FNP BOARD REVIEW EXAMINATION
400 Questions with Correct Answers and Detailed Rationales
ACTUAL FNP Boards 2026-2027 Review
FNP BOARD REVIEW EXAMINATION - TABLE OF CONTENTS
SECTION 1: MUSCULOSKELETAL AND NEUROLOGICAL DISORDERS .................. Questions 1-16
SECTION 2: GASTROINTESTINAL AND ABDOMINAL DISORDERS ................... Questions 17-30
SECTION 3: CARDIOLOGY AND VASCULAR DISORDERS .......................... Questions 31-50
SECTION 4: RESPIRATORY DISORDERS ...................................... Questions 51-65
SECTION 5: INFECTIOUS DISEASES ........................................ Questions 66-80
SECTION 6: DERMATOLOGICAL DISORDERS ................................... Questions 81-95
SECTION 7: ENDOCRINE AND METABOLIC DISORDERS ......................... Questions 96-110
SECTION 8: UROLOGICAL AND RENAL DISORDERS ............................ Questions 111-120
SECTION 9: REPRODUCTIVE HEALTH ....................................... Questions 121-130
SECTION 10: PSYCHIATRIC AND NEUROLOGICAL DISORDERS ................... Questions 131-140
SECTION 11: PEDIATRICS ............................................... Questions 141-150
SECTION 12: GERIATRICS ............................................... Questions 151-155
SECTION 13: EMERGENCY AND URGENT CARE ............................... Questions 156-160
SECTION 14: PREVENTIVE HEALTH ........................................ Questions 161-165
SECTION 15: PHARMACOLOGY ............................................. Questions 166-175
SECTION 16: LABORATORY AND DIAGNOSTIC TESTS .......................... Questions 176-180
SECTION 17: ETHICS AND LEGAL ISSUES .................................. Questions 181-185
SECTION 18: CULTURAL COMPETENCE ...................................... Questions 186-190
SECTION 19: RESEARCH AND EVIDENCE-BASED PRACTICE ..................... Questions 191-195
SECTION 20: COMMUNICATION AND PATIENT EDUCATION ...................... Questions 196-200
SECTION 21: OPHTHALMOLOGY AND EYE DISORDERS .......................... Questions 201-400
[1]
,SECTION 1: MUSCULOSKELETAL AND NEUROLOGICAL DISORDERS
1. An adult presents after a weekend of golfing with new onset pain and tenderness in the
low back and pain in the right great toe. The patient denies experiencing numbness and
tingling. The nurse practitioner knows the injury is most likely
A. T12 nerve root
B. L3 nerve root
C. L5 nerve root
D. L1 nerve root
Correct Answer: C. L5 nerve root
Rationale: The L5 nerve root innervates the great toe and contributes to the lumbosacral
plexus. Pain in the great toe with low back pain following a weekend of golfing suggests L5
radiculopathy. The L5 nerve root provides sensation to the medial aspect of the foot and
great toe, as well as motor function for foot dorsiflexion. Golfing involves repetitive
twisting motions that can exacerbate underlying degenerative disc disease or facet joint
pathology at the L4-L5 level. The absence of numbness and tingling suggests a mechanical
rather than neuropathic process, though radicular symptoms are still possible. T12 and L1
nerve roots do not typically cause pain radiating to the great toe, as they innervate the
lower abdominal and upper thigh regions. L3 nerve root affects the anterior thigh and knee
area.
2. A 45-year-old patient presents with acute onset of severe low back pain radiating down
the posterior thigh and calf, accompanied by foot drop. The patient reports difficulty
walking and a "pins and needles" sensation in the lateral foot. Which nerve root is most
likely affected?
A. L3
B. L4
C. L5
[2]
,D. S1
Correct Answer: D. S1
Rationale: S1 radiculopathy is characterized by pain radiating down the posterior thigh and
calf to the lateral foot, accompanied by decreased ankle reflex and possible foot weakness.
Foot drop is more commonly associated with L5 nerve root involvement, but the
combination of posterior leg pain, lateral foot paresthesias, and ankle reflex changes points
to S1 pathology. The S1 nerve root contributes to the sciatic nerve and innervates the
gastrocnemius muscle, which is responsible for plantar flexion. A positive straight leg raise
test often reproduces symptoms in S1 radiculopathy. MRI would confirm disc herniation at
the L5-S1 level in most cases.
3. An adult athlete presents with painful, erythematous, non-pustular firm cysts, which are
not the result of an injury. The patient was afebrile and started on cephalexin (Keflex). Two
days later, the patient returns with fluctuant, pustular, larger lesions that are more painful.
