AANP FNP CERTIFICATION EXAM
STUDY GUIDE 2026/2027 WITH 261
QUESTIONS AND CORFECT
ANSWERS RATED A+
Involves making a hole to drain the blood.
Moderate Acne Treatment
Includes topical retinoids and oral antibiotics like doxycycline or
tetracycline.
Heart Murmur with Holosystolic or Pan Systolic
Indicates mitral regurgitation (MR) or aortic stenosis (AS) with specific
radiation patterns.
Coarctation of Aorta
Characterized by bounding radial and weak femoral pulses, with increased
blood pressure in the arms and lower pressure in the legs.
Congenital cardiac condition
characterized by a narrowing of the aorta
Murmur Grade III - VI
Loud murmur easily heard
JVD caused by
tension pneumothorax, Rt. sided heart failure, cardiac tamponade,
traumatic asphyxia from increase in portal pressure(LIVER) in venous side
or cor pulmonale
Endocarditis
pt. with gradual onset of fever, hemorrhages on nail beds, painful raised
red nodules, rash on palms
Olser's nodes
painful red spots on fingers
Janeway lesions
rash on palms and soles
Peripheral Arterial Disease (PAD)
Absence of pulse, decrease blood flow, PAIN, Dx doppler or ABI<0.9, TX
exercise by walking or antiplatelet
Chronic Venous Insufficiency (PVD)
Volume, edema, discoloration, decrease blood going up
Chronic Bronchitis Treatment
,Smoking cessation, Pulmonary rehabilitation, Pharmacologic therapy,
Supplemental oxygen
PPD positive for TB
>5 mm in an immunocompromised patient or close contact, >10 mm in
immigrant, health care workers, drug user, >15 mm in a patient who lives in
an area where TB is very rare
Condition for Lateral X-ray of the neck
Drooling, Unable to do ROM of the neck / stiff neck
Croup/Epiglottitis
condition that would make you order Lateral X-ray of the neck
AV nicking
Arterioles pressing on vein of the eye indicative of HTN retinopathy
Intraocular pressure (IOP)
Fluid pressure inside the eye; measured with tonometry
Rovsing sign
pain in the RLQ when the LLQ is palpated (indicative of appendicitis)
Pencil-like stools
occur in an obstruction of the Sigmoid descending colon; thin narrow stool
possibly caused by colon cancer, diarrhea, IBS
Headache after trauma
SDH
Diastolic murmurs
All diastolic murmurs are pathological.
Murmur Grades
Grades I-barely, II-audible, III-clearly audible, IV-first time thrill, V-Steth
edge, VI-entire steth.
Fundal height at 12 weeks
Fundal Height 12 weeks above symphysis pubis.
Fundus at 16 weeks
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks
Fundus at 20 weeks is at umbilicus.
Normal fundal height variation
2 cm more or less from number of weeks gestation is normal if more or less
order US.
3 month old infant with down syndrome
Pale conjunctiva but otherwise healthy. Low HCT. Additional test: Iron,
TIBC.
TSH and T4 levels after 3 months of synthroid
TSH increased, T4 normal, increase medication.
,Assessing cognitive function
3 ways to assess cognitive function in patient with signs/symptoms of
memory loss: Mini mental exam.
4 month old with strabismus
Tell her it is normal.
4 month old won't keep anything down
Look at the growth chart.
6 month old closed anterior fontanel
X-ray.
Abnormal cells on PAP
Refer for Colposcopy.
CAGE acronym
Cut down, Annoyed by criticism, Guilty about drinking, Eye opener drink.
Causes of tachycardia
Fever, Anemia, Hypotension.
Cranial nerves for extraocular movements
CN 3, 4, 6.
Definition of metabolic syndrome
Cluster of conditions that increase risk of heart disease, stroke, diabetes.
Diagnosing trichomoniasis
Wet prep.
Elderly with atrophic vaginitis
Pelvic US.
Epistaxis location
Kiesselbach's triangle, located in the anterior septum.
