Page | 1
ANCC FNP BOARD QUESTIONS WITH
DETAILED VERIFIED ANSWERS
A middle-age female patient presents to the clinic with a recurrence of
mild hidradenitis suppurativa after topical therapies failed. Which first-
line treatment is recommended? Ans: Tetracycline
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-
line treatment for hidradenitis suppurativa.
__________________________________________________
Hidradenitis suppurativa is a disorder of the terminal follicular epithelium
in apocrine gland-bearing skin. It is a chronic, disabling disorder that
progresses, often causing keloids, contractures, and immobility. It is
characterized by comedone-like follicular occlusion, chronic and relapsing
inflammation, mucopurulent discharge, and progressive scarring.
Arthropathy associated with hidradenitis may be present. Typical
presentation includes nodules and sinus tracts (inflamed or noninflamed),
abscesses, and scarring found in the axilla, genitofemoral area,
perineum, gluteal area, and inframammary area in women.
Recommended treatments include antibiotics, steroids, retinoids,
dapsone, and anti-tumor necrosis factor agents. A dermatology
consultation should also be considered.
First-line treatment is a 12‑week course of an oral tetracycline (Sumycin)
such as doxycycline. For patients who do not respond to doxycycline, the
next recommended step is a combination of twice-daily clindamycin
(Cleocin) and rifampicin (Rifadin) for 10-12 weeks. If treatment fails,
acitretin (Soriatane, for males and nonfertile females) or dapsone
(Aczone) may be considered by a dermatologist. In patients with
moderate to severe hidradenitis suppurativa, adalimumab (Humira) may
possibly be considered.
When providing culturally competent health care services to an American
Indian elder, the nurse practitioner understands which is traditionally
, Page | 2
true? Ans: The "Medicine Wheel" is used by many for the purpose of
health and healing
The "Medicine Wheel" is traditionally used and contains four directions;
north, south, east, and west. Traditionally each tribe has different
meanings for each direction and they may represent the season of the
year or stage of life. It is aimed at providing a holistic view of life.
________________________________________
An understanding of different cultural preferences leads to cultural
competence in healthcare. Some patients may value traditional culture
and preferences as it relates to healthcare. These individual preferences
should be included in the interview and treatment plan for patients.
Traditionally, the American Indian culture values a holistic approach to
health care integrating the person, lifestyle, environment, family, and
religion. Patients adhering to these traditional cultural practices often feel
that illness is due to a lack of harmony with the physical body, mind,
spirit, and emotions. Patients may seek care from western medicine for
specific ailments while also consulting with traditional healers for spiritual
guidance.
Healthcare providers should seek to understand relevant cultural factors
and assess each individual's healthcare literacy in order to provide
culturally competent care.
The nurse practitioner sees an older adult patient in the clinic with the
primary report of hearing loss and a sensation of fullness in the right ear.
The nurse practitioner suspects conductive hearing loss. Which could
contribute to this? Ans: Cerumen, commonly called earwax, is a
combination of secretions and sloughed epithelial cells that protects the
ears from infection, water, and insects. It is normally expelled from the
ear canal through natural jaw movement. When this self-cleaning process
fails, cerumen can become impacted. Cerumen impaction occludes the
ear canal and can press against the tympanic membrane, resulting in
conductive hearing loss.
_________________________________________
, Page | 3
Conductive hearing is the transition of sound from the external and
middle ear to the inner ear. Conductive hearing loss is caused by
problems in the external and middle ear that interfere with the
transmission of sound and its conversion to mechanical vibration. Causes
of conductive hearing loss include obstruction of the external auditory
canal by cerumen, foreign bodies, debris from otitis externa, and large
exocytosis and osteomas.
Sensorineural hearing loss involves difficulty converting mechanical
vibrations to electrical potential in the cochlea or in auditory nerve
transmission to the brain. It is mostly caused by permanent damage in
the organ of Corti. It can be caused by age-related hearing loss, noise
trauma, medications, autoimmune diseases, mechanical trauma, Meniere
disease, infection, and neoplasm (acoustic neuroma).
Approximately one-third of older adults between the ages of 61 and 70
years have hearing loss. More than 90% of adults older than 85 years of
age have hearing loss. The most common type of hearing loss is age-
related and sensorineural. All adults older than 60 years of age should be
screened for hearing loss at periodic health examinations.
An otherwise healthy adult patient presents to the clinic with a diagnosis
of community-acquired pneumonia and no recent antibiotic therapy.
Which is the best option for treatment? Ans: Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-
line therapy for adults without comorbidities.
_____________________________________________
Community-acquired pneumonia (CAP) is pneumonia not acquired in a
hospital or long-term care facility. Patients with suspected CAP should
receive a chest X-ray for diagnosis. The Pneumonia Severity Index should
be used to assist in decisions regarding the need for hospitalization in
patients with CAP.
