ANCC FNP BOARDS EXAM REVIEW 2026/2027 | Family
Nurse Practitioner Certification | Questions & Verified
Answers | Latest Update | Pass Guaranteed - A+ Graded
Part One: Assessment and Diagnosis—Clinical Reasoning Across the
Lifespan
Q1: A 4-month-old infant is brought to the clinic for a well-child visit. The mother reports
the baby can roll from front to back, laughs out loud, and reaches for toys. Which
developmental milestone should also be present at this age?
A. Walking with support
B. Saying "mama" or "dada" specifically
C. Cooing and babbling [CORRECT]
D. Using a pincer grasp
Correct Answer: C
Rationale: At 4 months, infants typically coo, laugh, and roll front to back. Walking with
support occurs around 12 months; specific "mama/dada" around 9-12 months; pincer
,grasp develops at 9 months. Option A, B, and D represent advanced milestones for older
infants.
Q2: A 15-month-old toddler is not yet walking independently. The parents are concerned
about developmental delay. Which finding would be most concerning and warrant
immediate referral?
A. Not walking by 15 months
B. Not walking by 18 months
C. Loss of previously acquired milestones [CORRECT]
D. Cruising along furniture but not walking alone
Correct Answer: C
Rationale: While walking typically emerges by 12-15 months, the true red flag is
regression or loss of milestones, which suggests neurodegenerative disease, autism, or
other serious pathology. Not walking by 18 months warrants evaluation, but loss of
skills is always urgent. Cruising is normal pre-walking behavior.
,Q3: A 6-year-old presents with sore throat, fever of 101.5°F, tonsillar exudates, and
tender anterior cervical lymphadenopathy. There is no cough. Based on the Centor
criteria, what is the next best step?
A. Prescribe amoxicillin immediately
B. Order rapid antigen detection test for Group A Strep [CORRECT]
C. Recommend supportive care only
D. Order throat culture without rapid testing
Correct Answer: B
Rationale: This child has 4 Centor criteria (fever, exudate, tender nodes, no cough),
indicating high probability of GAS pharyngitis. Current guidelines recommend
confirmatory testing (rapid antigen test) before antibiotics to avoid unnecessary
treatment. Supportive care alone is inappropriate with high suspicion; culture alone
delays treatment.
Q4: A 9-month-old infant has acute otitis media with bulging tympanic membrane, fever,
and irritability. The child has no drug allergies. What is the first-line antibiotic treatment?
A. Azithromycin for 5 days
B. Amoxicillin 80-90 mg/kg/day for 10 days [CORRECT]
, C. Cefdinir for 5 days
D. Observation without antibiotics
Correct Answer: B
Rationale: Amoxicillin remains first-line for uncomplicated AOM in children under 2
years with severe symptoms (fever, bulging TM). High-dose amoxicillin (80-90
mg/kg/day) overcomes resistant pneumococcus. Observation is for mild cases in
children over 6 months; macrolides and cephalosporins are alternatives for
penicillin-allergic patients.
Q5: A 2-year-old with asthma has been using albuterol as needed 4 days per week and
waking at night with cough twice weekly. According to the stepwise approach, what is
the appropriate next step?
A. Continue albuterol as needed
B. Add low-dose inhaled corticosteroid [CORRECT]
C. Add oral corticosteroid burst
D. Refer to pulmonology immediately
Correct Answer: B
Nurse Practitioner Certification | Questions & Verified
Answers | Latest Update | Pass Guaranteed - A+ Graded
Part One: Assessment and Diagnosis—Clinical Reasoning Across the
Lifespan
Q1: A 4-month-old infant is brought to the clinic for a well-child visit. The mother reports
the baby can roll from front to back, laughs out loud, and reaches for toys. Which
developmental milestone should also be present at this age?
A. Walking with support
B. Saying "mama" or "dada" specifically
C. Cooing and babbling [CORRECT]
D. Using a pincer grasp
Correct Answer: C
Rationale: At 4 months, infants typically coo, laugh, and roll front to back. Walking with
support occurs around 12 months; specific "mama/dada" around 9-12 months; pincer
,grasp develops at 9 months. Option A, B, and D represent advanced milestones for older
infants.
Q2: A 15-month-old toddler is not yet walking independently. The parents are concerned
about developmental delay. Which finding would be most concerning and warrant
immediate referral?
A. Not walking by 15 months
B. Not walking by 18 months
C. Loss of previously acquired milestones [CORRECT]
D. Cruising along furniture but not walking alone
Correct Answer: C
Rationale: While walking typically emerges by 12-15 months, the true red flag is
regression or loss of milestones, which suggests neurodegenerative disease, autism, or
other serious pathology. Not walking by 18 months warrants evaluation, but loss of
skills is always urgent. Cruising is normal pre-walking behavior.
,Q3: A 6-year-old presents with sore throat, fever of 101.5°F, tonsillar exudates, and
tender anterior cervical lymphadenopathy. There is no cough. Based on the Centor
criteria, what is the next best step?
A. Prescribe amoxicillin immediately
B. Order rapid antigen detection test for Group A Strep [CORRECT]
C. Recommend supportive care only
D. Order throat culture without rapid testing
Correct Answer: B
Rationale: This child has 4 Centor criteria (fever, exudate, tender nodes, no cough),
indicating high probability of GAS pharyngitis. Current guidelines recommend
confirmatory testing (rapid antigen test) before antibiotics to avoid unnecessary
treatment. Supportive care alone is inappropriate with high suspicion; culture alone
delays treatment.
Q4: A 9-month-old infant has acute otitis media with bulging tympanic membrane, fever,
and irritability. The child has no drug allergies. What is the first-line antibiotic treatment?
A. Azithromycin for 5 days
B. Amoxicillin 80-90 mg/kg/day for 10 days [CORRECT]
, C. Cefdinir for 5 days
D. Observation without antibiotics
Correct Answer: B
Rationale: Amoxicillin remains first-line for uncomplicated AOM in children under 2
years with severe symptoms (fever, bulging TM). High-dose amoxicillin (80-90
mg/kg/day) overcomes resistant pneumococcus. Observation is for mild cases in
children over 6 months; macrolides and cephalosporins are alternatives for
penicillin-allergic patients.
Q5: A 2-year-old with asthma has been using albuterol as needed 4 days per week and
waking at night with cough twice weekly. According to the stepwise approach, what is
the appropriate next step?
A. Continue albuterol as needed
B. Add low-dose inhaled corticosteroid [CORRECT]
C. Add oral corticosteroid burst
D. Refer to pulmonology immediately
Correct Answer: B
