AANPCB FNP-C Full-Length Original
Practice Exam — 150 Questions
Answer Key At The End Page
Below is an original full-length AANPCB FNP-C practice exam aligned to the current AANPCB FNP
Questions 1–150
1. A 2-year-old has fever, ear pain, and a bulging, erythematous tympanic membrane. No drug allergies.
Best first-line therapy?
A. Azithromycin
B. Cefdinir
C. High-dose amoxicillin
D. Ciprofloxacin ear drops
2. A swimmer has ear pain worsened by tragus movement and an edematous ear canal. TM is intact.
Best treatment?
A. Oral amoxicillin
B. Topical fluoroquinolone ear drops
C. Oral prednisone
D. Watchful waiting only
3. A child has watery bilateral eye discharge, URI symptoms, and no vision changes. Most likely
diagnosis?
A. Bacterial conjunctivitis
B. Corneal abrasion
C. Allergic conjunctivitis
D. Viral conjunctivitis
,4. An adult has fever, tonsillar exudates, tender anterior cervical nodes, and no cough. Best next step?
A. Empiric antibiotics without testing
B. Rapid antigen detection test for group A strep
C. Chest x-ray
D. Throat culture only after antibiotics
5. Acute bacterial rhinosinusitis is most likely when symptoms:
A. Improve by day 3
B. Persist >10 days or worsen after initial improvement
C. Include clear rhinorrhea for 2 days
D. Occur only with sneezing
6. A patient has asthma symptoms 3 days weekly and nighttime symptoms twice monthly. Best
controller therapy?
A. SABA only
B. Low-dose inhaled corticosteroid
C. Daily oral prednisone
D. Long-term antibiotic therapy
7. Diagnostic confirmation of COPD requires:
A. Post-bronchodilator FEV1/FVC <0.70
B. Peak flow >90% predicted
C. Chest x-ray hyperinflation only
D. Positive methacholine challenge
8. A patient has fever, cough, pleuritic chest pain, crackles, and oxygen saturation 93%. Best test to
confirm pneumonia?
A. D-dimer
B. Spirometry
C. Chest x-ray
D. BNP
9. A patient develops cough on lisinopril. Best substitution for renal/cardiac benefit?
A. Amlodipine
B. Losartan
C. Hydrochlorothiazide only
D. Clonidine
10. Systolic crescendo-decrescendo murmur radiating to carotids suggests:
A. Aortic stenosis
B. Mitral stenosis
C. Tricuspid regurgitation
D. Mitral valve prolapse
11. Exertional calf pain relieved by rest suggests PAD. Best office diagnostic test?
A. ECG
B. Venous Doppler
C. Ankle-brachial index
D. D-dimer
, 12. Unilateral calf swelling and pain after surgery. Best initial diagnostic test?
A. Chest x-ray
B. Compression venous ultrasound
C. Arterial Doppler
D. ESR
13. New facial droop, arm weakness, and speech difficulty began 45 minutes ago. Best action?
A. Schedule neurology visit
B. Give aspirin and observe
C. Start oral steroids
D. Activate EMS/stroke protocol
14. A patient with migraine with aura requests combined oral contraceptives. Best response?
A. Safe if low-dose estrogen
B. Use only during menses
C. Avoid estrogen-containing contraception
D. Add aspirin
15. Bilateral “band-like” headache without nausea, photophobia, or neurologic deficits suggests:
A. Cluster headache
B. Tension-type headache
C. Subarachnoid hemorrhage
D. Temporal arteritis
16. A 72-year-old has new unilateral temporal headache, jaw claudication, and vision blurring. Best
initial management?
A. Start high-dose glucocorticoids and urgent evaluation
B. Wait for biopsy before treatment
C. Treat with triptan
D. Reassure and follow up in 1 month
17. Brief vertigo triggered by rolling over in bed with positive Dix-Hallpike suggests BPPV. Best
treatment?
A. Long-term benzodiazepine
B. Antibiotics
C. Loop diuretic
D. Canalith repositioning maneuver
18. Episodic vertigo, tinnitus, ear fullness, and fluctuating hearing loss suggests:
A. Vestibular neuritis
B. Otitis media
C. Ménière disease
D. Labyrinthitis from stroke
19. New major depression without psychosis or mania. Best initial approach?
A. Benzodiazepine only
B. Assess suicide risk; consider psychotherapy and/or SSRI
C. Antipsychotic only
D. No treatment for 6 months
Practice Exam — 150 Questions
Answer Key At The End Page
Below is an original full-length AANPCB FNP-C practice exam aligned to the current AANPCB FNP
Questions 1–150
1. A 2-year-old has fever, ear pain, and a bulging, erythematous tympanic membrane. No drug allergies.
Best first-line therapy?
