FNP 3P Practice Exam 1
High-Yield Study Guide
Built from the 150 tested concepts and answer rationales. Use this guide for active
recall, not as a substitute for current clinical guidelines or faculty instruction.
How to Use This Guide
First pass: read the clinical rule and cover the “Exam cue” sentence.
Second pass: import the companion flashcards and mark uncertain cards.
Final pass: practice recognizing emergencies, first tests, first-line treatments, and referral thresholds.
Core Test-Taking Framework
Stabilize before diagnosing: Airway, breathing, circulation, altered mental status, stroke signs, thunderclap
headache, meningismus, and severe respiratory distress override routine outpatient workups.
Start with the safest decisive test: Pregnancy testing precedes radiation in reproductive-age patients; ultrasound
is favored for AAA screening, infant hip dysplasia, and intussusception.
Treat the patient, not an isolated result: Confirm unexpected abnormalities when the patient is stable; avoid
antibiotics for asymptomatic bacteriuria except in defined situations such as pregnancy.
Match treatment intensity to risk: Comorbidities, pregnancy, age, organ function, frailty, and functional
impairment change drug choice, dose, and referral urgency.
Prevention
1. What imaging test is preferred for abdominal aortic aneurysm screening?
Exam cue: Abdominal ultrasonography; it is accurate, accessible, inexpensive, and avoids radiation.
11. What alcohol intake should trigger further assessment?
Exam cue: Intake above recommended limits or a binge pattern; quantify standard drinks and frequency rather than
relying on labels.
12. Who is preferentially offered a high-dose or adjuvanted influenza vaccine?
Exam cue: Adults age 65 years and older, when an age-appropriate enhanced vaccine is available.
24. Who should receive annual low-dose CT lung cancer screening?
Exam cue: Eligible adults are generally age 50–80 with at least a 20 pack-year history who currently smoke or quit
within 15 years; verify current guidance.
79. Do patients with diabetes need routine and risk-based vaccines even when A1c is controlled?
Exam cue: Yes. Diabetes increases infection risk; vaccination indications do not depend on poor glycemic control.
90. Who should be screened for hypertension?
Exam cue: All adults, with elevated office readings confirmed outside the clinic when feasible before diagnosis and
treatment.
FNP 3P Practice Exam 1 • Original study aid • Verify time-sensitive guidelines
, 120. Who may merit an earlier prostate-cancer screening discussion?
Exam cue: Higher-risk patients, including those with strong family history or certain inherited mutations; use
shared decision-making.
139. How can an adult who previously received PCV13 alone complete pneumococcal vaccination?
Exam cue: Current schedules may use PCV20 or PCV21 after the recommended interval; verify the latest CDC
schedule.
Cardiovascular
39. What score estimates stroke risk in atrial fibrillation?
Exam cue: CHA2DS2-VASc; use it with bleeding risk and current guideline thresholds to guide anticoagulation.
65. What is the preferred initial test for left-ventricular systolic function?
Exam cue: Two-dimensional transthoracic echocardiography.
126. What factors increase infective endocarditis risk?
Exam cue: Prosthetic valves, prior endocarditis, injection drug use, intracardiac devices, poor dentition, and certain
cardiac lesions.
134. Which common adult murmurs are systolic versus diastolic?
Exam cue: Aortic stenosis and mitral regurgitation are systolic; aortic regurgitation and mitral stenosis are diastolic.
141. What symptoms suggest severe aortic stenosis?
Exam cue: Exertional chest pain, syncope, and dyspnea/heart failure; symptomatic severe disease needs valve
evaluation.
147. Should a tolerated statin for secondary prevention automatically be stopped after age 75?
Exam cue: No. Continue when benefits outweigh risks and the patient tolerates therapy; reassess goals,
interactions, and frailty.
Pulmonary
23. What is EVALI?
Exam cue: Acute lung injury associated with recent vaping, often causing cough, dyspnea, chest pain, fever, GI
symptoms, and imaging opacities.
37. Where are normal vesicular breath sounds heard?
Exam cue: Over peripheral lung fields; they are soft with a longer inspiratory and short quiet expiratory phase.
63. How is exercise-induced bronchospasm prevented immediately before activity?
Exam cue: Use a rapid-acting inhaled bronchodilator shortly before exercise according to the patient’s asthma plan.
75. What is a common outpatient regimen for uncomplicated CAP in a healthy adult?
Exam cue: High-dose amoxicillin is a common first-line option; comorbidities change antibiotic selection.
88. How is mild persistent asthma commonly characterized?
Exam cue: Symptoms more than twice weekly but not daily and nocturnal awakenings about 3–4 times monthly,
with near-normal lung function.
101. What presentation is typical of COPD?
Exam cue: Progressive dyspnea, chronic productive cough, and exposure to tobacco or occupational irritants.
