ANCC FNP REVIEW EXAM QUESTIONS LATEST AND
COMPREHENSIVE VERSION QUESTIONS WITH VERIFIED
ANSWERS AND RATIONALES GUARANTEED PASS WITH
INSTANT PDF DOWNLOAD!!
A researcher is studying potential risk factors for obesity. She sends a questionnaire to 5000
patients who meet the CDC criteria for obesity that asks them about sedentary lifestyle factors,
consumption of processed food, and family history of obesity. The researcher sends the same
questionnaire to 5000 patients who are not obese. Which of the following best describes the
design of the study?
A. Cross-sectional study
B. Randomized controlled trial
C. Meta-analysis
D. Case-control study
CORRECT ANS: D. Case-control study
This is a retrospective case-control study. In this observational study design, subjects are
selected based on an outcome, and their prior exposures are assessed and compared to
subjects who do not have the particular outcome. The result of the study is expressed as an
odds ratio: OR = (# exposed with disease / # exposed without disease) / (# not exposed with
disease / # not exposed without disease). A retrospective case-control study does not prove
causation but demonstrates an association.
Incorrect
Answers:
A. A cross-sectional study is used to assess disease status and risk factors at 1 point in time.
B. A randomized controlled trial refers to a study where a group is given a treatment and
outcomes are compared against a control group given a placebo or treated with the standard of
care.
C. A meta-analysis provides a statistical analysis of the results of multiple studies.
Vital Concepts:
In an observational study design, subjects are selected based on an outcome, and their prior
exposures are assessed and compared to subjects who do not have a particular outcome. The
result of the study is expressed as an odds ratio: OR = (# exposed with disease / # exposed
,without disease) / (# not exposed with disease / # not exposed without disease). A
retrospective case-control study does not prove causation but demonstrates an association.
A 49-year-old female presents to the office with a history of breast cancer who is having
frequent hot flashes who already tried first-line lifestyle changes without improvement? What is
the best treatment for this patient?
A. Hormonal therapy with estrogen and progesterone
B. Bioidentical hormones
C. Citalopram
D. Black cohosh
CORRECT ANS: C. Citalopram
Selective serotonin reuptake inhibitors (SSRI)s are the most effective pharmacologic choice for
the vasomotor symptoms of menopause. Citalopram is an SSRI that has good evidence of
efficacy against these symptoms and is typically well-tolerated.
Incorrect Answers:
A. Women with a history of breast cancer are not candidates for hormone replacement therapy.
B. "Bioidentical hormones" are compounded mixtures of multiple hormones. There is no
evidence to support their use at this time, and again, hormone treatment would be
contraindicated in a patient with a history of breast cancer.
D. Black cohosh is an herbal remedy marketed for use with hot flashes. However, it has not been
demonstrated to be more effective than a placebo for this use. In addition, it has been posited
to have a possible estrogenic effect on breast tissue, which should be avoided in patients with a
history of breast cancer.
Vital Concepts:
Selective serotonin reuptake inhibitors (SSRI)s are the most effective pharmacologic choice for
the vasomotor symptoms of menopause. Citalopram is an SSRI that has good evidence of
efficacy against these symptoms and is typically well-tolerated.
A 20-year-old presents to the office for a wellness check. What is the prevalence of bulimia
nervosa in female college students?
A. 1%
B.2%
C. 4%
D. 5%
CORRECT ANS: D. 5%
Bulimia nervosa occurs in approximately 5% of female college students, who are 10x more likely
than male college students to develop this disorder. The prevalence of anorexia nervosa is 1.5%
in teenage girls overall.
,Incorrect Answers:
(A), (B), (C) are the not correct prevalence.
