2025 AANP FNP Certification Exam – Practice Test (210 Questions – Latest
Edition | Professor Verified | Graded A+)
Domain I: Assessment (1-60)
A 45-year-old patient presents for a routine physical exam. Which screening tool is
most appropriate to assess for alcohol use disorder?
A. PHQ-9
B. CAGE
C. AUDIT-C
D. GAD-7
C
1. The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) is the
preferred validated screening tool for hazardous drinking and alcohol use
disorders in primary care. PHQ-9 is for depression, CAGE is older and less
sensitive, GAD-7 is for anxiety.
During a well-child visit for a 12-month-old, the FNP assesses gross motor
development. Which finding is expected for this age?
A. Walks independently
B. Runs smoothly
C. Climbs stairs with alternating feet
D. Rides a tricycle
A
2. Walking independently is typically achieved between 11 and 15 months.
Running, alternating feet on stairs, and tricycle riding are expected at 2, 3,
and 3-4 years, respectively.
A 65-year-old patient is being screened for cognitive impairment. The FNP
administers the Mini-Cog. Which two components make up this test?
A. Clock drawing test and 3-word recall
B. Serial 7s and date orientation
C. Animal naming and phrase repetition
D. Trail making and finger tapping
A
3. The Mini-Cog consists of a 3-word recall test and a clock drawing test. It takes
about 3 minutes and is highly sensitive for dementia screening.
,A 50-year-old female asks about mammogram screening. According to the USPSTF
2024 guidelines, what is the recommendation?
A. Biennial screening starting at age 40
B. Biennial screening starting at age 50
C. Annual screening starting at age 45
D. No screening unless high risk
A
4. The USPSTF (2024 update) recommends biennial screening mammography
for women aged 40 to 74 years to reduce breast cancer mortality.
A 40-year-old male presents for a commercial driver's license physical. His blood
pressure is 138/84 mmHg. How should this be classified according to ACC/AHA
guidelines?
A. Normal
B. Elevated
C. Stage 1 Hypertension
D. Stage 2 Hypertension
C
5. Stage 1 hypertension is defined as a systolic BP of 130-139 mmHg or a
diastolic BP of 80-89 mmHg. Elevated is 120-129/<80.
A patient presents with a deep laceration to the hand sustained 3 hours ago. The
wound is heavily contaminated with dirt. What is the maximum recommended time
frame for primary closure of this wound?
A. 6 hours
B. 12 hours
C. 24 hours
D. 48 hours
A
6. Heavily contaminated wounds have a high risk of infection. Primary closure
should ideally occur within 6 hours; otherwise, delayed primary closure or
healing by secondary intention is preferred.
A 55-year-old patient with a history of smoking presents for a routine exam.
According to USPSTF guidelines, should they be screened for lung cancer?
A. Yes, if they have a 20 pack-year smoking history and currently smoke.
B. Yes, if they have a 20 pack-year history, currently smoke, and are aged 50-80.
C. No, they must have quit smoking to be screened.
D. No, lung cancer screening is not recommended by USPSTF.
B
, 7. USPSTF recommends annual low-dose CT scan for adults aged 50 to 80 who
have a 20 pack-year smoking history and currently smoke or have quit within
the past 15 years.
An 18-month-old child is seen for a well-visit. The parents report the child says
"mama" and "dada" but no other words. What is the appropriate action?
A. Reassure the parents this is normal.
B. Refer for audiological evaluation and early intervention.
C. Teach the parents sign language.
D. Schedule a follow-up in 6 months.
B
8. An 18-month-old should have a vocabulary of at least 4-6 words besides
mama/dada. A limited vocabulary at this age requires hearing evaluation and
speech referral to rule out hearing loss and developmental delay.
A 30-year-old female presents with a syncopal episode. Which component of the
history is most critical in determining the etiology?
A. Last menstrual period
B. Activity preceding the event and witness description
C. Dietary intake over the last 24 hours
D. Family history of diabetes
B
9. The circumstances surrounding the syncopal event (e.g., exertion, position
changes, palpitations) and a witness description (e.g., seizure activity, pallor)
are paramount in differentiating cardiac, neurologic, or vasovagal causes.
A 24-year-old female presents with a 3-day history of vaginal discharge and dysuria.
Wet mount reveals motile flagellated organisms. What is the diagnosis?