Diagnosis of acute bacterial prostatitis
Urinalysis and culture.
GERD treatment
H2 is first line, give hs.
Grade 3 cells on Pap treatment
LEEP excision.
Fingernail hematoma treatment
Drill hole and drain blood.
Increased risk of ectopic pregnancy
Salpingitis, or history of abortion, PID.
Roseola (6th Disease)
A viral infection that can result in a maculopapular rash, usually
accompanied by a high fever.
Chronic Alcoholism Treatment
Typically involves a 12 step program.
, Gonorrhea Treatment
Rocephin 250mg IMx1 plus Azithromycin 1 gm orally x1 or doxy 100 mg
BID x7d.
IUD
A birth control method suitable for young females who forget to take pills
and want to avoid pregnancy for at least 5 years.
Basal Cell Cancer
The most common type of skin cancer caused by UV exposure,
characterized by a waxy, pearly appearance.
Actinic Keratosis
A precancerous skin growth that appears as scaly red to yellow lesions on
sun-damaged skin.
Subungual Hematoma Treatment
Migraine headache
paroxysmal (sudden, periodic) attacks of mostly unilateral headache, often
accompanied by disordered vision, nausea, or vomiting, lasting hours or
days and caused by dilation of arteries
Abortive treatment for migraines
triptans
Prophylaxis for migraines
propranolol, TCA amitriptyline, anticonvulsants topiramate
Vitamin B12
shares a close relationship with Folate
Vitamin B12 deficiency
Cognitive deficits, glossitis, pernicious anemia
SED rate
checked after 6 weeks of treatment for joint arthritis; normal range is from
something to 25
Treatment for elevated SED rate
changed to NSAID, SED rate is a sign of inflammation
Medication causing low sperm count
SSRI
Grandiosity
Exaggerated belief in or claims about one's importance or identity
ADHD
A behavioral problem characterized by short attention span, restless
movement, and impaired learning capacity
Low Grade Squamous Intraepithelial Lesions
noted on pap's smear; HPV test if not done, refer for colposcopy
STUDY GUIDE 2026/2027 WITH 261
QUESTIONS AND CORFECT
ANSWERS RATED A+
Involves making a hole to drain the blood.
Moderate Acne Treatment
Includes topical retinoids and oral antibiotics like doxycycline or
tetracycline.
Heart Murmur with Holosystolic or Pan Systolic
Indicates mitral regurgitation (MR) or aortic stenosis (AS) with specific
radiation patterns.
Coarctation of Aorta
Characterized by bounding radial and weak femoral pulses, with increased
blood pressure in the arms and lower pressure in the legs.
Congenital cardiac condition
characterized by a narrowing of the aorta
Murmur Grade III - VI
Loud murmur easily heard
JVD caused by
tension pneumothorax, Rt. sided heart failure, cardiac tamponade,
traumatic asphyxia from increase in portal pressure(LIVER) in venous side
or cor pulmonale
Endocarditis
pt. with gradual onset of fever, hemorrhages on nail beds, painful raised
red nodules, rash on palms
Olser's nodes
painful red spots on fingers
Janeway lesions
rash on palms and soles
Peripheral Arterial Disease (PAD)
Absence of pulse, decrease blood flow, PAIN, Dx doppler or ABI<0.9, TX
exercise by walking or antiplatelet
Chronic Venous Insufficiency (PVD)
Volume, edema, discoloration, decrease blood going up
Chronic Bronchitis Treatment
,Smoking cessation, Pulmonary rehabilitation, Pharmacologic therapy,
Supplemental oxygen
PPD positive for TB
>5 mm in an immunocompromised patient or close contact, >10 mm in
immigrant, health care workers, drug user, >15 mm in a patient who lives in
an area where TB is very rare
Condition for Lateral X-ray of the neck
Drooling, Unable to do ROM of the neck / stiff neck
Croup/Epiglottitis
condition that would make you order Lateral X-ray of the neck
AV nicking
Arterioles pressing on vein of the eye indicative of HTN retinopathy
Intraocular pressure (IOP)
Fluid pressure inside the eye; measured with tonometry
Rovsing sign
pain in the RLQ when the LLQ is palpated (indicative of appendicitis)
Pencil-like stools
occur in an obstruction of the Sigmoid descending colon; thin narrow stool
possibly caused by colon cancer, diarrhea, IBS
Headache after trauma
SDH
Diastolic murmurs
All diastolic murmurs are pathological.
