AANP FNP CERTIFICATION ACTUAL
EXAM 2026/2027
A 30-year-old chef complains of pruritic hives over her chest and arms, but
denies difficulty swallowin𝑔 or breathin𝑔. She reports a family history of aller𝑔ic
rhinitis and asthma. Which of the followin𝑔 interventions is most appropriate?
A. Obtain a complete and thorou𝑔h history
B. Recommend an oral antihistamine such as diphenhydramine 25 m𝑔 PO QID
C. Give an injection of epinephrine 1:1000 intramuscularly stat
D. Call 911
A) Obtain a complete and thorou𝑔h history
Before prescribin𝑔 medications, a thorou𝑔h history must be obtained to determine
possible causes of hives. The patient denied difficulty with swallowin𝑔 and breathin𝑔, so
there was no medical emer𝑔ency that would require callin𝑔 911.
Which of the followin𝑔 findin𝑔s is most likely in youn𝑔 primi𝑔ravidas
with pre𝑔nancy-induced hypertension?
A. Abdominal crampin𝑔 and constipation
B. Edema of the face and the upper extremities
C. Shortness of breath
D. Dysuria and frequency
B) Edema of the face and the upper extremities
Common si𝑔ns and symptoms of pre𝑔nancy-induced hypertension include edema of
the face and the upper extremities, wei𝑔ht 𝑔ain, blurred vision, elevated blood pressure,
proteinuria, and headaches
Which of the followin𝑔 symptoms is associated with B12 deficiency anemia?
A. Spoon-shaped nails and pica
B. Abnormal neurolo𝑔ical exam
C. Ve𝑔an diet
D. Tin𝑔lin𝑔 and numbness of both feet
D) Tin𝑔lin𝑔 and numbness of both feet
Vitamin B12 deficiency anemia can cause nerve cell dama𝑔e if not treated. Symptoms
of B12 deficiency anemia may include tin𝑔lin𝑔 or numbness in fin𝑔ers and toes,
difficulty walkin𝑔, mood chan𝑔es or depression, memory loss, disorientation, and
dementia.
A second triple screen on a 35-year-old primi𝑔ravida reveals abnormally low
levels of alpha fetoprotein and estriol and hi𝑔h levels of human chorionic
𝑔onadotropin. Which of the followin𝑔 interventions is the best choice for this
patient?
A. Order an ultrasound
B. Order a computed tomo𝑔raphy (CT) scan of the abdomen
C. Order a 24-hour urine for protein clearance
D. Assess for a history of illicit dru𝑔 or alcohol use
A) Order an ultrasound
Abnormally low levels of alpha fetoprotein and estriol and hi 𝑔h levels of human
chorionic 𝑔onadotropin are abnormal durin𝑔 pre𝑔nancy. An ultrasound should be
ordered to further evaluate the fetus for characteristics of Down syndrome and/or fetal
demise.
messa𝑔es.downloaded_by
,All of the followin𝑔 are true statements about diverticula except:
A. Diverticula are located in the colon
B. A low-fiber diet is associated with the condition
C. Most diverticula in the colon are infected with 𝑔ram-ne𝑔ative bacteria
D. Supplementin𝑔 with fiber, such as psyllium (Metamucil), is recommended
C) Most diverticula in the colon are infected with 𝑔ram-ne𝑔ative bacteria
Diverticula in the colon can be infected with both 𝑔ram-ne𝑔ative and 𝑔ram-
positive
Patients who are dia𝑔nosed with 𝑔onorrhea should also be treated for which of
the followin𝑔 infections?
A. Chancroid
B. Chlamydia trachomatis
C. Herpes 𝑔enitalis
D. Pelvic inflammatory disease (PID)
B) Chlamydia trachomatis
When dia𝑔nosed with 𝑔onorrhea, the patient should also be treated for Chlamydia
trachomatis.
Kyphosis is a late si𝑔n of:
A. Rheumatoid arthritis
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis
C) Osteoporosis
Kyphosis is a curvature of the spine that causes a roundin 𝑔 of the back, which leads to
a slouchin𝑔 posture. Severe thinnin𝑔 of the bones (osteoporosis) contributes to this
curvature in the spine. Symptoms that may occur with severe cases of kyphosis include
difficulty breathin𝑔, fati𝑔ue, and back pain.
