8/13/25, 2:06 PM WHNP NCC Exam
NCC WHNP ACTUAL EXAM 2025-2026 \LATEST VERSION
WITH COMPLETE QUESTIONS AND ACCURATE DETAILED
ANSWERS \COMPLETE EXAM WITH VERIFIED
ANSWERS\LATEST UPDATE
Apical impulse 4th-5h left intercostal space medial to midclavicular line
S1 Occurs at start of systole at apex
S2 Occurs at start of diastole at base
- Heard at inspiration at base, normal
Physiologic split S2
- Best heard w/ diaphragm
- Heard at inspiration and expiration at base
- Delayed closure of pulmonic valve - caused by atrial
Fixed split S2
septal defect, right ventricular failure
- Best heard w/ diaphragm
- Ventricular gallop, best heard at apex with bell
- Early diastole, low pitch, increases w/ inspiration
Increased S3 - Normal in young adults & late preg.
- Dec myocardial contractility/heart failure/volume
overload = rapid ventricular filling
- Atrialgallop, best heard at apex w/ bell
- Late diastole, low pitch, increases w/ inspiration
Increased S4 - Normal in athletes, old
- Aortic stenosis, HTN heart disease, & cardiomyopathy
= forceful atrial ejection into distended ventricle
- 2-4th left ICS bw left sternal border & apex
Physiologic murmur - Mid-systole, soft-medium pitch, improves/gone when sitting,
standing, valsalva
- Normal, common in pregnancy
- Best heard at apex w/ bell
Murmur of mitral stenosis
- Early to late diastole, low-pitched
- Best heard at apex with diaphragm
Systolic click - Mid-to late systole, high pitch, inc w/ inspiration
- Mitral valve prolapse
/ 1/86
,8/13/25, 2:06 PM WHNP NCC Exam
- Smooth edge, sharp, nontender, </= 2 cm below right costal
Liver
margin
- Spans 6-12 cm at right MCL
Aorta Left of midline in upper abdomen, <3 cm wide
Splenic dullness 6-10th ICS posterior to midaxillary line - suspect splenomegaly
Peritonitis Guarding, rigidity, rebound tenderness is a sign of?
Appendicitis Mcburney's point, Rovsing, and Psoas/obturator are tests for
what?
McBurney localized RLQ tenderness
Referred rebound tenderness; RLQ pain when Left side
Rovsing
pressure is applied & withdrawn
Psoas/obturator Extension/rotation of thigh/hip causes right side muscle irritation
and pain
Cholecystitis + Murphy sign indicates what?
Sharp increase in tenderness and cessation of breathing
Murphy
when upward pressure placed under right costal
margin
/ 2/86
,8/13/25, 2:06 PM WHNP NCC Exam
for all adults 45+ with structural (visual) or high sensitivity
stool test; screen until 75 y.o.
-guaiac fecal occult: multiple stools, at home, annual
-stool DNA - 1 sample, at home, cancer/polyp DNA, q3y
-colonoscopy q10y
Colorectal screen
-flexible sigmoidoscopy q5y
-CT colonography q5y
start younger if risks like inflammatory bowel disease,
hx/fhx colon polyps/colon cancer, lynch syndrome,
1945-1965 Anyone born between these years or with risk factors should be
tested for Hep C
screen for this q3 years
starting at 45 y.o. hx GDM
DM - screen q3y for life
Dx made by:
- sx hyperglycemia & random non-fasting glucose 200+
- fasting glucose 126+
- 2 hour GTT - 200+
Must be repeated on another day to confirm
Lipids should be screened starting at what age; (or
starting at 20 if risk factors for CV disease)
40-75
done q5y
/ 3/86
, 8/13/25, 2:06 PM WHNP NCC Exam
-I - olfactory; familiar smells
- II - optic; acuity, peripheral vision, optic disc
- III, IV, VI - oculomotor/trochlear/abducens - PERRLA, EOM
function, ptosis
- V - trigeminal - palpate temporal/masseter muscle
strength, sharp/dull touch on forehead/cheeks/chin
Cranial nerves
- VII - facial - weakness, asymmetry, abnormal movement
- VIII - acoustic - auditory acuity
- IX & X - glossopharyngeal & vagus - swallow,
soft palate symmetry, uvula movement w/
"ah", gag, voice
- XI - spinal accessory - strength/symmetry, trapezius &
sternocleidomastoid muscles XII - Hypoglossal -
tongue deviation, asymmetry
Cerebellum Coordination, gait, walk heel-toe, Romberg, rapid alternating
movement
Romberg test balance with eyes closed
- Straight-sided
Pederson speculum
- Comes in pediatric, narrow, and regular sizes
- Duck-billed shape, used for lax musculature
Graves speculum
- Submucosal fat impedes visualization
5.5-8 cm; 2-3 cm Normal uterus size; usually this much larger in parous women
Normal adnexa Fallopian non-palpable, ovoid ovaries
epididymis posterolateral surface of tests, comma shape
spermatic cord from lower end of epididymis and extends to external inguinal
ring
/ 4/86
NCC WHNP ACTUAL EXAM 2025-2026 \LATEST VERSION
WITH COMPLETE QUESTIONS AND ACCURATE DETAILED
ANSWERS \COMPLETE EXAM WITH VERIFIED
ANSWERS\LATEST UPDATE
Apical impulse 4th-5h left intercostal space medial to midclavicular line
S1 Occurs at start of systole at apex
S2 Occurs at start of diastole at base
- Heard at inspiration at base, normal
Physiologic split S2
- Best heard w/ diaphragm
- Heard at inspiration and expiration at base
- Delayed closure of pulmonic valve - caused by atrial
Fixed split S2
septal defect, right ventricular failure
- Best heard w/ diaphragm
- Ventricular gallop, best heard at apex with bell
- Early diastole, low pitch, increases w/ inspiration
Increased S3 - Normal in young adults & late preg.
