HESI Exit Family Nurse Practitioner (FNP) Exam: 200
Verified Practice Questions with Rationales – Latest
2026/2027 Edition"
Section 1: Health Promotion & Disease Prevention (Questions 1–40)
1. A 55-year-old female asks about routine health screening. According to USPSTF grade A
recommendations, which test should the nurse practitioner order?
A) Annual ECG
B) Mammography every 2 years for women aged 50–74
C) PSA for prostate cancer
D) CT scan for lung cancer in all adults
Answer: B
Explanation: The USPSTF recommends biennial screening mammography for women aged 50–74 years
(Grade B, but among grade A/B). PSA is not recommended for routine screening (Grade C/D). Lung CT is
only for high-risk adults.
2. A 45-year-old man has a blood pressure of 138/86 mm Hg on two occasions. What is the most
appropriate next step?
A) Start hydrochlorothiazide
B) Recommend lifestyle modifications and recheck in 6 months
C) Order an echocardiogram
D) Diagnose hypertension and start amlodipine
Answer: B
Explanation: According to ACC/AHA guidelines, stage 1 hypertension (130-139/80-89) with low ASCVD
risk should first be managed with lifestyle changes for 3-6 months before medication.
3. A 65-year-old woman with a 30-pack-year smoking history asks about lung cancer screening. Which
test is recommended?
A) Chest X-ray annually
B) Low-dose CT scan annually if she meets age and pack-year criteria
C) Sputum cytology
D) No screening because she quit smoking 5 years ago
Answer: B
Explanation: USPSTF recommends annual low-dose CT for adults aged 50-80 with a 20-pack-year
smoking history who currently smoke or quit within the past 15 years.
,4. A 30-year-old woman desires contraception. Which method is most effective (>99%) with perfect
use?
A) Oral contraceptive pills
B) Copper intrauterine device (IUD)
C) Male condoms
D) Fertility awareness
Answer: B
Explanation: Long-acting reversible contraceptives (IUDs, implant) have failure rates <1% with typical
use. Pills and condoms have higher typical-use failure rates.
5. A 50-year-old man has a body mass index (BMI) of 32 kg/m² with no other comorbidities. Which
intervention is first-line for weight loss?
A) Bariatric surgery referral
B) Prescribe phentermine
C) Intensive behavioral counseling and lifestyle modification
D) Orlistat prescription
Answer: C
Explanation: USPSTF recommends intensive, multicomponent behavioral interventions for adults with
obesity. Medications or surgery are considered after lifestyle intervention failure.
6. A 25-year-old woman presents for preconception counseling. Which supplement should be
recommended to reduce neural tube defect risk?
A) Vitamin B12 1000 mcg daily
B) Folic acid 400-800 mcg daily
C) Iron 65 mg daily
D) Calcium 1200 mg daily
Answer: B
Explanation: Folic acid 400-800 mcg daily starting at least 1 month before conception reduces neural
tube defects. Higher doses for those with prior affected pregnancy.
7. A 65-year-old man with hypertension and hyperlipidemia has a 10-year ASCVD risk of 12%. Which
statin intensity is recommended?
A) No statin
B) Moderate-intensity statin (e.g., atorvastatin 10-20 mg)
C) High-intensity statin (e.g., atorvastatin 40-80 mg)
D) Low-intensity statin
,Answer: C
Explanation: For primary prevention with ASCVD risk ≥7.5% (especially ≥20%), high-intensity statin is
recommended if candidate.
8. A 72-year-old woman with osteoporosis has a T-score of –2.8 at the femoral neck. Which
medication is first-line?
A) Raloxifene
B) Alendronate (bisphosphonate)
C) Teriparatide
D) Calcium alone
Answer: B
Explanation: Oral bisphosphonates (alendronate, risedronate) are first-line for osteoporosis to reduce
fracture risk. Teriparatide is for severe cases.
9. A 38-year-old woman with no risk factors asks about cervical cancer screening. According to current
guidelines, what is recommended?
A) Pap test every 3 years starting at age 21
B) HPV test alone every 5 years starting at age 25
C) Cotesting (Pap + HPV) every 5 years starting at age 30 is an option
D) Both B and C are acceptable depending on age
Answer: D
Explanation: For women age 30-65, options: Pap every 3 years, HPV alone every 5 years, or cotesting
every 5 years. Starting age for HPV alone is 25 (ACS) or 30 (USPSTF). Pap starts at 21.
