Family Nurse Practitioner Test Patient Management

Question 1

A pregnant patient at 28 weeks is found to have a 1-hour glucose challenge test result of 155 mg/dL. The NEXT step is:

Accepted Answer

Order a 3-hour 100g oral glucose tolerance test (OGTT)

Answer

Diagnose gestational diabetes and initiate insulin

Answer

Repeat the 1-hour test in 4 weeks

Answer

Refer immediately to maternal-fetal medicine

Question 2

The FNP is managing a patient with newly diagnosed stage 1 hypertension (130–139/80–89 mmHg) with no comorbidities. The FIRST-LINE intervention is:

Accepted Answer

Lifestyle modification for 3–6 months before initiating medication

Answer

Immediately start a thiazide diuretic

Answer

Immediately start an ACE inhibitor

Answer

Refer to cardiology for management

Question 3

A 2-year-old with fever of 39.5°C and left ear pain is diagnosed with acute otitis media. Per AAP guidelines, the PREFERRED management is:

Accepted Answer

Amoxicillin 80–90 mg/kg/day for 10 days

Answer

Watchful waiting for 48–72 hours

Answer

Amoxicillin-clavulanate immediately

Answer

Tympanocentesis

Question 4

A 68-year-old woman with osteoporosis has a T-score of -2.7 at the lumbar spine. The FNP initiates bisphosphonate therapy and counsels the patient to:

Accepted Answer

Take it on an empty stomach with 8 oz of water and remain upright for 30 minutes

Answer

Take it with food to reduce GI upset

Answer

Crush it and mix with applesauce

Answer

Take it at bedtime for best absorption

Question 5

An FNP is managing a patient after an acute MI. Which medication has MOST clearly demonstrated mortality reduction post-MI?

Accepted Answer

Beta-blocker (e.g., metoprolol succinate)

Answer

Calcium channel blocker (e.g., diltiazem)

Answer

Nitrate (e.g., isosorbide mononitrate)

Answer

Digoxin

Question 6

A patient with GERD fails PPI therapy. The FNP considers referral to gastroenterology for which procedure?

Accepted Answer

Upper endoscopy (EGD) to assess for Barrett's esophagus or other pathology

Answer

Barium swallow

Answer

Esophageal pH monitoring only

Answer

Colonoscopy