ANCC FAMILY NURSE PRACTITIONER (FNP)
EXAM V2 Actual Exam | Official Exam –
Complete Q&A with Rationales – Pass
Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Assessment & Diagnosis | Q1 – Q8
Section 2 | Health Promotion & Disease Prevention | Q9 – Q16
Section 3 | Clinical Management – Acute Conditions | Q17 – Q25
Section 4 | Clinical Management – Chronic Conditions | Q26 – Q34
Section 5 | Pharmacology & Prescriptive Authority | Q35 – Q42
Section 6 | Professional Role, Ethics & Quality | Q43 – Q50
Instructions: Choose the single best answer. Pass: 38 in 210 minutes.
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SECTION 1: ASSESSMENT & DIAGNOSIS Q1 – Q8
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Question 1 of 50
A 34-year-old woman presents to the clinic with a two-week history of progressive
dyspnea on exertion and a nonproductive cough. She reports no fever, chest pain, or
hemoptysis. Physical exam reveals bilateral basilar crackles, digital clubbing, and fine
inspiratory crackles that do not clear with coughing. A chest X-ray shows diffuse
reticular opacities predominantly in the lower lobes. Pulmonary function tests
demonstrate a restrictive pattern with a reduced DLCO.
A. Community-acquired pneumonia, because the cough and dyspnea suggest an
infectious process
B. Idiopathic pulmonary fibrosis, because the combination of progressive dyspnea,
basilar crackles, clubbing, restrictive PFTs, and reduced DLCO is classic ✓ CORRECT
,C. Chronic obstructive pulmonary disease, because the patient has progressive
respiratory symptoms
D. Congestive heart failure, because bilateral basilar findings suggest fluid accumulation
Correct Answer: B
Rationale: Idiopathic pulmonary fibrosis presents with progressive dyspnea,
nonproductive cough, bilateral basilar crackles, digital clubbing, and a restrictive pattern
with reduced DLCO on PFTs. Community-acquired pneumonia would typically present
with fever, productive cough, and lobar infiltrates rather than diffuse reticular opacities.
IPF is more common in older adults but can present in younger patients, and early
recognition is critical since antifibrotic therapy can slow progression.
Question 2 of 50
A 62-year-old man with a 40-pack-year smoking history presents for a routine physical.
He has no current respiratory symptoms. A low-dose CT chest scan performed for lung
cancer screening shows a 1.2 cm solid pulmonary nodule in the right upper lobe with
smooth margins and no calcification. The nodule was not present on a chest X-ray from
five years ago.
A. Repeat low-dose CT in 12 months, because the nodule is small and likely benign
B. Obtain a PET-CT scan, because any new nodule in a heavy smoker requires
immediate metabolic evaluation
C. Schedule a diagnostic CT with contrast in 3 months, because a solid nodule over 8
mm in a high-risk patient warrants closer surveillance ✓ CORRECT
D. Proceed directly to transthoracic needle biopsy, because the nodule is new and
suspicious
Correct Answer: C
Rationale: Per Fleischner Society guidelines, a solid pulmonary nodule between 6–8 mm
in a high-risk patient requires a short-interval follow-up CT at 3 months, and nodules
over 8 mm warrant even closer evaluation with low-dose CT at 3 months or
consideration of PET-CT. Immediate biopsy is not indicated without prior imaging
,surveillance, and 12-month follow-up is too conservative for a new 1.2 cm nodule in a
heavy smoker. Lung cancer screening programs have increased detection of incidental
nodules, making guideline-concordant follow-up essential to balance cancer detection
with unnecessary invasive procedures.
Question 3 of 50
A 28-year-old woman presents with a six-month history of intermittent palpitations, heat
intolerance, and a 12-pound unintentional weight loss despite increased appetite. She
has noticed a painless anterior neck mass. Physical exam reveals a diffusely enlarged,
nontender thyroid with a bruit audible over the gland. She has fine tremor and warm,
moist skin. Laboratory studies show suppressed TSH and elevated free T4 and T3.
