AANP FNP Certification Advanced Practice
Exam Questions and Correct
Answers Verified Answer (2025)
Question 1
A 58-year-old male with hypertension and type 2 diabetes presents with persistent albuminuria
despite ACE inhibitor therapy. What is the next best step?
A. Add a beta-blocker
B. Increase ACE inhibitor dose
C. Add an SGLT2 inhibitor (Correct Answer)
D. Discontinue ACE inhibitor
Rationale:
SGLT2 inhibitors reduce progression of diabetic kidney disease and cardiovascular risk.
They are now guideline-recommended adjuncts.
Question 2
A 25-year-old female presents with dysuria and urinary frequency. Urinalysis shows leukocytes
and nitrites. She has no allergies. First-line treatment?
A. Ciprofloxacin
B. Nitrofurantoin (Correct Answer)
C. Amoxicillin
D. Doxycycline
Rationale:
Nitrofurantoin is first-line for uncomplicated UTI per current guidelines.
Question 3
A patient with asthma uses a short-acting beta agonist daily. What is the most appropriate next
step?
,A. Continue current therapy
B. Add oral steroids
C. Start inhaled corticosteroid (Correct Answer)
D. Add antihistamine
Rationale:
Frequent SABA use indicates poor control, requiring controller therapy (ICS).
Question 4
A 67-year-old with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is recommended?
A. Aspirin only
B. No treatment
C. Oral anticoagulation (Correct Answer)
D. Dual antiplatelet therapy
Rationale:
Score ≥2 in men → anticoagulation indicated to prevent stroke.
Question 5
A patient presents with sudden unilateral facial droop but can wrinkle the forehead. Diagnosis?
A. Bell’s palsy
B. Stroke (Correct Answer)
C. Trigeminal neuralgia
D. Migraine
Rationale:
Forehead sparing = central lesion (stroke).
Question 6
A 45-year-old obese patient presents with GERD symptoms. First-line management?
A. Immediate endoscopy
B. H2 blockers only
C. Lifestyle modification + PPI trial (Correct Answer)
D. Surgery
,Rationale:
Initial GERD management is PPI + lifestyle changes.
Question 7
Which medication is contraindicated in pregnancy?
A. Labetalol
B. Methyldopa
C. ACE inhibitors (Correct Answer)
D. Nifedipine
Rationale:
ACE inhibitors cause fetal renal damage and malformations.
Question 8
A patient with COPD has increasing dyspnea despite SABA use. Next step?
A. Add oral steroids
B. Add LABA or LAMA (Correct Answer)
C. Discontinue bronchodilator
D. Add antibiotics
Rationale:
Long-acting bronchodilators improve symptom control in COPD.
Question 9
A 30-year-old female presents with fatigue, cold intolerance, and weight gain. TSH elevated.
Treatment?
A. Methimazole
B. Levothyroxine (Correct Answer)
C. Propranolol
D. Radioiodine
Rationale:
Primary hypothyroidism → thyroid hormone replacement.
, Question 10
Which condition requires immediate antibiotic therapy?
A. Viral pharyngitis
B. Acute bronchitis
C. Bacterial meningitis (Correct Answer)
D. Influenza
Rationale:
Meningitis is a medical emergency requiring rapid antibiotics.
Question 11
A diabetic patient has an HbA1c of 9% despite metformin. Next step?
A. Stop metformin
B. Add second agent (GLP-1 or SGLT2) (Correct Answer)
C. Lifestyle only
D. No change
Rationale:
A1c above target → combination therapy needed.
Question 12
A patient presents with chest pain relieved by rest. Likely diagnosis?
A. STEMI
B. GERD
C. Stable angina (Correct Answer)
D. Pulmonary embolism
Rationale:
Exertional pain relieved by rest = stable angina.
Question 13
Exam Questions and Correct
Answers Verified Answer (2025)
Question 1
A 58-year-old male with hypertension and type 2 diabetes presents with persistent albuminuria
despite ACE inhibitor therapy. What is the next best step?
A. Add a beta-blocker
B. Increase ACE inhibitor dose
C. Add an SGLT2 inhibitor (Correct Answer)
D. Discontinue ACE inhibitor
Rationale:
SGLT2 inhibitors reduce progression of diabetic kidney disease and cardiovascular risk.
They are now guideline-recommended adjuncts.
Question 2
A 25-year-old female presents with dysuria and urinary frequency. Urinalysis shows leukocytes
and nitrites. She has no allergies. First-line treatment?
A. Ciprofloxacin
B. Nitrofurantoin (Correct Answer)
C. Amoxicillin
D. Doxycycline
Rationale:
Nitrofurantoin is first-line for uncomplicated UTI per current guidelines.
Question 3
A patient with asthma uses a short-acting beta agonist daily. What is the most appropriate next
step?
,A. Continue current therapy
B. Add oral steroids
C. Start inhaled corticosteroid (Correct Answer)
D. Add antihistamine
Rationale:
Frequent SABA use indicates poor control, requiring controller therapy (ICS).
Question 4
A 67-year-old with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is recommended?
A. Aspirin only
B. No treatment
C. Oral anticoagulation (Correct Answer)
D. Dual antiplatelet therapy
Rationale:
Score ≥2 in men → anticoagulation indicated to prevent stroke.
Question 5
A patient presents with sudden unilateral facial droop but can wrinkle the forehead. Diagnosis?
A. Bell’s palsy
B. Stroke (Correct Answer)
C. Trigeminal neuralgia
D. Migraine
Rationale:
Forehead sparing = central lesion (stroke).
Question 6
A 45-year-old obese patient presents with GERD symptoms. First-line management?
A. Immediate endoscopy
B. H2 blockers only
C. Lifestyle modification + PPI trial (Correct Answer)
D. Surgery
,Rationale:
Initial GERD management is PPI + lifestyle changes.
Question 7
Which medication is contraindicated in pregnancy?
A. Labetalol
B. Methyldopa
C. ACE inhibitors (Correct Answer)
D. Nifedipine
Rationale:
ACE inhibitors cause fetal renal damage and malformations.
Question 8
A patient with COPD has increasing dyspnea despite SABA use. Next step?
A. Add oral steroids
B. Add LABA or LAMA (Correct Answer)
C. Discontinue bronchodilator
D. Add antibiotics
Rationale:
Long-acting bronchodilators improve symptom control in COPD.
Question 9
A 30-year-old female presents with fatigue, cold intolerance, and weight gain. TSH elevated.
Treatment?
A. Methimazole
B. Levothyroxine (Correct Answer)
C. Propranolol
D. Radioiodine
Rationale:
Primary hypothyroidism → thyroid hormone replacement.
, Question 10
Which condition requires immediate antibiotic therapy?
A. Viral pharyngitis
B. Acute bronchitis
C. Bacterial meningitis (Correct Answer)
D. Influenza
Rationale:
Meningitis is a medical emergency requiring rapid antibiotics.
Question 11
A diabetic patient has an HbA1c of 9% despite metformin. Next step?
A. Stop metformin
B. Add second agent (GLP-1 or SGLT2) (Correct Answer)
C. Lifestyle only
D. No change
Rationale:
A1c above target → combination therapy needed.
Question 12
A patient presents with chest pain relieved by rest. Likely diagnosis?
A. STEMI
B. GERD
C. Stable angina (Correct Answer)
D. Pulmonary embolism
Rationale:
Exertional pain relieved by rest = stable angina.
Question 13
