ANCC LATEST 2026 EXAMINATION TEST QUESTIONS
AND SOLUTIONS GUARANTEE A+
✔✔tertiary prevention - ✔✔in established disease, adjusting therapy to avoid further
target organ damage. potentially viewed as a failure of primary prevention
minimizing negative disease induced outcomes
✔✔active immunity - ✔✔resistance developed in response to a vaccine and usually
characterized by the presence of an antibody produced by host
via immunization
onset of protection is usually within 1 month of vaccine dose
duration of protection- usually years or lifelong
✔✔passive immunity - ✔✔Immunity conferred by transferring antibodies from an
individual who is immune to a pathogen to another individual.
onset of protection- usually within hours of dose
duration of protection- usually time-limits, usually 6-9 months
available for limited number of infectious disease including varicella, hep A or B,
tetanus, rabies, others
✔✔Urticaria - ✔✔hives
✔✔Hep A - ✔✔contaminated food or water
✔✔Live Vaccines - ✔✔MMR, Varicella, intranasal influenza- not given during pregnancy
Rotavirus (oral)- not given with SCID
harmless virus shed from stool in first weeks post vaccine- standard diaper hygiene and
handwashing
✔✔MMR - ✔✔dose 1- 12 months
dose 2- 4-6 years
✔✔Varicella - ✔✔dose 1- 12 months
dose 2- 4-6 years
✔✔Rotavirus - ✔✔max age for 1st dose- 14 weeks 6 days
max age for last dose- 8 months
✔✔Stages of change - ✔✔precontemplation, contemplation, preparation, action,
maintenance
✔✔5 A's of smoking cessation - ✔✔1. Ask
,2. Advise
3. Assess
4. Assist
5. Arrange
✔✔leading cause of death in 10-44 - ✔✔unintentional injury
✔✔leading cause of death in 45-64 - ✔✔cancer
✔✔Hemoglobin/Hematocrit (H&H) ratio - ✔✔1:3
✔✔RBC size (MCV) - ✔✔microcytic- MCV <80
normocytic- MCV 80-96
macrocytic- MCV >96
✔✔MCHC - ✔✔normochromic- MCHC 31-37
hypochromic- <31
✔✔RDW - ✔✔11.5-14.5%
✔✔Normal reticulocyte count - ✔✔1-2%
✔✔normocytic normochromic anemia with NL RDW - ✔✔anemia of chronic disease
chronic kidney disease
acute blood loss
Next step: dictated by suspected underlying cause
✔✔microcytic, hypochromic, elevated RDW - ✔✔Iron deficiency
plumbism (lead toxicity)
Next step: ferritin for estimate iron stores
add lead testing in younger children
✔✔microcytic, hypochromic anemia, NL RDW - ✔✔thalassemia trait
✔✔alpa thalassemia minor - ✔✔A, A, A
asian, african ancestry
✔✔beta thalassemia minor - ✔✔B, A, M, M, E
african, mediterranean, middle eastern ancestry
next step: hemoglobin electrophoresis for evaluation of hemoglobin variant
, ✔✔macrocytic normochromic anemia with elevated RDW - ✔✔vitamin B12 deficiency,
especially pernicious anemia
folate deficiency anemia
next step: serum vitamin B12 and RBC folate
✔✔drug induced macrocystosis usually without anemia - ✔✔alcohol (Excess)
antiepileptic drugs (cabamazepine, phenytoin, methotrexate)
most common:
excessive alcohol >5 drink per day in male, >3 drinks per day in female
next step: usually not needed
✔✔Hemic murmur - ✔✔shows up in absence of cardiac pathology
but contact more than normal
high fever, profound dehydration, anemia is bad, thyroid toxicosis
happens in 3rd trimester of preggo sometimes
✔✔WBC - ✔✔Nobody Likes My Educational Background
neutrophils- 60% (bacteria)
lymphocyte- 30% (virus)
monocyte- 6% (debris)
eosinophil- 3% (allergens, parasites (worms, wheezes, weird diseases)
basophil- 1% (anaphylaxis)
✔✔Level of evidence ranking - ✔✔meta-analysis or systematic review
(cochrane/medline/cinahl/pubmed)
RCTs
experimental studies (control group, intervention group)
cohort/case control studies
retrospective chart reviews
expert/specialty society opinions
✔✔basal cell carcinoma - ✔✔skin lesion has pearly or waxlike appearance with
telangiectasia
risk factors: light-colored skin
✔✔actinic keratosis - ✔✔a precancerous skin growth that occurs on sun-damaged skin
✔✔gold standard for skin cancer - ✔✔skin biopsy
AND SOLUTIONS GUARANTEE A+
✔✔tertiary prevention - ✔✔in established disease, adjusting therapy to avoid further
target organ damage. potentially viewed as a failure of primary prevention
minimizing negative disease induced outcomes
✔✔active immunity - ✔✔resistance developed in response to a vaccine and usually
characterized by the presence of an antibody produced by host
via immunization
onset of protection is usually within 1 month of vaccine dose
duration of protection- usually years or lifelong
✔✔passive immunity - ✔✔Immunity conferred by transferring antibodies from an
individual who is immune to a pathogen to another individual.