- Dec myocardial contractility/heart failure/volume
overload = rapid ventricular filling
- Atrialgallop, best heard at apex w/ bell
- Late diastole, low pitch, increases w/ inspiration
Increased S4 - Normal in athletes, old
- Aortic stenosis, HTN heart disease, & cardiomyopathy
= forceful atrial ejection into distended ventricle
- 2-4th left ICS bw left sternal border & apex
Physiologic murmur - Mid-systole, soft-medium pitch, improves/gone when sitting,
standing, valsalva
- Normal, common in pregnancy
- Best heard at apex w/ bell
Murmur of mitral stenosis
- Early to late diastole, low-pitched
- Best heard at apex with diaphragm
Systolic click - Mid-to late systole, high pitch, inc w/ inspiration
- Mitral valve prolapse
/ 1/86
,8/13/25, 2:06 PM WHNP NCC Exam
- Smooth edge, sharp, nontender, </= 2 cm below right costal
Liver
margin
- Spans 6-12 cm at right MCL
Aorta Left of midline in upper abdomen, <3 cm wide
Splenic dullness 6-10th ICS posterior to midaxillary line - suspect splenomegaly
Peritonitis Guarding, rigidity, rebound tenderness is a sign of?
Appendicitis Mcburney's point, Rovsing, and Psoas/obturator are tests for
what?
McBurney localized RLQ tenderness
Referred rebound tenderness; RLQ pain when Left side
Rovsing
pressure is applied & withdrawn
Psoas/obturator Extension/rotation of thigh/hip causes right side muscle irritation
and pain
Cholecystitis + Murphy sign indicates what?
Sharp increase in tenderness and cessation of breathing
Murphy
when upward pressure placed under right costal
margin
/ 2/86
,8/13/25, 2:06 PM WHNP NCC Exam
for all adults 45+ with structural (visual) or high sensitivity
stool test; screen until 75 y.o.
-guaiac fecal occult: multiple stools, at home, annual
-stool DNA - 1 sample, at home, cancer/polyp DNA, q3y
-colonoscopy q10y
Colorectal screen
-flexible sigmoidoscopy q5y
-CT colonography q5y
start younger if risks like inflammatory bowel disease,
hx/fhx colon polyps/colon cancer, lynch syndrome,
1945-1965 Anyone born between these years or with risk factors should be
tested for Hep C
screen for this q3 years
starting at 45 y.o. hx GDM
DM - screen q3y for life
Dx made by:
- sx hyperglycemia & random non-fasting glucose 200+
- fasting glucose 126+
- 2 hour GTT - 200+
Must be repeated on another day to confirm
Lipids should be screened starting at what age; (or
starting at 20 if risk factors for CV disease)
40-75
done q5y
/ 3/86
, 8/13/25, 2:06 PM WHNP NCC Exam
-I - olfactory; familiar smells
- II - optic; acuity, peripheral vision, optic disc
- III, IV, VI - oculomotor/trochlear/abducens - PERRLA, EOM
function, ptosis
- V - trigeminal - palpate temporal/masseter muscle
strength, sharp/dull touch on forehead/cheeks/chin
Cranial nerves
- VII - facial - weakness, asymmetry, abnormal movement
- VIII - acoustic - auditory acuity
- IX & X - glossopharyngeal & vagus - swallow,
soft palate symmetry, uvula movement w/
"ah", gag, voice
- XI - spinal accessory - strength/symmetry, trapezius &
sternocleidomastoid muscles XII - Hypoglossal -
tongue deviation, asymmetry
Cerebellum Coordination, gait, walk heel-toe, Romberg, rapid alternating
movement
Romberg test balance with eyes closed
- Straight-sided
Pederson speculum
- Comes in pediatric, narrow, and regular sizes
- Duck-billed shape, used for lax musculature
Graves speculum
- Submucosal fat impedes visualization
5.5-8 cm; 2-3 cm Normal uterus size; usually this much larger in parous women
Normal adnexa Fallopian non-palpable, ovoid ovaries
epididymis posterolateral surface of tests, comma shape
spermatic cord from lower end of epididymis and extends to external inguinal
ring
/ 4/86
