FREE Family Nurse Practitioner Knowledge Questions and Answers

Question 1

Jerry, 35, has dermatosis and uses a high-potency corticosteroid cream. He also has tinea corporis. Tell him about the cream:

Accepted Answer

It may exacerbate your concurrent tinea corporis.

Answer

High-potency corticosteroid creams suppress the immune response, which can worsen fungal infections like tinea corporis. Using corticosteroids on a fungal infection can mask symptoms and allow the infection to spread or become more severe. Therefore, it's crucial to warn the patient about this potential exacerbation.

Question 2

When your thyroid-stimulating hormone (TSH) is low, it can cause ______.

Accepted Answer

Osteoporosis

Answer

A low TSH indicates hyperthyroidism (overactive thyroid), not hypothyroidism. Hyperthyroidism accelerates bone turnover, leading to increased bone loss and a higher risk of osteoporosis. Weight gain and brittle hair are typically associated with hypothyroidism, while osteoporosis is a known complication of chronic hyperthyroidism.

Question 3

Two days ago, a 21-year-old woman presented to the clinic for evaluation of urine frequency and urgency. She has also observed little vaginal discharge. Symptoms are new to the patient. Urinalysis and culture are done on a urine sample. Which further results suggest pyelonephritis?

Accepted Answer

White blood cell casts

Answer

White blood cell casts in a urinalysis are highly indicative of pyelonephritis (kidney infection) because they form in the renal tubules and signify inflammation within the kidney itself. While bacteriuria, leukocytosis, and microscopic hematuria can be present in UTIs, WBC casts specifically point to an upper urinary tract infection.

Question 4

In the middle of the night, after having a steak meal with friends, a 55-year-old man with type 2 diabetes mellitus appears with significant right foot discomfort. The first metatarsophalangeal joint is swollen and painful during physical examination. During a joint aspiration, monosodium urate crystals were seen in the synovial fluid under a microscope. Which of the following offers the most effective first care?

Accepted Answer

Non-steroidal anti-inflammatory drugs (NSAIDs)

Answer

The patient's symptoms (acute, severe right foot pain, swollen MTP joint after a steak meal, monosodium urate crystals) are classic for an acute gout attack. NSAIDs are typically the first-line treatment for acute gout due to their rapid anti-inflammatory and analgesic effects. Prednisone is an alternative if NSAIDs are contraindicated, while allopurinol and probenecid are for long-term prevention, not acute attacks.

Question 5

A 50-year-old guy arrives for a hypersomnolence assessment. The patient routinely nods off while watching TV at home and has even fallen asleep at his desk at work. He regularly gets 8 hours of sleep each night while working a standard 40-hour workweek as a systems analyst. The patient claims to have a daily cup of coffee to help him "wake up" on his way to work in the morning and another in the late afternoon. Hypertension is present in the medical past. BMI is 38 kg/m2, and blood pressure is 160/100 mm Hg. Normal results from heart, lung, and neurological exams. Which of the following is the ideal course of management to take next?

Accepted Answer

Nocturnal polysomnography

Answer

The patient presents with significant hypersomnolence despite adequate sleep, along with risk factors like obesity and hypertension, strongly suggesting obstructive sleep apnea. Nocturnal polysomnography (a sleep study) is the gold standard for diagnosing sleep apnea and other sleep disorders. It is the ideal next step to determine the underlying cause of his excessive daytime sleepiness.

Family Nurse Practitioner Test Practice Test

Family Nurse Practitioner Test Practice Test

FREE Family Nurse Practitioner Knowledge Questions and Answers