1
AANP Board Exam NEWEST 2025/2026
Actual Exam – 2 Versions Version A & B |
100% Verified | Graded A+ Detailed
Rationales – Pass Guaranteed – A+ Graded
[VERSION A: AANP FNP Board Exam (Assessment, Diagnosis, Treatment) — Questions 1-75]
Q1: A 65-year-old male presents with substernal chest pain radiating to the left arm. The pain is
described as "crushing" and does not change with inspiration or movement. Which diagnostic
tool is the gold standard for ruling out an acute coronary syndrome (ACS)?
A. Exercise Stress Test
B. Chest X-ray
C. 12-Lead Electrocardiogram (ECG)
D. Cardiac Troponin I
Correct Answer: C
Rationale: A 12-lead ECG is the initial gold standard diagnostic test for ACS. It can reveal ST-
elevation (STEMI), ST-depression, T-wave inversion, or new LBBB, guiding immediate
management. While troponin is highly specific for myocardial injury, the ECG is essential for
immediate triage for reperfusion therapy. Stress tests are for stable chest pain, and X-ray is not
definitive for ACS.
Q2: A patient presents with acute dyspnea. On auscultation, you hear crackles at the bases
bilaterally and a 3rd heart sound (S3). Which heart failure classification is consistent with these
findings?
A. Left-sided heart failure with preserved ejection fraction (HFpEF)
C. Left-sided heart failure with reduced ejection fraction (HFrEF)
D. Right-sided heart failure
B. Valvular regurgitation
,2
Correct Answer: C
Rationale: Bilateral crackles indicate pulmonary edema, and an S3 gallop is a classic sign of
volume overload and reduced ventricular contractility. These findings are characteristic of Left-
sided heart failure, specifically HFrEF, where the pump cannot eject blood effectively. Right-
sided failure typically presents with jugular venous distension (JVD) and peripheral edema, not
pulmonary edema.
Q3: During a focused cardiovascular exam, you auscultate a high-pitched, blowing, decrescendo
murmur best heard at the left sternal border with the diaphragm of the stethoscope. This is most
consistent with:
C. Aortic regurgitation
D. Mitral stenosis
B. Aortic stenosis
A. Mitral regurgitation
Correct Answer: C
Rationale: Aortic regurgitation produces a diastolic murmur that is often decrescendo (decreasing
in intensity) and high-pitched. It is best heard at the left sternal border (Erb's point) and radiates
to the apex. Mitral stenosis produces a diastolic rumble at the apex. Aortic stenosis is a systolic
ejection murmur heard at the right upper sternal border.
Q4: A 55-year-old female reports frequent flushing, night sweats, and unintentional weight loss.
Her blood pressure is 165/95 mmHg. What is the most likely cause of her secondary
hypertension?
A. Pheochromocytoma
C. Cushing's syndrome
D. Primary hyperaldosteronism
B. Coarctation of the aorta
Correct Answer: C
,3
Rationale: The triad of hypertension, central obesity/weight gain (or redistribution), and
vasomotor instability (flushing) strongly suggests Cushing's syndrome. Pheochromocytoma
typically presents with paroxysmal hypertension, palpitations, and headaches, not necessarily
flushing. Coarctation usually presents earlier with radiofemoral pulse delay in young patients.
Q5: A 70-year-old patient reports calf pain that occurs when walking two blocks and is relieved
by rest. On exam, the affected leg has diminished pulses and hair loss. What is the most likely
diagnosis?
A. Deep Vein Thrombosis (DVT)
C. Peripheral Artery Disease (PAD)
D. Sciatica
B. Acute Arterial Occlusion
Correct Answer: C
Rationale: Claudication (pain with exertion, relief with rest) is the hallmark of Peripheral Artery
Disease. Diminished pulses and hair loss indicate chronic ischemia. DVT causes swelling,
redness, and pain often present at rest, not necessarily exertion-related. Acute occlusion causes
pain at rest and pallor.
