrospective case-control study. In this observational study design, subjects are selected based on an
e e e e e e e e e e e e e e e e e
outcome, and their prior exposures are assessed and compared to subjects who do not have the particular
e e e e e e e e e e e e e e e e e
outcome. The result of the study is expressed as an odds ratio: OR = (# exposed with disease / # exposed
e e e e e e e e e e e e e e e e e e e e e
without disease) / (# not exposed with disease / # not exposed without disease). A retrospective case-control
e e e e e e e e e e e e e e e e e
study does not prove causation but demonstrates an association.
e e e e e e e e
Incorrect e
Answers:
A. A cross-sectional study is used to assess disease status and risk factors at 1 point in time.
e e e e e e e e e e e e e e e e e
B. A randomized controlled trial refers to a study where a group is given a treatment and outcomes are
e e e e e e e e e e e e e e e e e e e
compared against a control group given a placebo or treated with the standard of care.
e e e e e e e e e e e e e e
C. A meta-analysis provides a statistical analysis of the results of multiple studies.
e e e e e e e e e e e e
Vital Concepts: e
, In an observational study design, subjects are selected based on an outcome, and their prior exposures are
e e e e e e e e e e e e e e e e e
assessed and compared to subjects who do not have a particular outcome. The result of the study is expressed
e e e e e e e e e e e e e e e e e e e
as an odds ratio: OR = (# exposed with disease / # exposed without disease) / (# not exposed with disease / #
e e e e e e e e e e e e e e e e e e e e e e e
not exposed without disease). A retrospective case-control study does not prove causation but demonstrates
e e e e e e e e e e e e e
an association.
e e
A 49-year-old female presents to the office with a history of breast cancer who is having frequent hot flashes
e e e e e e e e e e e e e e e e e e e
who already tried first-line lifestyle changes without improvement? What is the best treatment for this
e e e e e e e e e e e e e e e
patient?
A. Hormonal therapy with estrogen and progesterone
e e e e e e e
B. Bioidentical hormones
e e e
C. Citalopram
e e
D. Black cohosh - correct answersCorrect Answer: C. Citalopram
e e e e e e e e
Selective serotonin reuptake inhibitors (SSRI)s are the most effective pharmacologic choice for the
e e e e e e e e e e e e e
vasomotor symptoms of menopause. Citalopram is an SSRI that has good evidence of efficacy against these
e e e e e e e e e e e e e e e e
symptoms and is typically well-tolerated. e e e e
Incorrect Answers: e
A. Women with a history of breast cancer are not candidates for hormone replacement therapy.
e e e e e e e e e e e e e e
B. "Bioidentical hormones" are compounded mixtures of multiple hormones. There is no evidence to support
e e e e e e e e e e e e e e e
their use at this time, and again, hormone treatment would be contraindicated in a patient with a history of
e e e e e e e e e e e e e e e e e e e
breast cancer. e
D. Black cohosh is an herbal remedy marketed for use with hot flashes. However, it has not been
e e e e e e e e e e e e e e e e e e
demonstrated to be more effective than a placebo for this use. In addition, it has been posited to have a e e e e e e e e e e e e e e e e e e e e
possible estrogenic effect on breast tissue, which should be avoided in patients with a history of breast cancer.
e e e e e e e e e e e e e e e e e
Vital Concepts: e
Selective serotonin reuptake inhibitors (SSRI)s are the most effective pharmacologic choice for the
e e e e e e e e e e e e e
vasomotor symptoms of menopause. Citalopram is an SSRI that has good evidence of efficacy against these
e e e e e e e e e e e e e e e e
symptoms and is typically well-tolerated. e e e e
A 20-year-old presents to the office for a wellness check. What is the prevalence of bulimia nervosa in female
e e e e e e e e e e e e e e e e e e e
college students? e
A. 1% e e
B.2% e
C. 4% e e
Questions & Answers (2026)
special considerations for Thiazides - correct answersChlorthalidone is preferred on the basis of prolonged
e e e e e e e e e e e e e e
half-life and proven trial reduction of CVD.
e e e e e e
Monitor for hyponatremia and hypokalemia, monitor uric acid and calcium levels.
e e e e e e e e e e
Use with caution in patients with history of acute gout unless patient is on uric acid-lowering therapy.
e e e e e e e e e e e e e e e e
special considerations for ACE inhibitors - correct answersDo not use in combination with ARBs or direct renin
e e e e e e e e e e e e e e e e e
inhibitor.
