QUESTIONS & ANSWERS.
FNP Board Certification Exam 2026: Orthopedics Practice Questions
Part 1: Degenerative and Inflammatory Disorders (Questions 1-30)
1. A 65-year-old carpenter complains of morning stiffness and pain in both hands
and right knee upon awakening. He feels some relief after warming up. On exam,
the nurse practitioner notes the presence of Heberden's nodes. Which of the
following is most likely?
A. Osteoporosis
B. Rheumatoid arthritis
C. Osteoarthritis
D. Reiter's syndrome
Answer: C
Rationale: Signs of osteoarthritis (OA) include stiffness of joints, especially in the
morning and after sitting for long periods. Heberden's nodes (bony overgrowths)
are classic signs of OA located at the distal interphalangeal joints. They are felt as
hard, nontender nodules usually 2 to 3 cm in diameter .
,2. Kyphosis is a late sign of which condition?
A. Rheumatoid arthritis
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis
Answer: C
Rationale: Kyphosis is a curvature of the spine that causes rounding of the back.
Severe thinning of the bones (osteoporosis) contributes to this curvature in the
spine. Symptoms that may occur with severe cases include difficulty breathing,
fatigue, and back pain .
3. Which antihypertensive medication has beneficial effects for an elderly White
woman with osteoporosis?
A. Calcium channel blockers
B. Angiotensin-converting enzyme (ACE) inhibitors
C. Beta-blockers
,D. Thiazide diuretics
Answer: D
Rationale: Thiazide diuretics have a favorable effect in patients with osteopenia
and osteoporosis by slowing down the kidney's excretion of calcium and
increasing distal tubule calcium reabsorption. This results in decreased bone
demineralization. They are a good choice for this population because they treat
hypertension and slow bone loss .
4. Which medication is the first-line choice for the PREVENTION of chronic
tophaceous gout?
A. Indomethacin
B. Colchicine
C. Allopurinol
D. Prednisone
Answer: C
, Rationale: Allopurinol is a xanthine oxidase inhibitor used for long-term uric acid
lowering. Indomethacin (NSAID) and Colchicine are primarily used to treat acute
flares .
5. A patient is starting Alendronate (Fosamax) for osteoporosis. What is the most
important administration instruction?
A. Take with a high-calcium meal
B. Take at bedtime with a full glass of milk
C. Take on an empty stomach and remain upright for 30 minutes
D. Take with a PPI to prevent stomach upset
Answer: C
Rationale: Bisphosphonates are poorly absorbed and can cause severe esophageal
irritation. Remaining upright ensures the pill reaches the stomach and minimizes
the risk of esophagitis .
6. A patient presents with a red, hot, swollen great toe (podagra). Which of the
following is an appropriate non-pharmacological recommendation for long-term
management?