According to the American Thoracic Society (ATS) and the Infectious
Diseases Society of America (IDSA) 2019 guidelines, the initial treatment
of CAP for most patients is amoxicillin or doxycycline. Macrolides are an
option for treatment, but are no longer recommended routinely as first-
ANCC FNP BOARD QUESTIONS WITH
DETAILED VERIFIED ANSWERS
A middle-age female patient presents to the clinic with a recurrence of
mild hidradenitis suppurativa after topical therapies failed. Which first-
line treatment is recommended? Ans: Tetracycline
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-
line treatment for hidradenitis suppurativa.
__________________________________________________
Hidradenitis suppurativa is a disorder of the terminal follicular epithelium
in apocrine gland-bearing skin. It is a chronic, disabling disorder that
progresses, often causing keloids, contractures, and immobility. It is
characterized by comedone-like follicular occlusion, chronic and relapsing
inflammation, mucopurulent discharge, and progressive scarring.
Arthropathy associated with hidradenitis may be present. Typical
presentation includes nodules and sinus tracts (inflamed or noninflamed),
abscesses, and scarring found in the axilla, genitofemoral area,
perineum, gluteal area, and inframammary area in women.
Recommended treatments include antibiotics, steroids, retinoids,
dapsone, and anti-tumor necrosis factor agents. A dermatology
consultation should also be considered.
First-line treatment is a 12‑week course of an oral tetracycline (Sumycin)
such as doxycycline. For patients who do not respond to doxycycline, the
next recommended step is a combination of twice-daily clindamycin
(Cleocin) and rifampicin (Rifadin) for 10-12 weeks. If treatment fails,
acitretin (Soriatane, for males and nonfertile females) or dapsone
(Aczone) may be considered by a dermatologist. In patients with
moderate to severe hidradenitis suppurativa, adalimumab (Humira) may
possibly be considered.
When providing culturally competent health care services to an American
Indian elder, the nurse practitioner understands which is traditionally
, Page | 2
true? Ans: The "Medicine Wheel" is used by many for the purpose of
health and healing
The "Medicine Wheel" is traditionally used and contains four directions;
north, south, east, and west. Traditionally each tribe has different
meanings for each direction and they may represent the season of the
year or stage of life. It is aimed at providing a holistic view of life.
________________________________________
An understanding of different cultural preferences leads to cultural
competence in healthcare. Some patients may value traditional culture
and preferences as it relates to healthcare. These individual preferences
should be included in the interview and treatment plan for patients.
Traditionally, the American Indian culture values a holistic approach to
health care integrating the person, lifestyle, environment, family, and
religion. Patients adhering to these traditional cultural practices often feel
that illness is due to a lack of harmony with the physical body, mind,
spirit, and emotions. Patients may seek care from western medicine for
specific ailments while also consulting with traditional healers for spiritual
guidance.
Healthcare providers should seek to understand relevant cultural factors
and assess each individual's healthcare literacy in order to provide
culturally competent care.
The nurse practitioner sees an older adult patient in the clinic with the
primary report of hearing loss and a sensation of fullness in the right ear.
The nurse practitioner suspects conductive hearing loss. Which could
contribute to this? Ans: Cerumen, commonly called earwax, is a
combination of secretions and sloughed epithelial cells that protects the
ears from infection, water, and insects. It is normally expelled from the
ear canal through natural jaw movement. When this self-cleaning process
fails, cerumen can become impacted. Cerumen impaction occludes the
ear canal and can press against the tympanic membrane, resulting in
conductive hearing loss.
_________________________________________
, Page | 3
Conductive hearing is the transition of sound from the external and
middle ear to the inner ear. Conductive hearing loss is caused by
problems in the external and middle ear that interfere with the
transmission of sound and its conversion to mechanical vibration. Causes
of conductive hearing loss include obstruction of the external auditory
canal by cerumen, foreign bodies, debris from otitis externa, and large
exocytosis and osteomas.
Sensorineural hearing loss involves difficulty converting mechanical
vibrations to electrical potential in the cochlea or in auditory nerve
transmission to the brain. It is mostly caused by permanent damage in
the organ of Corti. It can be caused by age-related hearing loss, noise
trauma, medications, autoimmune diseases, mechanical trauma, Meniere
disease, infection, and neoplasm (acoustic neuroma).
Approximately one-third of older adults between the ages of 61 and 70
years have hearing loss. More than 90% of adults older than 85 years of
age have hearing loss. The most common type of hearing loss is age-
related and sensorineural. All adults older than 60 years of age should be
screened for hearing loss at periodic health examinations.
An otherwise healthy adult patient presents to the clinic with a diagnosis
of community-acquired pneumonia and no recent antibiotic therapy.
Which is the best option for treatment? Ans: Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-
line therapy for adults without comorbidities.
_____________________________________________
Community-acquired pneumonia (CAP) is pneumonia not acquired in a
hospital or long-term care facility. Patients with suspected CAP should
receive a chest X-ray for diagnosis. The Pneumonia Severity Index should
be used to assist in decisions regarding the need for hospitalization in
patients with CAP.
According to the American Thoracic Society (ATS) and the Infectious
Diseases Society of America (IDSA) 2019 guidelines, the initial treatment
of CAP for most patients is amoxicillin or doxycycline. Macrolides are an
option for treatment, but are no longer recommended routinely as first-
