• 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 bell of the stethoscope is best used for auscultation of which of the following?
A. S3 and S4 and low-pitched tones
B. S3 and S4 only
C. S1 and S2 and high-pitched tones
P 1
, • FNP 654 FINAL 09/13/2026
EXAM
D. S1 and S2 only - Correct Answer :A) S3 and S4 and low-pitched tones The bell is most useful for picking up
low-pitched sounds; for example, S3, S4, and mitral stenosis. The diaphragm is most useful for picking up high-
pitched sounds; for example, S1, S2, aortic or mitral regurgitation, and pericardial friction rubs.
A 13-year-old boy wants to be treated for his acne. He has a large number of closed and open comedones on his
face. The patient has been treating himself with over-the-counter benzoyl peroxide and topical salicylic acid
products. Which of the following would be recommended next?
A. Isotretinoin (Accutane)
B. Tetracycline
C. Retin-A 0.25% gel
D. Careful face washing with medicated soap at bedtime - Correct Answer :C) Retin-A 0.25% gel Topical agents
are the first-line treatment for acne vulgaris. Retin-A 0.25% gel would be the next step. Oral preparations
(tetracycline) would then be offered, and Accutane would be the final step
The major difference between the quasi-experimental design and the experimental design is which of the
following?
A. The quasi-experimental design is a type of observational study
B. The quasi-experimental design uses convenience sampling instead of random sampling to recruit subjects
C. The quasi-experimental design is also known as a survey
D. The quasi-experimental design does not have an intervention group - Correct Answer :B) The quasi-
experimental design uses convenience sampling instead of random sampling to recruit subjects The quasi-
experimental design uses an intervention (it is not an observational study or a survey). It has many similarities to
an experimental study except that the human subjects are recruited by convenience and not at random (as in an
experimental study).
A mother brings in her 6-year-old daughter to see the nurse practitioner (NP). She complains that the school
nurse found a few nits in her daughter's hair. The mother states that the school has a "no nits" policy regarding
head lice and her daughter cannot go back to school until all the nits have been removed. The child was treated
with permethrin shampoo (Nix) twice about 3 months ago. During the physical exam, the NP sees a few nits that
are about 2 inches away from the scalp. The child denies itchiness on her scalp. Which of the following is the best
action for the NP to follow?
A. Prescribe lindane (Kwell) for the child because she may have head lice that are resistant to permethrin
B. Advise the mother to use a nit comb after spraying the child's hair with white distilled vinegar, wait for 15
minutes, and then rinse the hair
P 2
, • FNP 654 FINAL 09/13/2026
EXAM
C. Advise the mother to retreat the child with permethrin cream instead of shampoo - Correct Answer :B)
Advise the mother to use a nit comb after spraying the child's hair with white distilled vinegar, wait for 15
minutes, and then rinse the hair According to the Centers for Disease Control and Prevention (CDC), nits that are
more than ¼ inch from the scalp are usually not viable. The child also does not have an itchy scalp. One method
of removal is to soak the patient's head with distilled vinegar (and then rinse after), which will break down the
protein of the nit casings, making it easy to comb them out of the hair.
What is the pedigree symbol for a diseased male?
A. An empty square
B. An empty circle
C. A filled-in square
D. A filled-in circle - Correct Answer :C) A filled-in square A filled-in square is a diseased or affected male and a
filled-in circle is a diseased or affected female. An empty square is a healthy male and an empty circle is a healthy
female.
Systemic lupus erythematosus (SLE) is more common among patients from all of the following ethnic and racial
backgrounds except:
A. African American
B. Asian
C. Hispanic
D. Caucasian - Correct Answer :D) Caucasian Lupus is more common among women of African American, Asian,
Hispanic, and Native American backgrounds than in Caucasian women.
A homeless 47-year-old man with a history of injection drug use and alcohol abuse presents to the public health
clinic with a recent history of fever, night sweats, fatigue, and weakness. The patient has recently noticed some
thin red streaks on his nailbed and red bumps on some of his fingers that hurt. During the cardiac exam, the
nurse practitioner hears a grade 3/6 murmur over the mitral area. The subcutaneous red-purple nodules are
tender to palpation. The thin red lines on the nailbeds resemble subungual splinter hemorrhages. Which of the
following conditions is most likely?
