Free Sample FNP Practice Questions

See why TrueLearn is a trusted resource for thousands of medical students and residents. We understand that it’s all about the content. That’s why we have high-yield family nurse practitioner practice questions written and screened by high-performing physician authors, which are updated on a regular basis to ensure our SmartBanks stay up-to-date with exam blueprint changes. Below is a free FNP sample question so you can see what we mean.

Your First Free FNP Practice Question

A 4-year-old boy presents to the office with a chief complaint of fever for 6 days. Except for the fever, the patient had been asymptomatic until the development of “bloodshot eyes” 1 day ago. His father indicates that the patient has no past medical problems. Vital signs show a temperature of 103.2°F. Physical examination reveals right-sided cervical lymphadenopathy; painful induration on the soles of both feet with associated edema; and a diffuse, maculopapular, erythematous rash on the trunk. Laboratory analysis reveals an erythrocyte sedimentation rate of 107 mm/hr.

Which of the following is the most likely diagnosis?

• A) Acute rheumatic fever
• B) Kawasaki disease
• C) Rocky Mountain spotted fever
• D) Staphylococcal scalded skin syndrome
• E) Stevens-Johnson syndrome

The Answer and Explanation

The correct answer is: B

The differential diagnosis for a child with a history of fever and skin manifestations is extensive. Careful history and physical examination can help to quickly narrow the differential and formulate a diagnosis. Kawasaki disease is diagnosed based on clinical criteria as follows:

• Fever, usually greater than 102 °F, for at least 5 days
• At least 4 of the following:
  • Oral mucosal changes
  • Bilateral conjunctival injection
  • Cervical lymphadenopathy
  • Swelling or redness of the extremities
  • Polymorphous rash.

Treatment includes an initial single dose of intravenous immunoglobulin (2 g/kg) and high-dose aspirin (80–100 mg/kg/day, divided into 4 doses). Complications of Kawasaki disease include ischemic heart disease, coronary artery aneurysms, and sudden death.

Answer A: Acute rheumatic fever is a clinical sequelae of infection associated with group A streptococci that presents with cardiomegaly, friction rub due to pericarditis, heart murmur, and congestive heart failure. It is diagnosed using the Jones Criteria.

Answer C: Rocky Mountain spotted fever is a tickborne illness caused by Rickettsia rickettsii, that leads to sudden spiking fever, headache, myalgias, weakness, and confusion. A rash on the extremities spreading centrally to the trunk is a hallmark of the disease.

Answer D: Staphylococcal scalded skin syndrome produces bullous lesions causing cleavage of the stratum corneum. It is diagnosed clinically by way of Nikolsky’s sign, whereby gentle pressure on the lesion causes rupture of the bullae and reveals underlying skin.

Answer E: Stevens-Johnson syndrome is associated with a wide variety of infections (e.g., mycoplasma) or drug allergies. It leads to severe mucosal erosions and high fever; severe bullous erythema multiforme is sometimes seen.

Bottom Line

Kawasaki disease is indicated by fever, usually greater than 102 °F, for at least 5 days; and at least 4 of 5 of the following: 1) oral mucosal changes, 2) bilateral conjunctival injection, 3) cervical lymphadenopathy, 4) swelling or redness of the extremities, and 5) polymorphous rash.

For more information, see:

• Kliegman T, St. Geme, J, eds. Nelson Textbook of Pediatrics. 21st ed. Chapter 191: Kawasaki Disease. Philadelphia, PA; Elsevier Inc., 2020.
• Saguil A, Fargo M. Diagnosis and management of Kawasaki disease. Am Fam Physician. 2015;91(6):365-71.
• Sundel R. Kawasaki disease: clinical features and diagnosis. TePas E, ed. UpToDate. Waltham, MA.

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