AANP FNP Certification Exam Questions
and Answers (Verified Answers)
1. A 3-month-old infant with Down syndrome was started on goat's milk due to milk
intolerance. He now presents with pale conjunctiva and low HCT. What additional
test would you order?
A. Serum B12 and folate
B. Iron and TIBC
C. Peripheral blood smear
D. Reticulocyte count
Answer: B. Iron and TIBC
2. A patient has been on Synthroid for 3 months. TSH is increased and T4 is normal.
What is the next step?
A. Discontinue Synthroid
B. Switch to a different thyroid medication
C. Increase the medication dose
D. Recheck TSH in 6 weeks
Answer: C. Increase the medication dose
3. A 4-month-old infant presents with strabismus. The mother is very concerned.
What do you tell her?
A. Refer immediately to ophthalmology
B. Order a CT scan of the head
C. Tell her it is normal at this age
D. Refer to neurology
Answer: C. Tell her it is normal at this age
4. A 4-month-old infant won't keep anything down. What is the MOST important thing
to assess?
A. Stool consistency
B. Growth chart
C. Urine output
D. Serum electrolytes
Answer: B. Growth chart
5. A 6-month-old presents with a closed anterior fontanel. What is the next step?
A. MRI of the brain
B. CT scan of the head
C. X-ray
D. Reassure the parents it is normal
Answer: C. X-ray
,6. A patient's A1C is greater than 9 and is already on TWO oral diabetic medications.
What is the next step?
A. Add a third oral diabetic agent
B. Start basal insulin
C. Refer to endocrinology
D. Increase the dose of current medications
Answer: B. Start basal insulin
7. A Pap smear returns with abnormal cells. What is the next step?
A. Repeat Pap smear in 6 months
B. Start antibiotics
C. Refer for colposcopy
D. Order an MRI of the pelvis
Answer: C. Refer for colposcopy
8. Which of the following is a contraindication to ACE inhibitors?
A. Hypertension
B. Diabetes
C. Pregnancy
D. Hyperlipidemia
Answer: C. Pregnancy
9. A patient presents with chronic small acne-like papules and pustules around the
nose, mouth, and chin. What is the treatment?
A. Benzoyl peroxide and Retin-A
B. Metrogel and low-dose tetracycline
C. Oral isotretinoin
D. Salicylic acid wash
Answer: B. Metrogel and low-dose tetracycline (Acne Rosacea)
10. Actinic keratosis is a precursor to which type of cancer?
A. Basal cell carcinoma
B. Melanoma
C. Squamous cell carcinoma
D. Merkel cell carcinoma
Answer: C. Squamous cell carcinoma
11. A patient presents with acute severe halos, cupping of the optic nerve, cloudy
cornea, and a mid-dilated oval pupil. What is the next step?
A. Prescribe eye drops and follow up in one week
B. Send the patient to the ER STAT
C. Refer to ophthalmology in 24 hours
D. Start topical steroids
,Answer: B. Send the patient to the ER STAT (Acute Angle Closure Glaucoma)
12. On chest X-ray, acute bacterial pneumonia is most commonly found in which
lobe?
A. Upper lobe
B. Lower lobe
C. Middle lobe
D. All lobes equally
Answer: C. Middle lobe
13. A patient with Addison's disease will present with which electrolyte abnormality?
A. High sodium, low potassium
B. Low sodium, high potassium
C. Low sodium, low potassium
D. High sodium, high potassium
Answer: B. Low sodium, high potassium
14. Which grade of heart murmur is the FIRST to produce a palpable thrill?
A. Grade II
B. Grade III
C. Grade IV
D. Grade V
Answer: C. Grade IV
15. A patient with allergic conjunctivitis presents with stringy discharge and
increased tearing. What is the treatment?
A. Topical antibiotics
B. PO antihistamines
C. Topical corticosteroids
D. Warm compresses
Answer: B. PO antihistamines
16. What is the first-line treatment for allergic rhinitis?
A. Oral decongestants
B. Antihistamines
C. Inhaled corticosteroids
D. Leukotriene inhibitors
Answer: C. Inhaled corticosteroids
17. What is the GOLD standard diagnosis for Temporal Arteritis?
A. ESR
B. CT scan
C. MRI
D. Biopsy
, Answer: D. Biopsy
18. A patient presents with a target bull's-eye rash 10 days after a tick bite. What is
the treatment for a child OLDER than 7 years?
A. Amoxicillin
B. Azithromycin
C. Doxycycline
D. Ceftriaxone
Answer: C. Doxycycline (Erythema Migrans / Lyme Disease)
19. A patient presents with AV nicking on fundoscopic exam. What condition does
this indicate?
A. Diabetic retinopathy
B. Hypertensive retinopathy
C. Macular degeneration
D. Papilledema
Answer: B. Hypertensive retinopathy
20. What is the FIRST-LINE treatment for COPD Gold Stage 1-2?
A. LAMA (Long-acting anticholinergic)
B. LABA (Long-acting beta agonist)
C. SABA or SAMA (Short-acting agents)
D. Inhaled corticosteroids
Answer: C. SABA or SAMA
21. A patient with COPD Gold Stage 3-4, what is the FIRST-LINE treatment?
A. SABA
B. LAMA
C. ICS alone
D. SABA + ICS
Answer: B. LAMA
22. A fundoscopic exam shows cotton wool spots and microaneurysms. What
condition does this indicate?
A. Hypertensive retinopathy
B. Macular degeneration
C. Diabetic retinopathy
D. Glaucoma
Answer: C. Diabetic retinopathy
23. A patient with ascites would have what finding on percussion?
A. Resonance
B. Tympany
C. Dullness
and Answers (Verified Answers)
1. A 3-month-old infant with Down syndrome was started on goat's milk due to milk
intolerance. He now presents with pale conjunctiva and low HCT. What additional
test would you order?
