ANCC FNP BOARD ACTUAL EXAM
QUESTIONS WITH CORRECT
ANSWERS 100% VERIFIED GRADED
A+
Ammiddle-
agemfemalempatientmpresentsmtomthemclinicmwithmamrecurrencemofmmildmhidradenitismsuppurativama
ftermtopicalmtherapiesmfailed.mWhichmfirst-linemtreatmentmismrecommended?m-
mCORRECTmANSWERmTetracycline
Twelvemweeksmofmoralmtetracyclinem(Sumycin)mismthemrecommendedmfirst-
linemtreatmentmformhidradenitismsuppurativa.
__________________________________________________
Hidradenitismsuppurativamismamdisordermofmthemterminalmfollicularmepitheliumminmapocrinemgland-
bearingmskin.mItmismamchronic,mdisablingmdisordermthatmprogresses,moftenmcausingmkeloids,mcontrac
tures,mandmimmobility.mItmismcharacterizedmbymcomedone-
likemfollicularmocclusion,mchronicmandmrelapsingminflammation,mmucopurulentmdischarge,mandmpro
gressivemscarring.
Arthropathymassociatedmwithmhidradenitismmaymbempresent.mTypicalmpresentationmincludesmnodul
esmandmsinusmtractsm(inflamedmormnoninflamed),mabscesses,mandmscarringmfoundminmthemaxilla,mge
nitofemoralmarea,mperineum,mglutealmarea,mandminframammarymareaminmwomen.
Recommendedmtreatmentsmincludemantibiotics,msteroids,mretinoids,mdapsone,mandmanti-
tumormnecrosismfactormagents.mAmdermatologymconsultationmshouldmalsombemconsidered.
First-
linemtreatmentmismam12-weekmcoursemofmanmoralmtetracyclinem(Sumycin)msuchmasmdoxycycline.mForm
patientsmwhomdomnotmrespondmtomdoxycycline,mthemnextmrecommendedmstepmismamcombinationmo
fmtwice-dailymclindamycinm(Cleocin)mandmrifampicinm(Rifadin)mform10-
12mweeks.mIfmtreatmentmfails,macitretinm(Soriatane,mformmalesmandmnonfertilemfemales)mormdapson
em(Aczone)mmaymbemconsideredmbymamdermatologist.mInmpatientsmwithmmoderatemtomseveremhidra
denitismsuppurativa,madalimumabm(Humira)mmaympossiblymbemconsidered.
,WhenmprovidingmculturallymcompetentmhealthmcaremservicesmtomanmAmericanmIndianmelder,mthemn
ursempractitionermunderstandsmwhichmismtraditionallymtrue?m-
mCORRECTmANSWERmThem"MedicinemWheel"mismusedmbymmanymformthempurposemofmhealthmandmh
ealing
Them"MedicinemWheel"mismtraditionallymusedmandmcontainsmfourmdirections;mnorth,msouth,meast,ma
ndmwest.mTraditionallymeachmtribemhasmdifferentmmeaningsmformeachmdirectionmandmtheymmaymrepr
esentmthemseasonmofmthemyearmormstagemofmlife.mItmismaimedmatmprovidingmamholisticmviewmofmlife.
________________________________________
Anmunderstandingmofmdifferentmculturalmpreferencesmleadsmtomculturalmcompetenceminmhealthcare
.mSomempatientsmmaymvaluemtraditionalmculturemandmpreferencesmasmitmrelatesmtomhealthcare.mThe
semindividualmpreferencesmshouldmbemincludedminmtheminterviewmandmtreatmentmplanmformpatients
.
Traditionally,mthemAmericanmIndianmculturemvaluesmamholisticmapproachmtomhealthmcaremintegratin
gmthemperson,mlifestyle,menvironment,mfamily,mandmreligion.mPatientsmadheringmtomthesemtradition
almculturalmpracticesmoftenmfeelmthatmillnessmismduemtomamlackmofmharmonymwithmthemphysicalmbody
,mmind,mspirit,mandmemotions.mPatientsmmaymseekmcaremfrommwesternmmedicinemformspecificmailm
entsmwhilemalsomconsultingmwithmtraditionalmhealersmformspiritualmguidance.
