FNP COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS PACK
2026
▶ All of the following are false statements regarding acute gastritis except:
A) Chronic intake of nonsteroidal anti-inflammatory drugs (NSAIDs) can
cause the disorder
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening test for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy. Answer:
C) The screening test for the disorder is the barium swallow test
The gold standard for diagnosing gastric disease is biopsy of gastric and/or
duodenal tissue by upper endoscopy. Chronic use of NSAIDs disrupts the
production of prostaglandins, which decreases blood supply and then
breaks down the protective layer of the mucosa, which leads to gastric
disease.
▶ Signs and symptoms of depression include all of the following except:
A) Anhedonia and changes in appetite
B) Decreased energy and irritability
C) Apathy and low self-esteem
D) Apraxia and fatigue. Answer: D) Apraxia and fatigue
Apraxia is a disorder of the nervous system in which the brain is affected
and the patient is unable to move the arms/legs when asked to do so.
Common signs of depression include anhedonia (loss of interest in
activities that the patient finds pleasurable), unintentional weight loss or
gain, fatigue, change in appetite, insomnia or hypersomnia, feelings of guilt
and worthlessness, and recurrent thoughts of suicide.
▶ Which of the following is an accurate description of eliciting for Murphy's
sign?
,A) Upon deep inspiration by the patient, palpate firmly in the right upper
quad- rant of the abdomen below the costovertebral angle
B) Bend the patient's hips and knees at 90 degrees, then passively rotate
hip exter- nally, then internally
C) Ask the patient to squat, then place the stethoscope on the apical area
D) Press into the abdomen deeply, then release it suddenly. Answer: A)
Upon deep inspiration by the patient, palpate firmly in the right upper quad-
rant of the abdomen below the costovertebral angle
Murphy's sign is positive if pain occurs when performing RUQ palpation
while the patient takes a deep inspiration, causing the patient to abruptly
stop the deep breath due to pain. As the liver is palpated, it will descend
and push up against the inflamed gallbladder and cause sharp pain
(cholecystitis).
▶ A 28-year-old multipara who is at 32 weeks of gestation presents to your
office complaining of a sudden onset of small amounts of bright red vaginal
bleeding. She has had several episodes and appears anxious. On exam,
her uterus is soft to palpation. Which of the following is most likely?
A) Placenta abruptio
B) Placenta previa
C) Acute cervicitis
D) Molar pregnancy (hydatidiform mole). Answer: B) Placenta previa
Placenta previa occurs when abnormal implantation of the placenta occurs.
A common symptom of placenta previa is painless, bright red bleeding.
▶ Epidemiologic studies show that Hashimoto's disease occurs most
commonly in:
A) Middle-aged to older women
B) Smokers
C) Obese individuals
D) Older men. Answer: A) Middle-aged to older women
Hashimoto's disease commonly occurs in middle-aged to older women.
,▶ A 48-year-old woman is told by a physician that she is starting
menopause. All of the following are possible findings except:
A) Hot flashes
B) Irregular menstrual periods
C) Severe vaginal atrophic changes
D) Cyclic mood swings. Answer: C) Severe vaginal atrophic changes
As women reach menopause, changes that may occur include hot flashes,
irregular menstrual periods, and cyclic mood swings. Vaginal changes,
such as dryness and thinning, may also begin to occur
▶ A 63-year-old patient with a 10-year history of poorly controlled
hypertension presents with a cluster of physical exam findings. Which of
the following indicate target organ damage commonly seen in hypertensive
patients?
A) Pedal edema, hepatomegaly, and enlarged kidneys
B) Hepatomegaly, AV nicking, bibasilar crackles
C) Renal infection, S3, neuromuscular abnormalities
D) Glaucoma, jugular vein atrophy, heart failure. Answer: B)
Hepatomegaly, AV nicking, bibasilar crackles
With long-term, uncontrolled hypertension, organ damage may occur.
Organs commonly affected include: brain (stroke), eyes (retinopathy, AV
nicking, bleeding, blindness), heart (heart dis- ease, left ventricular
hypertrophy, MI, and/or CHF), and kidneys (renal failure, proteinuria).
