Family Nurse Practitioner (FNP-BC) Certification
Exam 2026/2027 Questions and Answers with
Rationales
1. A 45-year-old patient presents with fatigue and pallor. Laboratory results
reveal a hemoglobin of 9 g/dL, MCV of 70 fL, and low serum ferritin. What is the
most likely diagnosis?
A) Vitamin B12 deficiency
B) Iron deficiency anemia
C) Aplastic anemia
D) Anemia of chronic disease
Answer: B) Iron deficiency anemia
Rationale: Iron deficiency anemia presents with microcytic (low MCV),
hypochromic anemia and low serum ferritin, which reflects low iron stores.
2. Which of the following vaccines is contraindicated in a pregnant woman?
A) Influenza (inactivated)
B) Tdap
C) MMR
D) Hepatitis B
,Answer: C) MMR
Rationale: MMR (measles, mumps, rubella) vaccine is live attenuated and
contraindicated during pregnancy due to risk to the fetus.
3. What is the first-line treatment for uncomplicated community-acquired
pneumonia in an otherwise healthy adult?
A) Azithromycin
B) Ciprofloxacin
C) Amoxicillin-clavulanate
D) Doxycycline
Answer: A) Azithromycin
Rationale: Macrolides such as azithromycin are recommended first-line for
outpatient treatment of community-acquired pneumonia in healthy adults.
4. A 60-year-old patient with hypertension is found to have a blood pressure of
150/95 mmHg during a routine visit. According to the ACC/AHA 2017 guidelines,
what is the recommended next step?
A) Immediate start of antihypertensive medication
B) Lifestyle modifications and recheck BP in 3-6 months
C) Refer to cardiology for hypertensive urgency
D) Prescribe beta-blockers
,Answer: B) Lifestyle modifications and recheck BP in 3-6 months
Rationale: Stage 1 hypertension (130-139/80-89) without cardiovascular disease
is initially managed with lifestyle modifications and monitoring.
5. A 25-year-old woman presents with a painful, swollen right lower leg after a
long flight. What is the most appropriate diagnostic test?
A) MRI of the leg
B) Venous Doppler ultrasound
C) CT angiography
D) D-dimer test
Answer: B) Venous Doppler ultrasound
Rationale: Venous Doppler ultrasound is the gold standard initial test to diagnose
deep vein thrombosis (DVT).
6. Which of the following medications is safest to use during pregnancy for
gestational diabetes?
A) Glyburide
B) Metformin
C) Insulin
D) Pioglitazone
Answer: C) Insulin
Rationale: Insulin is the gold standard for treating gestational diabetes as it does
not cross the placenta and has no known fetal risk.
, 7. What is the screening recommendation for colorectal cancer in an average-
risk adult?
A) Colonoscopy starting at age 50 every 10 years
B) Fecal occult blood test annually starting at age 40
C) Flexible sigmoidoscopy every 3 years starting at age 55
D) No screening needed unless symptoms develop
Answer: A) Colonoscopy starting at age 50 every 10 years
Rationale: USPSTF recommends screening average-risk adults for colorectal
cancer starting at age 50 with colonoscopy every 10 years or other modalities.
8. A 30-year-old male presents with a painless, hard testicular mass. What is the
most likely diagnosis?
A) Hydrocele
B) Epididymitis
C) Testicular cancer
D) Varicocele
Answer: C) Testicular cancer
Rationale: Painless, hard testicular masses in young men are highly suspicious for
testicular cancer and require urgent evaluation.
9. Which of the following antihypertensive classes is contraindicated in
pregnancy?
Exam 2026/2027 Questions and Answers with
Rationales
1. A 45-year-old patient presents with fatigue and pallor. Laboratory results
reveal a hemoglobin of 9 g/dL, MCV of 70 fL, and low serum ferritin. What is the
most likely diagnosis?
A) Vitamin B12 deficiency
B) Iron deficiency anemia
C) Aplastic anemia
D) Anemia of chronic disease
Answer: B) Iron deficiency anemia
Rationale: Iron deficiency anemia presents with microcytic (low MCV),
hypochromic anemia and low serum ferritin, which reflects low iron stores.
2. Which of the following vaccines is contraindicated in a pregnant woman?
A) Influenza (inactivated)
B) Tdap
C) MMR
D) Hepatitis B
,Answer: C) MMR
Rationale: MMR (measles, mumps, rubella) vaccine is live attenuated and
contraindicated during pregnancy due to risk to the fetus.
3. What is the first-line treatment for uncomplicated community-acquired
pneumonia in an otherwise healthy adult?
A) Azithromycin
B) Ciprofloxacin
C) Amoxicillin-clavulanate
D) Doxycycline
Answer: A) Azithromycin
Rationale: Macrolides such as azithromycin are recommended first-line for
outpatient treatment of community-acquired pneumonia in healthy adults.
4. A 60-year-old patient with hypertension is found to have a blood pressure of
150/95 mmHg during a routine visit. According to the ACC/AHA 2017 guidelines,
what is the recommended next step?
A) Immediate start of antihypertensive medication
B) Lifestyle modifications and recheck BP in 3-6 months
C) Refer to cardiology for hypertensive urgency
D) Prescribe beta-blockers
,Answer: B) Lifestyle modifications and recheck BP in 3-6 months
Rationale: Stage 1 hypertension (130-139/80-89) without cardiovascular disease
is initially managed with lifestyle modifications and monitoring.
5. A 25-year-old woman presents with a painful, swollen right lower leg after a
long flight. What is the most appropriate diagnostic test?
A) MRI of the leg
B) Venous Doppler ultrasound
C) CT angiography
D) D-dimer test
Answer: B) Venous Doppler ultrasound
Rationale: Venous Doppler ultrasound is the gold standard initial test to diagnose
deep vein thrombosis (DVT).
6. Which of the following medications is safest to use during pregnancy for
gestational diabetes?
A) Glyburide
B) Metformin
C) Insulin
D) Pioglitazone
Answer: C) Insulin
Rationale: Insulin is the gold standard for treating gestational diabetes as it does
not cross the placenta and has no known fetal risk.
, 7. What is the screening recommendation for colorectal cancer in an average-
risk adult?
A) Colonoscopy starting at age 50 every 10 years
B) Fecal occult blood test annually starting at age 40
C) Flexible sigmoidoscopy every 3 years starting at age 55
D) No screening needed unless symptoms develop
Answer: A) Colonoscopy starting at age 50 every 10 years
Rationale: USPSTF recommends screening average-risk adults for colorectal
cancer starting at age 50 with colonoscopy every 10 years or other modalities.
8. A 30-year-old male presents with a painless, hard testicular mass. What is the
most likely diagnosis?
A) Hydrocele
B) Epididymitis
C) Testicular cancer
D) Varicocele
Answer: C) Testicular cancer
Rationale: Painless, hard testicular masses in young men are highly suspicious for
testicular cancer and require urgent evaluation.
9. Which of the following antihypertensive classes is contraindicated in
pregnancy?