10. A 60-year-old man asks about aspirin for primary prevention of cardiovascular disease. Which
statement is correct?
A) Aspirin is recommended for all adults over 50.
B) Aspirin is not routinely recommended for primary prevention due to bleeding risk.
C) Aspirin 81 mg daily is safe and effective for everyone.
D) Only enteric-coated aspirin works.
Answer: B
Explanation: Current guidelines recommend against routine aspirin for primary prevention in most
adults due to increased bleeding risk without net benefit.
11. An 18-year-old college student requests the meningococcal B vaccine. Which statement is true?
, A) MenB vaccine is routinely given to all adolescents at age 11-12.
B) MenB is recommended for adolescents and young adults aged 16-23 years with shared clinical
decision-making.
C) MenB is only for high-risk individuals.
D) MenB is the same as the MenACWY vaccine.
Answer: B
Explanation: MenB vaccine is not routinely recommended for all adolescents but may be given to those
aged 16-23 based on shared decision-making. MenACWY is routine at 11-12 years.
12. A 50-year-old woman with a first-degree relative with colorectal cancer diagnosed at age 55
should begin screening at age:
A) 45 years
B) 40 years (or 10 years before the relative’s age of diagnosis, whichever is earlier)
C) 50 years
D) 35 years
Answer: B
Explanation: For individuals with a first-degree relative with colorectal cancer diagnosed before age 60,
screening begins at age 40 or 10 years before the relative’s age at diagnosis.
13. A pregnant woman at 28 weeks gestation has a 1-hour glucose challenge test result of 150 mg/dL.
What is the next step?
A) Diagnose gestational diabetes
B) Perform a 3-hour oral glucose tolerance test (GTT)
C) Repeat the 1-hour test
D) No further testing
Answer: B
Explanation: A 1-hour glucose challenge test ≥140 mg/dL (or ≥135-140 depending on guidelines)
requires a diagnostic 3-hour 100-g GTT for gestational diabetes.
14. A healthy 2-year-old child is due for vaccines. Which combination is part of the routine schedule at
this age?
A) DTaP, IPV, MMR, Varicella, Hep A (if not previously given)
B) Only DTaP
C) Meningococcal and HPV
D) Rotavirus and PCV13
Verified Practice Questions with Rationales – Latest
2026/2027 Edition"
Section 1: Health Promotion & Disease Prevention (Questions 1–40)
1. A 55-year-old female asks about routine health screening. According to USPSTF grade A
recommendations, which test should the nurse practitioner order?
A) Annual ECG
B) Mammography every 2 years for women aged 50–74
C) PSA for prostate cancer
D) CT scan for lung cancer in all adults
Answer: B
Explanation: The USPSTF recommends biennial screening mammography for women aged 50–74 years
(Grade B, but among grade A/B). PSA is not recommended for routine screening (Grade C/D). Lung CT is
only for high-risk adults.
2. A 45-year-old man has a blood pressure of 138/86 mm Hg on two occasions. What is the most
appropriate next step?
A) Start hydrochlorothiazide
B) Recommend lifestyle modifications and recheck in 6 months
C) Order an echocardiogram
D) Diagnose hypertension and start amlodipine
Answer: B
Explanation: According to ACC/AHA guidelines, stage 1 hypertension (130-139/80-89) with low ASCVD
risk should first be managed with lifestyle changes for 3-6 months before medication.
3. A 65-year-old woman with a 30-pack-year smoking history asks about lung cancer screening. Which
test is recommended?
A) Chest X-ray annually
B) Low-dose CT scan annually if she meets age and pack-year criteria
C) Sputum cytology
D) No screening because she quit smoking 5 years ago
Answer: B
Explanation: USPSTF recommends annual low-dose CT for adults aged 50-80 with a 20-pack-year
smoking history who currently smoke or quit within the past 15 years.
,4. A 30-year-old woman desires contraception. Which method is most effective (>99%) with perfect
use?
A) Oral contraceptive pills
B) Copper intrauterine device (IUD)
C) Male condoms
D) Fertility awareness
Answer: B
Explanation: Long-acting reversible contraceptives (IUDs, implant) have failure rates <1% with typical
use. Pills and condoms have higher typical-use failure rates.
5. A 50-year-old man has a body mass index (BMI) of 32 kg/m² with no other comorbidities. Which
intervention is first-line for weight loss?
