ANCC FAMILY NURSE PRACTITIONER (FNP-BC) CERTIFICATION – 2026 EDITION
1. According to the USPSTF, at what age should colorectal cancer
screening begin for average-risk adults?
Answer: Age 45. The USPSTF recommends beginning colorectal cancer
screening at age 45 for average-risk adults, continuing through age 75.
Best Answer: A) Age 45
2. Which vaccine is recommended for adults aged 50 and older to prevent
herpes zoster (shingles)?
Answer: Recombinant zoster vaccine (RZV/Shingrix) is recommended for
adults ≥50 years, given as a 2-dose series 2–6 months apart. It is preferred
over the live zoster vaccine.
Best Answer: B) Recombinant zoster vaccine (Shingrix)
3. A 55-year-old woman with a 30 pack-year smoking history who
currently smokes asks about lung cancer screening. What is the
recommended screening?
Answer: Annual low-dose CT (LDCT) scan. The USPSTF recommends annual
LDCT for adults aged 50–80 who have a 20 pack-year history and currently
smoke or have quit within the past 15 years.
Best Answer: C) Annual low-dose CT scan
4. Which lipid value is considered the primary target for cardiovascular
risk reduction?
Answer: LDL-cholesterol (LDL-C) is the primary target. Reducing LDL-C is the
cornerstone of cardiovascular disease prevention and guides statin therapy
decisions.
Best Answer: A) LDL-cholesterol
5. What is the recommended interval for cervical cancer screening (Pap
smear alone) in women aged 21–29?
Answer: Every 3 years. Women aged 21–29 should have a Pap test every 3
years. HPV testing alone or co-testing is not recommended for this age group.
,Best Answer: B) Every 3 years
6. At what blood pressure level should pharmacologic treatment be
initiated for a previously healthy 45-year-old with no other cardiovascular
risk factors, per ACC/AHA guidelines?
Answer: ≥130/80 mmHg for high cardiovascular risk individuals. For those with
low 10-year CVD risk (<10%), lifestyle modification is first recommended for
stage 1 hypertension (130–139/80–89 mmHg), with medication at ≥140/90
mmHg.
Best Answer: C) ≥140/90 mmHg for low CVD risk
7. Which immunization is recommended for all adults aged 65 and older
who have not previously received it?
Answer: Pneumococcal vaccine (PCV20 or PCV15 followed by PPSV23). The
CDC recommends pneumococcal vaccination for all adults ≥65 years to
prevent pneumococcal pneumonia and invasive disease.
Best Answer: D) Pneumococcal vaccine
8. A patient has a BMI of 32 kg/m². How is this classified?
Answer: Obesity Class I. BMI 30.0–34.9 is classified as Obesity Class I. Class
II is 35.0–39.9, and Class III (severe obesity) is ≥40.0.
Best Answer: A) Obesity Class I
9. What is the recommended frequency for fasting blood glucose
screening in asymptomatic adults with risk factors for type 2 diabetes?
Answer: Every 3 years starting at age 35, or earlier/more frequently if risk
factors are present (overweight/obesity, family history, gestational diabetes,
prediabetes).
Best Answer: B) Every 3 years
10. Which USPSTF-recommended screening test is indicated for women
aged 40–74 with dense breasts or family history of breast cancer?
Answer: Mammography every 2 years. The USPSTF recommends biennial
mammography for all women aged 40–74. Supplemental screening with MRI
may be considered for those with very high risk.
Best Answer: C) Mammography every 2 years
11. A 62-year-old male smoker asks about abdominal aortic aneurysm
(AAA) screening. What is recommended?
,Answer: One-time abdominal ultrasound. The USPSTF recommends a one-
time screening abdominal ultrasound for AAA in men aged 65–75 who have
ever smoked (≥100 cigarettes lifetime).
Best Answer: A) One-time abdominal ultrasound at age 65–75
12. Which lifestyle modification has the greatest impact on reducing LDL
cholesterol?
Answer: Reducing dietary saturated and trans fats. Dietary modifications,
particularly reducing saturated fat (<7% of total calories) and eliminating trans
fats, produce the greatest reduction in LDL cholesterol among lifestyle
interventions.
Best Answer: B) Reducing saturated and trans fat intake
13. How often should a healthy adult with normal cholesterol be re-
screened for hyperlipidemia?
Answer: Every 5 years. For adults with normal lipid levels and no risk factors,
repeat fasting lipid panel every 5 years is appropriate.
Best Answer: C) Every 5 years
14. What is the recommended daily calcium intake for postmenopausal
women?
Answer: 1,200 mg/day. Postmenopausal women need 1,200 mg of elemental
calcium daily to support bone density and reduce the risk of osteoporosis.
Best Answer: D) 1,200 mg/day
15. The CAGE questionnaire is used to screen for which condition?
Answer: Alcohol use disorder. CAGE asks about Cutting down, Annoyance by
criticism, Guilty feelings, and Eye-opener drinks. A score of ≥2 is considered a
positive screen.
