NSG 6998 – FNP Exam 2026 | Practice Questions
(with Answers & Rationales)
1
A 55-year-old male presents for routine screening. If asymptomatic with no risk factors, at what
age should colorectal cancer screening begin?
A. 40
B. 45
C. 50
D. 55
Correct Answer: B
Rationale: Current USPSTF guidelines recommend starting average-risk colorectal cancer
screening at age 45. Screening methods include colonoscopy, FIT, or stool DNA tests.
2
A 24-year-old sexually active female requests contraception. Which method also provides
protection against most STIs?
A. Oral contraceptive pills
B. Male condom
C. IUD
D. Depo-Provera
Correct Answer: B
Rationale: Condoms are the only contraceptive method that effectively reduces the risk of
sexually transmitted infections (STIs) while providing pregnancy prevention.
3
A 68-year-old female with COPD reports increased sputum production. Purulent sputum
suggests:
A. Viral infection
,B. Bacterial infection
C. Asthma exacerbation
D. Heart failure
Correct Answer: B
Rationale: Purulent sputum often indicates a bacterial cause in COPD exacerbations.
Management may include antibiotics targeting common pathogens such as H. influenzae or S.
pneumoniae.
4
A child with suspected otitis media presents with ear pain and fever. First-line antibiotic (if
indicated) is:
A. Azithromycin
B. Amoxicillin
C. Ceftriaxone
D. Doxycycline
Correct Answer: B
Rationale: Amoxicillin is the first-line therapy for uncomplicated acute otitis media, unless the
child has a penicillin allergy.
5
A 30-year-old with acute pharyngitis tests positive for Group A Strep. Recommended treatment:
A. Cefuroxime
B. Erythromycin
C. Penicillin VK or Amoxicillin
D. Aztreonam
Correct Answer: C
Rationale: Group A Streptococcus pharyngitis should be treated with penicillin or amoxicillin
to prevent complications like rheumatic fever.
6
,A patient with chronic hypertension is started on an ACE inhibitor. Expected side effect:
A. Bradycardia
B. Hypokalemia
C. Persistent dry cough
D. Weight gain
Correct Answer: C
Rationale: ACE inhibitors may cause a dry, non-productive cough due to increased
bradykinin. Hyperkalemia is possible, not hypokalemia.
7
A 45-year-old with Type 2 diabetes presents for follow-up. Preferred test to monitor glycemic
control:
A. Fasting glucose
B. Random glucose
C. Urine glucose
D. Hemoglobin A1c
Correct Answer: D
Rationale: Hemoglobin A1c reflects average blood glucose over 2–3 months and is the standard
for monitoring glycemic control in diabetes.
8
A patient presents with acute unilateral ankle swelling, redness, and severe pain. Most likely
diagnosis:
A. Cellulitis
B. Deep vein thrombosis
C. Gout flare
D. Osteoarthritis
Correct Answer: C
Rationale: Sudden, severe pain with erythema and swelling in the first metatarsophalangeal joint
or ankle suggests gout; joint aspiration can confirm urate crystals.
, 9
First-line therapy for acute uncomplicated cystitis in women (no allergy):
A. Ciprofloxacin
B. Nitrofurantoin
C. Azithromycin
D. Cephalexin
Correct Answer: B
Rationale: Nitrofurantoin is first-line for uncomplicated UTI due to efficacy and low resistance
risk. Fluoroquinolones are reserved for complicated cases.
10
A 15-year-old with asthma experiences wheezing and cough after exercise. Best initial treatment:
A. Oral steroids
B. Short-acting beta-agonist (SABA)
C. Long-acting inhaled steroid
D. Antihistamine
Correct Answer: B
Rationale: SABA is first-line for exercise-induced bronchospasm and provides rapid relief.
Long-term control may require inhaled corticosteroids.
11
A 72-year-old male has a PSA of 6.0 ng/mL. Interpretation:
A. Normal
B. Elevated
C. Indicative of UTI
D. Diagnostic of prostate cancer
Correct Answer: B
Rationale: PSA >4.0 ng/mL is considered elevated, but this is not diagnostic; further evaluation
including repeat PSA and possible biopsy is indicated.
