• FNP 654 FINAL 09/13/2026
EXAM
FNP654/ FNP 654 FINAL EXAM | FAMILY
PRIMARY CARE II EXAM | QUESTIONS AND
VERIFIED ANSWERS RATED A+ | 2026/2027
GUIDE | GCU| 2026/2027 Latest Update |
Complete Chapter Questions & Answers with
Rationales | Verified Questions & Answers |
Graded A+
The sentinel nodes (Virchow's nodes) are found at the:
A. Right axillary area
B. Left supraclavicular area
C. Posterior cervical chain
P 1
, • FNP 654 FINAL 09/13/2026
EXAM
D. Submandibular chain
- Correct Answer :B) Left supraclavicular area The sentinel nodes are found at the supraclavicular area of the
chest. They are the first lymph nodes that a cancer lesion will drain into. Therefore, when cancer is diagnosed,
these nodes are biopsied to see whether the cancer has spread into the lymph system.
Which of the following laboratory values may be elevated on the liver function panel of a patient who is an
alcohol abusers?
A. Serum GGT
B. Serum creatinine
C. Serum Bilirubin
D. BUN –
Correct Answer :The serum gamma glutamyl transaminase may become elevated in patients who are alcohol
abusers. It can be used to screen for chronic alcohol abuse and occult alcoholism. The GGT can become elevated
in liver disease and bile duct obstruction. It is a sensitive test for detecting obstructive jaundice, cholangitis, and
cholecystitis.
All of the following are associated with emphysema except:
A. barrel-shaped chest
B. Pursed-lip breathing
C. chest radiograph result with infiltrates and flattening of the costovertebral angle
D. Dyspnea when at rest –
Correct Answer :C) A chest radiograph result with infiltrates and flattening of the costovertebral angle
Emphysema is characterized by having a barrel-shaped chest, pursed-lip breathing, and dyspnea when at rest.
Infiltrates on an x-ray indicate bacterial infection, such as pneumonia.
A split S2 heart sound is best heard at which of the following areas? A. The aortic area
P 2
, • FNP 654 FINAL 09/13/2026
EXAM
B. The pulmonic area
C. The tricuspid area
D. The mitral area –
Correct Answer :B) The pulmonic area The S2 heart sound is physiologically split in about 90% of people. The
second heart sound is produced by the closure of the aortic and pulmonic valves. The sound produced by the
closure of the aortic valve is termed A2, and the sound produced by the closure of the pulmonic valve is termed
P2. The A2 sound is normally much louder than the P2 due to higher pressures in the left side of the heart; thus,
A2 radiates to all cardiac listening posts (loudest at the right upper sternal border) and P2 is usually only heard at
the left upper sternal border.
Cluster headaches are most often seen in:
A. Adolescent girls
B. Middle-aged men
C. Elderly men
D. Postmenopausal women
- Correct Answer :B) Middle-aged men The most prominent feature of cluster headache is severe pain that is
almost always on only one side of the head, accompanied by tearing, rhinorrhea, ptosis (drooping of upper
eyelid), and miosis (constriction of the pupil). Cluster headaches occur periodically; spontaneous remissions
interrupt active periods of pain. The cause of the condition is currently unknown. It affects approximately 0.1% of
the population, and men are more commonly affected than women. The headaches typically start before age 30
An 18-year-old male patient is found to have a 47,XXY karyotype and is diagnosed with Klinefelter's syndrome.
The patient is most likely to have all of the following physical characteristics except:
A. Gynecomastia
B. Long limbs
C. Lack of secondary sexual characteristics
D. Large testes
P 3
, • FNP 654 FINAL 09/13/2026
EXAM
- Correct Answer :D) Large testes Signs and symptoms of Klinefelter's syndrome include gynecomastia, long
limbs, and lack of secondary sexual characteristics. Testes are usually small. Infertility is a major concern for these
boys. If treated early, they may have a normal sexual/reproductive system in the future.
Which of the following drugs can increase the risk of bleeding in patients who are receiving anticoagulation
therapy with warfarin sodium (Coumadin)?
A. Trimethoprim-sulfamethoxazole (Bactrim DS)
B. Carafate (Sucralfate)
C. Losartan (Cozaar)
D. Furosemide (Lasix) –
Correct Answer :A) Trimethoprim-sulfamethoxazole (Bactrim DS) Warfarin sodium (Coumadin) interacts with
Bactrim and will increase the risk of bleeding; therefore, concurrent use is contraindicated.
An adolescent female's areola, nipples, and breast tissue develop and become elevated as one mound. Which of
the following is the correct Tanner stage for this phase of breast development?
A. Tanner stage I
B. Tanner stage II
C. Tanner stage III
D. Tanner stage IV –
Correct Answer :C) Tanner stage III
During Tanner stage III, the breast and areola and nipples grow together in one mound. There is no separation
yet. At Tanner stage IV, the areola and the nipple separate to form a distinct mound. The most important clue is
"secondary mound."
