Family Nurse Practitioner Certification Exam
Prep Q&A (2026)
A middle-age female patient presents to the clinic with a recurrence of mild hidradenitis suppurativa after
e e e e e e e e e e e e e e e e
topical therapies failed. Which first-line treatment is recommended? - correct answersTetracycline
e e e e e e e e e e
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line treatment for hidradenitis
e e e e e e e e e e e e e
suppurativa.
__________________________________________________
Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in apocrine gland-bearing skin. It is
e e e e e e e e e e e e e e e e
a chronic, disabling disorder that progresses, often causing keloids, contractures, and immobility. It is
e e e e e e e e e e e e e e
characterized by comedone-like follicular occlusion, chronic and relapsing inflammation, mucopurulent
e e e e e e e e e e
discharge, and progressive scarring. e e e
Arthropathy associated with hidradenitis may be present. Typical presentation includes nodules and sinus
e e e e e e e e e e e e e
tracts (inflamed or noninflamed), abscesses, and scarring found in the axilla, genitofemoral area, perineum,
e e e e e e e e e e e e e e
gluteal area, and inframammary area in women.
e e e e e e
Recommended treatments include antibiotics, steroids, retinoids, dapsone, and anti-tumor necrosis factor
e e e e e e e e e e e
agents. A dermatology consultation should also be considered.
e e e e e e e
First-line treatment is a 12-week course of an oral tetracycline (Sumycin) such as doxycycline. For patients
e e e e e e e e e e e e e e e e
who do not respond to doxycycline, the next recommended step is a combination of twice-daily clindamycin
e e e e e e e e e e e e e e e e
(Cleocin) and rifampicin (Rifadin) for 10-12 weeks. If treatment fails, acitretin (Soriatane, for males and
e e e e e e e e e e e e e e e
nonfertile females) or dapsone (Aczone) may be considered by a dermatologist. In patients with moderate to
e e e e e e e e e e e e e e e e
severe hidradenitis suppurativa, adalimumab (Humira) may possibly be considered.
e e e e e e e e
,When providing culturally competent health care services to an American Indian elder, the nurse practitioner
e e e e e e e e e e e e e e e
understands which is traditionally true? - correct answersThe "Medicine Wheel" is used by many for the e e e e e e e e e e e e e e e e
purpose of health and healing e e e e
The "Medicine Wheel" is traditionally used and contains four directions; north, south, east, and west.
e e e e e e e e e e e e e e e
Traditionally each tribe has different meanings for each direction and they may represent the season of the e e e e e e e e e e e e e e e e e
year or stage of life. It is aimed at providing a holistic view of life.
e e e e e e e e e e e e e e
________________________________________
An understanding of different cultural preferences leads to cultural competence in healthcare. Some patients
e e e e e e e e e e e e e
may value traditional culture and preferences as it relates to healthcare. These individual preferences should
e e e e e e e e e e e e e e e e
be included in the interview and treatment plan for patients.
e e e e e e e e e
Traditionally, the American Indian culture values a holistic approach to health care integrating the person, e e e e e e e e e e e e e e e
lifestyle, environment, family, and religion. Patients adhering to these traditional cultural practices often feel
e e e e e e e e e e e e e e
that illness is due to a lack of harmony with the physical body, mind, spirit, and emotions. Patients may seek
e e e e e e e e e e e e e e e e e e e e
care from western medicine for specific ailments while also consulting with traditional healers for spiritual
e e e e e e e e e e e e e e e
guidance.
