ANCC FNP EXAM QUESTIONS & CORRECT
ANSWERS LATEST 2026/2027
1. A 9-month-old female infant presents to the clinic for a routine well-child
visit. Six months ago, she was prescribed omeprazole (Prilosec) due to
gastroesophageal reflux and poor weight gain. At the present visit, her parents
report that she is drinking approximately 24 ounces of formula daily and
eating some solid foods. They report no current issues with reflux. While
reviewing the patient's growth chart, the nurse practitioner notes steady and
appropriate weight gain over the past 6 months. Which of the following is the
next best step in management?
A. Continue omeprazole (Prilosec) as prescribed
B. Decrease the dose of omeprazole (Prilosec) and reevaluate in 3 weeks
C. Discontinue omeprazole (Prilosec) and prescribe metoclopramide (Reglan)
D. Discontinue omeprazole (Prilosec) and reevaluate in 3 months
Answer: B. Decrease the dose of omeprazole (Prilosec) and reevaluate in 3 weeks
Rationale:
In infants with gastroesophageal reflux disease (GERD), once symptoms have
resolved and appropriate weight gain is achieved, gradual weaning or dose
reduction of acid suppression therapy is recommended to minimize risks associated
with prolonged use of PPIs (e.g., increased infection risk, nutrient malabsorption).
Continuing full-dose therapy unnecessarily is not advised. Metoclopramide is no
longer recommended for routine use due to limited efficacy and safety concerns.
Monitoring for recurrence with a short follow-up is appropriate before complete
discontinuation.
, 2. A 70-year-old man presents to the clinic for a routine checkup. He has a
history of smoking one pack of cigarettes per day for the past 40 years. He
reports no discomfort today. Which of the following is the most appropriate
recommendation regarding abdominal aortic aneurysm (AAA) screening for
this patient?
A. Advise him to quit smoking but defer screening since he is asymptomatic
B. No screening necessary, as he is beyond the recommended age
C. Order an abdominal ultrasound for screening today
D. Perform a physical examination of the abdomen to assess for a pulsatile mass
Answer: C. Order an abdominal ultrasound for screening today
Rationale:
The USPSTF recommends one-time screening for AAA with abdominal ultrasound
in men aged 65-75 who have ever smoked. Given his heavy smoking history and
age, this is an evidence-based, preventative recommendation. Physical examination
alone lacks sensitivity and specificity to detect AAA. Delaying or deferring
screening ignores guideline-based opportunities to detect asymptomatic aneurysms
and intervene early.
3. Which of the following is the most important first step when evaluating a
15-year-old girl with a 4-month history of secondary amenorrhea?
A. Checking weight
B. Measuring FSH
C. Measuring human chorionic gonadotropin levels
,D. Measuring TSH
Answer: C. Measuring human chorionic gonadotropin levels
Rationale:
Pregnancy must be ruled out first in any adolescent or woman of reproductive age
presenting with secondary amenorrhea, as it is the most common cause. A
qualitative hCG test is fast, noninvasive, and cost-effective. Further hormonal
workup (FSH, TSH) may be considered only if pregnancy is excluded.
4. While reading a journal article, a nurse practitioner comes across a section
discussing the efficacy of a new drug. The article mentions a P value of .03 in
relation to the drug's effect. Which of the following best defines what a P value
is?
A. A measure of the relationship between two variables
B. The odds of an event in one group versus another
C. The percentage of patients who responded to the drug
D. The probability that observed results occurred by chance
Answer: D. The probability that observed res lts occ rred by chance
Rationale:
A P val e represents the probability of observing the st dy res lts, or more
extreme, if the n ll hypothesis is tr e (no real effect). A P of .03 means there is a
3% probability that the findings are d e to chance, which is s ally considered
, statistically significant at an alpha of 0.05. P val es do not indicate effect size,
odds, or relationships they specifically assess the probability related to chance.
5. A 47-year-old woman presents with 4 days of high fever, headache, and
myalgias. She developed a blanching erythemato s rash with mac les on her
wrists and ankles that spread to her tr nk 2 days ago. She reports no history
of overseas travel b t was camping in Arkansas last weekend. Which of the
following is the most appropriate treatment for the s spected diagnosis?
A. Ceftriaxone
B. Doxycycline (Vibramycin)
C. Erythromycin (Erythrocin)
D. Vancomycin (Vancocin)
Answer: B. Doxycycline (Vibramycin)
Rationale:
This patient's presentation is consistent with Rocky Mo ntain spotted fever
(RMSF), a tick-borne illness endemic in the Arkansas/Mid-So th region.
Doxycycline is first-line treatment for RMSF in ad lts and children regardless of
age, and early initiation red ces mortality and complications. Ceftriaxone,
erythromycin, and vancomycin are not effective treatments for RMSF.
