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
SCHOLARSOURCE 1
,SECTION 1: MUSCULOSKELETAL AND NEUROLOGICAL DISORDERS
1. A 35-year-old female presents with bilateral hand pain, morning stiffness lasting 2 hours,
and symmetric swelling of the metacarpophalangeal and proximal interphalangeal joints.
Which laboratory test would be most specific for diagnosis?
A. Antinuclear antibody (ANA)
B. Rheumatoid factor (RF)
C. Anti-cyclic citrullinated peptide (anti-CCP)
D. Erythrocyte sedimentation rate (ESR)
Correct Answer: C. Anti-cyclic citrullinated peptide (anti-CCP)
Rationale: Anti-CCP antibodies are highly specific (approximately 95-98%) for rheumatoid
arthritis (RA) and can appear early in the disease course. The patient's presentation of
symmetric polyarthritis affecting the MCP and PIP joints with morning stiffness lasting
more than 1 hour is classic for RA. Rheumatoid factor is also associated with RA but has
lower specificity (about 70-80%) and can be positive in other conditions. ANA is associated
with systemic lupus erythematosus and other autoimmune diseases. ESR is a nonspecific
marker of inflammation and is not diagnostic of RA.
2. A patient presents with severe pain in the left great toe that began after a large meal and
alcohol consumption. The joint is red, hot, and exquisitely tender. Which medication should
be used for acute treatment?
A. Allopurinol
B. Colchicine
C. Probenecid
D. Febuxostat
Correct Answer: B. Colchicine
SCHOLARSOURCE 2
,Rationale: The presentation is classic for acute gouty arthritis triggered by dietary
indiscretion, specifically large meals and alcohol consumption. Colchicine is the first-line
treatment for acute gout when started early. It works by reducing inflammation through
inhibition of microtubule polymerization and neutrophil chemotaxis. The recommended
dosing is 1.2 mg followed by 0.6 mg one hour later. NSAIDs are also effective for acute gout.
Allopurinol and febuxostat are used for chronic urate-lowering therapy and should not be
initiated during an acute flare. Probenecid is a uricosuric agent used in chronic
management.
3. A young adult male experiences a sudden onset of acute abdominal pain radiating to his
groin. Examination reveals diffuse swelling of the left testicle and absence of the
cremasteric reflex. The most likely diagnosis is:
A. Testicular torsion
B. Inguinal Hernia
C. Testicular Cancer
D. Epididymitis
Correct Answer: A. Testicular torsion
Rationale: Testicular torsion is a surgical emergency characterized by sudden onset of
severe scrotal pain that may radiate to the groin or abdomen. The absence of the
cremasteric reflex is a highly sensitive and specific finding for testicular torsion. The
cremasteric reflex is elicited by stroking the inner thigh, which normally causes the testicle
to rise. In torsion, this reflex is absent. Other findings include a high-riding testicle,
horizontal lie, and diffuse swelling. Testicular torsion most commonly occurs in young
males aged 12-18. Emergency surgical exploration is required to salvage the testicle.
Inguinal hernia presents with a bulge that may be reducible. Testicular cancer typically
presents as a painless mass. Epididymitis presents with gradual onset of pain and is
associated with fever and urinary symptoms.
SCHOLARSOURCE 3
, 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
Correct Answer: D. Cervical Radiculopathy
SCHOLARSOURCE 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
SCHOLARSOURCE 1
,SECTION 1: MUSCULOSKELETAL AND NEUROLOGICAL DISORDERS
1. A 35-year-old female presents with bilateral hand pain, morning stiffness lasting 2 hours,
and symmetric swelling of the metacarpophalangeal and proximal interphalangeal joints.
Which laboratory test would be most specific for diagnosis?
A. Antinuclear antibody (ANA)
B. Rheumatoid factor (RF)
C. Anti-cyclic citrullinated peptide (anti-CCP)
D. Erythrocyte sedimentation rate (ESR)
Correct Answer: C. Anti-cyclic citrullinated peptide (anti-CCP)
Rationale: Anti-CCP antibodies are highly specific (approximately 95-98%) for rheumatoid
arthritis (RA) and can appear early in the disease course. The patient's presentation of
symmetric polyarthritis affecting the MCP and PIP joints with morning stiffness lasting
more than 1 hour is classic for RA. Rheumatoid factor is also associated with RA but has
lower specificity (about 70-80%) and can be positive in other conditions. ANA is associated
with systemic lupus erythematosus and other autoimmune diseases. ESR is a nonspecific
marker of inflammation and is not diagnostic of RA.
2. A patient presents with severe pain in the left great toe that began after a large meal and
alcohol consumption. The joint is red, hot, and exquisitely tender. Which medication should
be used for acute treatment?
A. Allopurinol
B. Colchicine
C. Probenecid
D. Febuxostat
Correct Answer: B. Colchicine
SCHOLARSOURCE 2
,Rationale: The presentation is classic for acute gouty arthritis triggered by dietary
indiscretion, specifically large meals and alcohol consumption. Colchicine is the first-line
treatment for acute gout when started early. It works by reducing inflammation through
inhibition of microtubule polymerization and neutrophil chemotaxis. The recommended
dosing is 1.2 mg followed by 0.6 mg one hour later. NSAIDs are also effective for acute gout.
Allopurinol and febuxostat are used for chronic urate-lowering therapy and should not be
initiated during an acute flare. Probenecid is a uricosuric agent used in chronic
management.
3. A young adult male experiences a sudden onset of acute abdominal pain radiating to his
groin. Examination reveals diffuse swelling of the left testicle and absence of the
cremasteric reflex. The most likely diagnosis is:
A. Testicular torsion
B. Inguinal Hernia
C. Testicular Cancer
D. Epididymitis
Correct Answer: A. Testicular torsion
Rationale: Testicular torsion is a surgical emergency characterized by sudden onset of
severe scrotal pain that may radiate to the groin or abdomen. The absence of the
cremasteric reflex is a highly sensitive and specific finding for testicular torsion. The
cremasteric reflex is elicited by stroking the inner thigh, which normally causes the testicle
to rise. In torsion, this reflex is absent. Other findings include a high-riding testicle,
horizontal lie, and diffuse swelling. Testicular torsion most commonly occurs in young
males aged 12-18. Emergency surgical exploration is required to salvage the testicle.
Inguinal hernia presents with a bulge that may be reducible. Testicular cancer typically
presents as a painless mass. Epididymitis presents with gradual onset of pain and is
associated with fever and urinary symptoms.
SCHOLARSOURCE 3
, 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
Correct Answer: D. Cervical Radiculopathy
SCHOLARSOURCE 4