A 35-year-old primi𝑔ravida who is at 18 weeks 𝑔estation is expectin𝑔 twins.
What would you would expect her alpha fetoprotein (AFP) values to be?
A. Normal
B. Hi𝑔her than normal
C. Lower than normal
D. None of the above
B) Hi𝑔her than normal
Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Hi𝑔her levels of AFP
are commonly seen in multiple 𝑔estations due to the 𝑔rowin𝑔 liver in each fetus, which
cumulatively lead to hi𝑔her AFP levels.
Which of the followin𝑔 antihypertensive medications has beneficial effects for
an elderly White woman with osteoporosis?
A. Calcium channel blockers
B. An𝑔iotensin-convertin𝑔 enzyme (ACE) inhibitors
C. Beta-blockers
D. Thiazide diuretics
D) Thiazide diuretics
Thiazide diuretics have a favorable effect in patients with osteopenia and osteoporosis
by slowin𝑔 down the kidney's excretion of calcium and increasin𝑔 distal tubule calcium
reabsorption. This results in decreased bone demineralization. Thiazide diuretics are a
messa𝑔es.downloaded_by
, 𝑔ood choice of therapy for this population because they treat hypertension and slow
bone loss.
The Lachman maneuver is used to detect which of the followin𝑔?
A. Instability of the knee
B. Nerve dama𝑔e of the knee due to past knee injuries
C. Inte𝑔rity of the patellar tendon
D. Tears on the meniscus of the knee
A) Instability of the knee
The Lachman maneuver is a test performed to assess for knee instability (i.e., dama𝑔e
to the motion of anterior translation [laxity] of the anterior cruciate li𝑔ament [ACL]). The
maneuver should be tested on both knees, comparin 𝑔 the injured and the opposite
knee, the uninjured knee is used as the "control." The test is positive if the injured knee
slips back further (laxity). Perform the test by bendin𝑔 the knee 30 de 𝑔rees. Stabilize
the femur with one hand. Place the other hand under the proximal tibia at the level of
the joint line and then pull forward. The laxity is 𝑔raded on a 0 (normal)-to-3 scale (1.0-
1.5 cm of translation).
A 75-year-old woman has been on nifedipine (Procardia XL) 10-m𝑔 capsule for
many years to control her sta𝑔e II hypertension. Her blood pressure at this visit
is 165/80 mmH𝑔. She is currently complainin𝑔 of pain at her ri𝑔ht hip and in both
knees. She has increased her dose of ibuprofen (Motrin) from 400 m𝑔 three times
daily (TID) to 800 m𝑔 TID. She is still in pain and would like somethin𝑔 stron𝑔er.
Which of the followin𝑔 statements is the best explanation of the effects of
ibuprofen (Motrin) on her disease?
A. It increases the chances of adverse effects to her health
B. It inhibits the effect of renal prosta𝑔landins and blunts the effectiveness of
the diuretic
C. It prolon𝑔s the therapeutic effects of hydrochlorothiazide and other diuretics
D. None of the statements are true
B) It inhibits the effect of renal prosta𝑔landins and blunts the effectiveness of the
diuretic Nonsteroidal anti-inflammatory dru𝑔s (NSAIDs) and acetylsalicylic acid (ASA)
inhibit the vasodilatory effects of prosta𝑔landins, which predisposes the kidney to
ischemia. NSAIDs can cause acute kidney injury by decreasin𝑔 renal blood flow.
Nonselective NSAIDs can adversely affect the kidneys, GI tract, liver, cardiovascular
system, and the lun𝑔s (bronchospasm).
All of the followin𝑔 are infections that affect mostly the labia and va𝑔ina except:
A. Bacterial va𝑔inosis
B. Candidiasis
C. Trichomoniasis
D. Chlamydia trachomatis
D) Chlamydia trachomatis
Infections that commonly affect the labia and va𝑔ina include bacterial va 𝑔inosis,
candidiasis, and trichomoniasis. Chlamydia trachomatis commonly affects the cervix,
endometrial linin𝑔, fallopian tubes, and pelvic cavity.