A 16-year-old male presents because he is concerned about acne. He first began to notice
worsening acne 6 months ago and began using over-the-counter benzoyl peroxide and, after 3
months, saw his primary care physician who prescribed tretinoin and oral tetracycline. He states
that he has been using both medications for the last 3 months but there is no improvement in
acne. He also states he has noticed he is very quick to anger and moody over the last few
months and wonders whether that is a side effect of the acne medications. He is a football
player for his high school and has been participating in extra practices to "bulk up" in the hopes
of achieving a college scholarship. Upon closer inspection, he has gained 30 pounds in the last 3
months but does not appear overweight, rather has increased muscle mass. He states that a
friend on the football team has been giving him pills to help his performance. Which of the
following is most likely to be identified?
A. Increased serum luteinizing hormone levels
B. Decreased prothrombin time
C. Lowered thyroxine binding globulin (TBG) levels
D. Increased serum HDL cholesterol
CORRECT ANS: C. Lowered thyroxine binding globulin (TBG) levels
Anabolic steroids can lower thyroxine-binding globulin (TBG) levels which, in turn, can decrease
total T4 levels, although free T4 remains the same.
Incorrect Answers:
A. This patient has multiple features that are consistent with anabolic steroid use, including
acne, a rapid increase in weight and muscle mass, and mood swings. In men steroid use
decreases serum luteinizing hormone and follicle-stimulating hormone levels, which leads to
decreased endogenous testosterone production, decreased spermatogenesis, and testicular
atrophy. There is also an increased estrogen production due to the aromatization of circulating
testosterone which can lead to gynecomastia.
B. Anabolic steroid use can lead to increased prothrombin time as well as a suppression of
clotting factors II, V, VII, and X.
D. Anabolic steroid use can have multiple cardiovascular effects including decreased serum HDL
cholesterol, increased serum LDL cholesterol, increased total cholesterol, and increased blood
pressure. These effects appear to be reversible when anabolic steroid use is discontinued. The
risk of sudden death from cardiovascular causes can occur in an athlete abusing anabolic
steroids even when there is no evidence of atherosclerosis. This is due to an increased risk of
thrombus formation while using anabolic steroids.
, A 45-year-old woman presents with abnormal uterine bleeding. You discuss your
recommendation for endometrial sampling to rule out endometrial hyperplasia and carcinoma.
What is the most common cause of endometrial cancer?
A. Human papilloma virus
B. Hereditary nonpolyposis colorectal cancer
C. Multiple endocrine neoplasia
D. Unopposed estrogen
CORRECT ANS: D. Unopposed estrogen
Unopposed estrogen can lead to overgrowth of endometrial tissue, ultimately prompting
endometrial hyperplasia and endometrial cancer. Endometrial cancers occur that are not
related to estrogen exposure, which have a different pathologic appearance and a worse
prognosis. Women with anovulation or other types of unopposed estrogen exposure should
have exposure to progesterone or progestins at least every 3 months to reduce the risk of
endometrial hyperplasia and cancer.
Incorrect Answers:
(A) Human papilloma virus (HPV) is not the most common cause of endometrial cancer.
(B) Hereditary nonpolyposis colorectal cancer (HNPCC) is not the most common cause of
endometrial cancer.
(C) Multiple endocrine neoplasia (MEN) is not the most common cause of endometrial cancer.
A 25-year-old runner with no PMH complains of pain in the ball of her foot. She has been
experiencing this pain for 3 months, and the pain also spreads to her toes occasionally. It is
mitigated by rest and relaxation and is aggravated by running. The pain occurs at all times of the
day and is not related to psychological stress, sleep, or temperature. She recently started
running a lot more every day and has noticed that her new shoes seem a little tight.
The patient's temperature = 98.3°F, HR = 70, RR = 16, and BP = 115/75. Physical exam reveals
tenderness over the ball of the foot and over her metatarsals as well. Her foot also appears to
be quite arched. The patient has no trouble putting weight on the foot and does not have any
erythema, swelling, or discoloration. What is the best step in management?
A. Conservative therapy (rest, ice, NSAIDs)
B. X-ray of foot
C. MRI of foot
D. Arch support and orthotics of foot
CORRECT ANS: A. Conservative therapy (rest, ice, NSAIDs)
Metatarsalgia is pain on metatarsal heads that results in tenderness over the ball of the foot
COMPREHENSIVE VERSION QUESTIONS WITH VERIFIED
ANSWERS AND RATIONALES GUARANTEED PASS WITH
INSTANT PDF DOWNLOAD!!
