AANP FNP CERTIFICATION
ACTUAL EXAM
2026/2027
A 30-year-old chef complains of pruritic hives over her chest and arms, but
denies difficulty swallowing or breathing. She reports a family history of allergic
rhinitis and asthma. Which of the following interventions is most appropriate?
A. Obtain a complete and thorough history
B. Recommend an oral antihistamine such as diphenhydramine 25 mg PO QID
C. Give an injection of epinephrine 1:1000 intramuscularly stat
D. Call 911
A) Obtain a complete and thorough history
Before prescribing medications, a thorough history must be obtained to
determine possible causes of hives. The patient denied difficulty with
swallowing and breathing, so there was no medical emergency that would
require calling 911.
Which of the following findings is most likely in young primigravidas
with pregnancy-induced hypertension?
A. Abdominal cramping and constipation
B. Edema of the face and the upper extremities
C. Shortness of breath
D. Dysuria and frequency
B) Edema of the face and the upper extremities
Common signs and symptoms of pregnancy-induced hypertension include
edema of the face and the upper extremities, weight gain, blurred vision,
elevated blood pressure, proteinuria, and headaches
Which of the following symptoms is associated with B12 deficiency anemia?
A. Spoon-shaped nails and pica
B. Abnormal neurological exam
C. Vegan diet
D. Tingling and numbness of both feet
D) Tingling and numbness of both feet
Vitamin B12 deficiency anemia can cause nerve cell damage if not treated.
Symptoms of B12 deficiency anemia may include tingling or numbness in
fingers and toes, difficulty walking, mood changes or depression, memory
loss, disorientation, and dementia.
A second triple screen on a 35-year-old primigravida reveals abnormally low
levels of alpha fetoprotein and estriol and high levels of human chorionic
gonadotropin. Which of the following interventions is the best choice for this
patient?
A. Order an ultrasound
B. Order a computed tomography (CT) scan of the abdomen
C. Order a 24-hour urine for protein clearance
D. Assess for a history of illicit drug or alcohol use
A) Order an ultrasound
Abnormally low levels of alpha fetoprotein and estriol and high levels of
human chorionic gonadotropin are abnormal during pregnancy. An
ultrasound should be ordered to further evaluate the fetus for
characteristics of Down syndrome and/or fetal demise.
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,All of the following are true statements about diverticula except:
A. Diverticula are located in the colon
B. A low-fiber diet is associated with the condition
C. Most diverticula in the colon are infected with gram-negative bacteria
D. Supplementing with fiber, such as psyllium (Metamucil), is recommended
C) Most diverticula in the colon are infected with gram-negative
bacteria Diverticula in the colon can be infected with both gram-
negative and gram-positive
Patients who are diagnosed with gonorrhea should also be treated for which of
the following infections?
A. Chancroid
B. Chlamydia trachomatis
C. Herpes genitalis
D. Pelvic inflammatory disease (PID)
B) Chlamydia trachomatis
When diagnosed with gonorrhea, the patient should also be treated for
Chlamydia trachomatis.
Kyphosis is a late sign of:
A. Rheumatoid arthritis
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis
C) Osteoporosis
Kyphosis is a curvature of the spine that causes a rounding of the back,
which leads to a slouching posture. Severe thinning of the bones
(osteoporosis) contributes to this curvature in the spine. Symptoms that
may occur with severe cases of kyphosis include difficulty breathing,
fatigue, and back pain.
A 35-year-old primigravida who is at 18 weeks gestation is expecting twins. What
would you would expect her alpha fetoprotein (AFP) values to be?
A. Normal
B. Higher than normal
C. Lower than normal
D. None of the above
B) Higher than normal
Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Higher
levels of AFP are commonly seen in multiple gestations due to the growing
liver in each fetus, which cumulatively lead to higher AFP levels.
Which of the following antihypertensive medications has beneficial effects for an
elderly White woman with osteoporosis?
A. Calcium channel blockers
B. Angiotensin-converting enzyme (ACE) inhibitors
C. Beta-blockers
D. Thiazide diuretics
D) Thiazide diuretics
Thiazide diuretics have a favorable effect in patients with osteopenia and
osteoporosis by slowing down the kidney's excretion of calcium and
increasing distal tubule calcium reabsorption. This results in decreased
bone demineralization. Thiazide diuretics are a
messages.downloaded_
, good choice of therapy for this population because they treat hypertension
and slow bone loss.
The Lachman maneuver is used to detect which of the following?