There is an increased risk of hyperkalemia, especially in patients with CKD or in those on K+ supplements or K+-
e e e e e e e e e e e e e e e e e e e
sparing drugs. e
There is a risk of acute renal failure in patients with severe bilateral renal artery stenosis.
e e e e e e e e e e e e e e e
,Do not use if patient has history of angioedema with ACE inhibitors.
e e e e e e e e e e e
ACE inhibitor cough is common, in 5 to 20 percent of patients, due to bradykinin production.
e e e e e e e e e e e e e e e
Avoid in pregnant females or females of reproductive age without adequate contraception
e e e e e e e e e e e
special considerations for Angiotensin receptor blockers - correct answersDo not use in combination with
e e e e e e e e e e e e e e
ACE inhibitors or direct renin inhibitor.
e e e e e
There is an increased risk of hyperkalemia in CKD or in those on K+ supplements or K+-sparing drugs.
e e e e e e e e e e e e e e e e e
There is a risk of acute renal failure in patients with severe bilateral renal artery stenosis.
e e e e e e e e e e e e e e e
Do not use if patient has history of angioedema with ARBs. Patients with a history of angioedema with an ACE
e e e e e e e e e e e e e e e e e e e e
inhibitor can receive an ARB beginning 6 weeks after ACE inhibitor is discontinued.
e e e e e e e e e e e e
Avoid in pregnant females or females of reproductive age without adequate contraception.
e e e e e e e e e e e
Lower risk of cough than ACE-Is.
e e e e e
special considerations for Calcium channel blockers - correct answersAssociated with dose-related pedal
e e e e e e e e e e e e
edema, which is more common in females than men.
e e e e e e e e
When should you Refer to a Nephrologist or Cardiologist in a hypertensive patient? - correct answers-signs of
e e e e e e e e e e e e e e e e e
end-organ damage e
-evidence of a secondary cause of hypertension e e e e e e
-only on one to two medications
e e e e e
Generally, failure to achieve blood pressure goal in patients who are adhering to full doses of an appropriate
e e e e e e e e e e e e e e e e e e
three to four drug regimen that includes a diuretic may warrant referral to a nephrologist or cardiologist
e e e e e e e e e e e e e e e e
,Before referring, clinicians should first review other causes of inadequate hypertension control such as:
e e e e e e e e e e e e e
-Improper blood pressure measurement e e e
-White coat hypertension e e
-Excess sodium intake e e
-Medication issues (e.g., nonsteroidal anti-inflammatory drugs (NSAIDs), illicit drugs, sympathomimetics,
e e e e e e e e e e
oral contraceptives) e
-Excess alcohol intake e e
-Underlying identifiable causes of hypertension (secondary hypertension) e e e e e e
A researcher is studying potential risk factors for obesity. She sends a questionnaire to 5000 patients who
e e e e e e e e e e e e e e e e e
meet the CDC criteria for obesity that asks them about sedentary lifestyle factors, consumption of processed
e e e e e e e e e e e e e e e e
food, and family history of obesity. The researcher sends the same questionnaire to 5000 patients who are not
e e e e e e e e e e e e e e e e e
obese. Which of the following best describes the design of the study?