Healthcaremprovidersmshouldmseekmtomunderstandmrelevantmculturalmfactorsmandmassessmeachmindi
vidual'smhealthcaremliteracyminmordermtomprovidemculturallymcompetentmcare.
Themnursempractitionermseesmanmoldermadultmpatientminmthemclinicmwithmthemprimarymreportmofmhe
aringmlossmandmamsensationmofmfullnessminmthemrightmear.mThemnursempractitionermsuspectsmconduc
tivemhearingmloss.mWhichmcouldmcontributemtomthis?m-
mCORRECTmANSWERmCerumen,mcommonlymcalledmearwax,mismamcombinationmofmsecretionsmandmsl
oughedmepithelialmcellsmthatmprotectsmthemearsmfromminfection,mwater,mandminsects.mItmismnormall
ymexpelledmfrommthemearmcanalmthroughmnaturalmjawmmovement.mWhenmthismself-
cleaningmprocessmfails,mcerumenmcanmbecomemimpacted.mCerumenmimpactionmoccludesmthemearm
canalmandmcanmpressmagainstmthemtympanicmmembrane,mresultingminmconductivemhearingmloss.
_________________________________________
, Conductivemhearingmismthemtransitionmofmsoundmfrommthemexternalmandmmiddlemearmtomtheminnerm
ear.mConductivemhearingmlossmismcausedmbymproblemsminmthemexternalmandmmiddlemearmthatminterf
eremwithmthemtransmissionmofmsoundmandmitsmconversionmtommechanicalmvibration.mCausesmofmcon
ductivemhearingmlossmincludemobstructionmofmthemexternalmauditorymcanalmbymcerumen,mforeignmb
odies,mdebrismfrommotitismexterna,mandmlargemexocytosismandmosteomas.
Sensorineuralmhearingmlossminvolvesmdifficultymconvertingmmechanicalmvibrationsmtomelectricalmpo
tentialminmthemcochleamorminmauditorymnervemtransmissionmtomthembrain.mItmismmostlymcausedmbymp
ermanentmdamageminmthemorganmofmCorti.mItmcanmbemcausedmbymage-
relatedmhearingmloss,mnoisemtrauma,mmedications,mautoimmunemdiseases,mmechanicalmtrauma,m
Menieremdisease,minfection,mandmneoplasmm(acousticmneuroma).
Approximatelymone-
thirdmofmoldermadultsmbetweenmthemagesmofm61mandm70myearsmhavemhearingmloss.mMoremthanm90%
mofmadultsmoldermthanm85myearsmofmagemhavemhearingmloss.mThemmostmcommonmtypemofmhearingml
ossmismage-
relatedmandmsensorineural.mAllmadultsmoldermthanm60myearsmofmagemshouldmbemscreenedmformheari
ngmlossmatmperiodicmhealthmexaminations.
Anmotherwisemhealthymadultmpatientmpresentsmtomthemclinicmwithmamdiagnosismofmcommunity-
acquiredmpneumoniamandmnomrecentmantibioticmtherapy.mWhichmismthembestmoptionmformtreatmen
t?m-mCORRECTmANSWERmAmoxicillin
High-dosemamoxicillinm(Amoxil)mormdoxycyclinemaremrecommendedmasmfirst-
linemtherapymformadultsmwithoutmcomorbidities.
_____________________________________________
Community-acquiredmpneumoniam(CAP)mismpneumoniamnotmacquiredminmamhospitalmormlong-
termmcaremfacility.mPatientsmwithmsuspectedmCAPmshouldmreceivemamchestmX-
raymformdiagnosis.mThemPneumoniamSeveritymIndexmshouldmbemusedmtomassistminmdecisionsmregardi
ngmthemneedmformhospitalizationminmpatientsmwithmCAP.