A. Instability of the knee
B. Nerve damage of the knee due to past knee injuries
C. Integrity of the patellar tendon
D. Tears on the meniscus of the knee
A) Instability of the knee
The Lachman maneuver is a test performed to assess for knee instability
(i.e., damage to the motion of anterior translation [laxity] of the anterior
cruciate ligament [ACL]). The maneuver should be tested on both knees,
comparing the injured and the opposite knee, the uninjured knee is used as
the "control." The test is positive if the injured knee slips back further
(laxity). Perform the test by bending the knee 30 degrees. Stabilize the
femur with one hand. Place the other hand under the proximal tibia at the
level of the joint line and then pull forward. The laxity is graded on a 0
(normal)-to-3 scale (1.0-1.5 cm of translation).
A 75-year-old woman has been on nifedipine (Procardia XL) 10-mg capsule for
many years to control her stage II hypertension. Her blood pressure at this visit
is 165/80 mmHg. She is currently complaining of pain at her right hip and in both
knees. She has increased her dose of ibuprofen (Motrin) from 400 mg three times
daily (TID) to 800 mg TID. She is still in pain and would like something stronger.
Which of the following statements is the best explanation of the effects of
ibuprofen (Motrin) on her disease?
A. It increases the chances of adverse effects to her health
B. It inhibits the effect of renal prostaglandins and blunts the effectiveness of
the diuretic
C. It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics
D. None of the statements are true
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of
the diuretic Nonsteroidal anti-inflammatory drugs (NSAIDs) and
acetylsalicylic acid (ASA) inhibit the vasodilatory effects of prostaglandins,
which predisposes the kidney to ischemia. NSAIDs can cause acute kidney
injury by decreasing renal blood flow. Nonselective NSAIDs can adversely
affect the kidneys, GI tract, liver, cardiovascular system, and the lungs
(bronchospasm).
All of the following are infections that affect mostly the labia and vagina except:
A. Bacterial vaginosis
B. Candidiasis
C. Trichomoniasis
D. Chlamydia trachomatis
D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial
vaginosis, candidiasis, and trichomoniasis. Chlamydia trachomatis commonly
affects the cervix, endometrial lining, fallopian tubes, and pelvic cavity.
The nurse practitioner would test the obturator and iliopsoas muscle to evaluate
for:
A. Cholecystitis
messages.downloaded_
ACTUAL EXAM
2026/2027
A 30-year-old chef complains of pruritic hives over her chest and arms, but
denies difficulty swallowing or breathing. She reports a family history of allergic
rhinitis and asthma. Which of the following interventions is most appropriate?
A. Obtain a complete and thorough history
B. Recommend an oral antihistamine such as diphenhydramine 25 mg PO QID
C. Give an injection of epinephrine 1:1000 intramuscularly stat
D. Call 911
A) Obtain a complete and thorough history
Before prescribing medications, a thorough history must be obtained to
determine possible causes of hives. The patient denied difficulty with
swallowing and breathing, so there was no medical emergency that would
require calling 911.
Which of the following findings is most likely in young primigravidas
with pregnancy-induced hypertension?
A. Abdominal cramping and constipation
B. Edema of the face and the upper extremities
C. Shortness of breath
D. Dysuria and frequency
B) Edema of the face and the upper extremities
Common signs and symptoms of pregnancy-induced hypertension include
edema of the face and the upper extremities, weight gain, blurred vision,
elevated blood pressure, proteinuria, and headaches
Which of the following symptoms is associated with B12 deficiency anemia?
A. Spoon-shaped nails and pica
B. Abnormal neurological exam
C. Vegan diet
D. Tingling and numbness of both feet
D) Tingling and numbness of both feet
Vitamin B12 deficiency anemia can cause nerve cell damage if not treated.
Symptoms of B12 deficiency anemia may include tingling or numbness in
fingers and toes, difficulty walking, mood changes or depression, memory
loss, disorientation, and dementia.
A second triple screen on a 35-year-old primigravida reveals abnormally low
levels of alpha fetoprotein and estriol and high levels of human chorionic
gonadotropin. Which of the following interventions is the best choice for this
patient?
