ANCC FNP Actual Exam Newest
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Mary, who has recently been diagnosed with lupus, complains that her hands and feet always
feel cold even in the summertime. Sometimes her fingertips become numb and turn a blue color.
The fingertips eventually turn to a dark red color. Which of the following is most likely?
A) Chronic arterial insufficiency
B) This is a normal reaction when one feels very cold
C) Peripheral vascular disease
D) Raynaud's syndrome
- Correct Answer :D) Raynaud's syndrome
Raynaud's syndrome occurs from vasospasms of the blood vessels, leading to decreased blood
supply to the hands/feet, which causes bluish discoloration, with fingertips turning a dark red
color if severe. Stress and cold weather are classic triggers for this.
Mrs. Nottam, who has a BMI of 29, has a 20-year history of primary hypertension. She has been
on hydrochlorothiazide 25 mg PO daily with excellent results. On this visit, she is complaining of
feeling thirsty all the time even though she drinks more than 10 glasses of water per day. She
reports to the nurse practitioner that she has been having this problem for about 6 months.
Upon reading the chart, the nurse practitioner notes that the last two fasting blood glucose
levels have been 140 mg/dL and 168 mg/dL. A random blood glucose is at 210 mg/dL.
Which of the following is the best treatment plan to follow at this visit?
A) Order another random blood sugar test in 2 weeks
B) Initiate a prescription of metformin (Glucophage) 500 mg PO BID
C) Order a 3-hour glucose tolerance test
D) Order a HgbA1c leve
- Correct Answer :B) Initiate a prescription of metformin (Glucophage) 500 mg PO BID
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Initiating metformin is recommended because she has met the criteria for diagnosis of diabetes.
Criteria for diagnosing type 2 diabetes: fasting blood glucose 126 mg/dL or higher on 2 separate
occasions, 2-hour blood glucose 200 mg/dL or higher during OCT with 75 g glucose load,
symptoms of diabetes (polyuria, polydipsia, polyphagia) plus random blood glucose greater than
200 mg/dL.
A newly diagnosed middle-aged type 2 diabetic wants to start an exercise program. All of the
following statements are true except:
A) If the patient is unable to eat due to illness, anti-diabetic agents can be continued with
frequent glucose monitoring
B) Strenuous exercise is contraindicated for type 2 diabetics because of a higher risk of
hypoglycemic episodes
C) Exercise increases the body's ability to metabolize glucose
D) Patients who exercise vigorously in the afternoon may have hypoglycemic episodes in the
evening or at night if they do not eat
- Correct Answer :B) Strenuous exercise is contraindicated for type 2 diabetics because of a
higher risk of hypoglycemic episodes
Exercise is recommended because exercise helps to use the glucose stores and reduce blood
sugar. Blood sugar should be monitored closely, especially if on insulin, when exercising to avoid
hypoglycemia.
What is the least common pathogen found in community-acquired atypical pneumonia?
A) Moxarella catarrhalis
B) Streptococcus pneumoniae
C) Pseudomonas aeruginosa
D) Mycoplasma pneumonia
- Correct Answer :C) Pseudomonas aeruginosa
Pseudomonas aeruginosa is an uncommon cause of CAP but is a particularly difficult bacterial
infection to treat.
All of the following are true about strawberry hemangiomas found in infants except:
A) Most will involute spontaneously by the age of 18 to 24 months
B) Watchful waiting is the most useful strategy
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C) Hemangiomas should be treated with laser therapy if they have not resolved by the age of 12
months
D) Strawberry hemangiomas are benign
- Correct Answer :C) Hemangiomas should be treated with laser therapy if they have not
resolved by the age of 12 months
True strawberry hemangiomas will eventually resolve by the time the child goes to kindergarten.
Most will reduce or disappear in the first 2 years. Laser treatment is rarely needed.
A 56-year-old mechanic is brought to your office complaining of heavy pressure in the substernal
area of his chest that is radiating to his jaw. The pain began while he was lifting up a tire. He now
appears pale and is diaphoretic. His blood pressure is 100/60 mm Hg, and his pulse rate 50.
What is the most appropriate action?
A) Perform a 12-lead EKG
B) Dial 9-1-1
C) Administer a morphine injection for pain
D) Observe the patient in the office
- Correct Answer :B) Dial 9-1-1
Heavy chest pressure in the substernal area, radiating to the jaw, diaphoresis, low BP, and
bradycardia are signs of cardiac distress and 9-1-1 should be called immediately for transfer to
the emergency department.
Which of the following is indicated for initial treatment of an uncomplicated case of Helicobacter
pylori negative peptic ulcer disease?
A) Omeprazole (Prilosec)
B) Misoprostol (Cytotec)
C) Ranitidine (Zantac)
D) Pepto-Bismol tablets
- Correct Answer :B) Misoprostol (Cytotec)
Misoprostol is recommended for short-term, uncomplicated PUD; it acts by decreasing gastric
acid production and enhancing mucosal resistance to injury.
Erythromycin inhibits the cytochrome P-450 system. The following drugs should be avoided
because of a potential for a drug interaction except:
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A) Theophylline (Theo-Dur)
B) Warfarin (Coumadin)
C) Diazepam (Valium)
D) Furosemide (Lasix)
- Correct Answer :D) Furosemide (Lasix)
There are many medications that are contraindicated with the cytochrome P-450 system. Lasix is
one medication that can be used.
If left untreated, Zollinger-Ellison syndrome can cause which of the following?
A) Severe ulceration of the stomach or duodenum
B) Toxic megacolon
C) Chronic diarrhea
D) Malabsorption of fat-soluble vitamins
- Correct Answer :A) Severe ulceration of the stomach or duodenum
Untreated Zollinger-Ellison syndrome can lead to severe ulceration of the stomach or
duodenum. Zollinger- Ellison syndrome occurs when tumors (gastrinomas) in the intestine,
pancreas, or lymph nodes near the pancreas produce excessive amounts of gastrin, which in turn
will increase the amount of acid produced by the stomach. High amounts of acid in the stomach
will produce ulceration of the stomach or duodenum.
All of the following are considered Category X drugs except:
A) Misoprostol (Cytotec)
B) Isotretinoin (Accutane)
C) Finasteride (Proscar)
D) Meperidine (Demerol)
- Correct Answer :D) Meperidine (Demerol)
Demerol is in drug Category C and and treated by the FDA as a controlled drug Schedule II.
You note, during a physical exam on a 6-year-old child, some pitting on the finger nails. This
finding is correlated with:
A) Iron-deficiency anemia
B) Psoriasis
C) Onychomycosis
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