onset of protection- usually within hours of dose
duration of protection- usually time-limits, usually 6-9 months
available for limited number of infectious disease including varicella, hep A or B,
tetanus, rabies, others
✔✔Urticaria - ✔✔hives
✔✔Hep A - ✔✔contaminated food or water
✔✔Live Vaccines - ✔✔MMR, Varicella, intranasal influenza- not given during pregnancy
Rotavirus (oral)- not given with SCID
harmless virus shed from stool in first weeks post vaccine- standard diaper hygiene and
handwashing
✔✔MMR - ✔✔dose 1- 12 months
dose 2- 4-6 years
✔✔Varicella - ✔✔dose 1- 12 months
dose 2- 4-6 years
✔✔Rotavirus - ✔✔max age for 1st dose- 14 weeks 6 days
max age for last dose- 8 months
✔✔Stages of change - ✔✔precontemplation, contemplation, preparation, action,
maintenance
✔✔5 A's of smoking cessation - ✔✔1. Ask
,2. Advise
3. Assess
4. Assist
5. Arrange
✔✔leading cause of death in 10-44 - ✔✔unintentional injury
✔✔leading cause of death in 45-64 - ✔✔cancer
✔✔Hemoglobin/Hematocrit (H&H) ratio - ✔✔1:3
✔✔RBC size (MCV) - ✔✔microcytic- MCV <80
normocytic- MCV 80-96
macrocytic- MCV >96
✔✔MCHC - ✔✔normochromic- MCHC 31-37
hypochromic- <31
✔✔RDW - ✔✔11.5-14.5%
✔✔Normal reticulocyte count - ✔✔1-2%
✔✔normocytic normochromic anemia with NL RDW - ✔✔anemia of chronic disease
chronic kidney disease
acute blood loss
Next step: dictated by suspected underlying cause
✔✔microcytic, hypochromic, elevated RDW - ✔✔Iron deficiency
plumbism (lead toxicity)
Next step: ferritin for estimate iron stores
add lead testing in younger children
✔✔microcytic, hypochromic anemia, NL RDW - ✔✔thalassemia trait
✔✔alpa thalassemia minor - ✔✔A, A, A
asian, african ancestry
✔✔beta thalassemia minor - ✔✔B, A, M, M, E
african, mediterranean, middle eastern ancestry
next step: hemoglobin electrophoresis for evaluation of hemoglobin variant
, ✔✔macrocytic normochromic anemia with elevated RDW - ✔✔vitamin B12 deficiency,
especially pernicious anemia
folate deficiency anemia
next step: serum vitamin B12 and RBC folate
✔✔drug induced macrocystosis usually without anemia - ✔✔alcohol (Excess)
antiepileptic drugs (cabamazepine, phenytoin, methotrexate)
most common:
excessive alcohol >5 drink per day in male, >3 drinks per day in female
next step: usually not needed
✔✔Hemic murmur - ✔✔shows up in absence of cardiac pathology
but contact more than normal
high fever, profound dehydration, anemia is bad, thyroid toxicosis
happens in 3rd trimester of preggo sometimes
✔✔WBC - ✔✔Nobody Likes My Educational Background
neutrophils- 60% (bacteria)
lymphocyte- 30% (virus)
monocyte- 6% (debris)
eosinophil- 3% (allergens, parasites (worms, wheezes, weird diseases)
basophil- 1% (anaphylaxis)
✔✔Level of evidence ranking - ✔✔meta-analysis or systematic review
(cochrane/medline/cinahl/pubmed)
RCTs
experimental studies (control group, intervention group)
cohort/case control studies
retrospective chart reviews
expert/specialty society opinions
✔✔basal cell carcinoma - ✔✔skin lesion has pearly or waxlike appearance with
telangiectasia
risk factors: light-colored skin
✔✔actinic keratosis - ✔✔a precancerous skin growth that occurs on sun-damaged skin
✔✔gold standard for skin cancer - ✔✔skin biopsy