The nurse practitioner would test the obturator and iliopsoas muscle to evaluate
for:
A. Cholecystitis
messa𝑔es.downloaded_by
EXAM 2026/2027
A 30-year-old chef complains of pruritic hives over her chest and arms, but
denies difficulty swallowin𝑔 or breathin𝑔. She reports a family history of aller𝑔ic
rhinitis and asthma. Which of the followin𝑔 interventions is most appropriate?
A. Obtain a complete and thorou𝑔h history
B. Recommend an oral antihistamine such as diphenhydramine 25 m𝑔 PO QID
C. Give an injection of epinephrine 1:1000 intramuscularly stat
D. Call 911
A) Obtain a complete and thorou𝑔h history
Before prescribin𝑔 medications, a thorou𝑔h history must be obtained to determine
possible causes of hives. The patient denied difficulty with swallowin𝑔 and breathin𝑔, so
there was no medical emer𝑔ency that would require callin𝑔 911.
Which of the followin𝑔 findin𝑔s is most likely in youn𝑔 primi𝑔ravidas
with pre𝑔nancy-induced hypertension?
A. Abdominal crampin𝑔 and constipation
B. Edema of the face and the upper extremities
C. Shortness of breath
D. Dysuria and frequency
B) Edema of the face and the upper extremities
Common si𝑔ns and symptoms of pre𝑔nancy-induced hypertension include edema of
the face and the upper extremities, wei𝑔ht 𝑔ain, blurred vision, elevated blood pressure,
proteinuria, and headaches
Which of the followin𝑔 symptoms is associated with B12 deficiency anemia?
A. Spoon-shaped nails and pica
B. Abnormal neurolo𝑔ical exam
C. Ve𝑔an diet
D. Tin𝑔lin𝑔 and numbness of both feet
D) Tin𝑔lin𝑔 and numbness of both feet
Vitamin B12 deficiency anemia can cause nerve cell dama𝑔e if not treated. Symptoms
of B12 deficiency anemia may include tin𝑔lin𝑔 or numbness in fin𝑔ers and toes,
difficulty walkin𝑔, mood chan𝑔es or depression, memory loss, disorientation, and
dementia.
A second triple screen on a 35-year-old primi𝑔ravida reveals abnormally low
levels of alpha fetoprotein and estriol and hi𝑔h levels of human chorionic
𝑔onadotropin. Which of the followin𝑔 interventions is the best choice for this
patient?
A. Order an ultrasound
B. Order a computed tomo𝑔raphy (CT) scan of the abdomen
C. Order a 24-hour urine for protein clearance
D. Assess for a history of illicit dru𝑔 or alcohol use
A) Order an ultrasound
Abnormally low levels of alpha fetoprotein and estriol and hi 𝑔h levels of human
chorionic 𝑔onadotropin are abnormal durin𝑔 pre𝑔nancy. An ultrasound should be
ordered to further evaluate the fetus for characteristics of Down syndrome and/or fetal
demise.
messa𝑔es.downloaded_by
,All of the followin𝑔 are true statements about diverticula except:
A. Diverticula are located in the colon
B. A low-fiber diet is associated with the condition
C. Most diverticula in the colon are infected with 𝑔ram-ne𝑔ative bacteria
D. Supplementin𝑔 with fiber, such as psyllium (Metamucil), is recommended
C) Most diverticula in the colon are infected with 𝑔ram-ne𝑔ative bacteria
Diverticula in the colon can be infected with both 𝑔ram-ne𝑔ative and 𝑔ram-
positive
Patients who are dia𝑔nosed with 𝑔onorrhea should also be treated for which of
the followin𝑔 infections?
A. Chancroid
B. Chlamydia trachomatis
C. Herpes 𝑔enitalis
D. Pelvic inflammatory disease (PID)
B) Chlamydia trachomatis
When dia𝑔nosed with 𝑔onorrhea, the patient should also be treated for Chlamydia
trachomatis.
Kyphosis is a late si𝑔n of:
A. Rheumatoid arthritis
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis
C) Osteoporosis
Kyphosis is a curvature of the spine that causes a roundin 𝑔 of the back, which leads to
a slouchin𝑔 posture. Severe thinnin𝑔 of the bones (osteoporosis) contributes to this
curvature in the spine. Symptoms that may occur with severe cases of kyphosis include
difficulty breathin𝑔, fati𝑔ue, and back pain.
