AANP FNP certification Proficiency knowledge test Exam
Questions and certified Answers 2026/2027
Kawasaki disease - correct answer - acute high fever, enlarged lymph. BRIGHT RED
RASH, conjunctivitis, dry cracked lips, strawberry tongue, Swollen hands, feet, AFTER
the fever resides the rash PEELS on hands/feet. Treated with high dose aspirin and
gamma globulin. This is TOXIC and VASCULAR, think blood clots, heart problems etc.
Treat: high dose aspirin. EXAM
Erythema migrans - correct answer Erythema Migraines- (stage 1 Lyme) Target bulls-
eye, usually appears in 7-14 days POST bitten tick. Rash is hot to touch with rough
texture, flu like symptoms. DX: B. Burgdorferi via ELISA, confirm with western blot.
Increased ESR. TREATMENT: Less than 7 Amoxicillin or cefuroxime axetil. Older than 7
Doxycycline. EXAM
Rocky Mountain Spotted Fever - correct answer Inc. fever, chills, N/v, photophobia,
myalgia, arthralgias THEN 2-5 days later you develop a petechial rash on forearms,
ankles, wrists, that spreads towards trunk and becomes generalized. Think rocky
NC/OK/AK/TN/MO. DX: PCR essay with Rickessetti Antigen TREATMENT- doxycycline.
EXAM
Addison's - correct answer Addison's- deficient in cortisol (think low sodium, blood
sugar, but Increase K. You must give cortisol. (Diagnosis Plasma Cortisol <5 mcg/dl @
0800.) EXAM
rheumatoid arthritis - correct answer Early morning stiffness, sausage joints.
Symmetrical involvement. Longer stiffness than OA. Joint space narrowing. Pain, warm,
tender, swollen, things. TREAT: NSAIDS, steroids, DMARDS, TNF. Only has
BOUCHARDS, SWAN NECK IS DESCRIPTION ON EXAM
Osteoarthritis - correct answer Large weight bearing joints. Early morning stiffness with
inactivity. Has both nodes. FIRST LINE Acetaminophen. EXERCISE: Isometric
exercises for knee OA. Non-weight bearing, like biking, swimming, stationary bike.
EXAM
,Osteoporosis - correct answer OSTEOPOROSIS = WEIGHT BEARING- walking, lifting
weights etc. bones are forced against gravity. EXAM
Fibromyalgia polymyalgia - correct answer Fibro- 11/18 points. Widespread pain for at
least three months. EXAM. polymyalgia Tx prednisone 12 months. Must taper off. RISK
for Temporal arteritis, DX BX, elevated ESR
Serotonin syndrome - correct answer Acute Serotonin Syndrome- Dilated pupils, high
fever, muscular rigidity, mental status changes, hyperreflexes, clonus, uncontrolled
shivery. You get this from SSRI, MAOIs, TCA. Could be potentially life threatening.
EXAM
Fundal Height - correct answer Fundal Height 12 weeks above symphysis pubis.
EXAM TOPICS
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks is at umbilicus.
2 cm more of less from # of wk gestation is normal if more or less order US.
Psoriasis - correct answer Psoriasis- Inherited. Pruritic erythematous plaques, fine
silvery-white scales with pitted fingernails. Scalp, elbows, knees, sacrum, intergluteal
folds.
(Koebner phenomenon- new psoriatic plaques form over skin trauma)
(Auspitz sign- pinpoint bleeding when plaques are removed).
TREATMENT: Topical steroids, Tar preps (mild). For (severe) do anti-TNF, or
immunologic.
D
Dacrocystitis - correct answer Darcryotosis lacrimal sac, rub down towards mouth. If
think secondary infection abx. EXAM how it presents.
Acne Rosacea - correct answer Acne Rosacea- chronic small acne like
papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose
tetracycline. EXAM
,Parathyroid hormone - correct answer PTH is responsible for calcium loss or gain from
bones, kidneys, and GI tract. EXAM
Diabetic Retinopathy - correct answer Diabetic Retinopathy-Cotton wool spots
(moderate retinopathy), micro-aneurysms. ALSO RETINAL HEMORRHAGES ON
CENTER OF EYE APPEAR ORANGE RED
HTN Retinopathy - correct answer Hypertensive Retinopathy- Copper/silver wire
arterioles. AV nicking(mild retinopathy). Retinal Hemorrhages. EXAM
Wilms Tumor - correct answer Wilms tumor (Nephroblastoma)- Not painful.
