Family Nurse Practitioner Test Family Nurse Practitioner Practice 4 — Questions and Answers
Question 1: A 40-year-old woman presents with fatigue, weight gain, constipation, and cold intolerance. TSH is 8.2 mIU/L and free T4 is low. What is the treatment of choice?
- Liothyronine (T3)
- Desiccated thyroid extract
- Levothyroxine (T4) (Correct answer)
- Methimazole
Correct answer: Levothyroxine (T4)
Levothyroxine is the standard of care for hypothyroidism due to its consistent potency and long half-life.
Question 2: A 35-year-old HIV-positive patient has a CD4 count of 180 cells/μL. Which opportunistic infection prophylaxis is most urgently indicated?
- Azithromycin for MAC prophylaxis
- Fluconazole for cryptococcal meningitis
- Trimethoprim-sulfamethoxazole for PCP prophylaxis (Correct answer)
- Isoniazid for latent TB
Correct answer: Trimethoprim-sulfamethoxazole for PCP prophylaxis
TMP-SMX prophylaxis against Pneumocystis jirovecii pneumonia is indicated when CD4 count falls below 200 cells/μL.
Question 3: A 28-year-old woman presents 6 weeks postpartum with low mood, inability to bond with her infant, hopelessness, and passive suicidal ideation. What is the most appropriate initial intervention?
- Reassure her that baby blues are normal and will resolve
- Refer immediately to the emergency department
- Screen with the Edinburgh Postnatal Depression Scale and initiate an SSRI (Correct answer)
- Prescribe benzodiazepines for anxiety
Correct answer: Screen with the Edinburgh Postnatal Depression Scale and initiate an SSRI
Postpartum depression presenting at 6 weeks should be formally assessed and SSRIs (many safe during breastfeeding) are first-line pharmacotherapy.
Question 4: A 55-year-old woman with osteoporosis has a T-score of -2.8. She has no history of fractures. According to the NOF/USPSTF guidelines, what FRAX 10-year fracture risk threshold typically warrants pharmacotherapy in the US?
- ≥5% hip fracture or ≥15% major osteoporotic fracture
- ≥3% hip fracture or ≥10% major osteoporotic fracture (Correct answer)
- ≥7% hip fracture or ≥25% major osteoporotic fracture
- ≥10% hip fracture or ≥30% major osteoporotic fracture
Correct answer: ≥3% hip fracture or ≥10% major osteoporotic fracture
The NOF recommends treatment when 10-year FRAX probability is ≥3% for hip fracture or ≥20% for major osteoporotic fracture.
Question 5: A 7-year-old child presents with a 3-day history of sore throat, fever of 101.5°F, tonsillar exudates, and tender anterior cervical lymphadenopathy. Rapid strep test is positive. What is the treatment?
- Azithromycin 5-day course
- Amoxicillin 10-day course (Correct answer)
- Cephalexin 7-day course
- No antibiotics; supportive care only
Correct answer: Amoxicillin 10-day course
Amoxicillin for 10 days is the first-line treatment for Group A Streptococcal pharyngitis to prevent rheumatic fever.
Question 6: An 80-year-old man with moderate dementia is brought in by his daughter who suspects elder abuse. During the visit, the patient has unexplained bruises and appears fearful. What is the FNP's mandatory obligation?
- Discuss the situation with the daughter first before taking any action
- Report the suspected abuse to Adult Protective Services (Correct answer)
- Consult psychiatry for the patient's behavioral issues
- Document the findings and follow up in 2 weeks
Correct answer: Report the suspected abuse to Adult Protective Services
FNPs are mandated reporters and must report suspected elder abuse to Adult Protective Services regardless of caregiver relationship.
Question 7: A 50-year-old man presents with a total cholesterol of 240, LDL of 165, HDL of 38, and triglycerides of 210. He has diabetes and hypertension. Using the ACC/AHA Pooled Cohort Equations, his 10-year ASCVD risk is 13%. Which statin intensity is recommended?
- No statin indicated; lifestyle modification only
- Low-intensity statin
- Moderate-intensity statin
- High-intensity statin (Correct answer)
Correct answer: High-intensity statin
A 10-year ASCVD risk ≥10% with diabetes and additional risk factors warrants high-intensity statin therapy per ACC/AHA guidelines.
Family Nurse Practitioner Test Family Nurse Practitioner Practice 4
A 40-year-old woman presents with fatigue, weight gain, constipation, and cold intolerance.
TSH is 8.2 mIU/L and free T4 is low.
What is the treatment of choice?