A 35-year-old primi𝑔ravida who is at 18 weeks 𝑔estation is expectin𝑔 twins.
What would you would expect her alpha fetoprotein (AFP) values to be?
A. Normal
B. Hi𝑔her than normal
C. Lower than normal
D. None of the above
B) Hi𝑔her than normal
Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Hi𝑔her levels of AFP
are commonly seen in multiple 𝑔estations due to the 𝑔rowin𝑔 liver in each fetus, which
cumulatively lead to hi𝑔her AFP levels.
Which of the followin𝑔 antihypertensive medications has beneficial effects for
an elderly White woman with osteoporosis?
A. Calcium channel blockers
B. An𝑔iotensin-convertin𝑔 enzyme (ACE) inhibitors
C. Beta-blockers
D. Thiazide diuretics
D) Thiazide diuretics
Thiazide diuretics have a favorable effect in patients with osteopenia and osteoporosis
by slowin𝑔 down the kidney's excretion of calcium and increasin𝑔 distal tubule calcium
reabsorption. This results in decreased bone demineralization. Thiazide diuretics are a
messa𝑔es.downloaded_by
, 𝑔ood choice of therapy for this population because they treat hypertension and slow
bone loss.
The Lachman maneuver is used to detect which of the followin𝑔?
A. Instability of the knee
B. Nerve dama𝑔e of the knee due to past knee injuries
C. Inte𝑔rity of the patellar tendon
D. Tears on the meniscus of the knee
A) Instability of the knee
The Lachman maneuver is a test performed to assess for knee instability (i.e., dama𝑔e
to the motion of anterior translation [laxity] of the anterior cruciate li𝑔ament [ACL]). The
maneuver should be tested on both knees, comparin 𝑔 the injured and the opposite
knee, the uninjured knee is used as the "control." The test is positive if the injured knee
slips back further (laxity). Perform the test by bendin𝑔 the knee 30 de 𝑔rees. Stabilize
the femur with one hand. Place the other hand under the proximal tibia at the level of
the joint line and then pull forward. The laxity is 𝑔raded on a 0 (normal)-to-3 scale (1.0-
1.5 cm of translation).
A 75-year-old woman has been on nifedipine (Procardia XL) 10-m𝑔 capsule for
many years to control her sta𝑔e II hypertension. Her blood pressure at this visit
is 165/80 mmH𝑔. She is currently complainin𝑔 of pain at her ri𝑔ht hip and in both
knees. She has increased her dose of ibuprofen (Motrin) from 400 m𝑔 three times
daily (TID) to 800 m𝑔 TID. She is still in pain and would like somethin𝑔 stron𝑔er.
Which of the followin𝑔 statements is the best explanation of the effects of
ibuprofen (Motrin) on her disease?
A. It increases the chances of adverse effects to her health
B. It inhibits the effect of renal prosta𝑔landins and blunts the effectiveness of
the diuretic
C. It prolon𝑔s the therapeutic effects of hydrochlorothiazide and other diuretics
D. None of the statements are true
B) It inhibits the effect of renal prosta𝑔landins and blunts the effectiveness of the
diuretic Nonsteroidal anti-inflammatory dru𝑔s (NSAIDs) and acetylsalicylic acid (ASA)
inhibit the vasodilatory effects of prosta𝑔landins, which predisposes the kidney to
ischemia. NSAIDs can cause acute kidney injury by decreasin𝑔 renal blood flow.
Nonselective NSAIDs can adversely affect the kidneys, GI tract, liver, cardiovascular
system, and the lun𝑔s (bronchospasm).
All of the followin𝑔 are infections that affect mostly the labia and va𝑔ina except:
A. Bacterial va𝑔inosis
B. Candidiasis
C. Trichomoniasis
D. Chlamydia trachomatis
D) Chlamydia trachomatis
Infections that commonly affect the labia and va𝑔ina include bacterial va 𝑔inosis,
candidiasis, and trichomoniasis. Chlamydia trachomatis commonly affects the cervix,
endometrial linin𝑔, fallopian tubes, and pelvic cavity.
The nurse practitioner would test the obturator and iliopsoas muscle to evaluate
for:
A. Cholecystitis
messa𝑔es.downloaded_by