A. Bacterial vaginosis
B. Vulvovaginal candidiasis
C. Trichomoniasis
D. Chlamydia
C
10.Trichomoniasis is caused by the protozoan Trichomonas vaginalis. Wet mount
showing motile flagellated organisms is highly specific, though sensitivity is
only 60-70% compared to NAAT.
A 70-year-old patient reports new onset of a "whooshing" sound in their left ear
coinciding with their heartbeat. Auscultation reveals a bruit over the left carotid
artery. What is the next best step?
, A. Prescribe a beta-blocker.
B. Order a carotid ultrasound.
C. Refer for an MRI of the brain.
D. Reassure and monitor in 6 months.
B
11.Pulsatile tinnitus with a carotid bruit suggests turbulent blood flow, likely due
to carotid artery stenosis. A carotid duplex ultrasound is the non-invasive
diagnostic test of choice.
A 14-year-old male is seen for a sports physical. He has a history of passing out
during a basketball game last month. What finding on physical exam would be most
concerning for hypertrophic cardiomyopathy?
A. Mid-systolic click
B. Harsh 3/6 systolic crescendo-decrescendo murmur at the right upper sternal
border
C. Systolic ejection murmur that increases with Valsalva
D. Diastolic blowing murmur at the left sternal border
C
12.Hypertrophic cardiomyopathy (HCM) classically causes a systolic ejection
murmur that intensifies with Valsalva (decreased preload). A mid-systolic click
is mitral valve prolapse. A harsh RU SB murmur is aortic stenosis. A diastolic
murmur is aortic regurgitation.
A 50-year-old female asks about colorectal cancer screening. She has no family
history and is average risk. Which test is an acceptable option according to
USPSTF?
A. Flexible sigmoidoscopy every 10 years
B. Colonoscopy every 10 years
C. Annual FOBT without rehydration
D. Barium enema every 5 years
B
13.Colonoscopy every 10 years is a recommended screening option for
average-risk individuals starting at age 45. Flexible sigmoidoscopy is every 5
years (or 10 with annual FIT). Barium enema is no longer a standard
recommendation.
An infant is born at 38 weeks gestation. Birth weight is 2.1 kg (4.6 lbs). How should
this be classified?
A. Appropriate for gestational age (AGA)
B. Large for gestational age (LGA)
C. Small for gestational age (SGA)
Edition | Professor Verified | Graded A+)
Domain I: Assessment (1-60)
A 45-year-old patient presents for a routine physical exam. Which screening tool is
most appropriate to assess for alcohol use disorder?
A. PHQ-9
B. CAGE
C. AUDIT-C
D. GAD-7
C
1. The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) is the
preferred validated screening tool for hazardous drinking and alcohol use
disorders in primary care. PHQ-9 is for depression, CAGE is older and less
sensitive, GAD-7 is for anxiety.
During a well-child visit for a 12-month-old, the FNP assesses gross motor
development. Which finding is expected for this age?
A. Walks independently
B. Runs smoothly
C. Climbs stairs with alternating feet
D. Rides a tricycle
A
2. Walking independently is typically achieved between 11 and 15 months.
Running, alternating feet on stairs, and tricycle riding are expected at 2, 3,
and 3-4 years, respectively.
A 65-year-old patient is being screened for cognitive impairment. The FNP
administers the Mini-Cog. Which two components make up this test?
A. Clock drawing test and 3-word recall
B. Serial 7s and date orientation
C. Animal naming and phrase repetition
D. Trail making and finger tapping
A
3. The Mini-Cog consists of a 3-word recall test and a clock drawing test. It takes
about 3 minutes and is highly sensitive for dementia screening.
,A 50-year-old female asks about mammogram screening. According to the USPSTF
2024 guidelines, what is the recommendation?
A. Biennial screening starting at age 40
B. Biennial screening starting at age 50
C. Annual screening starting at age 45
D. No screening unless high risk
A
4. The USPSTF (2024 update) recommends biennial screening mammography
for women aged 40 to 74 years to reduce breast cancer mortality.
A 40-year-old male presents for a commercial driver's license physical. His blood
pressure is 138/84 mmHg. How should this be classified according to ACC/AHA
guidelines?
A. Normal
B. Elevated
C. Stage 1 Hypertension
D. Stage 2 Hypertension
C
5. Stage 1 hypertension is defined as a systolic BP of 130-139 mmHg or a
diastolic BP of 80-89 mmHg. Elevated is 120-129/<80.