A. Order an ultrasound
B. Order a computed tomography (CT) scan of the abdomen
C. Order a 24-hour urine for protein clearance
D. Assess for a history of illicit drug or alcohol use
A) Order an ultrasound
Abnormally low levels of alpha fetoprotein and estriol and high levels of
human chorionic gonadotropin are abnormal during pregnancy. An
ultrasound should be ordered to further evaluate the fetus for
characteristics of Down syndrome and/or fetal demise.
messages.downloaded_
,All of the following are true statements about diverticula except:
A. Diverticula are located in the colon
B. A low-fiber diet is associated with the condition
C. Most diverticula in the colon are infected with gram-negative bacteria
D. Supplementing with fiber, such as psyllium (Metamucil), is recommended
C) Most diverticula in the colon are infected with gram-negative
bacteria Diverticula in the colon can be infected with both gram-
negative and gram-positive
Patients who are diagnosed with gonorrhea should also be treated for which of
the following infections?
A. Chancroid
B. Chlamydia trachomatis
C. Herpes genitalis
D. Pelvic inflammatory disease (PID)
B) Chlamydia trachomatis
When diagnosed with gonorrhea, the patient should also be treated for
Chlamydia trachomatis.
Kyphosis is a late sign of:
A. Rheumatoid arthritis
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis
C) Osteoporosis
Kyphosis is a curvature of the spine that causes a rounding of the back,
which leads to a slouching posture. Severe thinning of the bones
(osteoporosis) contributes to this curvature in the spine. Symptoms that
may occur with severe cases of kyphosis include difficulty breathing,
fatigue, and back pain.
A 35-year-old primigravida who is at 18 weeks gestation is expecting twins. What
would you would expect her alpha fetoprotein (AFP) values to be?
A. Normal
B. Higher than normal
C. Lower than normal
D. None of the above
B) Higher than normal
Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Higher
levels of AFP are commonly seen in multiple gestations due to the growing
liver in each fetus, which cumulatively lead to higher AFP levels.
Which of the following antihypertensive medications has beneficial effects for an
elderly White woman with osteoporosis?
A. Calcium channel blockers
B. Angiotensin-converting enzyme (ACE) inhibitors
C. Beta-blockers
D. Thiazide diuretics
D) Thiazide diuretics
Thiazide diuretics have a favorable effect in patients with osteopenia and
osteoporosis by slowing down the kidney's excretion of calcium and
increasing distal tubule calcium reabsorption. This results in decreased
bone demineralization. Thiazide diuretics are a
messages.downloaded_
, good choice of therapy for this population because they treat hypertension
and slow bone loss.
The Lachman maneuver is used to detect which of the following?
A. Instability of the knee
B. Nerve damage of the knee due to past knee injuries
C. Integrity of the patellar tendon
D. Tears on the meniscus of the knee
A) Instability of the knee
The Lachman maneuver is a test performed to assess for knee instability
(i.e., damage to the motion of anterior translation [laxity] of the anterior
cruciate ligament [ACL]). The maneuver should be tested on both knees,
comparing the injured and the opposite knee, the uninjured knee is used as
the "control." The test is positive if the injured knee slips back further
(laxity). Perform the test by bending the knee 30 degrees. Stabilize the
femur with one hand. Place the other hand under the proximal tibia at the
level of the joint line and then pull forward. The laxity is graded on a 0
(normal)-to-3 scale (1.0-1.5 cm of translation).
A 75-year-old woman has been on nifedipine (Procardia XL) 10-mg capsule for
many years to control her stage II hypertension. Her blood pressure at this visit
is 165/80 mmHg. She is currently complaining of pain at her right hip and in both
knees. She has increased her dose of ibuprofen (Motrin) from 400 mg three times
daily (TID) to 800 mg TID. She is still in pain and would like something stronger.
Which of the following statements is the best explanation of the effects of
ibuprofen (Motrin) on her disease?
A. It increases the chances of adverse effects to her health
B. It inhibits the effect of renal prostaglandins and blunts the effectiveness of
the diuretic
C. It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics
D. None of the statements are true
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of
the diuretic Nonsteroidal anti-inflammatory drugs (NSAIDs) and
acetylsalicylic acid (ASA) inhibit the vasodilatory effects of prostaglandins,
which predisposes the kidney to ischemia. NSAIDs can cause acute kidney
injury by decreasing renal blood flow. Nonselective NSAIDs can adversely
affect the kidneys, GI tract, liver, cardiovascular system, and the lungs
(bronchospasm).
All of the following are infections that affect mostly the labia and vagina except:
A. Bacterial vaginosis
B. Candidiasis
C. Trichomoniasis
D. Chlamydia trachomatis
D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial
vaginosis, candidiasis, and trichomoniasis. Chlamydia trachomatis commonly
affects the cervix, endometrial lining, fallopian tubes, and pelvic cavity.
The nurse practitioner would test the obturator and iliopsoas muscle to evaluate
for:
A. Cholecystitis
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