ANCC FNP BOARD EXAM LATEST REAL EXAM 150 QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES|ALREDY GRADED
A+
1. A middle-age female patient presents to the clinic with a recurrence of
f f f f f f f f f f f
f mild hidradenitis suppurativa after topical therapies failed.Which first-line
f f f f f f f f
treatment is recommended?
f f f
Answer>>> Tetracycline ff
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line treatmentfor
f f f f f f f f f f f
hidradenitis suppurativa.
f f
Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in apocrine
f f f f f f f f f f f
gland-bearing skin. It is a chronic, disabling disorder that progresses, often causing
f f f f f f f f f f f f
keloids, contractures, and immobility. It is characterized by comedone-like follicular
f f f f f f f f f f
occlusion, chronic and relapsing inflammation, mucopurulent discharge, and pro-
f f f f f f f f f
gressive scarring.
f f
Arthropathy associated with hidradenitis may be present. Typical presentation in-
f f f f f f f f f
1 f/ f16
,cludes nodules and sinus tracts (inflamed or noninflamed), abscesses, and scarring
f f f f f f f f f f f
found in the axilla, genitofemoral area, perineum, gluteal area, and inframammary
f f f f f f f f f f f
area in women.
f f f
Recommended treatments include antibiotics, steroids, retinoids, dapsone, and anti-
f f f f f f f f
tumor necrosis factor agents. A dermatology consultation should also be con-sidered.
f f f f f f f f f f f
First-line treatment is a 12 f f f f week course of an oral tetracycline (Sumycin) such as
f f f f f f f f
doxycycline.For patients who do not respond to doxycycline, the next recommendedstep
f f f f f f f f f f f f f
is a combination of twice-daily clindamycin (Cleocin) and rifampicin (Rifadin) for 10-
f f f f f f f f f f f f
12 weeks. If treatment fails, acitretin (Soriatane, for males and nonfertile fe- males) or
f f f f f f f f f f f f f
dapsone (Aczone) may be considered by a dermatologist.In patients withmoderate to
f f f f f f f f f f f f f
severe hidradenitis suppurativa, adalimumab (Humira) may possibly beconsidered.
f f f f f f f f f
2. When providing culturally competent health care services to an American
f f f f f f f f f
f Indian elder, the nurse practitioner understands which is traditionally true?
f f f f f f f f f
Answer>>> -The "Medicine Wheel" is used by many for the purpose of health and
f f f f f f f f f f f f f f
healing
f
The "Medicine Wheel" is traditionally used and contains four directions;north, south,east,
f f f f f f f f f f f f
and west.Traditionally each tribe has different meanings for each direction andthey may
f f f f f f f f f f f f f f
represent the season of the year or stage of life. It is aimed at providing aholistic view
f f f f f f f f f f f f f f f f f f
of life.
f f
An understanding of different cultural preferences leads to cultural competence in
f f f f f f f f f f
healthcare.Some patients may value traditional culture and preferences as it relates
f f f f f f f f f f f f
2 f/ f16
,to healthcare.These individual preferences should be included in the interview and
f f f f f f f f f f f
treatment plan for patients.
f f f f
Traditionally, the American Indian culture values a holistic approach to health care
f f f f f f f f f f f
integrating the person, lifestyle, environment, family, and religion. Patients adheringto
f f f f f f f f f f f
these traditional cultural practices often feel that illness is due to a lack of harmonywith
f f f f f f f f f f f f f f f f
the physical body, mind, spirit, and emotions. Patients may seek care from western
f f f f f f f f f f f f f
medicine for specific ailments while also consulting with traditional healersfor
f f f f f f f f f f f
spiritual guidance.
f f
Healthcare providers should seek to understand relevant cultural factors and assesseach
f f f f f f f f f f f
individual's healthcare literacy in order to provide culturally competent care.
f f f f f f f f f f
3. The nurse practitioner sees an older adult patient in the clinic with the
f f f f f f f f f f f f
f primary report of hearing loss and a sensation of fullness in the right ear.The
f f f f f f f f f f f f f f
nurse practitioner suspects conductive hearing loss. Which could contributeto
f f f f f f f f f f
f this?