A. Serum B12 and folate
B. Iron and TIBC
C. Peripheral blood smear
D. Reticulocyte count
Answer: B. Iron and TIBC
2. A patient has been on Synthroid for 3 months. TSH is increased and T4 is normal.
What is the next step?
A. Discontinue Synthroid
B. Switch to a different thyroid medication
C. Increase the medication dose
D. Recheck TSH in 6 weeks
Answer: C. Increase the medication dose
3. A 4-month-old infant presents with strabismus. The mother is very concerned.
What do you tell her?
A. Refer immediately to ophthalmology
B. Order a CT scan of the head
C. Tell her it is normal at this age
D. Refer to neurology
Answer: C. Tell her it is normal at this age
4. A 4-month-old infant won't keep anything down. What is the MOST important thing
to assess?
A. Stool consistency
B. Growth chart
C. Urine output
D. Serum electrolytes
Answer: B. Growth chart
5. A 6-month-old presents with a closed anterior fontanel. What is the next step?
A. MRI of the brain
B. CT scan of the head
C. X-ray
D. Reassure the parents it is normal
Answer: C. X-ray
,6. A patient's A1C is greater than 9 and is already on TWO oral diabetic medications.
What is the next step?
A. Add a third oral diabetic agent
B. Start basal insulin
C. Refer to endocrinology
D. Increase the dose of current medications
Answer: B. Start basal insulin
7. A Pap smear returns with abnormal cells. What is the next step?
A. Repeat Pap smear in 6 months
B. Start antibiotics
C. Refer for colposcopy
D. Order an MRI of the pelvis
Answer: C. Refer for colposcopy
8. Which of the following is a contraindication to ACE inhibitors?
A. Hypertension
B. Diabetes
C. Pregnancy
D. Hyperlipidemia
Answer: C. Pregnancy
9. A patient presents with chronic small acne-like papules and pustules around the
nose, mouth, and chin. What is the treatment?
A. Benzoyl peroxide and Retin-A
B. Metrogel and low-dose tetracycline
C. Oral isotretinoin
D. Salicylic acid wash
Answer: B. Metrogel and low-dose tetracycline (Acne Rosacea)
10. Actinic keratosis is a precursor to which type of cancer?
A. Basal cell carcinoma
B. Melanoma
C. Squamous cell carcinoma
D. Merkel cell carcinoma
Answer: C. Squamous cell carcinoma
11. A patient presents with acute severe halos, cupping of the optic nerve, cloudy
cornea, and a mid-dilated oval pupil. What is the next step?
A. Prescribe eye drops and follow up in one week
B. Send the patient to the ER STAT
C. Refer to ophthalmology in 24 hours
D. Start topical steroids
,Answer: B. Send the patient to the ER STAT (Acute Angle Closure Glaucoma)
12. On chest X-ray, acute bacterial pneumonia is most commonly found in which
lobe?
A. Upper lobe
B. Lower lobe
C. Middle lobe
D. All lobes equally
Answer: C. Middle lobe
13. A patient with Addison's disease will present with which electrolyte abnormality?
A. High sodium, low potassium
B. Low sodium, high potassium
C. Low sodium, low potassium
D. High sodium, high potassium
Answer: B. Low sodium, high potassium
14. Which grade of heart murmur is the FIRST to produce a palpable thrill?
A. Grade II
B. Grade III
C. Grade IV
D. Grade V
Answer: C. Grade IV
15. A patient with allergic conjunctivitis presents with stringy discharge and
increased tearing. What is the treatment?
A. Topical antibiotics
B. PO antihistamines
C. Topical corticosteroids
D. Warm compresses
Answer: B. PO antihistamines
16. What is the first-line treatment for allergic rhinitis?
A. Oral decongestants
B. Antihistamines
C. Inhaled corticosteroids
D. Leukotriene inhibitors
Answer: C. Inhaled corticosteroids
17. What is the GOLD standard diagnosis for Temporal Arteritis?
A. ESR
B. CT scan
C. MRI
D. Biopsy
, Answer: D. Biopsy
18. A patient presents with a target bull's-eye rash 10 days after a tick bite. What is
the treatment for a child OLDER than 7 years?
A. Amoxicillin
B. Azithromycin
C. Doxycycline
D. Ceftriaxone
Answer: C. Doxycycline (Erythema Migrans / Lyme Disease)
19. A patient presents with AV nicking on fundoscopic exam. What condition does
this indicate?
A. Diabetic retinopathy
B. Hypertensive retinopathy
C. Macular degeneration
D. Papilledema
Answer: B. Hypertensive retinopathy
20. What is the FIRST-LINE treatment for COPD Gold Stage 1-2?
A. LAMA (Long-acting anticholinergic)
B. LABA (Long-acting beta agonist)
C. SABA or SAMA (Short-acting agents)
D. Inhaled corticosteroids
Answer: C. SABA or SAMA
21. A patient with COPD Gold Stage 3-4, what is the FIRST-LINE treatment?
A. SABA
B. LAMA
C. ICS alone
D. SABA + ICS
Answer: B. LAMA
22. A fundoscopic exam shows cotton wool spots and microaneurysms. What
condition does this indicate?
A. Hypertensive retinopathy
B. Macular degeneration
C. Diabetic retinopathy
D. Glaucoma
Answer: C. Diabetic retinopathy
23. A patient with ascites would have what finding on percussion?
A. Resonance
B. Tympany
C. Dullness