Asymptomatic abd mass does NOT cross the midline. 2-3 y. o.d. do not palpate. Do
ABD US. PUNT. Think Nephro doesn't cross. Stays where kidney is. EXAM
Primary Amenorrhea - correct answer Primary amenorrhea: NO menarche by 15 y.
with or w/o secondary sex characteristics.
Aphthous stomatitis - correct answer Cancer sores. Aphthous stomatitis: painful
shallow ulcers heal 7-10 days. Magic mouthwash.
Temporal arteritis - correct answer Temporal arteritis- one temple indurated cord like
gold stand. Biopsy. Abrupt visual changes blindness, inc. ESR. CPR. Most have
POLYMYALGIA RHEUMATICA. Treat high dose steroids.
Atopic Dermatitis (eczema) - correct answer Inherited. Extremely itchy. On flexural
folds, neck, hands. Inc. IgE. "small vesicles that rupture leaving painful, bright-red,
weepy lesions" they become lichenified from itching. First line: Topical steroids. Avoid
hot water/soaps. PO antihistamines. EXAM
Tinea Corporis - correct answer ring like itchy rash, slowly enlarge central clearing"-
Treatment: most respond to topical antifungals, if severe do oral Lamisil. EXAM AZOLE
ending
, Cellulitis - correct answer Deep dermis poor demarcated low legs. EXAM/ MULTIPLE
QUESTIONS. DVT RISK, DM WITH CELLULITIS WATCH FOR OSTEOMYLITIS.
Erysipelas - correct answer Group A strep, painful, Upper dermis, clear demarcated,
cheeks, shins.
TREATMENT- Dicloxacillin QID x10d. Cephalexin, Clinda. PCN ALLERGY? Do Azithro
x5d.
MRSA TREATMENT: Bactrim, doxy, mino, clinda. If sulfa allergy do not use Bactrim.
Varicella Zoster - correct answer "contagious 48 h. before, until all lesions crusted
over" low grade fever, generalized lymphadenopathy, intense itching, erythematous
macules, papules develop over macules, then vesicles erupt. "initially on trunk, then
scalp and face" TREATMENT supportive, antihistamines, acyclovir 20mg/kg 5xd. If
given first 24 hours works best. EXAM
Impetigo - correct answer Impetigo-Gram positive. Itchy pink-red lesions, evolve into
vesiculopustules that rupture. If bullous-large blisters. Severe- Keflex, dicloxacillin. PCN
Allergic-Azithro, clinda. If NO BULLAE- Bactroban. EXAM
Scarlet fever- scarlantina - correct answer "sandpaper textured-pink rash with sore
throat" strawberry tongue, rash starts on head and neck, spreads to trunk. The skin
THEN desquamates. EXAM
Lichen planus - correct answer LICHEN PLANUS: SMALL FLAT TOPPED, RED TO
PURPLE BUMPS THAT MAY HAVE WHITE SCALES/FLAKES.. WHISPY GREY
WHITE STREAKS CALLED WICHHAMS STRIAE. INNER WRISTS FOREARMS, AND
ANKLES. IF ON SCALP CAUSE HAIR LOSS. Causes hep C, medications, contact with
chemicals. EXAM
Spider bite - correct answer fever chills, n/v, located arms, upper legs, or the trunk.
Biten area becomes swollen, red, and tender, and blisters appear within 24-48 hours.
Necrotic in center, which kills the tissue. Ice packs to wound and cold inactivates the
toxin, tx like cellulitis of the skin, abx ointment at first, watch etc. Exam
Questions and certified Answers 2026/2027
Kawasaki disease - correct answer - acute high fever, enlarged lymph. BRIGHT RED
RASH, conjunctivitis, dry cracked lips, strawberry tongue, Swollen hands, feet, AFTER
the fever resides the rash PEELS on hands/feet. Treated with high dose aspirin and
gamma globulin. This is TOXIC and VASCULAR, think blood clots, heart problems etc.