Answer>>> Cerumen, commonly called earwax, is a combination of secretions and
f f f f f f f f f f
sloughed epithelial cells that protects the ears from infection, water, and insects.
f f f f f f f f f f f f
It is normally expelled from the ear canal through natural jaw movement. When this
f f f f f f f f f f f f f
self-cleaning process fails, cerumen can become impacted.Cerumen impactionoccludes
f f f f f f f f f f
the ear canal and can press against the tympanic membrane, resulting inconductive
f f f f f f f f f f f f f
hearing loss.
f f
Conductive hearing is the transition of sound from the external and middle earto
f f f f f f f f f f f f f
3 f/ f16
, f the inner ear. Conductive hearing loss is caused by problems in the external
f f f f f f f f f f f f
and middle ear that interfere with the transmission of sound and its conversion to
f f f f f f f f f f f f f
f mechanical vibration. Causes of conductive hearing loss include obstruction of the
f f f f f f f f f f
external auditory canal by cerumen, foreign bodies, debris from otitis externa, and
f f f f f f f f f f f f
large exocytosis and osteomas.
f f f f
Sensorineural hearing loss involves difficulty converting mechanical vibrations to
f f f f f f f f
electrical potential in the cochlea or in auditory nerve transmission to the brain. Itis
f f f f f f f f f f f f f f f
f mostly caused by permanent damage in the organ of Corti. It can be caused by age-
f f f f f f f f f f f f f f f
related hearing loss, noise trauma, medications, autoimmune diseases,
f f f f f f f
mechanical trauma, Meniere disease, infection, and neoplasm (acoustic neuroma).
f f f f f f f f
Approximately one-third of older adults between the ages of 61 and 70 years have
f f f f f f f f f f f f f f
hearing loss.More than 90% of adults older than 85 years of age have hearing loss.The
f f f f f f f f f f f f f f f f f
f most common type of hearing loss is age-related and sensorineural. All adultsolder
f f f f f f f f f f f f
f than 60 years of age should be screened for hearing loss at periodic health
f f f f f f f f f f f f f
f examinations.
4 f/ f16
AND CORRECT ANSWERS WITH RATIONALES|ALREDY GRADED
A+
1. A middle-age female patient presents to the clinic with a recurrence of
f f f f f f f f f f f
f mild hidradenitis suppurativa after topical therapies failed.Which first-line
f f f f f f f f
treatment is recommended?
f f f
Answer>>> Tetracycline ff
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line treatmentfor
f f f f f f f f f f f
hidradenitis suppurativa.
f f
Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in apocrine
f f f f f f f f f f f
gland-bearing skin. It is a chronic, disabling disorder that progresses, often causing
f f f f f f f f f f f f
keloids, contractures, and immobility. It is characterized by comedone-like follicular
f f f f f f f f f f
occlusion, chronic and relapsing inflammation, mucopurulent discharge, and pro-
f f f f f f f f f
gressive scarring.
f f
Arthropathy associated with hidradenitis may be present. Typical presentation in-
f f f f f f f f f
1 f/ f16
,cludes nodules and sinus tracts (inflamed or noninflamed), abscesses, and scarring
f f f f f f f f f f f
found in the axilla, genitofemoral area, perineum, gluteal area, and inframammary
f f f f f f f f f f f
area in women.
f f f
Recommended treatments include antibiotics, steroids, retinoids, dapsone, and anti-
f f f f f f f f
tumor necrosis factor agents. A dermatology consultation should also be con-sidered.
f f f f f f f f f f f
First-line treatment is a 12 f f f f week course of an oral tetracycline (Sumycin) such as
f f f f f f f f
doxycycline.For patients who do not respond to doxycycline, the next recommendedstep
f f f f f f f f f f f f f
is a combination of twice-daily clindamycin (Cleocin) and rifampicin (Rifadin) for 10-
f f f f f f f f f f f f
12 weeks. If treatment fails, acitretin (Soriatane, for males and nonfertile fe- males) or
f f f f f f f f f f f f f
dapsone (Aczone) may be considered by a dermatologist.In patients withmoderate to
f f f f f f f f f f f f f
severe hidradenitis suppurativa, adalimumab (Humira) may possibly beconsidered.