A. Azithromycin
B. Cefdinir
C. High-dose amoxicillin
D. Ciprofloxacin ear drops
2. A swimmer has ear pain worsened by tragus movement and an edematous ear canal. TM is intact.
Best treatment?
A. Oral amoxicillin
B. Topical fluoroquinolone ear drops
C. Oral prednisone
D. Watchful waiting only
3. A child has watery bilateral eye discharge, URI symptoms, and no vision changes. Most likely
diagnosis?
A. Bacterial conjunctivitis
B. Corneal abrasion
C. Allergic conjunctivitis
D. Viral conjunctivitis
,4. An adult has fever, tonsillar exudates, tender anterior cervical nodes, and no cough. Best next step?
A. Empiric antibiotics without testing
B. Rapid antigen detection test for group A strep
C. Chest x-ray
D. Throat culture only after antibiotics
5. Acute bacterial rhinosinusitis is most likely when symptoms:
A. Improve by day 3
B. Persist >10 days or worsen after initial improvement
C. Include clear rhinorrhea for 2 days
D. Occur only with sneezing
6. A patient has asthma symptoms 3 days weekly and nighttime symptoms twice monthly. Best
controller therapy?
A. SABA only
B. Low-dose inhaled corticosteroid
C. Daily oral prednisone
D. Long-term antibiotic therapy
7. Diagnostic confirmation of COPD requires:
A. Post-bronchodilator FEV1/FVC <0.70
B. Peak flow >90% predicted
C. Chest x-ray hyperinflation only
D. Positive methacholine challenge
8. A patient has fever, cough, pleuritic chest pain, crackles, and oxygen saturation 93%. Best test to
confirm pneumonia?
A. D-dimer
B. Spirometry
C. Chest x-ray
D. BNP
9. A patient develops cough on lisinopril. Best substitution for renal/cardiac benefit?
A. Amlodipine
B. Losartan
C. Hydrochlorothiazide only
D. Clonidine
10. Systolic crescendo-decrescendo murmur radiating to carotids suggests:
A. Aortic stenosis
B. Mitral stenosis
C. Tricuspid regurgitation
D. Mitral valve prolapse
11. Exertional calf pain relieved by rest suggests PAD. Best office diagnostic test?
A. ECG
B. Venous Doppler
C. Ankle-brachial index
D. D-dimer
, 12. Unilateral calf swelling and pain after surgery. Best initial diagnostic test?
A. Chest x-ray
B. Compression venous ultrasound
C. Arterial Doppler
D. ESR
13. New facial droop, arm weakness, and speech difficulty began 45 minutes ago. Best action?
A. Schedule neurology visit
B. Give aspirin and observe
C. Start oral steroids
D. Activate EMS/stroke protocol
14. A patient with migraine with aura requests combined oral contraceptives. Best response?
A. Safe if low-dose estrogen
B. Use only during menses
C. Avoid estrogen-containing contraception
D. Add aspirin
15. Bilateral “band-like” headache without nausea, photophobia, or neurologic deficits suggests:
A. Cluster headache
B. Tension-type headache
C. Subarachnoid hemorrhage
D. Temporal arteritis
16. A 72-year-old has new unilateral temporal headache, jaw claudication, and vision blurring. Best
initial management?
A. Start high-dose glucocorticoids and urgent evaluation
B. Wait for biopsy before treatment
C. Treat with triptan
D. Reassure and follow up in 1 month
17. Brief vertigo triggered by rolling over in bed with positive Dix-Hallpike suggests BPPV. Best
treatment?
A. Long-term benzodiazepine
B. Antibiotics
C. Loop diuretic
D. Canalith repositioning maneuver
18. Episodic vertigo, tinnitus, ear fullness, and fluctuating hearing loss suggests:
A. Vestibular neuritis
B. Otitis media
C. Ménière disease
D. Labyrinthitis from stroke
19. New major depression without psychosis or mania. Best initial approach?
A. Benzodiazepine only
B. Assess suicide risk; consider psychotherapy and/or SSRI
C. Antipsychotic only
D. No treatment for 6 months
