ANCC FNP Board Questions & Answers: Latest
Updated A+ Guide
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? - correct answer 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 true? - correct
answer 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? -
correct answer 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’
_________________________________________
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? - correct answer Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-line
therapy for adults without comorbidities’
Updated A+ Guide
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? - correct answer 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 true? - correct
answer 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? -
correct answer 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’
_________________________________________
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? - correct answer Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-line
therapy for adults without comorbidities’
