ANCC FNP BOARD EXAM LATEST 2025/
2026 ACTUAL EXAM TEST BANK| FAMILY
NURSING PRACTITIONER ANCC BOARD
EXAM PREP WITH COMPLETE 350 REAL
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST
RECENT!!)
DOMAIN 1: ASSESSMENT (Questions 1-35)
Q1. A 58-year-old male presents for a routine physical. He has a
history of hypertension and smokes one pack of cigarettes per day.
He reports no current complaints. According to USPSTF guidelines,
which screening recommendation is appropriate?
A. One-time abdominal aortic aneurysm (AAA) screening with
ultrasonography
B. Annual lung cancer screening with low-dose computed tomography
(LDCT)
C. Carotid artery stenosis screening with duplex ultrasound
D. Coronary artery disease screening with exercise stress test
,,,,ANSWER,,,: B. Annual lung cancer screening with low-dose
computed tomography (LDCT)
Rationale: The USPSTF recommends annual LDCT screening for lung
cancer in adults aged 50-80 years who have a 20 pack-year smoking
history and currently smoke or have quit within the past 15 years. This
patient meets the age and pack-year criteria (one pack/day for many
years). AAA screening is recommended for men aged 65-75 who have
ever smoked, making choice A incorrect for this 58-year-old patient.
Screening for carotid artery stenosis or CAD in asymptomatic
individuals is not recommended .
Q2. A 72-year-old female is brought in by her daughter who is
concerned about memory loss. The patient scores 25 on the
Montreal Cognitive Assessment (MoCA). What is the most
appropriate next step?
A. Diagnose Mild Cognitive Impairment and schedule a 6-month
follow-up
B. Order a CT scan of the head to rule out a mass lesion
C. Perform a functional assessment, including ability to manage finances
and medications
D. Immediately refer to a neurologist for definitive diagnosis
,,,ANSWER,,,: C. Perform a functional assessment, including ability
to manage finances and medications
Rationale: A MoCA score below 26 indicates possible cognitive
impairment. However, the diagnosis of dementia requires decline in both
cognitive function AND ability to perform daily activities (functional
,impairment). Before making a diagnosis or ordering expensive imaging,
it is essential to assess functional status. Imaging is not first-line without
focal neurological signs. Referral is appropriate but not the immediate
next step .
Q3. A 55-year-old male with hypertension and 40-pack-year
smoking history presents for a routine physical. On examination,
you palpate an abdominal aortic diameter of approximately 4.0 cm.
What is the most appropriate next step?
A. Reassure the patient and repeat physical exam in one year
B. Order an abdominal ultrasound to confirm the finding
C. Immediately refer to a vascular surgeon for repair
D. Prescribe a beta-blocker to reduce rupture risk
,,,ANSWER,,,: B. Order an abdominal ultrasound to confirm the
finding
Rationale: The USPSTF recommends one-time AAA screening by
ultrasonography in men aged 65-75 who have ever smoked. While this
patient is younger than 65, a palpable aorta of 3.0 cm or greater is
suspicious for AAA and requires ultrasound confirmation. Immediate
referral for repair is not indicated without confirmation of diagnosis and
size. Beta-blockers do not replace diagnostic confirmation .
Q4. A 28-year-old female presents with fatigue, weight gain, and
cold intolerance. Her thyroid exam reveals a diffusely enlarged, firm
, gland without nodules. Vital signs are stable. Which lab finding
would you most expect?
A. Elevated T3 and T4, decreased TSH
B. Decreased T3 and T4, elevated TSH
C. Elevated TSH, elevated T4
D. Normal TSH, decreased T4
,,,ANSWER,,,: B. Decreased T3 and T4, elevated TSH
Rationale: The patient's symptoms (fatigue, weight gain, cold
intolerance) and exam findings (diffuse goiter) suggest hypothyroidism,
most commonly Hashimoto's thyroiditis. Primary hypothyroidism is
characterized by low free T4 and elevated TSH due to lack of negative
feedback on the pituitary. Elevated T3/T4 with decreased TSH would
indicate hyperthyroidism .
Q5. A 6-month-old infant is brought for a well-child exam. Which
finding requires immediate referral to a pediatric neurologist?
A. Persistent head lag when pulled to sit
B. Inability to roll from back to front
C. Absence of stranger anxiety
D. Lack of babbling
,,,ANSWER,,,: A. Persistent head lag when pulled to sit
Rationale: By 6 months, an infant should have good head control with
no head lag when pulled to sit. Persistent head lag after 6 months
indicates possible neuromuscular or developmental delay requiring
further evaluation. Rolling typically develops between 4-6 months (some
2026 ACTUAL EXAM TEST BANK| FAMILY
NURSING PRACTITIONER ANCC BOARD
EXAM PREP WITH COMPLETE 350 REAL
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST
RECENT!!)