ANSWERS LATEST 2026/2027
1. A 9-month-old female infant presents to the clinic for a routine well-child
visit. Six months ago, she was prescribed omeprazole (Prilosec) due to
gastroesophageal reflux and poor weight gain. At the present visit, her parents
report that she is drinking approximately 24 ounces of formula daily and
eating some solid foods. They report no current issues with reflux. While
reviewing the patient's growth chart, the nurse practitioner notes steady and
appropriate weight gain over the past 6 months. Which of the following is the
next best step in management?
A. Continue omeprazole (Prilosec) as prescribed
B. Decrease the dose of omeprazole (Prilosec) and reevaluate in 3 weeks
C. Discontinue omeprazole (Prilosec) and prescribe metoclopramide (Reglan)
D. Discontinue omeprazole (Prilosec) and reevaluate in 3 months
Answer: B. Decrease the dose of omeprazole (Prilosec) and reevaluate in 3 weeks
Rationale:
In infants with gastroesophageal reflux disease (GERD), once symptoms have
resolved and appropriate weight gain is achieved, gradual weaning or dose
reduction of acid suppression therapy is recommended to minimize risks associated
with prolonged use of PPIs (e.g., increased infection risk, nutrient malabsorption).
Continuing full-dose therapy unnecessarily is not advised. Metoclopramide is no
longer recommended for routine use due to limited efficacy and safety concerns.
Monitoring for recurrence with a short follow-up is appropriate before complete
discontinuation.
, 2. A 70-year-old man presents to the clinic for a routine checkup. He has a
history of smoking one pack of cigarettes per day for the past 40 years. He
reports no discomfort today. Which of the following is the most appropriate
recommendation regarding abdominal aortic aneurysm (AAA) screening for
this patient?
A. Advise him to quit smoking but defer screening since he is asymptomatic
B. No screening necessary, as he is beyond the recommended age
C. Order an abdominal ultrasound for screening today
D. Perform a physical examination of the abdomen to assess for a pulsatile mass
Answer: C. Order an abdominal ultrasound for screening today
Rationale:
The USPSTF recommends one-time screening for AAA with abdominal ultrasound
in men aged 65-75 who have ever smoked. Given his heavy smoking history and
age, this is an evidence-based, preventative recommendation. Physical examination
alone lacks sensitivity and specificity to detect AAA. Delaying or deferring
screening ignores guideline-based opportunities to detect asymptomatic aneurysms
and intervene early.
3. Which of the following is the most important first step when evaluating a
15-year-old girl with a 4-month history of secondary amenorrhea?
A. Checking weight
B. Measuring FSH
C. Measuring human chorionic gonadotropin levels
,D. Measuring TSH
Answer: C. Measuring human chorionic gonadotropin levels
Rationale:
Pregnancy must be ruled out first in any adolescent or woman of reproductive age
presenting with secondary amenorrhea, as it is the most common cause. A
qualitative hCG test is fast, noninvasive, and cost-effective. Further hormonal
workup (FSH, TSH) may be considered only if pregnancy is excluded.
4. While reading a journal article, a nurse practitioner comes across a section
discussing the efficacy of a new drug. The article mentions a P value of .03 in
relation to the drug's effect. Which of the following best defines what a P value
is?
A. A measure of the relationship between two variables
B. The odds of an event in one group versus another
C. The percentage of patients who responded to the drug
D. The probability that observed results occurred by chance
Answer: D. The probability that observed res lts occ rred by chance
Rationale:
A P val e represents the probability of observing the st dy res lts, or more
extreme, if the n ll hypothesis is tr e (no real effect). A P of .03 means there is a
3% probability that the findings are d e to chance, which is s ally considered
, statistically significant at an alpha of 0.05. P val es do not indicate effect size,
odds, or relationships they specifically assess the probability related to chance.
5. A 47-year-old woman presents with 4 days of high fever, headache, and
myalgias. She developed a blanching erythemato s rash with mac les on her
wrists and ankles that spread to her tr nk 2 days ago. She reports no history
of overseas travel b t was camping in Arkansas last weekend. Which of the
following is the most appropriate treatment for the s spected diagnosis?
A. Ceftriaxone
B. Doxycycline (Vibramycin)
C. Erythromycin (Erythrocin)
D. Vancomycin (Vancocin)
Answer: B. Doxycycline (Vibramycin)
Rationale:
This patient's presentation is consistent with Rocky Mo ntain spotted fever
(RMSF), a tick-borne illness endemic in the Arkansas/Mid-So th region.
Doxycycline is first-line treatment for RMSF in ad lts and children regardless of
age, and early initiation red ces mortality and complications. Ceftriaxone,
erythromycin, and vancomycin are not effective treatments for RMSF.
