1
2025/2026 NEWEST AANP
FINAL EXAM QUESTIONS WITH
ACTUAL EXAM QUESTIONS
CORRECTLY ANSWERED AND A
COMPLETE STUDY GUIDE EXAM
WITH RATIONALES
A 6-year-old patient presents to the clinic accompanied by his mother,
who reports concerns regarding her child's progressive urinary issues. The
patient's mother states that she and the child's father recently divorced,
and the child alternates weekly between her house and his father's house.
She reports he experiences episodes of urinary incontinence and holds his
stomach as if he is in pain. He frequently asks to use the bathroom but is
scared of urination once he is there. Which of the following is the most
likely diagnosis?
A. Adjustment disorder
B. Constipation
C. Regression
D. Urinary tract infection -- ANSWER--D. Urinary tract infection
The most likely diagnosis is a urinary tract infection (D). His clinical
presentation includes abdominal pain, urinary frequency, and dysuria,
which are signs of cystitis in children, which is considered a lower urinary
tract infection (UTI). Pyelonephritis is a complicated form of UTI that may
present with persistent fever, flank pain, or vomiting.
A 12-year-old girl presents to the clinic with her parent, who is concerned
about the C-shaped appearance of the girl's spine. The degree of
curvature in her spine is 35 degrees. Which of the following is appropriate
to educate the parent?
,2
A. "Your daughter's spine has a mild curve but does not require
treatment and will likely resolve on its own."
B. "Your daughter's spine has a mild curve, so we will watch and
wait to see if it worsens. If so, treatment will be necessary."
C. "Your daughter's spine has moderate curvature, so we will need to
place her in a brace as treatment."
D. "Your daughter's spine has severe curvature, so we will need to
refer her for surgery as soon as possible. -- ANSWER--C. "Your
daughter's spine has moderate curvature, so we will need to place
her in a brace as treatment."
Scoliosis is a complex spinal deformity defined as a curve in the spine of
at least 10 degrees. A curvature of 25 to 40 degrees is considered
moderate scoliosis, and most cases require bracing for correction (C).
Braces are offered for treatment in patients who are skeletally immature
and have curves > 30 degrees at the first visit. Bracing is considered
ineffective if the curvature is > 45 degrees because the patient has
reached the threshold for surgical intervention. In male patients, the
brace is worn until they stop growing, and in female patients, the brace is
worn more than 1.5 years postmenarch or until the patient has grown < 1
cm over the previous 6 months.
An 11-year-old patient reports a severe sore throat, fever, nausea, and
headache. Upon exam, the nurse practitioner sees a strawberry red
pharynx with petechiae on the hard palate. The remainder of the exam is
benign. What would be the best initial test to order for this patient?
A Epstein-Barr virus panel
B Nucleic acid amplification test
C. Rapid antigen detection test
,3
D. Rapid plasma reagin test -- ANSWER--C. Rapid antigen detection test
The patient in the above scenario is exhibiting signs of an acute group A
streptococcal pharyngitis infection. Group A Streptococcus infections are
the most common cause of bacterial pharyngitis in children and
adolescents. Children typically present with the abrupt onset of
pharyngitis, fever, headache, abdominal pain or nausea, and vomiting.
Physical exam findings include throat erythema, palatal petechiae,
enlarged or erythematous tonsils, enlarged anterior cervical lymph nodes,
and a scarlatiniform rash. The gold standard for testing a patient with
suspected group A streptococcal pharyngitis is a rapid antigen detection
test (C). These tests provide quick, highly specific results and are readily
available in most care centers. Because the sensitivity of the rapid
antigen detection tests is a little lower, 70- 90%, if a child initially tests
negative, a confirmatory throat culture should be sent as a
follow-up.
All of the following are potential secondary causes of hyperparathyroidism
except:
A.
Chronic kidney
disease B.
Neck radiation
exposure C.
Parathyroid
adenoma D.
Vitamin D deficiency -- ANSWER--C. Parathyroid adenoma
Secondary hyperparathyroidism occurs when an issue external to the
parathyroid lowers calcium levels. This can be due to chronic kidney
disease (especially end-stage kidney disease), a vitamin D deficiency,
or neck radiation exposure. Primary causes of
, 4
hyperparathyroidism are due to an issue with the parathyroid itself, such
as a parathyroid adenoma (C).
A patient tells the nurse practitioner that she recently started taking the
supplement St. John's wort after reading about its benefits online. Which
of the following medications, if being actively consumed, must be
immediately stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex) -- ANSWER--D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and
belongs to a drug class known as serotonin agonists. When used in
conjunction with St. John's wort, it may increase the risk of serotonin
syndrome, a potentially life-threatening condition.
Which of the following is not a symptom of both major depressive
disorder and post- traumatic stress disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty -- ANSWER--B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major
depressive disorder (MDD) may also include symptoms of depressed mood,
anhedonia, weight loss or gain, and low energy. However, hypervigilance
(B) is not a symptom associated with this diagnosis.