A. Hashimoto thyroiditis, because the diffuse goiter and weight loss suggest
autoimmune thyroid disease
B. Graves disease, because the diffuse goiter with bruit, hypermetabolic symptoms, and
suppressed TSH with elevated T4/T3 are pathognomonic ✓ CORRECT
C. Toxic multinodular goiter, because the enlarged thyroid suggests multiple
autonomous nodules
D. Subacute thyroiditis, because the neck mass and systemic symptoms indicate an
inflammatory process
Correct Answer: B
Rationale: Graves disease is characterized by a diffusely enlarged thyroid with an
audible bruit due to increased vascularity, along with classic hyperthyroid symptoms
and a biochemical pattern of suppressed TSH with elevated free T4 and T3. Hashimoto
thyroiditis typically causes hypothyroidism with a firm, nontender goiter, not
hypermetabolic symptoms. The thyroid bruit is a highly specific physical finding for
Graves disease and is rarely present in other forms of thyrotoxicosis.
Question 4 of 50
, A 45-year-old man presents with acute onset of severe right flank pain radiating to the
groin, accompanied by nausea and vomiting. He describes the pain as colicky and rates
it 9/10. Urinalysis shows 25–30 RBCs per high-power field and no bacteria. Vital signs
are stable. A noncontrast CT scan of the abdomen and pelvis is ordered.
A. Acute pyelonephritis, because flank pain with hematuria suggests upper urinary tract
infection
B. Nephrolithiasis, because the colicky flank pain radiating to the groin with hematuria
and absence of infection is classic for ureteral stone ✓ CORRECT
C. Musculoskeletal back strain, because the pain is severe and the patient has no fever
D. Acute appendicitis, because the pain radiates and is associated with nausea and
vomiting
Correct Answer: B
Rationale: Nephrolithiasis presents with sudden, severe colicky flank pain that radiates
toward the groin, often accompanied by nausea, vomiting, and microscopic hematuria,
with a noncontrast CT being the imaging study of choice. Acute pyelonephritis would
present with fever, pyuria, and bacteriuria, which are absent here. The radiation pattern
to the groin is highly specific for ureteral stones and is not typical of musculoskeletal or
appendiceal pathology.
Question 5 of 50
A 55-year-old woman with type 2 diabetes presents for a routine foot exam. She reports
no pain or numbness. Monofilament testing reveals loss of protective sensation at three
of five sites on the plantar surface of both feet. Vibratory sensation is diminished at the
great toes. Ankle reflexes are absent bilaterally. There are no open lesions or
deformities.
A. Peripheral arterial disease, because diabetes causes macrovascular complications
affecting the lower extremities
B. Charcot neuroarthropathy, because diabetes causes progressive joint destruction in
the feet
EXAM V2 Actual Exam | Official Exam –
Complete Q&A with Rationales – Pass
Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Assessment & Diagnosis | Q1 – Q8
Section 2 | Health Promotion & Disease Prevention | Q9 – Q16
Section 3 | Clinical Management – Acute Conditions | Q17 – Q25
Section 4 | Clinical Management – Chronic Conditions | Q26 – Q34
Section 5 | Pharmacology & Prescriptive Authority | Q35 – Q42
Section 6 | Professional Role, Ethics & Quality | Q43 – Q50
Instructions: Choose the single best answer. Pass: 38 in 210 minutes.
══════════════════════════════════════
SECTION 1: ASSESSMENT & DIAGNOSIS Q1 – Q8
══════════════════════════════════════
Question 1 of 50
A 34-year-old woman presents to the clinic with a two-week history of progressive
dyspnea on exertion and a nonproductive cough. She reports no fever, chest pain, or
hemoptysis. Physical exam reveals bilateral basilar crackles, digital clubbing, and fine
inspiratory crackles that do not clear with coughing. A chest X-ray shows diffuse
reticular opacities predominantly in the lower lobes. Pulmonary function tests
demonstrate a restrictive pattern with a reduced DLCO.
A. Community-acquired pneumonia, because the cough and dyspnea suggest an
infectious process
B. Idiopathic pulmonary fibrosis, because the combination of progressive dyspnea,
basilar crackles, clubbing, restrictive PFTs, and reduced DLCO is classic ✓ CORRECT
,C. Chronic obstructive pulmonary disease, because the patient has progressive
respiratory symptoms
D. Congestive heart failure, because bilateral basilar findings suggest fluid accumulation
Correct Answer: B
Rationale: Idiopathic pulmonary fibrosis presents with progressive dyspnea,
nonproductive cough, bilateral basilar crackles, digital clubbing, and a restrictive pattern
with reduced DLCO on PFTs. Community-acquired pneumonia would typically present
with fever, productive cough, and lobar infiltrates rather than diffuse reticular opacities.
IPF is more common in older adults but can present in younger patients, and early
recognition is critical since antifibrotic therapy can slow progression.
Question 2 of 50
A 62-year-old man with a 40-pack-year smoking history presents for a routine physical.