Q6: You are evaluating a patient with suspected community-acquired pneumonia (CAP). The
CURB-65 score is calculated as 2 (Confusion, Urea >19 mg/dL). What is the appropriate
management setting?
A. Admission to the ICU
C. Hospital admission (general ward)
D. Outpatient treatment
B. Observation unit
Correct Answer: C
Rationale: A CURB-65 score of 2 indicates moderate risk. Patients with a score of 2 or higher are
generally recommended for hospital admission, though not necessarily ICU (which is reserved
for scores of 3 or higher). A score of 0-1 is often managed as an outpatient with oral antibiotics.
, 4
Q7: A 6-year-old child presents with wheezing, cough, and shortness of breath. The mother
reports these symptoms happen primarily at night or during exercise. What is the most likely
diagnosis?
A. Bronchiolitis
C. Asthma
D. Foreign body aspiration
B. Croup
Correct Answer: C
Rationale: Childhood asthma commonly presents with recurrent wheezing triggered by factors
like viral infections, exercise, or nighttime. Bronchiolitis typically affects infants <2 years old
and presents with respiratory distress and fever. Croup presents with a barking cough and stridor,
often after a viral upper respiratory infection.
Q8: A 45-year-old male smoker presents with a chronic productive cough and dyspnea.
Spirometry shows an FEV1/FVC ratio of 0.65 (65%). Based on GOLD guidelines, what is the
stage of his COPD?
A. GOLD Stage 1 (Mild)
C. GOLD Stage 2 (Moderate)
D. GOLD Stage 3 (Severe)
B. GOLD Stage 4 (Very Severe)
Correct Answer: C
Q9: A patient presents with sudden onset of right-sided hemiparesis and aphasia. Her NIHSS
stroke scale score is calculated at 18. The CT angiogram shows a Large Vessel Occlusion. What
is the time window for endovascular therapy (tPA) if she is eligible?
A. 3 hours from "last known normal"
C. 4.5 hours from "last known normal" (if no exclusion criteria)
AANP Board Exam NEWEST 2025/2026
Actual Exam – 2 Versions Version A & B |
100% Verified | Graded A+ Detailed
Rationales – Pass Guaranteed – A+ Graded
[VERSION A: AANP FNP Board Exam (Assessment, Diagnosis, Treatment) — Questions 1-75]
Q1: A 65-year-old male presents with substernal chest pain radiating to the left arm. The pain is
described as "crushing" and does not change with inspiration or movement. Which diagnostic
tool is the gold standard for ruling out an acute coronary syndrome (ACS)?
A. Exercise Stress Test
B. Chest X-ray
C. 12-Lead Electrocardiogram (ECG)
D. Cardiac Troponin I
Correct Answer: C
Rationale: A 12-lead ECG is the initial gold standard diagnostic test for ACS. It can reveal ST-
elevation (STEMI), ST-depression, T-wave inversion, or new LBBB, guiding immediate
management. While troponin is highly specific for myocardial injury, the ECG is essential for
immediate triage for reperfusion therapy. Stress tests are for stable chest pain, and X-ray is not
definitive for ACS.
Q2: A patient presents with acute dyspnea. On auscultation, you hear crackles at the bases
bilaterally and a 3rd heart sound (S3). Which heart failure classification is consistent with these
findings?
A. Left-sided heart failure with preserved ejection fraction (HFpEF)
C. Left-sided heart failure with reduced ejection fraction (HFrEF)
D. Right-sided heart failure
B. Valvular regurgitation
,2
Correct Answer: C
Rationale: Bilateral crackles indicate pulmonary edema, and an S3 gallop is a classic sign of
volume overload and reduced ventricular contractility. These findings are characteristic of Left-
sided heart failure, specifically HFrEF, where the pump cannot eject blood effectively. Right-
sided failure typically presents with jugular venous distension (JVD) and peripheral edema, not
pulmonary edema.