▶ A 30-year-old primigravida is diagnosed with a possible threatened
abortion. The result of the urine pregnancy test is positive. Which of the
following statements is true regarding a threatened abortion?
A) Vaginal bleeding and cramping are present, but the cervix remains
closed
B) Vaginal bleeding and cramping are present along with a dilated cervix
C) The fetus and placenta are all expelled
D) The products of conception and the placenta remain inside the uterus
along
, with a dilated cervix. Answer: A) Vaginal bleeding and cramping are
present, but the cervix remains closed
Threatened abortion is defined as vaginal bleeding and cramping with- out
the presence of cervical dilation.
▶ A 30-year-old female who is sexually active complains of a large amount
of milk- like vaginal discharge for several weeks. A microscopy slide
reveals a large amount of squamous epithelial cells that have blurred
margins. Very few white blood cells are seen. The vaginal pH is at 6.0.
What is most likely?
A) Trichomonas infection
B) Bacterial vaginosis
C) Candidal infection
D) A normal finding. Answer: B) Bacterial vaginosis
Bacterial vaginosis is a bacterial infection of the vagina. Signs and
symptoms include copious off-white to gray discharge with foul odor without
vaginal erythema or irritation. Wet prep will show positive for clue cells.
When performing a wet prep, the "whiff test" will be positive for a strong
"fishy" odor when vaginal discharge is mixed with one drop of KOH.
▶ The Pap smear result on a 20-year-old sexually active student who uses
condoms inconsistently shows a large amount of inflammation. Which of
the following is the best follow-up action?
A) The NP needs to do cervical cultures to verify the presence of gonorrhea
B) Prescribe metronidazole vaginal cream for the patient over the phone
C) Call the patient and tell her she needs a repeat Pap smear in 6 months
D) Advise the patient to use a Betadine douche at bedtime x 3 days.
Answer: A) The NP needs to do cervical cultures to verify the presence of
gonor-
rhea
Cultures should be taken at the time of the Pap smear, as the patient may
not return for later diagnostic testing.
QUESTIONS AND ANSWERS PACK
2026
▶ All of the following are false statements regarding acute gastritis except:
A) Chronic intake of nonsteroidal anti-inflammatory drugs (NSAIDs) can
cause the disorder
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening test for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy. Answer:
C) The screening test for the disorder is the barium swallow test
The gold standard for diagnosing gastric disease is biopsy of gastric and/or
duodenal tissue by upper endoscopy. Chronic use of NSAIDs disrupts the
production of prostaglandins, which decreases blood supply and then
breaks down the protective layer of the mucosa, which leads to gastric
disease.
▶ Signs and symptoms of depression include all of the following except:
A) Anhedonia and changes in appetite
B) Decreased energy and irritability
C) Apathy and low self-esteem
D) Apraxia and fatigue. Answer: D) Apraxia and fatigue
Apraxia is a disorder of the nervous system in which the brain is affected
and the patient is unable to move the arms/legs when asked to do so.
Common signs of depression include anhedonia (loss of interest in
activities that the patient finds pleasurable), unintentional weight loss or
gain, fatigue, change in appetite, insomnia or hypersomnia, feelings of guilt
and worthlessness, and recurrent thoughts of suicide.
▶ Which of the following is an accurate description of eliciting for Murphy's
sign?
,A) Upon deep inspiration by the patient, palpate firmly in the right upper
quad- rant of the abdomen below the costovertebral angle
B) Bend the patient's hips and knees at 90 degrees, then passively rotate
hip exter- nally, then internally
C) Ask the patient to squat, then place the stethoscope on the apical area
D) Press into the abdomen deeply, then release it suddenly. Answer: A)
Upon deep inspiration by the patient, palpate firmly in the right upper quad-
rant of the abdomen below the costovertebral angle
Murphy's sign is positive if pain occurs when performing RUQ palpation
while the patient takes a deep inspiration, causing the patient to abruptly
stop the deep breath due to pain. As the liver is palpated, it will descend
and push up against the inflamed gallbladder and cause sharp pain
(cholecystitis).
