FAMILY NURSE PRACTITIONER (FNP) BARKLEY FINAL EXAM COMPLETE QUESTIONS WITH 100% VERIFIED ANSWERS AND DETAILED RATIONALES

FAMILY NURSE PRACTITIONER (FNP) BARKLEY FINAL EXAM COMPLETE QUESTIONS WITH 100% VERIFIED ANSWERS AND DETAILED RATIONALES 1. A 45-year-old male with a history of hypertension presents with a blood pressure of 148/92 mmHg on two separate occasions. He has no other comorbidities. According to current guidelines, what is the most appropriate initial management? A. Begin antihypertensive medication immediately B. Recommend lifestyle modification and recheck in 3-6 months C. Refer to cardiology for further evaluation D. Order an echocardiogram to assess for target organ damage Correct Answer: B Explanation: For patients with Stage 1 hypertension (130-139/80-89) who have no other comorbidities, lifestyle modification (diet, exercise, sodium reduction) is recommended for 3-6 months before initiating pharmacotherapy. Medication is started if BP remains elevated after this period . ________________________________________ 2. A 6-month-old infant is brought for a well-child visit. Which vaccines are indicated at this visit? A. MMR and Varicella B. Tdap and HPV C. DTaP, IPV, Hib, PCV13, RV, and Hep B D. Influenza and Hepatitis A Correct Answer: C Explanation: At 6 months, the infant is due for DTaP #3, IPV #3, Hib #3, PCV13 #3, RV #3 (if rotavirus series not completed by 8 months), and Hep B #3. MMR and varicella are given at 12-15 months, while Tdap and HPV are adolescent vaccines . ________________________________________ 3. A 28-year-old female has a Pap smear result showing LSIL (low-grade squamous intraepithelial lesion) with positive high-risk HPV testing. What is the next appropriate step? A. Repeat Pap smear in 1 year B. Colposcopy C. HPV vaccination D. LEEP procedure Correct Answer: B Explanation: Current guidelines recommend colposcopy for LSIL with high-risk HPV. LEEP is treatment for CIN 2/3, not initial management. HPV vaccine is prevention, not treatment for existing lesions . ________________________________________ 4. A 55-year-old male has a lipid panel showing LDL of 190 mg/dL, HDL of 35 mg/dL, and triglycerides of 200 mg/dL. He has no prior ASCVD. According to ACC/AHA guidelines, what should the NP recommend? A. Lifestyle changes only B. High-intensity statin therapy C. Niacin supplementation D. Coronary calcium score before treatment Correct Answer: B Explanation: ACC/AHA guidelines recommend high-intensity statin therapy (atorvastatin 40-80 mg or rosuvastatin 20-40 mg) for patients with LDL ≥190 mg/dL regardless of risk factors. Lifestyle changes are important adjuncts but medication is indicated . ________________________________________ 5. A 22-year-old male presents with a painless, firm testicular mass. What is the most appropriate management? A. Reassure the patient it is likely a cyst B. Order a scrotal ultrasound C. Prescribe antibiotics for epididymitis D. Advise watchful waiting Correct Answer: B Explanation: A painless, firm testicular mass is suspicious for testicular cancer, the most common cancer in men aged 15-35. Immediate scrotal ultrasound is indicated. Epididymitis typically presents with pain and swelling . ________________________________________ 6. A 30-year-old female with a history of DVT is seeking contraception. Which method is contraindicated? A. Copper IUD B. Progestin-only pill C. Combined oral contraceptive D. Levonorgestrel IUD Correct Answer: C Explanation: Combined oral contraceptives containing estrogen increase the risk of venous thromboembolism and are contraindicated in women with a history of DVT/PE. Progestin-only methods are safe alternatives . ________________________________________ 7. A 17-year-old male presents with comedones and inflammatory papules on the face but no nodules or cysts. What is the first-line treatment? A. Oral isotretinoin B. Topical benzoyl peroxide or topical retinoid C. Oral antibiotics alone D. Intralesional corticosteroids Correct Answer: B Explanation: Mild to moderate acne with comedones and inflammatory papules is treated with topical agents: benzoyl peroxide (antibacterial, keratolytic) or topical retinoids (tretinoin, adapalene). Oral isotretinoin is reserved for severe nodulocystic acne . ________________________________________ 8. A 70-year-old male with benign prostatic hyperplasia reports nocturia and weak urinary stream. His PSA is 4.5 ng/mL. What is the most appropriate next step? A. Start an alpha-blocker B. Order a transrectal ultrasound C. Repeat PSA in 6 months D. Refer for urology evaluation Correct Answer: D Explanation: A PSA of 4.5 ng/mL is elevated for a 70-year-old male (normal 4.0). Urology referral is indicated for further evaluation including possible biopsy. Alpha-blockers may be appropriate after evaluation . ________________________________________ 9. A 45-year-old woman has gone 120 days without a menstrual period. A pregnancy test is negative. What should the NP do? A. Tell her she has developed early menopause B. Evaluate for various causes of amenorrhea C. Reassure her that this can be normal D. Tell her this is likely perimenopause Correct Answer: B Explanation: Amenorrhea of 120 days requires thorough evaluation for various causes including hypothalamic, pituitary, ovarian, and uterine etiologies. While perimenopause is possible, other causes must be ruled out . ________________________________________ 10. Which of the following bacterial causes of gastroenteritis is most common following antibiotic use or hospitalization? A. Campylobacter jejuni B. Salmonella