Best Answer: A) Alcohol use disorder
16. At what age does the USPSTF recommend initiating bone density
(DEXA) screening for women without risk factors?
Answer: Age 65. The USPSTF recommends screening for osteoporosis with
DEXA in women ≥65 years. Younger postmenopausal women with risk factors
may need earlier screening.
Best Answer: B) Age 65
17. Which measure best assesses central obesity and associated
cardiometabolic risk?
, Answer: Waist circumference. A waist circumference >40 inches in men and
>35 inches in women indicates central obesity and increased cardiometabolic
risk.
Best Answer: C) Waist circumference
18. A patient's PHQ-9 score is 15. What does this indicate?
Answer: Moderately severe depression. PHQ-9 scores: 0–4 none, 5–9 mild,
10–14 moderate, 15–19 moderately severe, 20–27 severe depression.
Best Answer: A) Moderately severe depression
19. Which adults should receive the high-dose or adjuvanted influenza
vaccine?
Answer: Adults ≥65 years. The CDC recommends high-dose (Fluzone High-
Dose) or adjuvanted influenza vaccine (Fluad) for older adults to improve
immune response.
Best Answer: D) Adults aged ≥65 years
20. A patient asks about aspirin use for primary prevention of
cardiovascular disease. Per current guidelines, for whom is aspirin
recommended?
Answer: Aspirin for primary CVD prevention is NOT routinely recommended.
The USPSTF recommends against initiating aspirin for primary prevention in
adults ≥60 years. For adults 40–59 with ≥10% 10-year CVD risk, the decision
should be individualized.
Best Answer: B) Not routinely recommended for primary prevention
21. What A1C level is diagnostic for diabetes mellitus?
Answer: ≥6.5%. An A1C ≥6.5% on two separate occasions (or once with
classic symptoms) is diagnostic for diabetes. A1C 5.7–6.4% indicates
prediabetes.
Best Answer: C) ≥6.5%
22. Which counseling intervention is recommended as first-line for
tobacco cessation?
Answer: Combined behavioral counseling and pharmacotherapy. The
combination of counseling (individual, group, or quitline) plus FDA-approved
pharmacotherapy (varenicline, bupropion, or NRT) produces the highest quit
rates.
Best Answer: A) Combined counseling and pharmacotherapy
23. A 70-year-old patient has a FRAX 10-year fracture risk of 20% for
major osteoporotic fracture. What is the recommended intervention?
1. According to the USPSTF, at what age should colorectal cancer
screening begin for average-risk adults?
Answer: Age 45. The USPSTF recommends beginning colorectal cancer
screening at age 45 for average-risk adults, continuing through age 75.
Best Answer: A) Age 45
2. Which vaccine is recommended for adults aged 50 and older to prevent
herpes zoster (shingles)?
Answer: Recombinant zoster vaccine (RZV/Shingrix) is recommended for
adults ≥50 years, given as a 2-dose series 2–6 months apart. It is preferred
over the live zoster vaccine.
Best Answer: B) Recombinant zoster vaccine (Shingrix)
3. A 55-year-old woman with a 30 pack-year smoking history who
currently smokes asks about lung cancer screening. What is the
recommended screening?
Answer: Annual low-dose CT (LDCT) scan. The USPSTF recommends annual
LDCT for adults aged 50–80 who have a 20 pack-year history and currently
smoke or have quit within the past 15 years.
Best Answer: C) Annual low-dose CT scan
4. Which lipid value is considered the primary target for cardiovascular
risk reduction?
Answer: LDL-cholesterol (LDL-C) is the primary target. Reducing LDL-C is the
cornerstone of cardiovascular disease prevention and guides statin therapy
decisions.
Best Answer: A) LDL-cholesterol
5. What is the recommended interval for cervical cancer screening (Pap
smear alone) in women aged 21–29?
Answer: Every 3 years. Women aged 21–29 should have a Pap test every 3
years. HPV testing alone or co-testing is not recommended for this age group.
,Best Answer: B) Every 3 years
6. At what blood pressure level should pharmacologic treatment be
initiated for a previously healthy 45-year-old with no other cardiovascular
risk factors, per ACC/AHA guidelines?
Answer: ≥130/80 mmHg for high cardiovascular risk individuals. For those with
low 10-year CVD risk (<10%), lifestyle modification is first recommended for
stage 1 hypertension (130–139/80–89 mmHg), with medication at ≥140/90
mmHg.
Best Answer: C) ≥140/90 mmHg for low CVD risk
7. Which immunization is recommended for all adults aged 65 and older
who have not previously received it?
Answer: Pneumococcal vaccine (PCV20 or PCV15 followed by PPSV23). The
CDC recommends pneumococcal vaccination for all adults ≥65 years to
prevent pneumococcal pneumonia and invasive disease.