A researcher is studying potential risk factors for obesity. She sends a questionnaire to 5000
patients who meet the CDC criteria for obesity that asks them about sedentary lifestyle factors,
consumption of processed food, and family history of obesity. The researcher sends the same
questionnaire to 5000 patients who are not obese. Which of the following best describes the
design of the study?
A. Cross-sectional study
B. Randomized controlled trial
C. Meta-analysis
D. Case-control study
CORRECT ANS: D. Case-control study
This is a retrospective case-control study. In this observational study design, subjects are
selected based on an outcome, and their prior exposures are assessed and compared to
subjects who do not have the particular outcome. The result of the study is expressed as an
odds ratio: OR = (# exposed with disease / # exposed without disease) / (# not exposed with
disease / # not exposed without disease). A retrospective case-control study does not prove
causation but demonstrates an association.
Incorrect
Answers:
A. A cross-sectional study is used to assess disease status and risk factors at 1 point in time.
B. A randomized controlled trial refers to a study where a group is given a treatment and
outcomes are compared against a control group given a placebo or treated with the standard of
care.
C. A meta-analysis provides a statistical analysis of the results of multiple studies.
Vital Concepts:
In an observational study design, subjects are selected based on an outcome, and their prior
exposures are assessed and compared to subjects who do not have a particular outcome. The
result of the study is expressed as an odds ratio: OR = (# exposed with disease / # exposed
,without disease) / (# not exposed with disease / # not exposed without disease). A
retrospective case-control study does not prove causation but demonstrates an association.
A 49-year-old female presents to the office with a history of breast cancer who is having
frequent hot flashes who already tried first-line lifestyle changes without improvement? What is
the best treatment for this patient?
A. Hormonal therapy with estrogen and progesterone
B. Bioidentical hormones
C. Citalopram
D. Black cohosh
CORRECT ANS: C. Citalopram
Selective serotonin reuptake inhibitors (SSRI)s are the most effective pharmacologic choice for
the vasomotor symptoms of menopause. Citalopram is an SSRI that has good evidence of
efficacy against these symptoms and is typically well-tolerated.
Incorrect Answers:
A. Women with a history of breast cancer are not candidates for hormone replacement therapy.
B. "Bioidentical hormones" are compounded mixtures of multiple hormones. There is no
evidence to support their use at this time, and again, hormone treatment would be
contraindicated in a patient with a history of breast cancer.
D. Black cohosh is an herbal remedy marketed for use with hot flashes. However, it has not been
demonstrated to be more effective than a placebo for this use. In addition, it has been posited
to have a possible estrogenic effect on breast tissue, which should be avoided in patients with a
history of breast cancer.
Vital Concepts:
Selective serotonin reuptake inhibitors (SSRI)s are the most effective pharmacologic choice for
the vasomotor symptoms of menopause. Citalopram is an SSRI that has good evidence of
efficacy against these symptoms and is typically well-tolerated.
A 20-year-old presents to the office for a wellness check. What is the prevalence of bulimia
nervosa in female college students?
A. 1%
B.2%
C. 4%
D. 5%
CORRECT ANS: D. 5%
Bulimia nervosa occurs in approximately 5% of female college students, who are 10x more likely
than male college students to develop this disorder. The prevalence of anorexia nervosa is 1.5%
in teenage girls overall.
,Incorrect Answers:
(A), (B), (C) are the not correct prevalence.
