**Family Nurse Practitioner Surge: 2024
Certification Readiness** (Theme: Family Nurse
Practitioner Certification Exam 2024)
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1. Pt 45, BMI 34, hypertension, fatigue. Labs: fasting glucose 130, HbA1c 7.2%. Diagnosis?
💫RATIONALE✔️✔️: FPG ≥126 or A1c ≥6.5% = diabetes; repeat confirmatory test.
💫ANSWER✔️✔️: C. Type 2 diabetes.
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2. Pt 32, G2P1, 28 weeks pregnant, BP 145/95, urine protein 2+. Next step?
💫RATIONALE✔️✔️: Preeclampsia; admit for BP control, magnesium if severe.
💫ANSWER✔️✔️: B. Admit for monitoring.
---
3. Pt 60, postmenopausal, vaginal dryness, dyspareunia, no contraindication to estrogen. First-line
treatment?
💫RATIONALE✔️✔️: Low-dose vaginal estrogen (cream, ring, tablet); safe without progestin.
💫ANSWER✔️✔️: A. Vaginal estrogen cream.
---
4. Pt 25, G0, annual exam, cervical cytology: LSIL, HPV negative. Next step?
💫RATIONALE✔️✔️: Repeat Pap in 12 months; LSIL with negative HPV low risk.
💫ANSWER✔️✔️: C. Repeat Pap in 12 months.
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5. Pt 50, G3P3, breast lump, mammogram BI-RADS 3 (probably benign). Next?
💫RATIONALE✔️✔️: Short-interval follow-up mammogram in 6 months.
💫ANSWER✔️✔️: D. Repeat mammogram in 6 months.
---
, 6. Pt 35, G0, trying to conceive 18 months, regular cycles. Initial workup?
💫RATIONALE✔️✔️: Semen analysis, ovulation confirmation, HSG, ovarian reserve.
💫ANSWER✔️✔️: B. Semen analysis.
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7. Pt 28, G1P0, 10 weeks, vaginal spotting, US: intrauterine pregnancy, fetal HR 120, subchorionic
hematoma. Next?
💫RATIONALE✔️✔️: Threatened miscarriage; reassure, pelvic rest, repeat US in 2 weeks.
💫ANSWER✔️✔️: A. Reassure, repeat US.
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8. Pt 42, G4P3, heavy menses, dysmenorrhea, US: intramural fibroid 4 cm, endometrial stripe 8 mm.
Next?
💫RATIONALE✔️✔️: Rule out endometrial pathology; biopsy if risk factors.
💫ANSWER✔️✔️: C. Endometrial biopsy.
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9. Pt 55, postmenopausal, new-onset bleeding, endometrial stripe 12 mm. Next?
💫RATIONALE✔️✔️: Postmenopausal bleeding + stripe >4-5 mm needs endometrial biopsy.
💫ANSWER✔️✔️: B. Endometrial biopsy.
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10. Pt 30, G0, dysuria, frequency, UA positive nitrites, leukocytes. Treatment?
💫RATIONALE✔️✔️: Uncomplicated cystitis; nitrofurantoin 100 mg BID x 5 days.
💫ANSWER✔️✔️: A. Nitrofurantoin.
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11. Pt 22, G0, vaginal discharge, itching, pH 5.0, clue cells on wet mount. Diagnosis?
💫RATIONALE✔️✔️: Bacterial vaginosis; metronidazole 500 mg BID x 7 days.
💫ANSWER✔️✔️: C. Bacterial vaginosis.
---
12. Pt 26, G0, vaginal discharge, itching, pH 4.5, pseudohyphae on KOH. Diagnosis?
💫RATIONALE✔️✔️: Candida vaginitis; fluconazole 150 mg PO x 1.
💫ANSWER✔️✔️: B. Candida.
Certification Readiness** (Theme: Family Nurse
Practitioner Certification Exam 2024)
---
1. Pt 45, BMI 34, hypertension, fatigue. Labs: fasting glucose 130, HbA1c 7.2%. Diagnosis?
💫RATIONALE✔️✔️: FPG ≥126 or A1c ≥6.5% = diabetes; repeat confirmatory test.
💫ANSWER✔️✔️: C. Type 2 diabetes.
---
2. Pt 32, G2P1, 28 weeks pregnant, BP 145/95, urine protein 2+. Next step?
💫RATIONALE✔️✔️: Preeclampsia; admit for BP control, magnesium if severe.
💫ANSWER✔️✔️: B. Admit for monitoring.
---
3. Pt 60, postmenopausal, vaginal dryness, dyspareunia, no contraindication to estrogen. First-line
treatment?
💫RATIONALE✔️✔️: Low-dose vaginal estrogen (cream, ring, tablet); safe without progestin.
💫ANSWER✔️✔️: A. Vaginal estrogen cream.
---
4. Pt 25, G0, annual exam, cervical cytology: LSIL, HPV negative. Next step?
💫RATIONALE✔️✔️: Repeat Pap in 12 months; LSIL with negative HPV low risk.
💫ANSWER✔️✔️: C. Repeat Pap in 12 months.
---
5. Pt 50, G3P3, breast lump, mammogram BI-RADS 3 (probably benign). Next?
💫RATIONALE✔️✔️: Short-interval follow-up mammogram in 6 months.
💫ANSWER✔️✔️: D. Repeat mammogram in 6 months.
---
, 6. Pt 35, G0, trying to conceive 18 months, regular cycles. Initial workup?
💫RATIONALE✔️✔️: Semen analysis, ovulation confirmation, HSG, ovarian reserve.
💫ANSWER✔️✔️: B. Semen analysis.
---
7. Pt 28, G1P0, 10 weeks, vaginal spotting, US: intrauterine pregnancy, fetal HR 120, subchorionic
hematoma. Next?
💫RATIONALE✔️✔️: Threatened miscarriage; reassure, pelvic rest, repeat US in 2 weeks.
💫ANSWER✔️✔️: A. Reassure, repeat US.
---
8. Pt 42, G4P3, heavy menses, dysmenorrhea, US: intramural fibroid 4 cm, endometrial stripe 8 mm.
Next?
💫RATIONALE✔️✔️: Rule out endometrial pathology; biopsy if risk factors.
💫ANSWER✔️✔️: C. Endometrial biopsy.
---
9. Pt 55, postmenopausal, new-onset bleeding, endometrial stripe 12 mm. Next?
💫RATIONALE✔️✔️: Postmenopausal bleeding + stripe >4-5 mm needs endometrial biopsy.
💫ANSWER✔️✔️: B. Endometrial biopsy.
---
10. Pt 30, G0, dysuria, frequency, UA positive nitrites, leukocytes. Treatment?
💫RATIONALE✔️✔️: Uncomplicated cystitis; nitrofurantoin 100 mg BID x 5 days.
💫ANSWER✔️✔️: A. Nitrofurantoin.
---
11. Pt 22, G0, vaginal discharge, itching, pH 5.0, clue cells on wet mount. Diagnosis?
💫RATIONALE✔️✔️: Bacterial vaginosis; metronidazole 500 mg BID x 7 days.
💫ANSWER✔️✔️: C. Bacterial vaginosis.
---
12. Pt 26, G0, vaginal discharge, itching, pH 4.5, pseudohyphae on KOH. Diagnosis?
💫RATIONALE✔️✔️: Candida vaginitis; fluconazole 150 mg PO x 1.
💫ANSWER✔️✔️: B. Candida.