Best Answer: D) Pneumococcal vaccine
8. A patient has a BMI of 32 kg/m². How is this classified?
Answer: Obesity Class I. BMI 30.0–34.9 is classified as Obesity Class I. Class
II is 35.0–39.9, and Class III (severe obesity) is ≥40.0.
Best Answer: A) Obesity Class I
9. What is the recommended frequency for fasting blood glucose
screening in asymptomatic adults with risk factors for type 2 diabetes?
Answer: Every 3 years starting at age 35, or earlier/more frequently if risk
factors are present (overweight/obesity, family history, gestational diabetes,
prediabetes).
Best Answer: B) Every 3 years
10. Which USPSTF-recommended screening test is indicated for women
aged 40–74 with dense breasts or family history of breast cancer?
Answer: Mammography every 2 years. The USPSTF recommends biennial
mammography for all women aged 40–74. Supplemental screening with MRI
may be considered for those with very high risk.
Best Answer: C) Mammography every 2 years
11. A 62-year-old male smoker asks about abdominal aortic aneurysm
(AAA) screening. What is recommended?
,Answer: One-time abdominal ultrasound. The USPSTF recommends a one-
time screening abdominal ultrasound for AAA in men aged 65–75 who have
ever smoked (≥100 cigarettes lifetime).
Best Answer: A) One-time abdominal ultrasound at age 65–75
12. Which lifestyle modification has the greatest impact on reducing LDL
cholesterol?
Answer: Reducing dietary saturated and trans fats. Dietary modifications,
particularly reducing saturated fat (<7% of total calories) and eliminating trans
fats, produce the greatest reduction in LDL cholesterol among lifestyle
interventions.
Best Answer: B) Reducing saturated and trans fat intake
13. How often should a healthy adult with normal cholesterol be re-
screened for hyperlipidemia?
Answer: Every 5 years. For adults with normal lipid levels and no risk factors,
repeat fasting lipid panel every 5 years is appropriate.
Best Answer: C) Every 5 years
14. What is the recommended daily calcium intake for postmenopausal
women?
Answer: 1,200 mg/day. Postmenopausal women need 1,200 mg of elemental
calcium daily to support bone density and reduce the risk of osteoporosis.
Best Answer: D) 1,200 mg/day
15. The CAGE questionnaire is used to screen for which condition?
Answer: Alcohol use disorder. CAGE asks about Cutting down, Annoyance by
criticism, Guilty feelings, and Eye-opener drinks. A score of ≥2 is considered a
positive screen.
Best Answer: A) Alcohol use disorder
16. At what age does the USPSTF recommend initiating bone density
(DEXA) screening for women without risk factors?
Answer: Age 65. The USPSTF recommends screening for osteoporosis with
DEXA in women ≥65 years. Younger postmenopausal women with risk factors
may need earlier screening.
Best Answer: B) Age 65
17. Which measure best assesses central obesity and associated
cardiometabolic risk?
, Answer: Waist circumference. A waist circumference >40 inches in men and
>35 inches in women indicates central obesity and increased cardiometabolic
risk.
Best Answer: C) Waist circumference
18. A patient's PHQ-9 score is 15. What does this indicate?
Answer: Moderately severe depression. PHQ-9 scores: 0–4 none, 5–9 mild,
10–14 moderate, 15–19 moderately severe, 20–27 severe depression.
Best Answer: A) Moderately severe depression
19. Which adults should receive the high-dose or adjuvanted influenza
vaccine?
Answer: Adults ≥65 years. The CDC recommends high-dose (Fluzone High-
Dose) or adjuvanted influenza vaccine (Fluad) for older adults to improve
immune response.
Best Answer: D) Adults aged ≥65 years
20. A patient asks about aspirin use for primary prevention of
cardiovascular disease. Per current guidelines, for whom is aspirin
recommended?
Answer: Aspirin for primary CVD prevention is NOT routinely recommended.
The USPSTF recommends against initiating aspirin for primary prevention in
adults ≥60 years. For adults 40–59 with ≥10% 10-year CVD risk, the decision
should be individualized.
Best Answer: B) Not routinely recommended for primary prevention
21. What A1C level is diagnostic for diabetes mellitus?
Answer: ≥6.5%. An A1C ≥6.5% on two separate occasions (or once with
classic symptoms) is diagnostic for diabetes. A1C 5.7–6.4% indicates
prediabetes.
Best Answer: C) ≥6.5%
22. Which counseling intervention is recommended as first-line for
tobacco cessation?
Answer: Combined behavioral counseling and pharmacotherapy. The
combination of counseling (individual, group, or quitline) plus FDA-approved
pharmacotherapy (varenicline, bupropion, or NRT) produces the highest quit
rates.
Best Answer: A) Combined counseling and pharmacotherapy
23. A 70-year-old patient has a FRAX 10-year fracture risk of 20% for
major osteoporotic fracture. What is the recommended intervention?