A patient presents with a deep laceration to the hand sustained 3 hours ago. The
wound is heavily contaminated with dirt. What is the maximum recommended time
frame for primary closure of this wound?
A. 6 hours
B. 12 hours
C. 24 hours
D. 48 hours
A
6. Heavily contaminated wounds have a high risk of infection. Primary closure
should ideally occur within 6 hours; otherwise, delayed primary closure or
healing by secondary intention is preferred.
A 55-year-old patient with a history of smoking presents for a routine exam.
According to USPSTF guidelines, should they be screened for lung cancer?
A. Yes, if they have a 20 pack-year smoking history and currently smoke.
B. Yes, if they have a 20 pack-year history, currently smoke, and are aged 50-80.
C. No, they must have quit smoking to be screened.
D. No, lung cancer screening is not recommended by USPSTF.
B
, 7. USPSTF recommends annual low-dose CT scan for adults aged 50 to 80 who
have a 20 pack-year smoking history and currently smoke or have quit within
the past 15 years.
An 18-month-old child is seen for a well-visit. The parents report the child says
"mama" and "dada" but no other words. What is the appropriate action?
A. Reassure the parents this is normal.
B. Refer for audiological evaluation and early intervention.
C. Teach the parents sign language.
D. Schedule a follow-up in 6 months.
B
8. An 18-month-old should have a vocabulary of at least 4-6 words besides
mama/dada. A limited vocabulary at this age requires hearing evaluation and
speech referral to rule out hearing loss and developmental delay.
A 30-year-old female presents with a syncopal episode. Which component of the
history is most critical in determining the etiology?
A. Last menstrual period
B. Activity preceding the event and witness description
C. Dietary intake over the last 24 hours
D. Family history of diabetes
B
9. The circumstances surrounding the syncopal event (e.g., exertion, position
changes, palpitations) and a witness description (e.g., seizure activity, pallor)
are paramount in differentiating cardiac, neurologic, or vasovagal causes.
A 24-year-old female presents with a 3-day history of vaginal discharge and dysuria.
Wet mount reveals motile flagellated organisms. What is the diagnosis?
A. Bacterial vaginosis
B. Vulvovaginal candidiasis
C. Trichomoniasis
D. Chlamydia
C
10.Trichomoniasis is caused by the protozoan Trichomonas vaginalis. Wet mount
showing motile flagellated organisms is highly specific, though sensitivity is
only 60-70% compared to NAAT.
A 70-year-old patient reports new onset of a "whooshing" sound in their left ear
coinciding with their heartbeat. Auscultation reveals a bruit over the left carotid
artery. What is the next best step?
, A. Prescribe a beta-blocker.
B. Order a carotid ultrasound.
C. Refer for an MRI of the brain.
D. Reassure and monitor in 6 months.
B
11.Pulsatile tinnitus with a carotid bruit suggests turbulent blood flow, likely due
to carotid artery stenosis. A carotid duplex ultrasound is the non-invasive
diagnostic test of choice.
A 14-year-old male is seen for a sports physical. He has a history of passing out
during a basketball game last month. What finding on physical exam would be most
concerning for hypertrophic cardiomyopathy?
A. Mid-systolic click
B. Harsh 3/6 systolic crescendo-decrescendo murmur at the right upper sternal
border
C. Systolic ejection murmur that increases with Valsalva
D. Diastolic blowing murmur at the left sternal border
C
12.Hypertrophic cardiomyopathy (HCM) classically causes a systolic ejection
murmur that intensifies with Valsalva (decreased preload). A mid-systolic click
is mitral valve prolapse. A harsh RU SB murmur is aortic stenosis. A diastolic
murmur is aortic regurgitation.
A 50-year-old female asks about colorectal cancer screening. She has no family
history and is average risk. Which test is an acceptable option according to
USPSTF?
A. Flexible sigmoidoscopy every 10 years
B. Colonoscopy every 10 years
C. Annual FOBT without rehydration
D. Barium enema every 5 years
B
13.Colonoscopy every 10 years is a recommended screening option for
average-risk individuals starting at age 45. Flexible sigmoidoscopy is every 5
years (or 10 with annual FIT). Barium enema is no longer a standard
recommendation.
An infant is born at 38 weeks gestation. Birth weight is 2.1 kg (4.6 lbs). How should
this be classified?
A. Appropriate for gestational age (AGA)
B. Large for gestational age (LGA)
C. Small for gestational age (SGA)
