FNP ANCC PRACTICE EXAM
QUESTIONS AND DETAILED
SOLUTIONS 2026
▶ Koplik's spots are associated with:
A) Poxvirus infections
B) Measles
C) Kawasaki's disease
D) Reye's syndrome. Answer: B) Measles
Signs and symptoms of the measles include fever over 101°F, coryza,
cough, conjunctivitis, rash, and Koplik's spots on buccal mucosa.
▶ Stella, a new mother, complains to you that she has been feeling irritable
and jittery almost daily for the past few months. She complains of frequent
palpitations and more frequent bowel movements along with weight loss.
Her BP is 160/70, her pulse is 110, and she is afebrile. All of the following
conditions should be considered in the differential diagnosis for this patient
except:
A) Mitral regurgitation
B) Graves' disease
C) Generalized anxiety disorder
D) Illicit drug use. Answer: A) Mitral regurgitation
Signs and symptoms of mitral regurgitation do not include frequent bowel
movements with weight loss.
▶ An elderly patient with a productive cough and fever is diagnosed with
pneumonia. All of the following organisms are capable of causing
community-acquired pneumonia except:
A) Haemophilus influenzae
,B) Mycoplasma pneumoniae
C) Treponema pallidum
D) Streptococcus pneumoniae. Answer: C) Treponema pallidum
Treponema pallidum is a gram-negative spirochete bacterium that causes
syphilis
▶ Human chorionic gonadotropin (hCG) is produced by the:
A) Placenta
B) Hypothalamus
C) Anterior pituitary
D) Ovaries. Answer: A) Placenta
HCG is produced by the placenta.
▶ The majority of serum alpha fetoprotein is produced by the:
A) Fetal liver
B) Mother's liver
C) Placenta
D) Fetal neural tube. Answer: A) Fetal liver
Serum alpha fetoprotein is produced by the fetal liver.
▶ Stella works in the housekeeping department of a hospital. She presents
to the employee health clinic with a complaint of a needlestick to her left
thumb. The needle was in one of the garbage bags from the emergency
room. The patient had a little bleeding that stopped spontaneously. Which
of the following is the next step?
A) Order an enzyme-linked immunosorbent assay (ELISA) test as soon as
possible
B) Recommend a tetanus booster in 1 week
C) Offer the patient hepatitis B immunoglobulin
D) Order a chest x-ray. Answer: A) Order an enzyme-linked
immunosorbent assay (ELISA) test as soon as possible
,Employee health clinic protocols for needlesticks recommend ordering an
ELISA test as soon as possible to establish baseline blood work for the
employee.
▶ An elderly woman has been on digoxin (Lanoxin) for 10 years. Her
electrocardio- graph (EKG) is showing a new onset of atrial fibrillation. Her
pulse is 64/min. She denies syncope and dizziness. Which of the following
interventions is most appropriate?
A) Order an electrolyte panel and a digoxin level
B) Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an
electrolyte panel
C) Order a serum digoxin level and decrease her digoxin dose by half while
waiting for results
D) Discontinue the digoxin and order another 12-lead EKG. Answer: B)
Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an
electrolyte panel
Obtaining baseline blood work to evaluate for causes of new- onset atrial
fibrillation is recommended prior to decreasing or stopping medications.
Thyroid disease is a common cause of new-onset atrial fibrillation.
▶ You note the following result on a routine urinalysis of a 37-year-old
primigravida who is at 30 weeks of gestation. Leukocyte = trace, nitrite =
negative, protein = 2 +, blood = negative. Her weight has increased by 5
lbs during the past week. Which of the following is most likely?
A) HELLP syndrome
B) Pregnancy-induced hypertension (preeclampsia)
C) Eclampsia of pregnancy
D) Primary hypertension. Answer: B) Pregnancy-induced hypertension
(preeclampsia)
The classic triad of symptoms of preeclampsia includes hypertension,
edema (weight gain), and proteinuria.
▶ The nurse practitioner who suspects that one of her hypertensive
patients has Cushing's syndrome would expect to find which of the
following laboratory results?
, A) Hyponatremia
B) Hypoglycemia
C) Elevated serum cortisol levels
D) Decreased urine 17-ketosteroids. Answer: C) Elevated serum cortisol
levels
Elevated serum cortisol levels are seen with Cushing's syndrome.
▶ The first teeth to erupt during infancy are which of the following?
A) First molars
B) Second molars
C) Incisors
D) Canines. Answer: C) Incisors
The incisors are the first teeth to erupt during infancy.
▶ The positive signs of pregnancy include:
A) Palpation of the fetus and auscultation of the fetal heart tones by the
nurse practitioner
B) Palpation of the fetus and a positive quantitative serum pregnancy test
C) Fetal heart tones and a positive quantitative serum pregnancy test
D) Fetal heart tones and feeling of movement of the baby by the mother.
Answer: A) Palpation of the fetus and auscultation of the fetal heart tones
by the nurse practitioner
Presumptive signs of pregnancy are symptoms experienced by the woman,
such as amenorrhea, breast tenderness, nausea/vomiting, fatigue, and
increased urinary frequency. Probable signs of pregnancy are signs
detected by the examiner, such as an enlarged uterus. Positive signs of
pregnancy are direct evidence of pregnancy such as audible fetal heart
tones or cardiac activity on ultrasound.