A 16-year-old male presents because he is concerned about acne. He first began to notice
worsening acne 6 months ago and began using over-the-counter benzoyl peroxide and, after 3
months, saw his primary care physician who prescribed tretinoin and oral tetracycline. He states
that he has been using both medications for the last 3 months but there is no improvement in
acne. He also states he has noticed he is very quick to anger and moody over the last few
months and wonders whether that is a side effect of the acne medications. He is a football
player for his high school and has been participating in extra practices to "bulk up" in the hopes
of achieving a college scholarship. Upon closer inspection, he has gained 30 pounds in the last 3
months but does not appear overweight, rather has increased muscle mass. He states that a
friend on the football team has been giving him pills to help his performance. Which of the
following is most likely to be identified?
A. Increased serum luteinizing hormone levels
B. Decreased prothrombin time
C. Lowered thyroxine binding globulin (TBG) levels
D. Increased serum HDL cholesterol
CORRECT ANS: C. Lowered thyroxine binding globulin (TBG) levels
Anabolic steroids can lower thyroxine-binding globulin (TBG) levels which, in turn, can decrease
total T4 levels, although free T4 remains the same.
Incorrect Answers:
A. This patient has multiple features that are consistent with anabolic steroid use, including
acne, a rapid increase in weight and muscle mass, and mood swings. In men steroid use
decreases serum luteinizing hormone and follicle-stimulating hormone levels, which leads to
decreased endogenous testosterone production, decreased spermatogenesis, and testicular
atrophy. There is also an increased estrogen production due to the aromatization of circulating
testosterone which can lead to gynecomastia.
B. Anabolic steroid use can lead to increased prothrombin time as well as a suppression of
clotting factors II, V, VII, and X.
D. Anabolic steroid use can have multiple cardiovascular effects including decreased serum HDL
cholesterol, increased serum LDL cholesterol, increased total cholesterol, and increased blood
pressure. These effects appear to be reversible when anabolic steroid use is discontinued. The
risk of sudden death from cardiovascular causes can occur in an athlete abusing anabolic
steroids even when there is no evidence of atherosclerosis. This is due to an increased risk of
thrombus formation while using anabolic steroids.
, A 45-year-old woman presents with abnormal uterine bleeding. You discuss your
recommendation for endometrial sampling to rule out endometrial hyperplasia and carcinoma.
What is the most common cause of endometrial cancer?
A. Human papilloma virus
B. Hereditary nonpolyposis colorectal cancer
C. Multiple endocrine neoplasia
D. Unopposed estrogen
CORRECT ANS: D. Unopposed estrogen
Unopposed estrogen can lead to overgrowth of endometrial tissue, ultimately prompting
endometrial hyperplasia and endometrial cancer. Endometrial cancers occur that are not
related to estrogen exposure, which have a different pathologic appearance and a worse
prognosis. Women with anovulation or other types of unopposed estrogen exposure should
have exposure to progesterone or progestins at least every 3 months to reduce the risk of
endometrial hyperplasia and cancer.
Incorrect Answers:
(A) Human papilloma virus (HPV) is not the most common cause of endometrial cancer.
(B) Hereditary nonpolyposis colorectal cancer (HNPCC) is not the most common cause of
endometrial cancer.
(C) Multiple endocrine neoplasia (MEN) is not the most common cause of endometrial cancer.
A 25-year-old runner with no PMH complains of pain in the ball of her foot. She has been
experiencing this pain for 3 months, and the pain also spreads to her toes occasionally. It is
mitigated by rest and relaxation and is aggravated by running. The pain occurs at all times of the
day and is not related to psychological stress, sleep, or temperature. She recently started
running a lot more every day and has noticed that her new shoes seem a little tight.
The patient's temperature = 98.3°F, HR = 70, RR = 16, and BP = 115/75. Physical exam reveals
tenderness over the ball of the foot and over her metatarsals as well. Her foot also appears to
be quite arched. The patient has no trouble putting weight on the foot and does not have any
erythema, swelling, or discoloration. What is the best step in management?
A. Conservative therapy (rest, ice, NSAIDs)
B. X-ray of foot
C. MRI of foot
D. Arch support and orthotics of foot
CORRECT ANS: A. Conservative therapy (rest, ice, NSAIDs)
Metatarsalgia is pain on metatarsal heads that results in tenderness over the ball of the foot