DOMAIN 1: ASSESSMENT (Questions 1-35)
Q1. A 58-year-old male presents for a routine physical. He has a
history of hypertension and smokes one pack of cigarettes per day.
He reports no current complaints. According to USPSTF guidelines,
which screening recommendation is appropriate?
A. One-time abdominal aortic aneurysm (AAA) screening with
ultrasonography
B. Annual lung cancer screening with low-dose computed tomography
(LDCT)
C. Carotid artery stenosis screening with duplex ultrasound
D. Coronary artery disease screening with exercise stress test
,,,,ANSWER,,,: B. Annual lung cancer screening with low-dose
computed tomography (LDCT)
Rationale: The USPSTF recommends annual LDCT screening for lung
cancer in adults aged 50-80 years who have a 20 pack-year smoking
history and currently smoke or have quit within the past 15 years. This
patient meets the age and pack-year criteria (one pack/day for many
years). AAA screening is recommended for men aged 65-75 who have
ever smoked, making choice A incorrect for this 58-year-old patient.
Screening for carotid artery stenosis or CAD in asymptomatic
individuals is not recommended .
Q2. A 72-year-old female is brought in by her daughter who is
concerned about memory loss. The patient scores 25 on the
Montreal Cognitive Assessment (MoCA). What is the most
appropriate next step?
A. Diagnose Mild Cognitive Impairment and schedule a 6-month
follow-up
B. Order a CT scan of the head to rule out a mass lesion
C. Perform a functional assessment, including ability to manage finances
and medications
D. Immediately refer to a neurologist for definitive diagnosis
,,,ANSWER,,,: C. Perform a functional assessment, including ability
to manage finances and medications
Rationale: A MoCA score below 26 indicates possible cognitive
impairment. However, the diagnosis of dementia requires decline in both
cognitive function AND ability to perform daily activities (functional
,impairment). Before making a diagnosis or ordering expensive imaging,
it is essential to assess functional status. Imaging is not first-line without
focal neurological signs. Referral is appropriate but not the immediate
next step .
Q3. A 55-year-old male with hypertension and 40-pack-year
smoking history presents for a routine physical. On examination,
you palpate an abdominal aortic diameter of approximately 4.0 cm.
What is the most appropriate next step?
A. Reassure the patient and repeat physical exam in one year
B. Order an abdominal ultrasound to confirm the finding
C. Immediately refer to a vascular surgeon for repair
D. Prescribe a beta-blocker to reduce rupture risk
,,,ANSWER,,,: B. Order an abdominal ultrasound to confirm the
finding
Rationale: The USPSTF recommends one-time AAA screening by
ultrasonography in men aged 65-75 who have ever smoked. While this
patient is younger than 65, a palpable aorta of 3.0 cm or greater is
suspicious for AAA and requires ultrasound confirmation. Immediate
referral for repair is not indicated without confirmation of diagnosis and
size. Beta-blockers do not replace diagnostic confirmation .
Q4. A 28-year-old female presents with fatigue, weight gain, and
cold intolerance. Her thyroid exam reveals a diffusely enlarged, firm
, gland without nodules. Vital signs are stable. Which lab finding
would you most expect?
A. Elevated T3 and T4, decreased TSH
B. Decreased T3 and T4, elevated TSH
C. Elevated TSH, elevated T4
D. Normal TSH, decreased T4
,,,ANSWER,,,: B. Decreased T3 and T4, elevated TSH
Rationale: The patient's symptoms (fatigue, weight gain, cold
intolerance) and exam findings (diffuse goiter) suggest hypothyroidism,
most commonly Hashimoto's thyroiditis. Primary hypothyroidism is
characterized by low free T4 and elevated TSH due to lack of negative
feedback on the pituitary. Elevated T3/T4 with decreased TSH would
indicate hyperthyroidism .
Q5. A 6-month-old infant is brought for a well-child exam. Which
finding requires immediate referral to a pediatric neurologist?
A. Persistent head lag when pulled to sit
B. Inability to roll from back to front
C. Absence of stranger anxiety
D. Lack of babbling
,,,ANSWER,,,: A. Persistent head lag when pulled to sit
Rationale: By 6 months, an infant should have good head control with
no head lag when pulled to sit. Persistent head lag after 6 months
indicates possible neuromuscular or developmental delay requiring
further evaluation. Rolling typically develops between 4-6 months (some