Healthcare providers should seek to understand relevant cultural factors and assess each individual's
e e e e e e e e e e e e e
healthcare literacy in order to provide culturally competent care. e e e e e e e e
The nurse practitioner sees an older adult patient in the clinic with the primary report of hearing loss and a
e e e e e e e e e e e e e e e e e e e e
sensation of fullness in the right ear. The nurse practitioner suspects conductive hearing loss. Which could
e e e e e e e e e e e e e e e e
contribute to this? - correct answersCerumen, commonly called earwax, is a combination of secretions and
e e e e e e e e e e e e e e e
sloughed epithelial cells that protects the ears from infection, water, and insects. It is normally expelled from
e e e e e e e e e e e e e e e e e
the ear canal through natural jaw movement. When this self-cleaning process fails, cerumen can become
e e e e e e e e e e e e e e e
impacted. Cerumen impaction occludes the ear canal and can press against the tympanic membrane,
e e e e e e e e e e e e e e
resulting in conductive hearing loss. e e e e
_________________________________________
Conductive hearing is the transition of sound from the external and middle ear to the inner ear. Conductive
e e e e e e e e e e e e e e e e e e
hearing loss is caused by problems in the external and middle ear that interfere with the transmission of sound
e e e e e e e e e e e e e e e e e e
and its conversion to mechanical vibration. Causes of conductive hearing loss include obstruction of the
e e e e e e e e e e e e e e e e
external auditory canal by cerumen, foreign bodies, debris from otitis externa, and large exocytosis and
e e e e e e e e e e e e e e e
osteomas.
, Sensorineural hearing loss involves difficulty converting mechanical vibrations to electrical potential in the e e e e e e e e e e e e e
cochlea or in auditory nerve transmission to the brain. It is mostly caused by permanent damage in the organ
e e e e e e e e e e e e e e e e e e e
of Corti. It can be caused by age-related hearing loss, noise trauma, medications, autoimmune diseases,
e e e e e e e e e e e e e e e
mechanical trauma, Meniere disease, infection, and neoplasm (acoustic neuroma). e e e e e e e e
Approximately one-third of older adults between the ages of 61 and 70 years have hearing loss. More than e e e e e e e e e e e e e e e e e e
90% of adults older than 85 years of age have hearing loss. The most common type of hearing loss is age-
e e e e e e e e e e e e e e e e e e e e
related and sensorineural. All adults older than 60 years of age should be screened for hearing loss at periodic
e e e e e e e e e e e e e e e e e e e
health examinations. e
An otherwise healthy adult patient presents to the clinic with a diagnosis of community-acquired pneumonia
e e e e e e e e e e e e e e e
and no recent antibiotic therapy. Which is the best option for treatment? - correct answersAmoxicillin
e e e e e e e e e e e e e e
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-line therapy for adults without
e e e e e e e e e e e e e
comorbidities.
_____________________________________________
Community-acquired pneumonia (CAP) is pneumonia not acquired in a hospital or long-term care facility. e e e e e e e e e e e e e e
Patients with suspected CAP should receive a chest X-ray for diagnosis. The Pneumonia Severity Index should
e e e e e e e e e e e e e e e e
be used to assist in decisions regarding the need for hospitalization in patients with CAP.
e e e e e e e e e e e e e e
According to the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) 2019
e e e e e e e e e e e e e e e e
guidelines, the initial treatment of CAP for most patients is amoxicillin or doxycycline. Macrolides are an
e e e e e e e e e e e e e e e e
option for treatment, but are no longer recommended routinely as first-line treatment, given increased
e e e e e e e e e e e e e e
macrolide resistance. This is a change from the 2007 ATS/IDSA guidelines. Respiratory fluoroquinolones and
e e e e e e e e e e e e e e
amoxicillin/clavulanate should be used in patients who fail first-line medications, have significant e e e e e e e e e e e e
comorbidities, have had recent antibiotic therapy, are allergic to alternative agents, or have a documented e e e e e e e e e e e e e e e
infection with highly drug-resistant pneumococci. e e e e
A patient presents to the clinic for conception counseling. She recently stopped taking oral contraceptives
e e e e e e e e e e e e e e e
and would like to become pregnant. Which statement about conception safety after stopping oral
e e e e e e e e e e e e e e
contraceptives is correct? - correct answers e e e e e
You have a 35-year-old female patient who is complaining of wrist pain. She is an administrative assistant who
e e e e e e e e e e e e e e e e e e
does a great deal of computer work in her job. You will test her for carpal tunnel syndrome. When you tap at
e e e e e e e e e e e e e e e e e e e e e e
the volar surface of the wrist you are performing which of the following tests? - correct answersTinel's sign
e e e e e e e e e e e e e e e e e
Prep Q&A (2026)
A middle-age female patient presents to the clinic with a recurrence of mild hidradenitis suppurativa after
e e e e e e e e e e e e e e e e
topical therapies failed. Which first-line treatment is recommended? - correct answersTetracycline
e e e e e e e e e e
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line treatment for hidradenitis
e e e e e e e e e e e e e
suppurativa.
