ANCC FNP Board Certification Exam 2026| 150
Questions and Correct Explained Answers for
Guaranteed Pass
Question 1
A middle-age female patient presents to the clinic with a recurrence of mild hidradenitis
suppurativa after topical therapies failed. Which first-line treatment is recommended?
A. Tetracycline
B. Clindamycin (topical)
C. Adalimumab
D. Isotretinoin
Correct Answer: A. Tetracycline
Explanation: For mild-to-moderate hidradenitis suppurativa (HS) that recurs or is not fully
controlled with topical agents (e.g., topical clindamycin), oral tetracyclines (such as doxycycline
or tetracycline) are a recommended first-line systemic antibiotic option, often for a 12-week
course. Topical clindamycin is typically first-line for initial mild disease; biologics like
adalimumab are reserved for moderate-to-severe refractory cases.
Question 2
When providing culturally competent health care services to an American Indian elder, the nurse
practitioner understands which is traditionally true?
A. The "Medicine Wheel" is used by many for the purpose of health and healing
B. Western medicine is always preferred over traditional practices
C. Elders do not value holistic approaches
D. Spiritual elements are irrelevant to physical health
Correct Answer: A. The "Medicine Wheel" is used by many for the purpose of health and
healing
Explanation: Many American Indian/Indigenous cultures use the Medicine Wheel as a holistic
framework representing balance among physical, emotional, mental, and spiritual aspects of
health and healing. It guides wellness and is an important element of cultural competence in care.
,Question 3
The nurse practitioner sees an older adult patient in the clinic with the primary report of hearing
loss and a sensation of fullness in the right ear. The nurse practitioner suspects conductive
hearing loss. Which could contribute to this?
A. Cerumen
B. Presbycusis
C. Acoustic neuroma
D. Meniere's disease
Correct Answer: A. Cerumen
Explanation: Cerumen (earwax) impaction is a common, reversible cause of conductive hearing
loss in older adults, often presenting with hearing loss and a sensation of fullness or blockage.
Sensorineural causes like presbycusis, acoustic neuroma, or Meniere's disease do not typically
cause a fullness sensation from mechanical obstruction.
Question 4
An otherwise healthy adult patient presents to the clinic with a diagnosis of community-acquired
pneumonia and no recent antibiotic therapy. Which is the best option for treatment?
A. Amoxicillin
B. Levofloxacin
C. Azithromycin monotherapy (if high resistance)
D. Ceftriaxone IV
Correct Answer: A. Amoxicillin
Explanation: For healthy outpatient adults with community-acquired pneumonia (CAP) and no
comorbidities or recent antibiotic use, high-dose amoxicillin (1 g three times daily) is a
recommended first-line empiric therapy targeting Streptococcus pneumoniae. Macrolides or
doxycycline are alternatives depending on local resistance; fluoroquinolones or IV therapy are
not first-line in this low-risk setting.
Question 5
A patient presents to the clinic for conception counseling. She recently stopped taking oral
contraceptives and would like to become pregnant. Which statement about conception safety
after stopping oral contraceptives is correct?
A. Fertility returns immediately with no delay in most women
,B. There is a mandatory waiting period of 3 months
C. Conception rates are significantly lower than non-users
D. Prior use permanently impairs fertility
Correct Answer: A. Fertility returns immediately with no delay in most women (or very quickly;
conception is possible right away)
Explanation: Fertility generally returns quickly after discontinuing combined oral
contraceptives, with no negative long-term effect on ability to conceive. Many women can
become pregnant within the first few cycles (about half within 3 months, most within 12
months), similar to non-users. There is no required waiting period for safety.
Question 6
You have a 35-year-old female patient who is complaining of wrist pain. She is an administrative
assistant who does a great deal of computer work in her job. You will test her for carpal tunnel
syndrome. When you tap at the volar surface of the wrist you are performing which of the
following tests?
A. Tinel's sign
B. Phalen's test
C. Finkelstein's test
D. Allen's test
Correct Answer: A. Tinel's sign
Explanation: Tinel's sign involves tapping (percussion) over the median nerve at the volar wrist
to elicit tingling or paresthesia in the median nerve distribution, suggestive of carpal tunnel
syndrome. Phalen's involves wrist flexion; Finkelstein's is for de Quervain's; Allen's assesses
vascular patency.