e e e e e e e e e e e e
A. Cross-sectional study
e e
B. Randomized controlled trial
e e e e
C. Meta-analysis
e
e D. Case-control study - correct answersCorrect Answer: D. Case-control study
e e e e e e e e e
This is a retrospective case-control study. In this observational study design, subjects are selected based on an
e e e e e e e e e e e e e e e e e
outcome, and their prior exposures are assessed and compared to subjects who do not have the particular
e e e e e e e e e e e e e e e e e
outcome. The result of the study is expressed as an odds ratio: OR = (# exposed with disease / # exposed
e e e e e e e e e e e e e e e e e e e e e
without disease) / (# not exposed with disease / # not exposed without disease). A retrospective case-control
e e e e e e e e e e e e e e e e e
study does not prove causation but demonstrates an association.
e e e e e e e e
Incorrect e
Answers:
A. A cross-sectional study is used to assess disease status and risk factors at 1 point in time.
e e e e e e e e e e e e e e e e e
B. A randomized controlled trial refers to a study where a group is given a treatment and outcomes are
e e e e e e e e e e e e e e e e e e e
compared against a control group given a placebo or treated with the standard of care.
e e e e e e e e e e e e e e
C. A meta-analysis provides a statistical analysis of the results of multiple studies.
e e e e e e e e e e e e
Vital Concepts: e
, In an observational study design, subjects are selected based on an outcome, and their prior exposures are
e e e e e e e e e e e e e e e e e
assessed and compared to subjects who do not have a particular outcome. The result of the study is expressed
e e e e e e e e e e e e e e e e e e e
as an odds ratio: OR = (# exposed with disease / # exposed without disease) / (# not exposed with disease / #
e e e e e e e e e e e e e e e e e e e e e e e
not exposed without disease). A retrospective case-control study does not prove causation but demonstrates
e e e e e e e e e e e e e
an association.
e e
A 49-year-old female presents to the office with a history of breast cancer who is having frequent hot flashes
e e e e e e e e e e e e e e e e e e e
who already tried first-line lifestyle changes without improvement? What is the best treatment for this
e e e e e e e e e e e e e e e
patient?
A. Hormonal therapy with estrogen and progesterone
e e e e e e e
B. Bioidentical hormones
e e e
C. Citalopram
e e
D. Black cohosh - correct answersCorrect Answer: C. Citalopram
e e e e e e e e
Selective serotonin reuptake inhibitors (SSRI)s are the most effective pharmacologic choice for the
e e e e e e e e e e e e e
vasomotor symptoms of menopause. Citalopram is an SSRI that has good evidence of efficacy against these
e e e e e e e e e e e e e e e e
symptoms and is typically well-tolerated. e e e e
Incorrect Answers: e
A. Women with a history of breast cancer are not candidates for hormone replacement therapy.
e e e e e e e e e e e e e e
B. "Bioidentical hormones" are compounded mixtures of multiple hormones. There is no evidence to support
e e e e e e e e e e e e e e e
their use at this time, and again, hormone treatment would be contraindicated in a patient with a history of
e e e e e e e e e e e e e e e e e e e
breast cancer. e
D. Black cohosh is an herbal remedy marketed for use with hot flashes. However, it has not been
e e e e e e e e e e e e e e e e e e
demonstrated to be more effective than a placebo for this use. In addition, it has been posited to have a e e e e e e e e e e e e e e e e e e e e
possible estrogenic effect on breast tissue, which should be avoided in patients with a history of breast cancer.
e e e e e e e e e e e e e e e e e
Vital Concepts: e
Selective serotonin reuptake inhibitors (SSRI)s are the most effective pharmacologic choice for the
e e e e e e e e e e e e e
vasomotor symptoms of menopause. Citalopram is an SSRI that has good evidence of efficacy against these
e e e e e e e e e e e e e e e e
symptoms and is typically well-tolerated. e e e e
A 20-year-old presents to the office for a wellness check. What is the prevalence of bulimia nervosa in female
e e e e e e e e e e e e e e e e e e e
college students? e
A. 1% e e
B.2% e
C. 4% e e