__________________________________________________
Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in apocrine gland-bearing skin. It is
e e e e e e e e e e e e e e e e
a chronic, disabling disorder that progresses, often causing keloids, contractures, and immobility. It is
e e e e e e e e e e e e e e
characterized by comedone-like follicular occlusion, chronic and relapsing inflammation, mucopurulent
e e e e e e e e e e
discharge, and progressive scarring. e e e
Arthropathy associated with hidradenitis may be present. Typical presentation includes nodules and sinus
e e e e e e e e e e e e e
tracts (inflamed or noninflamed), abscesses, and scarring found in the axilla, genitofemoral area, perineum,
e e e e e e e e e e e e e e
gluteal area, and inframammary area in women.
e e e e e e
Recommended treatments include antibiotics, steroids, retinoids, dapsone, and anti-tumor necrosis factor
e e e e e e e e e e e
agents. A dermatology consultation should also be considered.
e e e e e e e
First-line treatment is a 12-week course of an oral tetracycline (Sumycin) such as doxycycline. For patients
e e e e e e e e e e e e e e e e
who do not respond to doxycycline, the next recommended step is a combination of twice-daily clindamycin
e e e e e e e e e e e e e e e e
(Cleocin) and rifampicin (Rifadin) for 10-12 weeks. If treatment fails, acitretin (Soriatane, for males and
e e e e e e e e e e e e e e e
nonfertile females) or dapsone (Aczone) may be considered by a dermatologist. In patients with moderate to
e e e e e e e e e e e e e e e e
severe hidradenitis suppurativa, adalimumab (Humira) may possibly be considered.
e e e e e e e e
,When providing culturally competent health care services to an American Indian elder, the nurse practitioner
e e e e e e e e e e e e e e e
understands which is traditionally true? - correct answersThe "Medicine Wheel" is used by many for the e e e e e e e e e e e e e e e e
purpose of health and healing e e e e
The "Medicine Wheel" is traditionally used and contains four directions; north, south, east, and west.
e e e e e e e e e e e e e e e
Traditionally each tribe has different meanings for each direction and they may represent the season of the e e e e e e e e e e e e e e e e e
year or stage of life. It is aimed at providing a holistic view of life.
e e e e e e e e e e e e e e
________________________________________
An understanding of different cultural preferences leads to cultural competence in healthcare. Some patients
e e e e e e e e e e e e e
may value traditional culture and preferences as it relates to healthcare. These individual preferences should
e e e e e e e e e e e e e e e e
be included in the interview and treatment plan for patients.
e e e e e e e e e
Traditionally, the American Indian culture values a holistic approach to health care integrating the person, e e e e e e e e e e e e e e e
lifestyle, environment, family, and religion. Patients adhering to these traditional cultural practices often feel
e e e e e e e e e e e e e e
that illness is due to a lack of harmony with the physical body, mind, spirit, and emotions. Patients may seek
e e e e e e e e e e e e e e e e e e e e
care from western medicine for specific ailments while also consulting with traditional healers for spiritual
e e e e e e e e e e e e e e e
guidance.
