FNP-C Practice Questions: 10 Free Sample Questions with Rationales

Question: A 55-year-old male with no significant medical history presents with a blood pressure of 152/94 mmHg on two separate visits. According to the latest ACC/AHA guidelines, what is the most appropriate first-line treatment?

A) Beta-blocker
B) ACE inhibitor
C) Loop diuretic
D) Alpha-blocker

Answer: B) ACE inhibitor

Rationale: First-line treatment for **stage 1 hypertension** in a patient without compelling indications includes **ACE inhibitors, ARBs, calcium channel blockers, or thiazide diuretics**. Beta-blockers are not first-line unless there is a specific indication (e.g., post-MI, heart failure).

Question: Which of the following lab values confirms a diagnosis of diabetes mellitus?

A) Fasting glucose of 115 mg/dL
B) A1C of 6.3%
C) Random glucose of 205 mg/dL with symptoms
D) 2-hour OGTT result of 175 mg/dL

Answer: C) Random glucose of 205 mg/dL with symptoms

Rationale: A **random blood glucose ≥ 200 mg/dL with classic symptoms** (polyuria, polydipsia, weight loss) confirms diabetes. Other criteria include **A1C ≥ 6.5%, fasting glucose ≥ 126 mg/dL, or OGTT ≥ 200 mg/dL**.

Question: A patient with COPD presents with increased dyspnea, wheezing, and a productive cough. What is the most appropriate next step?

A) Initiate oxygen therapy at 6 L/min
B) Prescribe oral corticosteroids and bronchodilators
C) Order a chest X-ray to rule out pneumonia
D) Start a long-acting beta agonist (LABA)

Answer: B) Prescribe oral corticosteroids and bronchodilators

Rationale: COPD exacerbations are managed with **bronchodilators (SABA/SAMA), corticosteroids, and possibly antibiotics**. Oxygen should be given cautiously to avoid CO2 retention.

Question: What is the first-line antibiotic for acute otitis media in a child with no allergies?

A) Azithromycin
B) Amoxicillin
C) Ceftriaxone
D) Levofloxacin

Answer: B) Amoxicillin

Rationale: **Amoxicillin is the first-line antibiotic** for acute otitis media unless the child has allergies or recent antibiotic use, in which case **amoxicillin-clavulanate** or **cephalosporins** may be used.

Question: A 30-year-old woman presents with fatigue and pallor. Her labs show low hemoglobin, low MCV, and low ferritin. What is the most likely diagnosis?

A) Iron-deficiency anemia
B) Vitamin B12 deficiency
C) Anemia of chronic disease
D) Hemolytic anemia

Answer: A) Iron-deficiency anemia

Rationale: **Iron-deficiency anemia** is characterized by **low MCV (microcytic), low ferritin, and low hemoglobin**. B12 deficiency presents with **macrocytic anemia**, and anemia of chronic disease has normal or increased ferritin.