f f f f f f f f f
2. When providing culturally competent health care services to an American
f f f f f f f f f
f Indian elder, the nurse practitioner understands which is traditionally true?
f f f f f f f f f
Answer>>> -The "Medicine Wheel" is used by many for the purpose of health and
f f f f f f f f f f f f f f
healing
f
The "Medicine Wheel" is traditionally used and contains four directions;north, south,east,
f f f f f f f f f f f f
and west.Traditionally each tribe has different meanings for each direction andthey may
f f f f f f f f f f f f f f
represent the season of the year or stage of life. It is aimed at providing aholistic view
f f f f f f f f f f f f f f f f f f
of life.
f f
An understanding of different cultural preferences leads to cultural competence in
f f f f f f f f f f
healthcare.Some patients may value traditional culture and preferences as it relates
f f f f f f f f f f f f
2 f/ f16
,to healthcare.These individual preferences should be included in the interview and
f f f f f f f f f f f
treatment plan for patients.
f f f f
Traditionally, the American Indian culture values a holistic approach to health care
f f f f f f f f f f f
integrating the person, lifestyle, environment, family, and religion. Patients adheringto
f f f f f f f f f f f
these traditional cultural practices often feel that illness is due to a lack of harmonywith
f f f f f f f f f f f f f f f f
the physical body, mind, spirit, and emotions. Patients may seek care from western
f f f f f f f f f f f f f
medicine for specific ailments while also consulting with traditional healersfor
f f f f f f f f f f f
spiritual guidance.
f f
Healthcare providers should seek to understand relevant cultural factors and assesseach
f f f f f f f f f f f
individual's healthcare literacy in order to provide culturally competent care.
f f f f f f f f f f
3. The nurse practitioner sees an older adult patient in the clinic with the
f f f f f f f f f f f f
f primary report of hearing loss and a sensation of fullness in the right ear.The
f f f f f f f f f f f f f f
nurse practitioner suspects conductive hearing loss. Which could contributeto
f f f f f f f f f f
f this?
Answer>>> Cerumen, commonly called earwax, is a combination of secretions and
f f f f f f f f f f
sloughed epithelial cells that protects the ears from infection, water, and insects.
f f f f f f f f f f f f
It is normally expelled from the ear canal through natural jaw movement. When this
f f f f f f f f f f f f f
self-cleaning process fails, cerumen can become impacted.Cerumen impactionoccludes
f f f f f f f f f f
the ear canal and can press against the tympanic membrane, resulting inconductive
f f f f f f f f f f f f f
hearing loss.
f f
Conductive hearing is the transition of sound from the external and middle earto
f f f f f f f f f f f f f
3 f/ f16
, f the inner ear. Conductive hearing loss is caused by problems in the external
f f f f f f f f f f f f
and middle ear that interfere with the transmission of sound and its conversion to
f f f f f f f f f f f f f
f mechanical vibration. Causes of conductive hearing loss include obstruction of the
f f f f f f f f f f
external auditory canal by cerumen, foreign bodies, debris from otitis externa, and
f f f f f f f f f f f f
large exocytosis and osteomas.
f f f f
Sensorineural hearing loss involves difficulty converting mechanical vibrations to
f f f f f f f f
electrical potential in the cochlea or in auditory nerve transmission to the brain. Itis
f f f f f f f f f f f f f f f
f mostly caused by permanent damage in the organ of Corti. It can be caused by age-
f f f f f f f f f f f f f f f
related hearing loss, noise trauma, medications, autoimmune diseases,
f f f f f f f
mechanical trauma, Meniere disease, infection, and neoplasm (acoustic neuroma).
f f f f f f f f
Approximately one-third of older adults between the ages of 61 and 70 years have
f f f f f f f f f f f f f f
hearing loss.More than 90% of adults older than 85 years of age have hearing loss.The
f f f f f f f f f f f f f f f f f
f most common type of hearing loss is age-related and sensorineural. All adultsolder
f f f f f f f f f f f f
f than 60 years of age should be screened for hearing loss at periodic health
f f f f f f f f f f f f f
f examinations.
4 f/ f16