Murmur Grades
Grades I-barely, II-audible, III-clearly audible, IV-first time thrill, V-Steth
edge, VI-entire steth.
Fundal height at 12 weeks
Fundal Height 12 weeks above symphysis pubis.
Fundus at 16 weeks
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks
Fundus at 20 weeks is at umbilicus.
Normal fundal height variation
2 cm more or less from number of weeks gestation is normal if more or less
order US.
3 month old infant with down syndrome
Pale conjunctiva but otherwise healthy. Low HCT. Additional test: Iron,
TIBC.
TSH and T4 levels after 3 months of synthroid
TSH increased, T4 normal, increase medication.
,Assessing cognitive function
3 ways to assess cognitive function in patient with signs/symptoms of
memory loss: Mini mental exam.
4 month old with strabismus
Tell her it is normal.
4 month old won't keep anything down
Look at the growth chart.
6 month old closed anterior fontanel
X-ray.
Abnormal cells on PAP
Refer for Colposcopy.
CAGE acronym
Cut down, Annoyed by criticism, Guilty about drinking, Eye opener drink.
Causes of tachycardia
Fever, Anemia, Hypotension.
Cranial nerves for extraocular movements
CN 3, 4, 6.
Definition of metabolic syndrome
Cluster of conditions that increase risk of heart disease, stroke, diabetes.
Diagnosing trichomoniasis
Wet prep.
Elderly with atrophic vaginitis
Pelvic US.
Epistaxis location
Kiesselbach's triangle, located in the anterior septum.
Diagnosis of acute bacterial prostatitis
Urinalysis and culture.
GERD treatment
H2 is first line, give hs.
Grade 3 cells on Pap treatment
LEEP excision.
Fingernail hematoma treatment
Drill hole and drain blood.
Increased risk of ectopic pregnancy
Salpingitis, or history of abortion, PID.
Roseola (6th Disease)
A viral infection that can result in a maculopapular rash, usually
accompanied by a high fever.
Chronic Alcoholism Treatment
Typically involves a 12 step program.
, Gonorrhea Treatment
Rocephin 250mg IMx1 plus Azithromycin 1 gm orally x1 or doxy 100 mg
BID x7d.
IUD
A birth control method suitable for young females who forget to take pills
and want to avoid pregnancy for at least 5 years.
Basal Cell Cancer
The most common type of skin cancer caused by UV exposure,
characterized by a waxy, pearly appearance.
Actinic Keratosis
A precancerous skin growth that appears as scaly red to yellow lesions on
sun-damaged skin.
Subungual Hematoma Treatment
Migraine headache
paroxysmal (sudden, periodic) attacks of mostly unilateral headache, often
accompanied by disordered vision, nausea, or vomiting, lasting hours or
days and caused by dilation of arteries
Abortive treatment for migraines
triptans
Prophylaxis for migraines
propranolol, TCA amitriptyline, anticonvulsants topiramate
Vitamin B12
shares a close relationship with Folate
Vitamin B12 deficiency
Cognitive deficits, glossitis, pernicious anemia
SED rate
checked after 6 weeks of treatment for joint arthritis; normal range is from
something to 25
Treatment for elevated SED rate
changed to NSAID, SED rate is a sign of inflammation
Medication causing low sperm count
SSRI
Grandiosity
Exaggerated belief in or claims about one's importance or identity
ADHD
A behavioral problem characterized by short attention span, restless
movement, and impaired learning capacity
Low Grade Squamous Intraepithelial Lesions
noted on pap's smear; HPV test if not done, refer for colposcopy