Question 7
A gastrinoma located on the pancreas or the stomach which secretes gastrin, stimulating high
levels of acid production in the stomach is which of the following?
A. Zollinger-Ellison syndrome
B. Cushing's syndrome
C. Carcinoid syndrome
D. VIPoma
Correct Answer: A. Zollinger-Ellison syndrome
, Explanation: Zollinger-Ellison syndrome is caused by a gastrin-secreting tumor (gastrinoma),
usually in the pancreas or duodenum, leading to hypergastrinemia, excessive gastric acid, and
often refractory peptic ulcers.
Question 8
A 16-year-old male is in the office. He has an insect bite on his left forearm and you suspect a
brown recluse spider bite. What medical management would you provide?
A. Ice pack and elevation of the area
B. Immediate surgical debridement
C. Systemic corticosteroids
D. Broad-spectrum IV antibiotics
Correct Answer: A. Ice pack and elevation of the area
Explanation: Management of suspected brown recluse spider bites is primarily supportive: ice
packs, elevation, pain control, and monitoring for necrosis or systemic effects. Antibiotics are not
routine unless secondary infection occurs; aggressive early surgery or steroids are not first-line.
Question 9
In addition to being overweight, the American Diabetes Association recommends type 2 diabetes
mellitus testing in adults who:
A. have an HDL level of < 35 mg/dL
B. exercise regularly
C. have a family history of type 1 diabetes
D. are under 45 with normal BMI
Correct Answer: A. have an HDL level of < 35 mg/dL
Explanation: Testing for type 2 diabetes is recommended in overweight/obese adults plus
additional risk factors, including HDL <35 mg/dL (or triglycerides >250 mg/dL), hypertension,
family history, etc. Low HDL is a component of metabolic syndrome and increases risk.
Question 10
Which of the following found on an ECG would confirm atrial fibrillation?
A. Absent P waves and irregular ventricular rate
B. Sawtooth flutter waves
C. Wide QRS complexes
Questions and Correct Explained Answers for
Guaranteed Pass
Question 1
A middle-age female patient presents to the clinic with a recurrence of mild hidradenitis
suppurativa after topical therapies failed. Which first-line treatment is recommended?
A. Tetracycline
B. Clindamycin (topical)
C. Adalimumab
D. Isotretinoin
Correct Answer: A. Tetracycline
Explanation: For mild-to-moderate hidradenitis suppurativa (HS) that recurs or is not fully
controlled with topical agents (e.g., topical clindamycin), oral tetracyclines (such as doxycycline
or tetracycline) are a recommended first-line systemic antibiotic option, often for a 12-week
course. Topical clindamycin is typically first-line for initial mild disease; biologics like
adalimumab are reserved for moderate-to-severe refractory cases.
Question 2
When providing culturally competent health care services to an American Indian elder, the nurse
practitioner understands which is traditionally true?
A. The "Medicine Wheel" is used by many for the purpose of health and healing
B. Western medicine is always preferred over traditional practices
C. Elders do not value holistic approaches
D. Spiritual elements are irrelevant to physical health
Correct Answer: A. The "Medicine Wheel" is used by many for the purpose of health and
healing
Explanation: Many American Indian/Indigenous cultures use the Medicine Wheel as a holistic
framework representing balance among physical, emotional, mental, and spiritual aspects of
health and healing. It guides wellness and is an important element of cultural competence in care.
,Question 3
The nurse practitioner sees an older adult patient in the clinic with the primary report of hearing
loss and a sensation of fullness in the right ear. The nurse practitioner suspects conductive
hearing loss. Which could contribute to this?
A. Cerumen
B. Presbycusis
C. Acoustic neuroma
D. Meniere's disease
Correct Answer: A. Cerumen
Explanation: Cerumen (earwax) impaction is a common, reversible cause of conductive hearing
loss in older adults, often presenting with hearing loss and a sensation of fullness or blockage.
Sensorineural causes like presbycusis, acoustic neuroma, or Meniere's disease do not typically
cause a fullness sensation from mechanical obstruction.