FNP 3P Practice Exam 1 • Original study aid • Verify time-sensitive guidelines
High-Yield Study Guide
Built from the 150 tested concepts and answer rationales. Use this guide for active
recall, not as a substitute for current clinical guidelines or faculty instruction.
How to Use This Guide
First pass: read the clinical rule and cover the “Exam cue” sentence.
Second pass: import the companion flashcards and mark uncertain cards.
Final pass: practice recognizing emergencies, first tests, first-line treatments, and referral thresholds.
Core Test-Taking Framework
Stabilize before diagnosing: Airway, breathing, circulation, altered mental status, stroke signs, thunderclap
headache, meningismus, and severe respiratory distress override routine outpatient workups.
Start with the safest decisive test: Pregnancy testing precedes radiation in reproductive-age patients; ultrasound
is favored for AAA screening, infant hip dysplasia, and intussusception.
Treat the patient, not an isolated result: Confirm unexpected abnormalities when the patient is stable; avoid
antibiotics for asymptomatic bacteriuria except in defined situations such as pregnancy.
Match treatment intensity to risk: Comorbidities, pregnancy, age, organ function, frailty, and functional
impairment change drug choice, dose, and referral urgency.
Prevention
1. What imaging test is preferred for abdominal aortic aneurysm screening?
Exam cue: Abdominal ultrasonography; it is accurate, accessible, inexpensive, and avoids radiation.
11. What alcohol intake should trigger further assessment?
Exam cue: Intake above recommended limits or a binge pattern; quantify standard drinks and frequency rather than
relying on labels.
12. Who is preferentially offered a high-dose or adjuvanted influenza vaccine?
Exam cue: Adults age 65 years and older, when an age-appropriate enhanced vaccine is available.
24. Who should receive annual low-dose CT lung cancer screening?
Exam cue: Eligible adults are generally age 50–80 with at least a 20 pack-year history who currently smoke or quit
within 15 years; verify current guidance.
79. Do patients with diabetes need routine and risk-based vaccines even when A1c is controlled?
Exam cue: Yes. Diabetes increases infection risk; vaccination indications do not depend on poor glycemic control.
90. Who should be screened for hypertension?
Exam cue: All adults, with elevated office readings confirmed outside the clinic when feasible before diagnosis and
treatment.
FNP 3P Practice Exam 1 • Original study aid • Verify time-sensitive guidelines
, 120. Who may merit an earlier prostate-cancer screening discussion?
Exam cue: Higher-risk patients, including those with strong family history or certain inherited mutations; use
shared decision-making.
139. How can an adult who previously received PCV13 alone complete pneumococcal vaccination?
Exam cue: Current schedules may use PCV20 or PCV21 after the recommended interval; verify the latest CDC
schedule.
Cardiovascular
39. What score estimates stroke risk in atrial fibrillation?
Exam cue: CHA2DS2-VASc; use it with bleeding risk and current guideline thresholds to guide anticoagulation.
65. What is the preferred initial test for left-ventricular systolic function?
Exam cue: Two-dimensional transthoracic echocardiography.
126. What factors increase infective endocarditis risk?
Exam cue: Prosthetic valves, prior endocarditis, injection drug use, intracardiac devices, poor dentition, and certain
cardiac lesions.
134. Which common adult murmurs are systolic versus diastolic?
Exam cue: Aortic stenosis and mitral regurgitation are systolic; aortic regurgitation and mitral stenosis are diastolic.
141. What symptoms suggest severe aortic stenosis?
Exam cue: Exertional chest pain, syncope, and dyspnea/heart failure; symptomatic severe disease needs valve
evaluation.
147. Should a tolerated statin for secondary prevention automatically be stopped after age 75?
Exam cue: No. Continue when benefits outweigh risks and the patient tolerates therapy; reassess goals,
interactions, and frailty.
Pulmonary
23. What is EVALI?
Exam cue: Acute lung injury associated with recent vaping, often causing cough, dyspnea, chest pain, fever, GI
symptoms, and imaging opacities.
37. Where are normal vesicular breath sounds heard?
Exam cue: Over peripheral lung fields; they are soft with a longer inspiratory and short quiet expiratory phase.
63. How is exercise-induced bronchospasm prevented immediately before activity?
Exam cue: Use a rapid-acting inhaled bronchodilator shortly before exercise according to the patient’s asthma plan.
75. What is a common outpatient regimen for uncomplicated CAP in a healthy adult?
Exam cue: High-dose amoxicillin is a common first-line option; comorbidities change antibiotic selection.
88. How is mild persistent asthma commonly characterized?
Exam cue: Symptoms more than twice weekly but not daily and nocturnal awakenings about 3–4 times monthly,
with near-normal lung function.
101. What presentation is typical of COPD?
Exam cue: Progressive dyspnea, chronic productive cough, and exposure to tobacco or occupational irritants.
FNP 3P Practice Exam 1 • Original study aid • Verify time-sensitive guidelines