A. Pericarditis
B. Acute bacterial endocarditis
C. Rheumatic fever
P 3
, • FNP 654 FINAL 09/13/2026
EXAM
D. Viral cardiomyopathy - Correct Answer :B) Acute bacterial endocarditis Bacterial endocarditis is also known as
infective endocarditis (IC). It is a serious bacterial infection of the heart valves and the endocardial surface. The
bacteria most commonly involved are Staphylococcus and Streptococcus species. Subcutaneous red painful
nodules on the finger pads are called Osler's nodes. Subungual splinter hemorrhages on the nailbeds are caused
by microemboli. Janeway's lesions are caused by bleeding under the skin (usually located on the palms and the
soles) and are painless red papules and macules. Other findings are conjunctival hemorrhages, petechiae, cardiac
friction rubs, arrhythmias, murmurs, and others. Three blood cultures obtained at separate sites 1 hour apart are
used to identify the causative organism. Some of the risk factors are damaged prosthetic valves, history of
rheumatic fever, and injection drug use
Which of the following pathogenic bacteria are commonly found in the lungs of older children and adults with
cystic fibrosis?
A. Streptococcus pneumoniae
B. Chlamydia pneumoniae
C. Pseudomonas aeruginosa
D. Staphylococcus aureu - Correct Answer :C) Pseudomonas aeruginosa
P. aeruginosa is a common chronic lung infection seen in older children and adults with cystic fibrosis. This
infection is difficult to eliminate and sometimes is the cause of death.
A 15-month-old who is eating and behaving normally is found to have a high fever. After a few days, the fever
resolves and the child breaks out in a maculopapular rash. This is a description of which of the following
conditions?
A. Erythema infectiosum
B. Roseola infantum
C. Fifth disease
D. Scarlet fever - Correct Answer :B) Roseola infantum Roseola infantum is caused by herpes virus 6 (HHV-6).
The signs and symptoms of roseola infantum include high fever for a few days with a maculopapular rash
occurring after the fever breaks. Febrile seizures occur in up to 15% of infants. Fifth disease (erythema
infectiosum) is caused by parvovirus B 19 . It causes a red facial rash or "slapped cheek" appearance; in a few
days a lacy-appearing rash appears on the trunk, arms, and legs. Erythema infectiosum is the same as fifth
disease. Scarlet fever is a red rash that feels like sandpaper that usually begins on the neck and trunk and
spreads to the extremities. Patients with scarlet fever have other symptoms such as fever, sore throat, and
beefy red tongue. Scarlet fever is caused by the group A Streptococcus bacterium.
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 bell of the stethoscope is best used for auscultation of which of the following?
A. S3 and S4 and low-pitched tones
B. S3 and S4 only
C. S1 and S2 and high-pitched tones
P 1
, • FNP 654 FINAL 09/13/2026
EXAM
D. S1 and S2 only - Correct Answer :A) S3 and S4 and low-pitched tones The bell is most useful for picking up
low-pitched sounds; for example, S3, S4, and mitral stenosis. The diaphragm is most useful for picking up high-
pitched sounds; for example, S1, S2, aortic or mitral regurgitation, and pericardial friction rubs.
A 13-year-old boy wants to be treated for his acne. He has a large number of closed and open comedones on his
face. The patient has been treating himself with over-the-counter benzoyl peroxide and topical salicylic acid
products. Which of the following would be recommended next?
A. Isotretinoin (Accutane)
B. Tetracycline
C. Retin-A 0.25% gel
D. Careful face washing with medicated soap at bedtime - Correct Answer :C) Retin-A 0.25% gel Topical agents
are the first-line treatment for acne vulgaris. Retin-A 0.25% gel would be the next step. Oral preparations
(tetracycline) would then be offered, and Accutane would be the final step
The major difference between the quasi-experimental design and the experimental design is which of the
following?
A. The quasi-experimental design is a type of observational study
B. The quasi-experimental design uses convenience sampling instead of random sampling to recruit subjects
C. The quasi-experimental design is also known as a survey
D. The quasi-experimental design does not have an intervention group - Correct Answer :B) The quasi-
experimental design uses convenience sampling instead of random sampling to recruit subjects The quasi-
experimental design uses an intervention (it is not an observational study or a survey). It has many similarities to
an experimental study except that the human subjects are recruited by convenience and not at random (as in an
experimental study).
A mother brings in her 6-year-old daughter to see the nurse practitioner (NP). She complains that the school
nurse found a few nits in her daughter's hair. The mother states that the school has a "no nits" policy regarding
head lice and her daughter cannot go back to school until all the nits have been removed. The child was treated
with permethrin shampoo (Nix) twice about 3 months ago. During the physical exam, the NP sees a few nits that
are about 2 inches away from the scalp. The child denies itchiness on her scalp. Which of the following is the best
action for the NP to follow?