After collecting culture, the nurse practitioner should:
A. switch to trimethoprim-sulfamethoxazole (Bactrim).
B. switch to ciprofloxacin (Cipro).
C. continue with cephalexin (Keflex).
D. switch to amoxicillin (Amoxil).
Correct Answer: A. switch to trimethoprim-sulfamethoxazole (Bactrim).
Rationale: The patient's condition has worsened despite cephalexin therapy, suggesting
infection with a resistant organism, most likely community-acquired methicillin-resistant
Staphylococcus aureus (CA-MRSA). CA-MRSA is a common cause of skin and soft tissue
infections in athletes due to close contact and shared equipment. Cephalexin is a first-
generation cephalosporin that is ineffective against MRSA. Trimethoprim-sulfamethoxazole
(Bactrim) is a first-line agent for CA-MRSA skin infections, along with doxycycline and
clindamycin. The development of fluctuance indicates abscess formation, which may
require incision and drainage in addition to antibiotic therapy. Ciprofloxacin has poor
[3]
, activity against MRSA and is not recommended for skin infections. Amoxicillin is also
ineffective against MRSA and provides no additional coverage beyond cephalexin.
4. A 55-year-old patient presents with gradual onset of low back pain that worsens with
standing and improves with sitting. The patient also reports pain in both buttocks and
thighs. Which condition is most likely?
A. Lumbar spinal stenosis
B. Herniated nucleus pulposus
C. Ankylosing spondylitis
D. Spondylolisthesis
Correct Answer: A. Lumbar spinal stenosis
Rationale: Lumbar spinal stenosis is characterized by neurogenic claudication, where pain
worsens with standing and walking and improves with sitting or forward flexion. This
occurs because sitting decreases lumbar lordosis and increases the spinal canal diameter,
relieving pressure on the cauda equina. The typical patient is over 50 years old with
degenerative changes. Symptoms include bilateral buttock and thigh pain, numbness, and
weakness. Herniated nucleus pulposus typically causes unilateral radicular pain that
worsens with sitting and improves with standing. Ankylosing spondylitis is associated with
morning stiffness and improves with activity. Spondylolisthesis causes mechanical back
pain that worsens with extension.
5. A patient presents with neck pain, headaches, and progressive right shoulder pain that
radiates from the forearm and worsens with activity. The shoulder examination is negative.
What diagnosis is most likely?
A. Cholecystitis
B. Unstable Angina
C. Humeral Enchondroma
D. Cervical Radiculopathy
[4]
400 Questions with Correct Answers and Detailed Rationales
ACTUAL FNP Boards 2026-2027 Review
FNP BOARD REVIEW EXAMINATION - TABLE OF CONTENTS
SECTION 1: MUSCULOSKELETAL AND NEUROLOGICAL DISORDERS .................. Questions 1-16
SECTION 2: GASTROINTESTINAL AND ABDOMINAL DISORDERS ................... Questions 17-30
SECTION 3: CARDIOLOGY AND VASCULAR DISORDERS .......................... Questions 31-50
SECTION 4: RESPIRATORY DISORDERS ...................................... Questions 51-65
SECTION 5: INFECTIOUS DISEASES ........................................ Questions 66-80
SECTION 6: DERMATOLOGICAL DISORDERS ................................... Questions 81-95
SECTION 7: ENDOCRINE AND METABOLIC DISORDERS ......................... Questions 96-110
SECTION 8: UROLOGICAL AND RENAL DISORDERS ............................ Questions 111-120
SECTION 9: REPRODUCTIVE HEALTH ....................................... Questions 121-130
SECTION 10: PSYCHIATRIC AND NEUROLOGICAL DISORDERS ................... Questions 131-140
SECTION 11: PEDIATRICS ............................................... Questions 141-150
SECTION 12: GERIATRICS ............................................... Questions 151-155
SECTION 13: EMERGENCY AND URGENT CARE ............................... Questions 156-160
SECTION 14: PREVENTIVE HEALTH ........................................ Questions 161-165
SECTION 15: PHARMACOLOGY ............................................. Questions 166-175
SECTION 16: LABORATORY AND DIAGNOSTIC TESTS .......................... Questions 176-180
SECTION 17: ETHICS AND LEGAL ISSUES .................................. Questions 181-185
SECTION 18: CULTURAL COMPETENCE ...................................... Questions 186-190
SECTION 19: RESEARCH AND EVIDENCE-BASED PRACTICE ..................... Questions 191-195
SECTION 20: COMMUNICATION AND PATIENT EDUCATION ...................... Questions 196-200
SECTION 21: OPHTHALMOLOGY AND EYE DISORDERS .......................... Questions 201-400
[1]
,SECTION 1: MUSCULOSKELETAL AND NEUROLOGICAL DISORDERS
1. An adult presents after a weekend of golfing with new onset pain and tenderness in the
low back and pain in the right great toe. The patient denies experiencing numbness and
tingling. The nurse practitioner knows the injury is most likely
A. T12 nerve root
B. L3 nerve root
C. L5 nerve root
D. L1 nerve root
Correct Answer: C. L5 nerve root
Rationale: The L5 nerve root innervates the great toe and contributes to the lumbosacral
plexus. Pain in the great toe with low back pain following a weekend of golfing suggests L5
radiculopathy. The L5 nerve root provides sensation to the medial aspect of the foot and
great toe, as well as motor function for foot dorsiflexion. Golfing involves repetitive
twisting motions that can exacerbate underlying degenerative disc disease or facet joint
pathology at the L4-L5 level. The absence of numbness and tingling suggests a mechanical
rather than neuropathic process, though radicular symptoms are still possible. T12 and L1
nerve roots do not typically cause pain radiating to the great toe, as they innervate the
lower abdominal and upper thigh regions. L3 nerve root affects the anterior thigh and knee
area.