▶ A 28-year-old multipara who is at 32 weeks of gestation presents to your
office complaining of a sudden onset of small amounts of bright red vaginal
bleeding. She has had several episodes and appears anxious. On exam,
her uterus is soft to palpation. Which of the following is most likely?
A) Placenta abruptio
B) Placenta previa
C) Acute cervicitis
D) Molar pregnancy (hydatidiform mole). Answer: B) Placenta previa
Placenta previa occurs when abnormal implantation of the placenta occurs.
A common symptom of placenta previa is painless, bright red bleeding.
▶ Epidemiologic studies show that Hashimoto's disease occurs most
commonly in:
A) Middle-aged to older women
B) Smokers
C) Obese individuals
D) Older men. Answer: A) Middle-aged to older women
Hashimoto's disease commonly occurs in middle-aged to older women.
,▶ A 48-year-old woman is told by a physician that she is starting
menopause. All of the following are possible findings except:
A) Hot flashes
B) Irregular menstrual periods
C) Severe vaginal atrophic changes
D) Cyclic mood swings. Answer: C) Severe vaginal atrophic changes
As women reach menopause, changes that may occur include hot flashes,
irregular menstrual periods, and cyclic mood swings. Vaginal changes,
such as dryness and thinning, may also begin to occur
▶ A 63-year-old patient with a 10-year history of poorly controlled
hypertension presents with a cluster of physical exam findings. Which of
the following indicate target organ damage commonly seen in hypertensive
patients?
A) Pedal edema, hepatomegaly, and enlarged kidneys
B) Hepatomegaly, AV nicking, bibasilar crackles
C) Renal infection, S3, neuromuscular abnormalities
D) Glaucoma, jugular vein atrophy, heart failure. Answer: B)
Hepatomegaly, AV nicking, bibasilar crackles
With long-term, uncontrolled hypertension, organ damage may occur.
Organs commonly affected include: brain (stroke), eyes (retinopathy, AV
nicking, bleeding, blindness), heart (heart dis- ease, left ventricular
hypertrophy, MI, and/or CHF), and kidneys (renal failure, proteinuria).
▶ A 30-year-old primigravida is diagnosed with a possible threatened
abortion. The result of the urine pregnancy test is positive. Which of the
following statements is true regarding a threatened abortion?
A) Vaginal bleeding and cramping are present, but the cervix remains
closed
B) Vaginal bleeding and cramping are present along with a dilated cervix
C) The fetus and placenta are all expelled
D) The products of conception and the placenta remain inside the uterus
along
, with a dilated cervix. Answer: A) Vaginal bleeding and cramping are
present, but the cervix remains closed
Threatened abortion is defined as vaginal bleeding and cramping with- out
the presence of cervical dilation.
▶ A 30-year-old female who is sexually active complains of a large amount
of milk- like vaginal discharge for several weeks. A microscopy slide
reveals a large amount of squamous epithelial cells that have blurred
margins. Very few white blood cells are seen. The vaginal pH is at 6.0.
What is most likely?
A) Trichomonas infection
B) Bacterial vaginosis
C) Candidal infection
D) A normal finding. Answer: B) Bacterial vaginosis
Bacterial vaginosis is a bacterial infection of the vagina. Signs and
symptoms include copious off-white to gray discharge with foul odor without
vaginal erythema or irritation. Wet prep will show positive for clue cells.
When performing a wet prep, the "whiff test" will be positive for a strong
"fishy" odor when vaginal discharge is mixed with one drop of KOH.
▶ The Pap smear result on a 20-year-old sexually active student who uses
condoms inconsistently shows a large amount of inflammation. Which of
the following is the best follow-up action?
A) The NP needs to do cervical cultures to verify the presence of gonorrhea
B) Prescribe metronidazole vaginal cream for the patient over the phone
C) Call the patient and tell her she needs a repeat Pap smear in 6 months
D) Advise the patient to use a Betadine douche at bedtime x 3 days.
Answer: A) The NP needs to do cervical cultures to verify the presence of
gonor-
rhea
Cultures should be taken at the time of the Pap smear, as the patient may
not return for later diagnostic testing.
