FNP 654 Final Exam 2026 – Complete
Questions & Answers with Rationales
1. The primary care nurse practitioner attempts to learn more about the
emotional health of an 18-month-old child through which assessment
strategy? - answer-Observation of the child with caretakers in structured
and unstructured situation
2. What is an important purpose of conducting an interview prior to beginning
neuropsychological testing on an older adult suspected of having
dementia? - answer-To assess the patient's ability to cooperate with the
testing
3. A patient has unexplained weight loss and the provider notes increased skin
pigmentation on light-exposed skin folds along with darkened palmar
creases. Which laboratory test will the provider NOT order? - answer-
Serum cortisol
4. A patient with cancer is expected to require long-term pain medication to
manage cancer pain. Which agent will be best for this patient? - answer-
Morphine
5. A 16-year-old female has primary amenorrhea. A pregnancy test is
negative. Further testing reveals a normal TSH and an elevated prolactin
level. Which test will the provider order next? - answer-Magnetic
resonance imaging
6. During a well-baby exam on a 9-month-old infant, the parent reports that
the baby always uses the left hand to pick up objects and asks if the baby
, will be left-handed. What will the primary care nurse practitioner do? -
answer-Perform a careful assessment of fine and gross motor skills.
7. An asymptomatic female learns that her boyfriend has gonorrhea and asks
about antibiotics. What will the provider recommend? - answer-Empiric
ceftriaxone and azithromycin
8. A 16-year-old sexually active female has symptoms of PID with fever.
Cultures are pending. For outpatient treatment, what will the provider
order? - answer-Rocephin, doxycycline, and metronidazole
9. A 30-year-old male patient has a positive leukocyte esterase and nitrites on
a random urine dipstick during a well patient exam. What type of urinary
tract infection does this represent? - answer-Complicated
10.A woman who has had routine Pap tests all of her adult life has an
abnormal Pap with low-grade intraepithelial lesion. What will the provider
tell her about this result? - answer-Colposcopy with biopsy is necessary
11.A patient has bone pain and laboratory testing reveals an elevated serum
alkaline phosphatase (SAP). Which test can help distinguish Paget's from
malignant bone disease? - answer-Bone radiograph
12.What is the most important role of the primary care provider in cancer
management? - answer-Counseling about healthy practices to reduce risk
factors
13.A 35-year-old woman without a previous history of dysmenorrhea reports
lower pelvic pain and irregular bleeding between periods. What is the initial
, action in managing this patient? - answer-Performing an abdominal, pelvic,
and rectovaginal examination
14.A patient being treated for cancer has had chemotherapy within the past
two weeks and comes to the primary care clinic with a fever of 38.5° C.
What is the initial action? - answer-Obtain a STAT CBC with differential
15.What is a possible cause of decreased arousal, libido, and orgasm in a
postmenopausal woman? - answer-Diminished testosterone
16.A middle-school-age child is skipping school frequently and getting poor
grades since the child's father was killed while deployed in the military.
How will the primary care nurse practitioner manage this situation? -
answer-Refer the child to a mental health specialist for evaluation and
treatment.
17.A 40-year-old patient with primary hyperparathyroidism has increased
serum calcium 0.5 mg/dL above normal without signs of nephrolithiasis.
What is the recommended treatment for this patient? - answer-Annual
monitoring of calcium, creatinine, and bone density
18.What is true about HPV infection in women? - answer-Most HPV lesions will
resolve spontaneously without causing cancer.
19.An elderly patient is diagnosed with osteoporosis. What is the
recommended treatment once the diagnosis is made? - answer-
Bisphosphonate therapy
, 20.A postmenopausal woman reports unilateral breast pain that she describes
as sharp and burning and localized to one area. A breast examination
reveals no dimpling, discharge, or masses. Which diagnostic test will the
provider order? - answer-Bilateral mammography
21.An adolescent female has amenorrhea. The provider notes short stature,
neck webbing, and a pigeon chest deformity. Based on these symptoms,
what is the underlying disorder causing this patient's amenorrhea? -
answer-Turner's syndrome
22.A young female has a Pap test which reveals atypical squamous cells of
undetermined significance. What will the next step be in managing this
patient? - answer-Repeat cytology in 12 months
23.Which drug is used to treat patients with focal epilepsy and complex partial
seizures? - answer-Carbamazepine
24.A 35-year-old patient reports suddenly experiencing an asymmetric smile
along with drooping and tearing in one eye. The patient has a history of a
recent viral illness, but is otherwise healthy. During the exam, the provider
notes that there is unilateral full face paralysis on the right side. What is the
initial intervention for this patient? - answer-Prescribe oral prednisolone
25.A primary care provider suspects Parkinson's disease (PD) in a 70-year-old
patient. Which tests may be performed to diagnose this disorder? - answer-
Presence of 2 cardinal signs which improve with levodopa
26.A toddler has begun hitting and biting other children at a day care center
and is exhibiting temper tantrums and bad language at home. The parent
reports that these behaviors began shortly after a sibling was born. What
Questions & Answers with Rationales
1. The primary care nurse practitioner attempts to learn more about the
emotional health of an 18-month-old child through which assessment
strategy? - answer-Observation of the child with caretakers in structured
and unstructured situation
2. What is an important purpose of conducting an interview prior to beginning
neuropsychological testing on an older adult suspected of having
dementia? - answer-To assess the patient's ability to cooperate with the
testing
3. A patient has unexplained weight loss and the provider notes increased skin
pigmentation on light-exposed skin folds along with darkened palmar
creases. Which laboratory test will the provider NOT order? - answer-
Serum cortisol
4. A patient with cancer is expected to require long-term pain medication to
manage cancer pain. Which agent will be best for this patient? - answer-
Morphine
5. A 16-year-old female has primary amenorrhea. A pregnancy test is
negative. Further testing reveals a normal TSH and an elevated prolactin
level. Which test will the provider order next? - answer-Magnetic
resonance imaging
6. During a well-baby exam on a 9-month-old infant, the parent reports that
the baby always uses the left hand to pick up objects and asks if the baby
, will be left-handed. What will the primary care nurse practitioner do? -
answer-Perform a careful assessment of fine and gross motor skills.