AccordingmtomthemAmericanmThoracicmSocietym(ATS)mandmthemInfectiousmDiseasesmSocietymofmAme
ricam(IDSA)m2019mguidelines,mtheminitialmtreatmentmofmCAPmformmostmpatientsmismamoxicillinmormdo
xycycline.mMacrolidesmaremanmoptionmformtreatment,mbutmaremnomlongermrecommendedmroutinely
QUESTIONS WITH CORRECT
ANSWERS 100% VERIFIED GRADED
A+
Ammiddle-
agemfemalempatientmpresentsmtomthemclinicmwithmamrecurrencemofmmildmhidradenitismsuppurativama
ftermtopicalmtherapiesmfailed.mWhichmfirst-linemtreatmentmismrecommended?m-
mCORRECTmANSWERmTetracycline
Twelvemweeksmofmoralmtetracyclinem(Sumycin)mismthemrecommendedmfirst-
linemtreatmentmformhidradenitismsuppurativa.
__________________________________________________
Hidradenitismsuppurativamismamdisordermofmthemterminalmfollicularmepitheliumminmapocrinemgland-
bearingmskin.mItmismamchronic,mdisablingmdisordermthatmprogresses,moftenmcausingmkeloids,mcontrac
tures,mandmimmobility.mItmismcharacterizedmbymcomedone-
likemfollicularmocclusion,mchronicmandmrelapsingminflammation,mmucopurulentmdischarge,mandmpro
gressivemscarring.
Arthropathymassociatedmwithmhidradenitismmaymbempresent.mTypicalmpresentationmincludesmnodul
esmandmsinusmtractsm(inflamedmormnoninflamed),mabscesses,mandmscarringmfoundminmthemaxilla,mge
nitofemoralmarea,mperineum,mglutealmarea,mandminframammarymareaminmwomen.
Recommendedmtreatmentsmincludemantibiotics,msteroids,mretinoids,mdapsone,mandmanti-
tumormnecrosismfactormagents.mAmdermatologymconsultationmshouldmalsombemconsidered.
First-
linemtreatmentmismam12-weekmcoursemofmanmoralmtetracyclinem(Sumycin)msuchmasmdoxycycline.mForm
patientsmwhomdomnotmrespondmtomdoxycycline,mthemnextmrecommendedmstepmismamcombinationmo
fmtwice-dailymclindamycinm(Cleocin)mandmrifampicinm(Rifadin)mform10-
12mweeks.mIfmtreatmentmfails,macitretinm(Soriatane,mformmalesmandmnonfertilemfemales)mormdapson
em(Aczone)mmaymbemconsideredmbymamdermatologist.mInmpatientsmwithmmoderatemtomseveremhidra
denitismsuppurativa,madalimumabm(Humira)mmaympossiblymbemconsidered.
,WhenmprovidingmculturallymcompetentmhealthmcaremservicesmtomanmAmericanmIndianmelder,mthemn
ursempractitionermunderstandsmwhichmismtraditionallymtrue?m-
mCORRECTmANSWERmThem"MedicinemWheel"mismusedmbymmanymformthempurposemofmhealthmandmh
ealing
Them"MedicinemWheel"mismtraditionallymusedmandmcontainsmfourmdirections;mnorth,msouth,meast,ma
ndmwest.mTraditionallymeachmtribemhasmdifferentmmeaningsmformeachmdirectionmandmtheymmaymrepr
esentmthemseasonmofmthemyearmormstagemofmlife.mItmismaimedmatmprovidingmamholisticmviewmofmlife.
________________________________________
Anmunderstandingmofmdifferentmculturalmpreferencesmleadsmtomculturalmcompetenceminmhealthcare
.mSomempatientsmmaymvaluemtraditionalmculturemandmpreferencesmasmitmrelatesmtomhealthcare.mThe
semindividualmpreferencesmshouldmbemincludedminmtheminterviewmandmtreatmentmplanmformpatients
.
Traditionally,mthemAmericanmIndianmculturemvaluesmamholisticmapproachmtomhealthmcaremintegratin
gmthemperson,mlifestyle,menvironment,mfamily,mandmreligion.mPatientsmadheringmtomthesemtradition
almculturalmpracticesmoftenmfeelmthatmillnessmismduemtomamlackmofmharmonymwithmthemphysicalmbody
,mmind,mspirit,mandmemotions.mPatientsmmaymseekmcaremfrommwesternmmedicinemformspecificmailm
entsmwhilemalsomconsultingmwithmtraditionalmhealersmformspiritualmguidance.