2. A 45-year-old patient presents with acute onset of severe low back pain radiating down
the posterior thigh and calf, accompanied by foot drop. The patient reports difficulty
walking and a "pins and needles" sensation in the lateral foot. Which nerve root is most
likely affected?
A. L3
B. L4
C. L5
[2]
,D. S1
Correct Answer: D. S1
Rationale: S1 radiculopathy is characterized by pain radiating down the posterior thigh and
calf to the lateral foot, accompanied by decreased ankle reflex and possible foot weakness.
Foot drop is more commonly associated with L5 nerve root involvement, but the
combination of posterior leg pain, lateral foot paresthesias, and ankle reflex changes points
to S1 pathology. The S1 nerve root contributes to the sciatic nerve and innervates the
gastrocnemius muscle, which is responsible for plantar flexion. A positive straight leg raise
test often reproduces symptoms in S1 radiculopathy. MRI would confirm disc herniation at
the L5-S1 level in most cases.
3. An adult athlete presents with painful, erythematous, non-pustular firm cysts, which are
not the result of an injury. The patient was afebrile and started on cephalexin (Keflex). Two
days later, the patient returns with fluctuant, pustular, larger lesions that are more painful.
After collecting culture, the nurse practitioner should:
A. switch to trimethoprim-sulfamethoxazole (Bactrim).
B. switch to ciprofloxacin (Cipro).
C. continue with cephalexin (Keflex).
D. switch to amoxicillin (Amoxil).
Correct Answer: A. switch to trimethoprim-sulfamethoxazole (Bactrim).
Rationale: The patient's condition has worsened despite cephalexin therapy, suggesting
infection with a resistant organism, most likely community-acquired methicillin-resistant
Staphylococcus aureus (CA-MRSA). CA-MRSA is a common cause of skin and soft tissue
infections in athletes due to close contact and shared equipment. Cephalexin is a first-
generation cephalosporin that is ineffective against MRSA. Trimethoprim-sulfamethoxazole
(Bactrim) is a first-line agent for CA-MRSA skin infections, along with doxycycline and
clindamycin. The development of fluctuance indicates abscess formation, which may
require incision and drainage in addition to antibiotic therapy. Ciprofloxacin has poor
[3]
, activity against MRSA and is not recommended for skin infections. Amoxicillin is also
ineffective against MRSA and provides no additional coverage beyond cephalexin.
4. A 55-year-old patient presents with gradual onset of low back pain that worsens with
standing and improves with sitting. The patient also reports pain in both buttocks and
thighs. Which condition is most likely?
A. Lumbar spinal stenosis
B. Herniated nucleus pulposus
C. Ankylosing spondylitis
D. Spondylolisthesis
Correct Answer: A. Lumbar spinal stenosis
Rationale: Lumbar spinal stenosis is characterized by neurogenic claudication, where pain
worsens with standing and walking and improves with sitting or forward flexion. This
occurs because sitting decreases lumbar lordosis and increases the spinal canal diameter,
relieving pressure on the cauda equina. The typical patient is over 50 years old with
degenerative changes. Symptoms include bilateral buttock and thigh pain, numbness, and
weakness. Herniated nucleus pulposus typically causes unilateral radicular pain that
worsens with sitting and improves with standing. Ankylosing spondylitis is associated with
morning stiffness and improves with activity. Spondylolisthesis causes mechanical back
pain that worsens with extension.
5. A patient presents with neck pain, headaches, and progressive right shoulder pain that
radiates from the forearm and worsens with activity. The shoulder examination is negative.
What diagnosis is most likely?
A. Cholecystitis
B. Unstable Angina
C. Humeral Enchondroma
D. Cervical Radiculopathy
[4]