The cremasteric reflex is elicited by:
A. Asking the patient to open his or her mouth and touching the back of the pharynx with a tongue blade
B. Hitting the biceps tendon briskly with a reflex hammer and watching the lower arm for movement
C. Hitting the patellar tendon briskly with a reflex hammer and watching the lower leg for movement
P 4
EXAM
FNP654/ FNP 654 FINAL EXAM | FAMILY
PRIMARY CARE II EXAM | QUESTIONS AND
VERIFIED ANSWERS RATED A+ | 2026/2027
GUIDE | GCU| 2026/2027 Latest Update |
Complete Chapter Questions & Answers with
Rationales | Verified Questions & Answers |
Graded A+
The sentinel nodes (Virchow's nodes) are found at the:
A. Right axillary area
B. Left supraclavicular area
C. Posterior cervical chain
P 1
, • FNP 654 FINAL 09/13/2026
EXAM
D. Submandibular chain
- Correct Answer :B) Left supraclavicular area The sentinel nodes are found at the supraclavicular area of the
chest. They are the first lymph nodes that a cancer lesion will drain into. Therefore, when cancer is diagnosed,
these nodes are biopsied to see whether the cancer has spread into the lymph system.
Which of the following laboratory values may be elevated on the liver function panel of a patient who is an
alcohol abusers?
A. Serum GGT
B. Serum creatinine
C. Serum Bilirubin
D. BUN –
Correct Answer :The serum gamma glutamyl transaminase may become elevated in patients who are alcohol
abusers. It can be used to screen for chronic alcohol abuse and occult alcoholism. The GGT can become elevated
in liver disease and bile duct obstruction. It is a sensitive test for detecting obstructive jaundice, cholangitis, and
cholecystitis.
All of the following are associated with emphysema except:
A. barrel-shaped chest
B. Pursed-lip breathing
C. chest radiograph result with infiltrates and flattening of the costovertebral angle
D. Dyspnea when at rest –
Correct Answer :C) A chest radiograph result with infiltrates and flattening of the costovertebral angle
Emphysema is characterized by having a barrel-shaped chest, pursed-lip breathing, and dyspnea when at rest.
Infiltrates on an x-ray indicate bacterial infection, such as pneumonia.
A split S2 heart sound is best heard at which of the following areas? A. The aortic area
P 2
, • FNP 654 FINAL 09/13/2026
EXAM
B. The pulmonic area
C. The tricuspid area
D. The mitral area –
Correct Answer :B) The pulmonic area The S2 heart sound is physiologically split in about 90% of people. The
second heart sound is produced by the closure of the aortic and pulmonic valves. The sound produced by the
closure of the aortic valve is termed A2, and the sound produced by the closure of the pulmonic valve is termed
P2. The A2 sound is normally much louder than the P2 due to higher pressures in the left side of the heart; thus,
A2 radiates to all cardiac listening posts (loudest at the right upper sternal border) and P2 is usually only heard at
the left upper sternal border.
Cluster headaches are most often seen in:
A. Adolescent girls
B. Middle-aged men
C. Elderly men
D. Postmenopausal women
- Correct Answer :B) Middle-aged men The most prominent feature of cluster headache is severe pain that is
almost always on only one side of the head, accompanied by tearing, rhinorrhea, ptosis (drooping of upper
eyelid), and miosis (constriction of the pupil). Cluster headaches occur periodically; spontaneous remissions
interrupt active periods of pain. The cause of the condition is currently unknown. It affects approximately 0.1% of
the population, and men are more commonly affected than women. The headaches typically start before age 30
An 18-year-old male patient is found to have a 47,XXY karyotype and is diagnosed with Klinefelter's syndrome.
The patient is most likely to have all of the following physical characteristics except:
A. Gynecomastia
B. Long limbs
C. Lack of secondary sexual characteristics
D. Large testes
P 3
, • FNP 654 FINAL 09/13/2026
EXAM
- Correct Answer :D) Large testes Signs and symptoms of Klinefelter's syndrome include gynecomastia, long
limbs, and lack of secondary sexual characteristics. Testes are usually small. Infertility is a major concern for these
boys. If treated early, they may have a normal sexual/reproductive system in the future.
Which of the following drugs can increase the risk of bleeding in patients who are receiving anticoagulation
therapy with warfarin sodium (Coumadin)?
A. Trimethoprim-sulfamethoxazole (Bactrim DS)
B. Carafate (Sucralfate)
C. Losartan (Cozaar)
D. Furosemide (Lasix) –
Correct Answer :A) Trimethoprim-sulfamethoxazole (Bactrim DS) Warfarin sodium (Coumadin) interacts with
Bactrim and will increase the risk of bleeding; therefore, concurrent use is contraindicated.
An adolescent female's areola, nipples, and breast tissue develop and become elevated as one mound. Which of
the following is the correct Tanner stage for this phase of breast development?
A. Tanner stage I
B. Tanner stage II
C. Tanner stage III
D. Tanner stage IV –
Correct Answer :C) Tanner stage III
During Tanner stage III, the breast and areola and nipples grow together in one mound. There is no separation
yet. At Tanner stage IV, the areola and the nipple separate to form a distinct mound. The most important clue is
"secondary mound."
The cremasteric reflex is elicited by:
A. Asking the patient to open his or her mouth and touching the back of the pharynx with a tongue blade
B. Hitting the biceps tendon briskly with a reflex hammer and watching the lower arm for movement
C. Hitting the patellar tendon briskly with a reflex hammer and watching the lower leg for movement
P 4