Healthcaremprovidersmshouldmseekmtomunderstandmrelevantmculturalmfactorsmandmassessmeachmindi
vidual'smhealthcaremliteracyminmordermtomprovidemculturallymcompetentmcare.
Themnursempractitionermseesmanmoldermadultmpatientminmthemclinicmwithmthemprimarymreportmofmhe
aringmlossmandmamsensationmofmfullnessminmthemrightmear.mThemnursempractitionermsuspectsmconduc
tivemhearingmloss.mWhichmcouldmcontributemtomthis?m-
mCORRECTmANSWERmCerumen,mcommonlymcalledmearwax,mismamcombinationmofmsecretionsmandmsl
oughedmepithelialmcellsmthatmprotectsmthemearsmfromminfection,mwater,mandminsects.mItmismnormall
ymexpelledmfrommthemearmcanalmthroughmnaturalmjawmmovement.mWhenmthismself-
cleaningmprocessmfails,mcerumenmcanmbecomemimpacted.mCerumenmimpactionmoccludesmthemearm
canalmandmcanmpressmagainstmthemtympanicmmembrane,mresultingminmconductivemhearingmloss.
_________________________________________
, Conductivemhearingmismthemtransitionmofmsoundmfrommthemexternalmandmmiddlemearmtomtheminnerm
ear.mConductivemhearingmlossmismcausedmbymproblemsminmthemexternalmandmmiddlemearmthatminterf
eremwithmthemtransmissionmofmsoundmandmitsmconversionmtommechanicalmvibration.mCausesmofmcon
ductivemhearingmlossmincludemobstructionmofmthemexternalmauditorymcanalmbymcerumen,mforeignmb
odies,mdebrismfrommotitismexterna,mandmlargemexocytosismandmosteomas.
Sensorineuralmhearingmlossminvolvesmdifficultymconvertingmmechanicalmvibrationsmtomelectricalmpo
tentialminmthemcochleamorminmauditorymnervemtransmissionmtomthembrain.mItmismmostlymcausedmbymp
ermanentmdamageminmthemorganmofmCorti.mItmcanmbemcausedmbymage-
relatedmhearingmloss,mnoisemtrauma,mmedications,mautoimmunemdiseases,mmechanicalmtrauma,m
Menieremdisease,minfection,mandmneoplasmm(acousticmneuroma).
Approximatelymone-
thirdmofmoldermadultsmbetweenmthemagesmofm61mandm70myearsmhavemhearingmloss.mMoremthanm90%
mofmadultsmoldermthanm85myearsmofmagemhavemhearingmloss.mThemmostmcommonmtypemofmhearingml
ossmismage-
relatedmandmsensorineural.mAllmadultsmoldermthanm60myearsmofmagemshouldmbemscreenedmformheari
ngmlossmatmperiodicmhealthmexaminations.
Anmotherwisemhealthymadultmpatientmpresentsmtomthemclinicmwithmamdiagnosismofmcommunity-
acquiredmpneumoniamandmnomrecentmantibioticmtherapy.mWhichmismthembestmoptionmformtreatmen
t?m-mCORRECTmANSWERmAmoxicillin
High-dosemamoxicillinm(Amoxil)mormdoxycyclinemaremrecommendedmasmfirst-
linemtherapymformadultsmwithoutmcomorbidities.
_____________________________________________
Community-acquiredmpneumoniam(CAP)mismpneumoniamnotmacquiredminmamhospitalmormlong-
termmcaremfacility.mPatientsmwithmsuspectedmCAPmshouldmreceivemamchestmX-
raymformdiagnosis.mThemPneumoniamSeveritymIndexmshouldmbemusedmtomassistminmdecisionsmregardi
ngmthemneedmformhospitalizationminmpatientsmwithmCAP.
AccordingmtomthemAmericanmThoracicmSocietym(ATS)mandmthemInfectiousmDiseasesmSocietymofmAme
ricam(IDSA)m2019mguidelines,mtheminitialmtreatmentmofmCAPmformmostmpatientsmismamoxicillinmormdo
xycycline.mMacrolidesmaremanmoptionmformtreatment,mbutmaremnomlongermrecommendedmroutinely