(with Answers & Rationales)
1
A 55-year-old male presents for routine screening. If asymptomatic with no risk factors, at what
age should colorectal cancer screening begin?
A. 40
B. 45
C. 50
D. 55
Correct Answer: B
Rationale: Current USPSTF guidelines recommend starting average-risk colorectal cancer
screening at age 45. Screening methods include colonoscopy, FIT, or stool DNA tests.
2
A 24-year-old sexually active female requests contraception. Which method also provides
protection against most STIs?
A. Oral contraceptive pills
B. Male condom
C. IUD
D. Depo-Provera
Correct Answer: B
Rationale: Condoms are the only contraceptive method that effectively reduces the risk of
sexually transmitted infections (STIs) while providing pregnancy prevention.
3
A 68-year-old female with COPD reports increased sputum production. Purulent sputum
suggests:
A. Viral infection
,B. Bacterial infection
C. Asthma exacerbation
D. Heart failure
Correct Answer: B
Rationale: Purulent sputum often indicates a bacterial cause in COPD exacerbations.
Management may include antibiotics targeting common pathogens such as H. influenzae or S.
pneumoniae.
4
A child with suspected otitis media presents with ear pain and fever. First-line antibiotic (if
indicated) is:
A. Azithromycin
B. Amoxicillin
C. Ceftriaxone
D. Doxycycline
Correct Answer: B
Rationale: Amoxicillin is the first-line therapy for uncomplicated acute otitis media, unless the
child has a penicillin allergy.
5
A 30-year-old with acute pharyngitis tests positive for Group A Strep. Recommended treatment:
A. Cefuroxime
B. Erythromycin
C. Penicillin VK or Amoxicillin
D. Aztreonam
Correct Answer: C
Rationale: Group A Streptococcus pharyngitis should be treated with penicillin or amoxicillin
to prevent complications like rheumatic fever.
6
,A patient with chronic hypertension is started on an ACE inhibitor. Expected side effect:
A. Bradycardia
B. Hypokalemia
C. Persistent dry cough
D. Weight gain
Correct Answer: C
Rationale: ACE inhibitors may cause a dry, non-productive cough due to increased
bradykinin. Hyperkalemia is possible, not hypokalemia.
7
A 45-year-old with Type 2 diabetes presents for follow-up. Preferred test to monitor glycemic
control:
A. Fasting glucose
B. Random glucose
C. Urine glucose
D. Hemoglobin A1c
Correct Answer: D
Rationale: Hemoglobin A1c reflects average blood glucose over 2–3 months and is the standard
for monitoring glycemic control in diabetes.
8
A patient presents with acute unilateral ankle swelling, redness, and severe pain. Most likely
diagnosis:
A. Cellulitis
B. Deep vein thrombosis
C. Gout flare
D. Osteoarthritis
Correct Answer: C
Rationale: Sudden, severe pain with erythema and swelling in the first metatarsophalangeal joint
or ankle suggests gout; joint aspiration can confirm urate crystals.
, 9
First-line therapy for acute uncomplicated cystitis in women (no allergy):
A. Ciprofloxacin
B. Nitrofurantoin
C. Azithromycin
D. Cephalexin
Correct Answer: B
Rationale: Nitrofurantoin is first-line for uncomplicated UTI due to efficacy and low resistance
risk. Fluoroquinolones are reserved for complicated cases.
10
A 15-year-old with asthma experiences wheezing and cough after exercise. Best initial treatment:
A. Oral steroids
B. Short-acting beta-agonist (SABA)
C. Long-acting inhaled steroid
D. Antihistamine
Correct Answer: B
Rationale: SABA is first-line for exercise-induced bronchospasm and provides rapid relief.
Long-term control may require inhaled corticosteroids.
11
A 72-year-old male has a PSA of 6.0 ng/mL. Interpretation:
A. Normal
B. Elevated
C. Indicative of UTI
D. Diagnostic of prostate cancer
Correct Answer: B
Rationale: PSA >4.0 ng/mL is considered elevated, but this is not diagnostic; further evaluation
including repeat PSA and possible biopsy is indicated.
