FNP-C Family Nurse Practitioner (FNP) Certification Examination Practice Questions
Prepare for FNP-C with more than an answer.
- 1
A 2-day-old newborn infant develops acute, persistent bilious (dark green) vomiting and abdominal distension. The infant is lethargic, tachycardic, and irritable. Which life-threatening diagnosis must the nurse practitioner prioritize above all other differential conditions until definitively excluded?
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Correct answer: D
Bilious vomiting in a newborn is an emergent surgical red flag indicating obstruction distal to the ampulla of Vater; midgut volvulus carries imminent risk of bowel necrosis.
- 2
An 18-month-old toddler presents with a 2-day history of low-grade fever (38.1°C / 100.6°F), clear rhinorrhea, and the sudden nocturnal development of a harsh, barking 'seal-like' cough with inspiratory stridor that worsens with crying. The child is non-toxic, has no drooling, and is drinking fluids without difficulty. What is the most likely primary diagnosis?
flowchart TD Presentation[Barking Cough + Inspiratory Stridor + Low Fever] --> Airway[Subglottic Laryngeal Edema] Airway --> Evaluation{Drooling or Toxic Appearance?} Evaluation -->|No| PrimaryDx[Viral Laryngotracheobronchitis / Croup] Evaluation -->|Yes| Emergency[Acute Epiglottitis / Bacterial Tracheitis]Show answer details
Correct answer: C
Croup typically affects toddlers with low fever, barking cough, and inspiratory stridor due to subglottic inflammation without toxic drooling.
- 3
A 9-year-old child presents with a 4-day history of migratory joint pain and swelling shifting from the right knee to the left ankle. Examination reveals a pink, non-pruritic serpiginous macular rash with central clearing on the trunk (erythema marginatum) and a new apical systolic murmur of mitral regurgitation. The guardian notes the child had an untreated severe sore throat 3 weeks ago. Elevated antistreptolysin O (ASO) titers are documented. Which condition represents the primary diagnosis?
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Correct answer: D
The findings satisfy major Jones criteria (migratory arthritis, carditis, erythema marginatum) occurring several weeks following untreated group A streptococcal pharyngitis.
- 4
An advanced practice registered nurse interviews a 16-year-old adolescent presenting for an annual well-care examination accompanied by a guardian. The adolescent appears hesitant when discussing social activities, substance exposure, and sexual health. Which communication strategy is most appropriate to obtain sensitive subjective health history?
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Correct answer: B
Providing private, confidential time during adolescent visits encourages honest disclosure of sensitive sexual, substance, and mental health histories.
- 5
A 72-year-old male presents with a chief complaint of sudden, painless vision loss in his right eye that resolved spontaneously after 15 minutes, which he describes as 'a black shade pulled halfway down across the eye.' During the review of systems, the nurse practitioner recognizes this subjective description as characteristic of which clinical phenomenon?
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Correct answer: D
Amaurosis fugax presents as transient, painless monocular visual loss ('curtain descending') typically caused by retinal microemboli from ipsilateral carotid stenosis.
- 6
During a developmental assessment of a 4-year-old child, the parent reports the child speaks in 4-word sentences, hops on one foot, can copy a circle or cross, and that outside acquaintances understand approximately 80% to 100% of the child's speech. How should the nurse practitioner interpret these historical findings?
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Correct answer: C
At age 4, children normally copy crosses, hop on one foot, converse in 4-to-5 word sentences, and exhibit speech nearly 100% intelligible to strangers.