7. An asymptomatic female learns that her boyfriend has gonorrhea and asks
about antibiotics. What will the provider recommend? - answer-Empiric
ceftriaxone and azithromycin
8. A 16-year-old sexually active female has symptoms of PID with fever.
Cultures are pending. For outpatient treatment, what will the provider
order? - answer-Rocephin, doxycycline, and metronidazole
9. A 30-year-old male patient has a positive leukocyte esterase and nitrites on
a random urine dipstick during a well patient exam. What type of urinary
tract infection does this represent? - answer-Complicated
10.A woman who has had routine Pap tests all of her adult life has an
abnormal Pap with low-grade intraepithelial lesion. What will the provider
tell her about this result? - answer-Colposcopy with biopsy is necessary
11.A patient has bone pain and laboratory testing reveals an elevated serum
alkaline phosphatase (SAP). Which test can help distinguish Paget's from
malignant bone disease? - answer-Bone radiograph
12.What is the most important role of the primary care provider in cancer
management? - answer-Counseling about healthy practices to reduce risk
factors
13.A 35-year-old woman without a previous history of dysmenorrhea reports
lower pelvic pain and irregular bleeding between periods. What is the initial
, action in managing this patient? - answer-Performing an abdominal, pelvic,
and rectovaginal examination
14.A patient being treated for cancer has had chemotherapy within the past
two weeks and comes to the primary care clinic with a fever of 38.5° C.
What is the initial action? - answer-Obtain a STAT CBC with differential
15.What is a possible cause of decreased arousal, libido, and orgasm in a
postmenopausal woman? - answer-Diminished testosterone
16.A middle-school-age child is skipping school frequently and getting poor
grades since the child's father was killed while deployed in the military.
How will the primary care nurse practitioner manage this situation? -
answer-Refer the child to a mental health specialist for evaluation and
treatment.
17.A 40-year-old patient with primary hyperparathyroidism has increased
serum calcium 0.5 mg/dL above normal without signs of nephrolithiasis.
What is the recommended treatment for this patient? - answer-Annual
monitoring of calcium, creatinine, and bone density
18.What is true about HPV infection in women? - answer-Most HPV lesions will
resolve spontaneously without causing cancer.
19.An elderly patient is diagnosed with osteoporosis. What is the
recommended treatment once the diagnosis is made? - answer-
Bisphosphonate therapy
, 20.A postmenopausal woman reports unilateral breast pain that she describes
as sharp and burning and localized to one area. A breast examination
reveals no dimpling, discharge, or masses. Which diagnostic test will the
provider order? - answer-Bilateral mammography
21.An adolescent female has amenorrhea. The provider notes short stature,
neck webbing, and a pigeon chest deformity. Based on these symptoms,
what is the underlying disorder causing this patient's amenorrhea? -
answer-Turner's syndrome
22.A young female has a Pap test which reveals atypical squamous cells of
undetermined significance. What will the next step be in managing this
patient? - answer-Repeat cytology in 12 months
23.Which drug is used to treat patients with focal epilepsy and complex partial
seizures? - answer-Carbamazepine
24.A 35-year-old patient reports suddenly experiencing an asymmetric smile
along with drooping and tearing in one eye. The patient has a history of a
recent viral illness, but is otherwise healthy. During the exam, the provider
notes that there is unilateral full face paralysis on the right side. What is the
initial intervention for this patient? - answer-Prescribe oral prednisolone
25.A primary care provider suspects Parkinson's disease (PD) in a 70-year-old
patient. Which tests may be performed to diagnose this disorder? - answer-
Presence of 2 cardinal signs which improve with levodopa
26.A toddler has begun hitting and biting other children at a day care center
and is exhibiting temper tantrums and bad language at home. The parent
reports that these behaviors began shortly after a sibling was born. What