▶ Chadwick's sign is characterized by:
A) Softening of the cervix
B) Blue coloration of the cervix and vagina
C) Softening of the uterine isthmus
QUESTIONS AND DETAILED
SOLUTIONS 2026
▶ Koplik's spots are associated with:
A) Poxvirus infections
B) Measles
C) Kawasaki's disease
D) Reye's syndrome. Answer: B) Measles
Signs and symptoms of the measles include fever over 101°F, coryza,
cough, conjunctivitis, rash, and Koplik's spots on buccal mucosa.
▶ Stella, a new mother, complains to you that she has been feeling irritable
and jittery almost daily for the past few months. She complains of frequent
palpitations and more frequent bowel movements along with weight loss.
Her BP is 160/70, her pulse is 110, and she is afebrile. All of the following
conditions should be considered in the differential diagnosis for this patient
except:
A) Mitral regurgitation
B) Graves' disease
C) Generalized anxiety disorder
D) Illicit drug use. Answer: A) Mitral regurgitation
Signs and symptoms of mitral regurgitation do not include frequent bowel
movements with weight loss.
▶ An elderly patient with a productive cough and fever is diagnosed with
pneumonia. All of the following organisms are capable of causing
community-acquired pneumonia except:
A) Haemophilus influenzae
,B) Mycoplasma pneumoniae
C) Treponema pallidum
D) Streptococcus pneumoniae. Answer: C) Treponema pallidum
Treponema pallidum is a gram-negative spirochete bacterium that causes
syphilis
▶ Human chorionic gonadotropin (hCG) is produced by the:
A) Placenta
B) Hypothalamus
C) Anterior pituitary
D) Ovaries. Answer: A) Placenta
HCG is produced by the placenta.
▶ The majority of serum alpha fetoprotein is produced by the:
A) Fetal liver
B) Mother's liver
C) Placenta
D) Fetal neural tube. Answer: A) Fetal liver
Serum alpha fetoprotein is produced by the fetal liver.
▶ Stella works in the housekeeping department of a hospital. She presents
to the employee health clinic with a complaint of a needlestick to her left
thumb. The needle was in one of the garbage bags from the emergency
room. The patient had a little bleeding that stopped spontaneously. Which
of the following is the next step?
A) Order an enzyme-linked immunosorbent assay (ELISA) test as soon as
possible
B) Recommend a tetanus booster in 1 week
C) Offer the patient hepatitis B immunoglobulin
D) Order a chest x-ray. Answer: A) Order an enzyme-linked
immunosorbent assay (ELISA) test as soon as possible
,Employee health clinic protocols for needlesticks recommend ordering an
ELISA test as soon as possible to establish baseline blood work for the
employee.
▶ An elderly woman has been on digoxin (Lanoxin) for 10 years. Her
electrocardio- graph (EKG) is showing a new onset of atrial fibrillation. Her
pulse is 64/min. She denies syncope and dizziness. Which of the following
interventions is most appropriate?
A) Order an electrolyte panel and a digoxin level
B) Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an
electrolyte panel
C) Order a serum digoxin level and decrease her digoxin dose by half while
waiting for results
D) Discontinue the digoxin and order another 12-lead EKG. Answer: B)
Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an
electrolyte panel
Obtaining baseline blood work to evaluate for causes of new- onset atrial
fibrillation is recommended prior to decreasing or stopping medications.
Thyroid disease is a common cause of new-onset atrial fibrillation.
▶ You note the following result on a routine urinalysis of a 37-year-old
primigravida who is at 30 weeks of gestation. Leukocyte = trace, nitrite =
negative, protein = 2 +, blood = negative. Her weight has increased by 5
lbs during the past week. Which of the following is most likely?
A) HELLP syndrome
B) Pregnancy-induced hypertension (preeclampsia)
C) Eclampsia of pregnancy
D) Primary hypertension. Answer: B) Pregnancy-induced hypertension
(preeclampsia)
The classic triad of symptoms of preeclampsia includes hypertension,
edema (weight gain), and proteinuria.
▶ The nurse practitioner who suspects that one of her hypertensive
patients has Cushing's syndrome would expect to find which of the
following laboratory results?
, A) Hyponatremia
B) Hypoglycemia
C) Elevated serum cortisol levels
D) Decreased urine 17-ketosteroids. Answer: C) Elevated serum cortisol
levels
Elevated serum cortisol levels are seen with Cushing's syndrome.
▶ The first teeth to erupt during infancy are which of the following?
A) First molars
B) Second molars
C) Incisors
D) Canines. Answer: C) Incisors
The incisors are the first teeth to erupt during infancy.
▶ The positive signs of pregnancy include:
A) Palpation of the fetus and auscultation of the fetal heart tones by the
nurse practitioner
B) Palpation of the fetus and a positive quantitative serum pregnancy test
C) Fetal heart tones and a positive quantitative serum pregnancy test
D) Fetal heart tones and feeling of movement of the baby by the mother.
Answer: A) Palpation of the fetus and auscultation of the fetal heart tones
by the nurse practitioner
Presumptive signs of pregnancy are symptoms experienced by the woman,
such as amenorrhea, breast tenderness, nausea/vomiting, fatigue, and
increased urinary frequency. Probable signs of pregnancy are signs
detected by the examiner, such as an enlarged uterus. Positive signs of
pregnancy are direct evidence of pregnancy such as audible fetal heart
tones or cardiac activity on ultrasound.
▶ Chadwick's sign is characterized by:
A) Softening of the cervix
B) Blue coloration of the cervix and vagina
C) Softening of the uterine isthmus
