ANCC FNP SAMPLE ACTUAL EXAM V3 2026/2027 | Family
Nurse Practitioner Practice Questions & Verified Answers |
Grade A | Pass Guaranteed - A+ Graded
Assessment and Diagnosis (35 Questions)
Q1: A 4-year-old child is brought to the clinic with a 2-day history of ear pain and fever.
Physical examination reveals a bulging, erythematous tympanic membrane with poor
mobility on pneumatic otoscopy. The child has had three similar episodes in the past 6
months. Which diagnosis is most consistent with these findings?
A. Acute otitis media
B. Otitis media with effusion
C. Acute otitis media [CORRECT]
D. Chronic suppurative otitis media
Correct Answer: C
Rationale: The presentation of acute ear pain, fever, and a bulging erythematous TM
with poor mobility is classic for acute otitis media (AOM). Recurrent episodes (3+ in 6
months) may warrant tympanostomy tube referral. Otitis media with effusion (B)
typically presents with hearing loss and a dull TM without acute pain or fever. Chronic
suppurative otitis media (D) involves persistent TM perforation with drainage.
,Q2: A 62-year-old male presents with progressive shortness of breath and dry cough. He
has a 40 pack-year smoking history. Chest X-ray shows a peripheral spiculated mass in
the left upper lobe. CT scan confirms a 2.8 cm lesion with pleural retraction. Which
diagnostic procedure is most appropriate next?
A. Percutaneous needle biopsy under CT guidance
B. Positron emission tomography (PET) scan
C. CT-guided percutaneous needle biopsy [CORRECT]
D. Surgical wedge resection
Correct Answer: C
Rationale: A new spiculated peripheral lung mass in a heavy smoker is highly suspicious
for primary lung cancer. Tissue diagnosis via CT-guided percutaneous needle biopsy is
the standard of care before definitive treatment planning. PET scan (B) is used for
staging after tissue diagnosis. Surgical resection (D) follows diagnosis confirmation.
Q3: A 28-year-old female at 18 weeks gestation presents with nausea, vomiting, and
epigastric pain. Her blood pressure is 158/96 mmHg, and urinalysis shows 2+ protein.
She reports no headache or visual changes. Which condition best fits this presentation?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia [CORRECT]
D. Eclampsia
Correct Answer: C
,Rationale: New-onset hypertension (≥140/90) after 20 weeks gestation with proteinuria
(2+ on dipstick) without severe features (no headache, visual changes, or RUQ pain)
defines preeclampsia. Gestational hypertension (B) would present without proteinuria.
Chronic hypertension (A) would have been present before pregnancy or before 20
weeks.
Q4: During a routine well-child visit, a mother expresses concern that her 18-month-old
son is not yet speaking any words. He babbles but has no clear words. He points to
objects and follows simple commands. Which action is most appropriate?
A. Reassure the mother this is normal development
B. Refer immediately for autism evaluation
C. Schedule a hearing test and continue monitoring [CORRECT]
D. Begin speech therapy
Correct Answer: C
Rationale: By 18 months, children should have at least 6-10 words. While pointing and
following commands are positive signs, the lack of any words warrants hearing
screening to rule out hearing impairment, which could affect speech development. This
is within the window for appropriate developmental surveillance.
Q5: A 45-year-old male with type 2 diabetes presents for follow-up. His last eye exam
was 2 years ago. He has no visual complaints. According to current ADA guidelines,
which screening recommendation applies?
A. Annual dilated eye exam by an ophthalmologist
, B. Dilated eye exam every 2 years if normal, annually if retinopathy present
C. Annual dilated eye exam by optometrist or ophthalmologist [CORRECT]
D. No screening needed if asymptomatic
Correct Answer: C
Rationale: The ADA Standards of Care recommend annual dilated eye examinations by
an optometrist or ophthalmologist for all patients with diabetes, regardless of
symptoms, as diabetic retinopathy may be asymptomatic until advanced. Annual
screening allows for early detection and intervention.
Q6: A 16-year-old female presents for contraceptive counseling. She is sexually active
with one partner and wants a long-acting reversible method. Her medical history is
significant for migraine with aura. Which contraceptive is contraindicated?
A. Copper IUD
B. Combined oral contraceptive pills
C. Combined hormonal contraception [CORRECT]
D. Progestin-only implant
Correct Answer: C
Rationale: Combined hormonal contraception (containing estrogen) is contraindicated
in patients with migraine with aura due to increased stroke risk. Progestin-only methods
(D) and copper IUD (A) are safe alternatives. The presence of aura (visual or sensory
symptoms before headache) specifically contraindicates estrogen-containing methods.