He has no current respiratory symptoms. A low-dose CT chest scan performed for lung
cancer screening shows a 1.2 cm solid pulmonary nodule in the right upper lobe with
smooth margins and no calcification. The nodule was not present on a chest X-ray from
five years ago.
A. Repeat low-dose CT in 12 months, because the nodule is small and likely benign
B. Obtain a PET-CT scan, because any new nodule in a heavy smoker requires
immediate metabolic evaluation
C. Schedule a diagnostic CT with contrast in 3 months, because a solid nodule over 8
mm in a high-risk patient warrants closer surveillance ✓ CORRECT
D. Proceed directly to transthoracic needle biopsy, because the nodule is new and
suspicious
Correct Answer: C
Rationale: Per Fleischner Society guidelines, a solid pulmonary nodule between 6–8 mm
in a high-risk patient requires a short-interval follow-up CT at 3 months, and nodules
over 8 mm warrant even closer evaluation with low-dose CT at 3 months or
consideration of PET-CT. Immediate biopsy is not indicated without prior imaging
,surveillance, and 12-month follow-up is too conservative for a new 1.2 cm nodule in a
heavy smoker. Lung cancer screening programs have increased detection of incidental
nodules, making guideline-concordant follow-up essential to balance cancer detection
with unnecessary invasive procedures.
Question 3 of 50
A 28-year-old woman presents with a six-month history of intermittent palpitations, heat
intolerance, and a 12-pound unintentional weight loss despite increased appetite. She
has noticed a painless anterior neck mass. Physical exam reveals a diffusely enlarged,
nontender thyroid with a bruit audible over the gland. She has fine tremor and warm,
moist skin. Laboratory studies show suppressed TSH and elevated free T4 and T3.
A. Hashimoto thyroiditis, because the diffuse goiter and weight loss suggest
autoimmune thyroid disease
B. Graves disease, because the diffuse goiter with bruit, hypermetabolic symptoms, and
suppressed TSH with elevated T4/T3 are pathognomonic ✓ CORRECT
C. Toxic multinodular goiter, because the enlarged thyroid suggests multiple
autonomous nodules
D. Subacute thyroiditis, because the neck mass and systemic symptoms indicate an
inflammatory process
Correct Answer: B
Rationale: Graves disease is characterized by a diffusely enlarged thyroid with an
audible bruit due to increased vascularity, along with classic hyperthyroid symptoms
and a biochemical pattern of suppressed TSH with elevated free T4 and T3. Hashimoto
thyroiditis typically causes hypothyroidism with a firm, nontender goiter, not
hypermetabolic symptoms. The thyroid bruit is a highly specific physical finding for
Graves disease and is rarely present in other forms of thyrotoxicosis.
Question 4 of 50
, A 45-year-old man presents with acute onset of severe right flank pain radiating to the
groin, accompanied by nausea and vomiting. He describes the pain as colicky and rates
it 9/10. Urinalysis shows 25–30 RBCs per high-power field and no bacteria. Vital signs
are stable. A noncontrast CT scan of the abdomen and pelvis is ordered.
A. Acute pyelonephritis, because flank pain with hematuria suggests upper urinary tract
infection
B. Nephrolithiasis, because the colicky flank pain radiating to the groin with hematuria
and absence of infection is classic for ureteral stone ✓ CORRECT
C. Musculoskeletal back strain, because the pain is severe and the patient has no fever
D. Acute appendicitis, because the pain radiates and is associated with nausea and
vomiting
Correct Answer: B
Rationale: Nephrolithiasis presents with sudden, severe colicky flank pain that radiates
toward the groin, often accompanied by nausea, vomiting, and microscopic hematuria,
with a noncontrast CT being the imaging study of choice. Acute pyelonephritis would
present with fever, pyuria, and bacteriuria, which are absent here. The radiation pattern
to the groin is highly specific for ureteral stones and is not typical of musculoskeletal or
appendiceal pathology.
Question 5 of 50
A 55-year-old woman with type 2 diabetes presents for a routine foot exam. She reports
no pain or numbness. Monofilament testing reveals loss of protective sensation at three
of five sites on the plantar surface of both feet. Vibratory sensation is diminished at the
great toes. Ankle reflexes are absent bilaterally. There are no open lesions or
deformities.
A. Peripheral arterial disease, because diabetes causes macrovascular complications
affecting the lower extremities
B. Charcot neuroarthropathy, because diabetes causes progressive joint destruction in
the feet