Question 4
An otherwise healthy adult patient presents to the clinic with a diagnosis of community-acquired
pneumonia and no recent antibiotic therapy. Which is the best option for treatment?
A. Amoxicillin
B. Levofloxacin
C. Azithromycin monotherapy (if high resistance)
D. Ceftriaxone IV
Correct Answer: A. Amoxicillin
Explanation: For healthy outpatient adults with community-acquired pneumonia (CAP) and no
comorbidities or recent antibiotic use, high-dose amoxicillin (1 g three times daily) is a
recommended first-line empiric therapy targeting Streptococcus pneumoniae. Macrolides or
doxycycline are alternatives depending on local resistance; fluoroquinolones or IV therapy are
not first-line in this low-risk setting.
Question 5
A patient presents to the clinic for conception counseling. She recently stopped taking oral
contraceptives and would like to become pregnant. Which statement about conception safety
after stopping oral contraceptives is correct?
A. Fertility returns immediately with no delay in most women
,B. There is a mandatory waiting period of 3 months
C. Conception rates are significantly lower than non-users
D. Prior use permanently impairs fertility
Correct Answer: A. Fertility returns immediately with no delay in most women (or very quickly;
conception is possible right away)
Explanation: Fertility generally returns quickly after discontinuing combined oral
contraceptives, with no negative long-term effect on ability to conceive. Many women can
become pregnant within the first few cycles (about half within 3 months, most within 12
months), similar to non-users. There is no required waiting period for safety.
Question 6
You have a 35-year-old female patient who is complaining of wrist pain. She is an administrative
assistant who does a great deal of computer work in her job. You will test her for carpal tunnel
syndrome. When you tap at the volar surface of the wrist you are performing which of the
following tests?
A. Tinel's sign
B. Phalen's test
C. Finkelstein's test
D. Allen's test
Correct Answer: A. Tinel's sign
Explanation: Tinel's sign involves tapping (percussion) over the median nerve at the volar wrist
to elicit tingling or paresthesia in the median nerve distribution, suggestive of carpal tunnel
syndrome. Phalen's involves wrist flexion; Finkelstein's is for de Quervain's; Allen's assesses
vascular patency.
Question 7
A gastrinoma located on the pancreas or the stomach which secretes gastrin, stimulating high
levels of acid production in the stomach is which of the following?
A. Zollinger-Ellison syndrome
B. Cushing's syndrome
C. Carcinoid syndrome
D. VIPoma
Correct Answer: A. Zollinger-Ellison syndrome
, Explanation: Zollinger-Ellison syndrome is caused by a gastrin-secreting tumor (gastrinoma),
usually in the pancreas or duodenum, leading to hypergastrinemia, excessive gastric acid, and
often refractory peptic ulcers.
Question 8
A 16-year-old male is in the office. He has an insect bite on his left forearm and you suspect a
brown recluse spider bite. What medical management would you provide?
A. Ice pack and elevation of the area
B. Immediate surgical debridement
C. Systemic corticosteroids
D. Broad-spectrum IV antibiotics
Correct Answer: A. Ice pack and elevation of the area
Explanation: Management of suspected brown recluse spider bites is primarily supportive: ice
packs, elevation, pain control, and monitoring for necrosis or systemic effects. Antibiotics are not
routine unless secondary infection occurs; aggressive early surgery or steroids are not first-line.
Question 9
In addition to being overweight, the American Diabetes Association recommends type 2 diabetes
mellitus testing in adults who:
A. have an HDL level of < 35 mg/dL
B. exercise regularly
C. have a family history of type 1 diabetes
D. are under 45 with normal BMI
Correct Answer: A. have an HDL level of < 35 mg/dL
Explanation: Testing for type 2 diabetes is recommended in overweight/obese adults plus
additional risk factors, including HDL <35 mg/dL (or triglycerides >250 mg/dL), hypertension,
family history, etc. Low HDL is a component of metabolic syndrome and increases risk.
Question 10
Which of the following found on an ECG would confirm atrial fibrillation?
A. Absent P waves and irregular ventricular rate
B. Sawtooth flutter waves
C. Wide QRS complexes
