ANCC Family Nurse Practitioner (FNP-BC) Ultimate Certification
Review Bundle | Complete QUESTION Bank, Practice Exams &
Verified Answers
QUESTION 1
An 18-month-old toddler is brought to the clinic for a routine well-child
visit. Which developmental milestone should the nurse practitioner
expect the child to have achieved?
A. Walking backward and running stiffly
B. Riding a tricycle
C. Copying a circle
D. Using 3-4 word sentences
Correct Answer: A. Walking backward and running stiffly
Detailed Rationale: By 18 months, a toddler typically walks
independently, can run stiffly, and can walk backward. Riding a tricycle
,and copying a circle are 3-year milestones, and 3-4 word sentences are
characteristic of a 2 to 3-year-old child.
QUESTION 2
A 62-year-old male with heart failure with reduced ejection fraction
(HFrEF) is currently stable on lisinopril and metoprolol succinate. To
further reduce morbidity and mortality, guideline-directed medical
therapy supports replacing the ACE inhibitor with an angiotensin
receptor-neprilysin inhibitor (ARNI). What is the primary mechanism of
action of the neprilysin inhibitor component?
A. It blocks aldosterone receptors in the distal renal tubules.
B. It inhibits the degradation of natriuretic peptides, promoting
vasodilation and natriuresis.
C. It directly stimulates beta-2 receptors to cause bronchodilation.
D. It decreases hepatic gluconeogenesis and lowers circulating insulin
levels.
,Correct Answer: B. It inhibits the degradation of natriuretic peptides,
promoting vasodilation and natriuresis.
Detailed Rationale: Neprilysin inhibitors (e.g., sacubitril) prevent the
breakdown of endogenous vasoactive peptides like atrial and brain
natriuretic peptides, leading to diuresis, natriuresis, and vasodilation.
QUESTION 3
A 58-year-old male with a 40 pack-year smoking history presents with
chronic productive cough and progressive dyspnea. Spirometry confirms
GOLD Group B chronic obstructive pulmonary disease (COPD). What is
the recommended first-line maintenance pharmacological therapy?
A. Inhaled corticosteroid (ICS) monotherapy
B. Short-acting muscarinic antagonist (SAMA) PRN alone
C. Long-acting muscarinic antagonist (LAMA) or long-acting beta2-
agonist (LABA)
D. Oral systemic corticosteroids on a daily schedule
, Correct Answer: C. Long-acting muscarinic antagonist (LAMA) or long-
acting beta2-agonist (LABA)
Detailed Rationale: Initial maintenance therapy for GOLD Group B COPD
patients involves a long-acting bronchodilator, either a LAMA or a LABA,
to improve breathlessness and exercise tolerance.
QUESTION 4
A 52-year-old female with type 2 diabetes mellitus and established
atherosclerotic cardiovascular disease (ASCVD) is being evaluated for
glucose-lowering therapy adjustment. According to current ADA
guidelines, which class of medications should be prioritized alongside
metformin due to proven cardiovascular and renal benefits?
A. Sulfonylureas (e.g., Glipizide)
B. Sodium-glucose cotransporter-2 (SGLT2) inhibitors or GLP-1 receptor
agonists
C. Thiazolidinediones (e.g., Pioglitazone)
D. Alpha-glucosidase inhibitors (e.g., Acarbose)
Review Bundle | Complete QUESTION Bank, Practice Exams &
Verified Answers
QUESTION 1
An 18-month-old toddler is brought to the clinic for a routine well-child
visit. Which developmental milestone should the nurse practitioner
expect the child to have achieved?
A. Walking backward and running stiffly
B. Riding a tricycle
C. Copying a circle
D. Using 3-4 word sentences
Correct Answer: A. Walking backward and running stiffly
Detailed Rationale: By 18 months, a toddler typically walks
independently, can run stiffly, and can walk backward. Riding a tricycle
,and copying a circle are 3-year milestones, and 3-4 word sentences are
characteristic of a 2 to 3-year-old child.
QUESTION 2
A 62-year-old male with heart failure with reduced ejection fraction
(HFrEF) is currently stable on lisinopril and metoprolol succinate. To
further reduce morbidity and mortality, guideline-directed medical
therapy supports replacing the ACE inhibitor with an angiotensin
receptor-neprilysin inhibitor (ARNI). What is the primary mechanism of
action of the neprilysin inhibitor component?
A. It blocks aldosterone receptors in the distal renal tubules.
B. It inhibits the degradation of natriuretic peptides, promoting
vasodilation and natriuresis.
C. It directly stimulates beta-2 receptors to cause bronchodilation.
D. It decreases hepatic gluconeogenesis and lowers circulating insulin
levels.
,Correct Answer: B. It inhibits the degradation of natriuretic peptides,
promoting vasodilation and natriuresis.
Detailed Rationale: Neprilysin inhibitors (e.g., sacubitril) prevent the
breakdown of endogenous vasoactive peptides like atrial and brain
natriuretic peptides, leading to diuresis, natriuresis, and vasodilation.
QUESTION 3
A 58-year-old male with a 40 pack-year smoking history presents with
chronic productive cough and progressive dyspnea. Spirometry confirms
GOLD Group B chronic obstructive pulmonary disease (COPD). What is
the recommended first-line maintenance pharmacological therapy?
A. Inhaled corticosteroid (ICS) monotherapy
B. Short-acting muscarinic antagonist (SAMA) PRN alone
C. Long-acting muscarinic antagonist (LAMA) or long-acting beta2-
agonist (LABA)
D. Oral systemic corticosteroids on a daily schedule
, Correct Answer: C. Long-acting muscarinic antagonist (LAMA) or long-
acting beta2-agonist (LABA)
Detailed Rationale: Initial maintenance therapy for GOLD Group B COPD
patients involves a long-acting bronchodilator, either a LAMA or a LABA,
to improve breathlessness and exercise tolerance.
QUESTION 4
A 52-year-old female with type 2 diabetes mellitus and established
atherosclerotic cardiovascular disease (ASCVD) is being evaluated for
glucose-lowering therapy adjustment. According to current ADA
guidelines, which class of medications should be prioritized alongside
metformin due to proven cardiovascular and renal benefits?
A. Sulfonylureas (e.g., Glipizide)
B. Sodium-glucose cotransporter-2 (SGLT2) inhibitors or GLP-1 receptor
agonists
C. Thiazolidinediones (e.g., Pioglitazone)
D. Alpha-glucosidase inhibitors (e.g., Acarbose)
