AANP CERTIFICATION EXAM PRACTICE 2026
UPDATE 100 QUESTIONS AND DETAILED VERIFIED
ANSWERS FROM ACTUAL EXAMS TEST GRADE A+
1. A 45-year-old patient presents with chest pain radiating to the left arm. Which
is the priority action?
A. Administer ibuprofen
B. Obtain ECG immediately
C. Schedule outpatient cardiology referral
D. Give antacid
Rationale: Chest pain with radiation is suspicious for acute coronary syndrome;
ECG is the first diagnostic step.
Answer: B. Obtain ECG immediately
2. Which condition is most associated with a “butterfly rash” on the face?
A. Rosacea
B. Systemic lupus erythematosus
C. Dermatitis
D. Psoriasis
Rationale: Malar rash across cheeks and nose is classic for SLE.
Answer: B. Systemic lupus erythematosus
3. First-line treatment for uncomplicated urinary tract infection in a non-
pregnant woman?
,A. Amoxicillin
B. Nitrofurantoin
C. Ciprofloxacin IV
D. Vancomycin
Rationale: Nitrofurantoin is first-line for uncomplicated cystitis.
Answer: B. Nitrofurantoin
4. A newborn has a heart rate of 90 bpm after birth. What is the next step?
A. Start chest compressions
B. Provide positive pressure ventilation
C. Give epinephrine
D. Observe only
Rationale: HR <100 in newborn requires ventilation support.
Answer: B. Provide positive pressure ventilation
5. Which lab test confirms diabetes mellitus?
A. Random glucose 180 mg/dL
B. HbA1c ≥6.5%
C. Fasting glucose 110 mg/dL
D. Urine ketones
Rationale: HbA1c ≥6.5% is diagnostic of diabetes.
Answer: B. HbA1c ≥6.5%
6. A patient with asthma is using albuterol daily. What does this indicate?
A. Controlled asthma
B. Severe persistent asthma
C. Poor asthma control
D. COPD
,Rationale: Daily rescue inhaler use indicates poor control.
Answer: C. Poor asthma control
7. First-line drug for hypertension in diabetic patients?
A. ACE inhibitor
B. Beta blocker
C. Calcium channel blocker
D. Diuretic only
Rationale: ACE inhibitors protect kidneys in diabetics.
Answer: A. ACE inhibitor
8. Which symptom is most consistent with hypothyroidism?
A. Weight loss
B. Heat intolerance
C. Bradycardia
D. Tachycardia
Rationale: Hypothyroidism causes decreased metabolism and bradycardia.
Answer: C. Bradycardia
9. What is the most appropriate screening test for cervical cancer?
A. Pelvic ultrasound
B. Pap smear
C. CT scan
D. Urinalysis
Rationale: Pap smear is standard cervical cancer screening.
Answer: B. Pap smear
, 10. Which organism commonly causes strep throat?
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. E. coli
D. Klebsiella
Rationale: Group A strep causes pharyngitis.
Answer: B. Streptococcus pyogenes
11. A patient presents with sudden severe headache described as “worst of life.”
What is suspected?
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Sinusitis
Rationale: Thunderclap headache suggests subarachnoid hemorrhage.
Answer: C. Subarachnoid hemorrhage
12. First-line treatment for anaphylaxis?
A. Diphenhydramine
B. Epinephrine
C. Albuterol
D. Steroids only
Rationale: Epinephrine is life-saving first-line treatment.
Answer: B. Epinephrine
13. Which electrolyte abnormality is seen in Addison’s disease?
UPDATE 100 QUESTIONS AND DETAILED VERIFIED
ANSWERS FROM ACTUAL EXAMS TEST GRADE A+
1. A 45-year-old patient presents with chest pain radiating to the left arm. Which
is the priority action?
A. Administer ibuprofen
B. Obtain ECG immediately
C. Schedule outpatient cardiology referral
D. Give antacid
Rationale: Chest pain with radiation is suspicious for acute coronary syndrome;
ECG is the first diagnostic step.
Answer: B. Obtain ECG immediately
2. Which condition is most associated with a “butterfly rash” on the face?
A. Rosacea
B. Systemic lupus erythematosus
C. Dermatitis
D. Psoriasis
Rationale: Malar rash across cheeks and nose is classic for SLE.
Answer: B. Systemic lupus erythematosus
3. First-line treatment for uncomplicated urinary tract infection in a non-
pregnant woman?
,A. Amoxicillin
B. Nitrofurantoin
C. Ciprofloxacin IV
D. Vancomycin
Rationale: Nitrofurantoin is first-line for uncomplicated cystitis.
Answer: B. Nitrofurantoin
4. A newborn has a heart rate of 90 bpm after birth. What is the next step?
A. Start chest compressions
B. Provide positive pressure ventilation
C. Give epinephrine
D. Observe only
Rationale: HR <100 in newborn requires ventilation support.
Answer: B. Provide positive pressure ventilation
5. Which lab test confirms diabetes mellitus?
A. Random glucose 180 mg/dL
B. HbA1c ≥6.5%
C. Fasting glucose 110 mg/dL
D. Urine ketones
Rationale: HbA1c ≥6.5% is diagnostic of diabetes.
Answer: B. HbA1c ≥6.5%
6. A patient with asthma is using albuterol daily. What does this indicate?
A. Controlled asthma
B. Severe persistent asthma
C. Poor asthma control
D. COPD
,Rationale: Daily rescue inhaler use indicates poor control.
Answer: C. Poor asthma control
7. First-line drug for hypertension in diabetic patients?
A. ACE inhibitor
B. Beta blocker
C. Calcium channel blocker
D. Diuretic only
Rationale: ACE inhibitors protect kidneys in diabetics.
Answer: A. ACE inhibitor
8. Which symptom is most consistent with hypothyroidism?
A. Weight loss
B. Heat intolerance
C. Bradycardia
D. Tachycardia
Rationale: Hypothyroidism causes decreased metabolism and bradycardia.
Answer: C. Bradycardia
9. What is the most appropriate screening test for cervical cancer?
A. Pelvic ultrasound
B. Pap smear
C. CT scan
D. Urinalysis
Rationale: Pap smear is standard cervical cancer screening.
Answer: B. Pap smear
, 10. Which organism commonly causes strep throat?
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. E. coli
D. Klebsiella
Rationale: Group A strep causes pharyngitis.
Answer: B. Streptococcus pyogenes
11. A patient presents with sudden severe headache described as “worst of life.”
What is suspected?
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Sinusitis
Rationale: Thunderclap headache suggests subarachnoid hemorrhage.
Answer: C. Subarachnoid hemorrhage
12. First-line treatment for anaphylaxis?
A. Diphenhydramine
B. Epinephrine
C. Albuterol
D. Steroids only
Rationale: Epinephrine is life-saving first-line treatment.
Answer: B. Epinephrine
13. Which electrolyte abnormality is seen in Addison’s disease?