A) Bariatric surgery referral
B) Prescribe phentermine
C) Intensive behavioral counseling and lifestyle modification
D) Orlistat prescription
Answer: C
Explanation: USPSTF recommends intensive, multicomponent behavioral interventions for adults with
obesity. Medications or surgery are considered after lifestyle intervention failure.
6. A 25-year-old woman presents for preconception counseling. Which supplement should be
recommended to reduce neural tube defect risk?
A) Vitamin B12 1000 mcg daily
B) Folic acid 400-800 mcg daily
C) Iron 65 mg daily
D) Calcium 1200 mg daily
Answer: B
Explanation: Folic acid 400-800 mcg daily starting at least 1 month before conception reduces neural
tube defects. Higher doses for those with prior affected pregnancy.
7. A 65-year-old man with hypertension and hyperlipidemia has a 10-year ASCVD risk of 12%. Which
statin intensity is recommended?
A) No statin
B) Moderate-intensity statin (e.g., atorvastatin 10-20 mg)
C) High-intensity statin (e.g., atorvastatin 40-80 mg)
D) Low-intensity statin
,Answer: C
Explanation: For primary prevention with ASCVD risk ≥7.5% (especially ≥20%), high-intensity statin is
recommended if candidate.
8. A 72-year-old woman with osteoporosis has a T-score of –2.8 at the femoral neck. Which
medication is first-line?
A) Raloxifene
B) Alendronate (bisphosphonate)
C) Teriparatide
D) Calcium alone
Answer: B
Explanation: Oral bisphosphonates (alendronate, risedronate) are first-line for osteoporosis to reduce
fracture risk. Teriparatide is for severe cases.
9. A 38-year-old woman with no risk factors asks about cervical cancer screening. According to current
guidelines, what is recommended?
A) Pap test every 3 years starting at age 21
B) HPV test alone every 5 years starting at age 25
C) Cotesting (Pap + HPV) every 5 years starting at age 30 is an option
D) Both B and C are acceptable depending on age
Answer: D
Explanation: For women age 30-65, options: Pap every 3 years, HPV alone every 5 years, or cotesting
every 5 years. Starting age for HPV alone is 25 (ACS) or 30 (USPSTF). Pap starts at 21.
10. A 60-year-old man asks about aspirin for primary prevention of cardiovascular disease. Which
statement is correct?
A) Aspirin is recommended for all adults over 50.
B) Aspirin is not routinely recommended for primary prevention due to bleeding risk.
C) Aspirin 81 mg daily is safe and effective for everyone.
D) Only enteric-coated aspirin works.
Answer: B
Explanation: Current guidelines recommend against routine aspirin for primary prevention in most
adults due to increased bleeding risk without net benefit.
11. An 18-year-old college student requests the meningococcal B vaccine. Which statement is true?
, A) MenB vaccine is routinely given to all adolescents at age 11-12.
B) MenB is recommended for adolescents and young adults aged 16-23 years with shared clinical
decision-making.
C) MenB is only for high-risk individuals.
D) MenB is the same as the MenACWY vaccine.
Answer: B
Explanation: MenB vaccine is not routinely recommended for all adolescents but may be given to those
aged 16-23 based on shared decision-making. MenACWY is routine at 11-12 years.
12. A 50-year-old woman with a first-degree relative with colorectal cancer diagnosed at age 55
should begin screening at age:
A) 45 years
B) 40 years (or 10 years before the relative’s age of diagnosis, whichever is earlier)
C) 50 years
D) 35 years
Answer: B
Explanation: For individuals with a first-degree relative with colorectal cancer diagnosed before age 60,
screening begins at age 40 or 10 years before the relative’s age at diagnosis.
13. A pregnant woman at 28 weeks gestation has a 1-hour glucose challenge test result of 150 mg/dL.
What is the next step?
A) Diagnose gestational diabetes
B) Perform a 3-hour oral glucose tolerance test (GTT)
C) Repeat the 1-hour test
D) No further testing
Answer: B
Explanation: A 1-hour glucose challenge test ≥140 mg/dL (or ≥135-140 depending on guidelines)
requires a diagnostic 3-hour 100-g GTT for gestational diabetes.
14. A healthy 2-year-old child is due for vaccines. Which combination is part of the routine schedule at
this age?
A) DTaP, IPV, MMR, Varicella, Hep A (if not previously given)
B) Only DTaP
C) Meningococcal and HPV
D) Rotavirus and PCV13