A. Prescribe lindane (Kwell) for the child because she may have head lice that are resistant to permethrin
B. Advise the mother to use a nit comb after spraying the child's hair with white distilled vinegar, wait for 15
minutes, and then rinse the hair
P 2
, • FNP 654 FINAL 09/13/2026
EXAM
C. Advise the mother to retreat the child with permethrin cream instead of shampoo - Correct Answer :B)
Advise the mother to use a nit comb after spraying the child's hair with white distilled vinegar, wait for 15
minutes, and then rinse the hair According to the Centers for Disease Control and Prevention (CDC), nits that are
more than ¼ inch from the scalp are usually not viable. The child also does not have an itchy scalp. One method
of removal is to soak the patient's head with distilled vinegar (and then rinse after), which will break down the
protein of the nit casings, making it easy to comb them out of the hair.
What is the pedigree symbol for a diseased male?
A. An empty square
B. An empty circle
C. A filled-in square
D. A filled-in circle - Correct Answer :C) A filled-in square A filled-in square is a diseased or affected male and a
filled-in circle is a diseased or affected female. An empty square is a healthy male and an empty circle is a healthy
female.
Systemic lupus erythematosus (SLE) is more common among patients from all of the following ethnic and racial
backgrounds except:
A. African American
B. Asian
C. Hispanic
D. Caucasian - Correct Answer :D) Caucasian Lupus is more common among women of African American, Asian,
Hispanic, and Native American backgrounds than in Caucasian women.
A homeless 47-year-old man with a history of injection drug use and alcohol abuse presents to the public health
clinic with a recent history of fever, night sweats, fatigue, and weakness. The patient has recently noticed some
thin red streaks on his nailbed and red bumps on some of his fingers that hurt. During the cardiac exam, the
nurse practitioner hears a grade 3/6 murmur over the mitral area. The subcutaneous red-purple nodules are
tender to palpation. The thin red lines on the nailbeds resemble subungual splinter hemorrhages. Which of the
following conditions is most likely?
A. Pericarditis
B. Acute bacterial endocarditis
C. Rheumatic fever
P 3
, • FNP 654 FINAL 09/13/2026
EXAM
D. Viral cardiomyopathy - Correct Answer :B) Acute bacterial endocarditis Bacterial endocarditis is also known as
infective endocarditis (IC). It is a serious bacterial infection of the heart valves and the endocardial surface. The
bacteria most commonly involved are Staphylococcus and Streptococcus species. Subcutaneous red painful
nodules on the finger pads are called Osler's nodes. Subungual splinter hemorrhages on the nailbeds are caused
by microemboli. Janeway's lesions are caused by bleeding under the skin (usually located on the palms and the
soles) and are painless red papules and macules. Other findings are conjunctival hemorrhages, petechiae, cardiac
friction rubs, arrhythmias, murmurs, and others. Three blood cultures obtained at separate sites 1 hour apart are
used to identify the causative organism. Some of the risk factors are damaged prosthetic valves, history of
rheumatic fever, and injection drug use
Which of the following pathogenic bacteria are commonly found in the lungs of older children and adults with
cystic fibrosis?
A. Streptococcus pneumoniae
B. Chlamydia pneumoniae
C. Pseudomonas aeruginosa
D. Staphylococcus aureu - Correct Answer :C) Pseudomonas aeruginosa
P. aeruginosa is a common chronic lung infection seen in older children and adults with cystic fibrosis. This
infection is difficult to eliminate and sometimes is the cause of death.
A 15-month-old who is eating and behaving normally is found to have a high fever. After a few days, the fever
resolves and the child breaks out in a maculopapular rash. This is a description of which of the following
conditions?
A. Erythema infectiosum
B. Roseola infantum
C. Fifth disease
D. Scarlet fever - Correct Answer :B) Roseola infantum Roseola infantum is caused by herpes virus 6 (HHV-6).
The signs and symptoms of roseola infantum include high fever for a few days with a maculopapular rash
occurring after the fever breaks. Febrile seizures occur in up to 15% of infants. Fifth disease (erythema
infectiosum) is caused by parvovirus B 19 . It causes a red facial rash or "slapped cheek" appearance; in a few
days a lacy-appearing rash appears on the trunk, arms, and legs. Erythema infectiosum is the same as fifth
disease. Scarlet fever is a red rash that feels like sandpaper that usually begins on the neck and trunk and
spreads to the extremities. Patients with scarlet fever have other symptoms such as fever, sore throat, and
beefy red tongue. Scarlet fever is caused by the group A Streptococcus bacterium.
P 4
