Family Nurse Practitioner Test Family Nurse Practitioner Knowledge 3 — Questions and Answers
Question 1: A 45-year-old with newly diagnosed hypertension also has chronic kidney disease (eGFR 42). Which antihypertensive is the first-line choice?
- Amlodipine
- Metoprolol
- Lisinopril (Correct answer)
- Hydrochlorothiazide
Correct answer: Lisinopril
ACE inhibitors (e.g., lisinopril) are first-line in CKD with hypertension due to their nephroprotective effects and reduction of proteinuria.
Question 2: Which vaccine is contraindicated in a pregnant woman at 20 weeks gestation?
- Tdap
- Inactivated influenza
- MMR (Correct answer)
- COVID-19 mRNA vaccine
Correct answer: MMR
MMR is a live-attenuated vaccine and is contraindicated during pregnancy due to theoretical risk of fetal infection.
Question 3: A 7-year-old child is brought in with a rash that started on the face and moved to the trunk, along with low-grade fever and Koplik spots. What is the diagnosis?
- Roseola
- Scarlet fever
- Measles (Correct answer)
- Rubella
Correct answer: Measles
Koplik spots (white spots on the buccal mucosa) are pathognomonic for measles (rubeola), which presents with cephalocaudal rash spread.
Question 4: A patient with rheumatoid arthritis on methotrexate develops oral ulcers and fatigue. Which supplement should be routinely recommended?
- Vitamin D
- Iron
- Folic acid (Correct answer)
- Vitamin B12
Correct answer: Folic acid
Folic acid supplementation reduces methotrexate-related adverse effects including mucositis, GI upset, and cytopenias.
Question 5: A 72-year-old presents with sudden onset of painless vision loss in one eye described as a 'curtain coming down.' What is the most likely diagnosis?
- Central retinal artery occlusion
- Acute angle-closure glaucoma
- Retinal detachment (Correct answer)
- Optic neuritis
Correct answer: Retinal detachment
Painless, sudden vision loss described as a descending curtain is the classic presentation of retinal detachment, an ophthalmologic emergency.
Question 6: Which parameter is used to calculate the CURB-65 score for pneumonia severity?
- SpO2 <90%
- Blood urea nitrogen >19 mg/dL (Correct answer)
- White blood cell count >12,000
- Pleural effusion on X-ray
Correct answer: Blood urea nitrogen >19 mg/dL
CURB-65 includes Confusion, Urea >7 mmol/L (BUN >19 mg/dL), Respiratory rate ≥30, Blood pressure <90/60, and age ≥65 to assess pneumonia severity.
Question 7: A 16-year-old athlete presents with anterior knee pain worsened by stairs and prolonged sitting. Examination reveals tenderness at the inferior pole of the patella. What is the most likely diagnosis?
- Osgood-Schlatter disease
- Patellofemoral pain syndrome
- Sinding-Larsen-Johansson syndrome (Correct answer)
- Meniscal tear
Correct answer: Sinding-Larsen-Johansson syndrome
Sinding-Larsen-Johansson syndrome involves traction apophysitis at the inferior pole of the patella, distinct from Osgood-Schlatter which affects the tibial tuberosity.
Family Nurse Practitioner Test Family Nurse Practitioner Knowledge 3
A 45-year-old with newly diagnosed hypertension also has chronic kidney disease (eGFR 42).
Which antihypertensive is the first-line choice?