Nurse Practitioner Practice Questions & Verified Answers |
Grade A | Pass Guaranteed - A+ Graded
Assessment and Diagnosis (35 Questions)
Q1: A 4-year-old child is brought to the clinic with a 2-day history of ear pain and fever.
Physical examination reveals a bulging, erythematous tympanic membrane with poor
mobility on pneumatic otoscopy. The child has had three similar episodes in the past 6
months. Which diagnosis is most consistent with these findings?
A. Acute otitis media
B. Otitis media with effusion
C. Acute otitis media [CORRECT]
D. Chronic suppurative otitis media
Correct Answer: C
Rationale: The presentation of acute ear pain, fever, and a bulging erythematous TM
with poor mobility is classic for acute otitis media (AOM). Recurrent episodes (3+ in 6
months) may warrant tympanostomy tube referral. Otitis media with effusion (B)
typically presents with hearing loss and a dull TM without acute pain or fever. Chronic
suppurative otitis media (D) involves persistent TM perforation with drainage.
,Q2: A 62-year-old male presents with progressive shortness of breath and dry cough. He
has a 40 pack-year smoking history. Chest X-ray shows a peripheral spiculated mass in
the left upper lobe. CT scan confirms a 2.8 cm lesion with pleural retraction. Which
diagnostic procedure is most appropriate next?
A. Percutaneous needle biopsy under CT guidance
B. Positron emission tomography (PET) scan
C. CT-guided percutaneous needle biopsy [CORRECT]
D. Surgical wedge resection
Correct Answer: C
Rationale: A new spiculated peripheral lung mass in a heavy smoker is highly suspicious
for primary lung cancer. Tissue diagnosis via CT-guided percutaneous needle biopsy is
the standard of care before definitive treatment planning. PET scan (B) is used for
staging after tissue diagnosis. Surgical resection (D) follows diagnosis confirmation.
Q3: A 28-year-old female at 18 weeks gestation presents with nausea, vomiting, and
epigastric pain. Her blood pressure is 158/96 mmHg, and urinalysis shows 2+ protein.
She reports no headache or visual changes. Which condition best fits this presentation?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia [CORRECT]
D. Eclampsia
Correct Answer: C
,Rationale: New-onset hypertension (≥140/90) after 20 weeks gestation with proteinuria
(2+ on dipstick) without severe features (no headache, visual changes, or RUQ pain)
defines preeclampsia. Gestational hypertension (B) would present without proteinuria.
Chronic hypertension (A) would have been present before pregnancy or before 20
weeks.
Q4: During a routine well-child visit, a mother expresses concern that her 18-month-old
son is not yet speaking any words. He babbles but has no clear words. He points to
objects and follows simple commands. Which action is most appropriate?
A. Reassure the mother this is normal development
B. Refer immediately for autism evaluation
C. Schedule a hearing test and continue monitoring [CORRECT]
D. Begin speech therapy
Correct Answer: C
Rationale: By 18 months, children should have at least 6-10 words. While pointing and
following commands are positive signs, the lack of any words warrants hearing
screening to rule out hearing impairment, which could affect speech development. This
is within the window for appropriate developmental surveillance.
Q5: A 45-year-old male with type 2 diabetes presents for follow-up. His last eye exam
was 2 years ago. He has no visual complaints. According to current ADA guidelines,
which screening recommendation applies?
A. Annual dilated eye exam by an ophthalmologist
, B. Dilated eye exam every 2 years if normal, annually if retinopathy present
C. Annual dilated eye exam by optometrist or ophthalmologist [CORRECT]
D. No screening needed if asymptomatic
Correct Answer: C
Rationale: The ADA Standards of Care recommend annual dilated eye examinations by
an optometrist or ophthalmologist for all patients with diabetes, regardless of
symptoms, as diabetic retinopathy may be asymptomatic until advanced. Annual
screening allows for early detection and intervention.
Q6: A 16-year-old female presents for contraceptive counseling. She is sexually active
with one partner and wants a long-acting reversible method. Her medical history is
significant for migraine with aura. Which contraceptive is contraindicated?
A. Copper IUD
B. Combined oral contraceptive pills
C. Combined hormonal contraception [CORRECT]
D. Progestin-only implant
Correct Answer: C
Rationale: Combined hormonal contraception (containing estrogen) is contraindicated
in patients with migraine with aura due to increased stroke risk. Progestin-only methods
(D) and copper IUD (A) are safe alternatives. The presence of aura (visual or sensory
symptoms before headache) specifically contraindicates estrogen-containing methods.