Q3: During a focused cardiovascular exam, you auscultate a high-pitched, blowing, decrescendo
murmur best heard at the left sternal border with the diaphragm of the stethoscope. This is most
consistent with:
C. Aortic regurgitation
D. Mitral stenosis
B. Aortic stenosis
A. Mitral regurgitation
Correct Answer: C
Rationale: Aortic regurgitation produces a diastolic murmur that is often decrescendo (decreasing
in intensity) and high-pitched. It is best heard at the left sternal border (Erb's point) and radiates
to the apex. Mitral stenosis produces a diastolic rumble at the apex. Aortic stenosis is a systolic
ejection murmur heard at the right upper sternal border.
Q4: A 55-year-old female reports frequent flushing, night sweats, and unintentional weight loss.
Her blood pressure is 165/95 mmHg. What is the most likely cause of her secondary
hypertension?
A. Pheochromocytoma
C. Cushing's syndrome
D. Primary hyperaldosteronism
B. Coarctation of the aorta
Correct Answer: C
,3
Rationale: The triad of hypertension, central obesity/weight gain (or redistribution), and
vasomotor instability (flushing) strongly suggests Cushing's syndrome. Pheochromocytoma
typically presents with paroxysmal hypertension, palpitations, and headaches, not necessarily
flushing. Coarctation usually presents earlier with radiofemoral pulse delay in young patients.
Q5: A 70-year-old patient reports calf pain that occurs when walking two blocks and is relieved
by rest. On exam, the affected leg has diminished pulses and hair loss. What is the most likely
diagnosis?
A. Deep Vein Thrombosis (DVT)
C. Peripheral Artery Disease (PAD)
D. Sciatica
B. Acute Arterial Occlusion
Correct Answer: C
Rationale: Claudication (pain with exertion, relief with rest) is the hallmark of Peripheral Artery
Disease. Diminished pulses and hair loss indicate chronic ischemia. DVT causes swelling,
redness, and pain often present at rest, not necessarily exertion-related. Acute occlusion causes
pain at rest and pallor.
Q6: You are evaluating a patient with suspected community-acquired pneumonia (CAP). The
CURB-65 score is calculated as 2 (Confusion, Urea >19 mg/dL). What is the appropriate
management setting?
A. Admission to the ICU
C. Hospital admission (general ward)
D. Outpatient treatment
B. Observation unit
Correct Answer: C
Rationale: A CURB-65 score of 2 indicates moderate risk. Patients with a score of 2 or higher are
generally recommended for hospital admission, though not necessarily ICU (which is reserved
for scores of 3 or higher). A score of 0-1 is often managed as an outpatient with oral antibiotics.
, 4
Q7: A 6-year-old child presents with wheezing, cough, and shortness of breath. The mother
reports these symptoms happen primarily at night or during exercise. What is the most likely
diagnosis?
A. Bronchiolitis
C. Asthma
D. Foreign body aspiration
B. Croup
Correct Answer: C
Rationale: Childhood asthma commonly presents with recurrent wheezing triggered by factors
like viral infections, exercise, or nighttime. Bronchiolitis typically affects infants <2 years old
and presents with respiratory distress and fever. Croup presents with a barking cough and stridor,
often after a viral upper respiratory infection.
Q8: A 45-year-old male smoker presents with a chronic productive cough and dyspnea.
Spirometry shows an FEV1/FVC ratio of 0.65 (65%). Based on GOLD guidelines, what is the
stage of his COPD?
A. GOLD Stage 1 (Mild)
C. GOLD Stage 2 (Moderate)
D. GOLD Stage 3 (Severe)
B. GOLD Stage 4 (Very Severe)
Correct Answer: C
Q9: A patient presents with sudden onset of right-sided hemiparesis and aphasia. Her NIHSS
stroke scale score is calculated at 18. The CT angiogram shows a Large Vessel Occlusion. What
is the time window for endovascular therapy (tPA) if she is eligible?
A. 3 hours from "last known normal"
C. 4.5 hours from "last known normal" (if no exclusion criteria)