2025/2026 NEWEST AANP
FINAL EXAM QUESTIONS WITH
ACTUAL EXAM QUESTIONS
CORRECTLY ANSWERED AND A
COMPLETE STUDY GUIDE EXAM
WITH RATIONALES
A 6-year-old patient presents to the clinic accompanied by his mother,
who reports concerns regarding her child's progressive urinary issues. The
patient's mother states that she and the child's father recently divorced,
and the child alternates weekly between her house and his father's house.
She reports he experiences episodes of urinary incontinence and holds his
stomach as if he is in pain. He frequently asks to use the bathroom but is
scared of urination once he is there. Which of the following is the most
likely diagnosis?
A. Adjustment disorder
B. Constipation
C. Regression
D. Urinary tract infection -- ANSWER--D. Urinary tract infection
The most likely diagnosis is a urinary tract infection (D). His clinical
presentation includes abdominal pain, urinary frequency, and dysuria,
which are signs of cystitis in children, which is considered a lower urinary
tract infection (UTI). Pyelonephritis is a complicated form of UTI that may
present with persistent fever, flank pain, or vomiting.
A 12-year-old girl presents to the clinic with her parent, who is concerned
about the C-shaped appearance of the girl's spine. The degree of
curvature in her spine is 35 degrees. Which of the following is appropriate
to educate the parent?
,2
A. "Your daughter's spine has a mild curve but does not require
treatment and will likely resolve on its own."
B. "Your daughter's spine has a mild curve, so we will watch and
wait to see if it worsens. If so, treatment will be necessary."
C. "Your daughter's spine has moderate curvature, so we will need to
place her in a brace as treatment."
D. "Your daughter's spine has severe curvature, so we will need to
refer her for surgery as soon as possible. -- ANSWER--C. "Your
daughter's spine has moderate curvature, so we will need to place
her in a brace as treatment."
Scoliosis is a complex spinal deformity defined as a curve in the spine of
at least 10 degrees. A curvature of 25 to 40 degrees is considered
moderate scoliosis, and most cases require bracing for correction (C).
Braces are offered for treatment in patients who are skeletally immature
and have curves > 30 degrees at the first visit. Bracing is considered
ineffective if the curvature is > 45 degrees because the patient has
reached the threshold for surgical intervention. In male patients, the
brace is worn until they stop growing, and in female patients, the brace is
worn more than 1.5 years postmenarch or until the patient has grown < 1
cm over the previous 6 months.
An 11-year-old patient reports a severe sore throat, fever, nausea, and
headache. Upon exam, the nurse practitioner sees a strawberry red
pharynx with petechiae on the hard palate. The remainder of the exam is
benign. What would be the best initial test to order for this patient?
A Epstein-Barr virus panel
B Nucleic acid amplification test
C. Rapid antigen detection test
,3
D. Rapid plasma reagin test -- ANSWER--C. Rapid antigen detection test
The patient in the above scenario is exhibiting signs of an acute group A
streptococcal pharyngitis infection. Group A Streptococcus infections are
the most common cause of bacterial pharyngitis in children and
adolescents. Children typically present with the abrupt onset of
pharyngitis, fever, headache, abdominal pain or nausea, and vomiting.
Physical exam findings include throat erythema, palatal petechiae,
enlarged or erythematous tonsils, enlarged anterior cervical lymph nodes,
and a scarlatiniform rash. The gold standard for testing a patient with
suspected group A streptococcal pharyngitis is a rapid antigen detection
test (C). These tests provide quick, highly specific results and are readily
available in most care centers. Because the sensitivity of the rapid
antigen detection tests is a little lower, 70- 90%, if a child initially tests
negative, a confirmatory throat culture should be sent as a
follow-up.
All of the following are potential secondary causes of hyperparathyroidism
except:
A.
Chronic kidney
disease B.
Neck radiation
exposure C.
Parathyroid
adenoma D.
Vitamin D deficiency -- ANSWER--C. Parathyroid adenoma
Secondary hyperparathyroidism occurs when an issue external to the
parathyroid lowers calcium levels. This can be due to chronic kidney
disease (especially end-stage kidney disease), a vitamin D deficiency,
or neck radiation exposure. Primary causes of
, 4
hyperparathyroidism are due to an issue with the parathyroid itself, such
as a parathyroid adenoma (C).
A patient tells the nurse practitioner that she recently started taking the
supplement St. John's wort after reading about its benefits online. Which
of the following medications, if being actively consumed, must be
immediately stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex) -- ANSWER--D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and
belongs to a drug class known as serotonin agonists. When used in
conjunction with St. John's wort, it may increase the risk of serotonin
syndrome, a potentially life-threatening condition.
Which of the following is not a symptom of both major depressive
disorder and post- traumatic stress disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty -- ANSWER--B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major
depressive disorder (MDD) may also include symptoms of depressed mood,
anhedonia, weight loss or gain, and low energy. However, hypervigilance
(B) is not a symptom associated with this diagnosis.