Healthcare providers should seek to understand relevant cultural factors and assess each individual's
e e e e e e e e e e e e e
healthcare literacy in order to provide culturally competent care. e e e e e e e e
The nurse practitioner sees an older adult patient in the clinic with the primary report of hearing loss and a
e e e e e e e e e e e e e e e e e e e e
sensation of fullness in the right ear. The nurse practitioner suspects conductive hearing loss. Which could
e e e e e e e e e e e e e e e e
contribute to this? - correct answersCerumen, commonly called earwax, is a combination of secretions and
e e e e e e e e e e e e e e e
sloughed epithelial cells that protects the ears from infection, water, and insects. It is normally expelled from
e e e e e e e e e e e e e e e e e
the ear canal through natural jaw movement. When this self-cleaning process fails, cerumen can become
e e e e e e e e e e e e e e e
impacted. Cerumen impaction occludes the ear canal and can press against the tympanic membrane,
e e e e e e e e e e e e e e
resulting in conductive hearing loss. e e e e
_________________________________________
Conductive hearing is the transition of sound from the external and middle ear to the inner ear. Conductive
e e e e e e e e e e e e e e e e e e
hearing loss is caused by problems in the external and middle ear that interfere with the transmission of sound
e e e e e e e e e e e e e e e e e e
and its conversion to mechanical vibration. Causes of conductive hearing loss include obstruction of the
e e e e e e e e e e e e e e e e
external auditory canal by cerumen, foreign bodies, debris from otitis externa, and large exocytosis and
e e e e e e e e e e e e e e e
osteomas.
, Sensorineural hearing loss involves difficulty converting mechanical vibrations to electrical potential in the e e e e e e e e e e e e e
cochlea or in auditory nerve transmission to the brain. It is mostly caused by permanent damage in the organ
e e e e e e e e e e e e e e e e e e e
of Corti. It can be caused by age-related hearing loss, noise trauma, medications, autoimmune diseases,
e e e e e e e e e e e e e e e
mechanical trauma, Meniere disease, infection, and neoplasm (acoustic neuroma). e e e e e e e e
Approximately one-third of older adults between the ages of 61 and 70 years have hearing loss. More than e e e e e e e e e e e e e e e e e e
90% of adults older than 85 years of age have hearing loss. The most common type of hearing loss is age-
e e e e e e e e e e e e e e e e e e e e
related and sensorineural. All adults older than 60 years of age should be screened for hearing loss at periodic
e e e e e e e e e e e e e e e e e e e
health examinations. e
An otherwise healthy adult patient presents to the clinic with a diagnosis of community-acquired pneumonia
e e e e e e e e e e e e e e e
and no recent antibiotic therapy. Which is the best option for treatment? - correct answersAmoxicillin
e e e e e e e e e e e e e e
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-line therapy for adults without
e e e e e e e e e e e e e
comorbidities.
_____________________________________________
Community-acquired pneumonia (CAP) is pneumonia not acquired in a hospital or long-term care facility. e e e e e e e e e e e e e e
Patients with suspected CAP should receive a chest X-ray for diagnosis. The Pneumonia Severity Index should
e e e e e e e e e e e e e e e e
be used to assist in decisions regarding the need for hospitalization in patients with CAP.
e e e e e e e e e e e e e e
According to the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) 2019
e e e e e e e e e e e e e e e e
guidelines, the initial treatment of CAP for most patients is amoxicillin or doxycycline. Macrolides are an
e e e e e e e e e e e e e e e e
option for treatment, but are no longer recommended routinely as first-line treatment, given increased
e e e e e e e e e e e e e e
macrolide resistance. This is a change from the 2007 ATS/IDSA guidelines. Respiratory fluoroquinolones and
e e e e e e e e e e e e e e
amoxicillin/clavulanate should be used in patients who fail first-line medications, have significant e e e e e e e e e e e e
comorbidities, have had recent antibiotic therapy, are allergic to alternative agents, or have a documented e e e e e e e e e e e e e e e
infection with highly drug-resistant pneumococci. e e e e
A patient presents to the clinic for conception counseling. She recently stopped taking oral contraceptives
e e e e e e e e e e e e e e e
and would like to become pregnant. Which statement about conception safety after stopping oral
e e e e e e e e e e e e e e
contraceptives is correct? - correct answers e e e e e
You have a 35-year-old female patient who is complaining of wrist pain. She is an administrative assistant who
e e e e e e e e e e e e e e e e e e
does a great deal of computer work in her job. You will test her for carpal tunnel syndrome. When you tap at
e e e e e e e e e e e e e e e e e e e e e e
the volar surface of the wrist you are performing which of the following tests? - correct answersTinel's sign
e e e e e e e e e e e e e e e e e