Treat: high dose aspirin. EXAM
Erythema migrans - correct answer Erythema Migraines- (stage 1 Lyme) Target bulls-
eye, usually appears in 7-14 days POST bitten tick. Rash is hot to touch with rough
texture, flu like symptoms. DX: B. Burgdorferi via ELISA, confirm with western blot.
Increased ESR. TREATMENT: Less than 7 Amoxicillin or cefuroxime axetil. Older than 7
Doxycycline. EXAM
Rocky Mountain Spotted Fever - correct answer Inc. fever, chills, N/v, photophobia,
myalgia, arthralgias THEN 2-5 days later you develop a petechial rash on forearms,
ankles, wrists, that spreads towards trunk and becomes generalized. Think rocky
NC/OK/AK/TN/MO. DX: PCR essay with Rickessetti Antigen TREATMENT- doxycycline.
EXAM
Addison's - correct answer Addison's- deficient in cortisol (think low sodium, blood
sugar, but Increase K. You must give cortisol. (Diagnosis Plasma Cortisol <5 mcg/dl @
0800.) EXAM
rheumatoid arthritis - correct answer Early morning stiffness, sausage joints.
Symmetrical involvement. Longer stiffness than OA. Joint space narrowing. Pain, warm,
tender, swollen, things. TREAT: NSAIDS, steroids, DMARDS, TNF. Only has
BOUCHARDS, SWAN NECK IS DESCRIPTION ON EXAM
Osteoarthritis - correct answer Large weight bearing joints. Early morning stiffness with
inactivity. Has both nodes. FIRST LINE Acetaminophen. EXERCISE: Isometric
exercises for knee OA. Non-weight bearing, like biking, swimming, stationary bike.
EXAM
,Osteoporosis - correct answer OSTEOPOROSIS = WEIGHT BEARING- walking, lifting
weights etc. bones are forced against gravity. EXAM
Fibromyalgia polymyalgia - correct answer Fibro- 11/18 points. Widespread pain for at
least three months. EXAM. polymyalgia Tx prednisone 12 months. Must taper off. RISK
for Temporal arteritis, DX BX, elevated ESR
Serotonin syndrome - correct answer Acute Serotonin Syndrome- Dilated pupils, high
fever, muscular rigidity, mental status changes, hyperreflexes, clonus, uncontrolled
shivery. You get this from SSRI, MAOIs, TCA. Could be potentially life threatening.
EXAM
Fundal Height - correct answer Fundal Height 12 weeks above symphysis pubis.
EXAM TOPICS
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks is at umbilicus.
2 cm more of less from # of wk gestation is normal if more or less order US.
Psoriasis - correct answer Psoriasis- Inherited. Pruritic erythematous plaques, fine
silvery-white scales with pitted fingernails. Scalp, elbows, knees, sacrum, intergluteal
folds.
(Koebner phenomenon- new psoriatic plaques form over skin trauma)
(Auspitz sign- pinpoint bleeding when plaques are removed).
TREATMENT: Topical steroids, Tar preps (mild). For (severe) do anti-TNF, or
immunologic.
D
Dacrocystitis - correct answer Darcryotosis lacrimal sac, rub down towards mouth. If
think secondary infection abx. EXAM how it presents.
Acne Rosacea - correct answer Acne Rosacea- chronic small acne like
papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose
tetracycline. EXAM
,Parathyroid hormone - correct answer PTH is responsible for calcium loss or gain from
bones, kidneys, and GI tract. EXAM
Diabetic Retinopathy - correct answer Diabetic Retinopathy-Cotton wool spots
(moderate retinopathy), micro-aneurysms. ALSO RETINAL HEMORRHAGES ON
CENTER OF EYE APPEAR ORANGE RED
HTN Retinopathy - correct answer Hypertensive Retinopathy- Copper/silver wire
arterioles. AV nicking(mild retinopathy). Retinal Hemorrhages. EXAM
Wilms Tumor - correct answer Wilms tumor (Nephroblastoma)- Not painful.
Asymptomatic abd mass does NOT cross the midline. 2-3 y. o.d. do not palpate. Do
ABD US. PUNT. Think Nephro doesn't cross. Stays where kidney is. EXAM
Primary Amenorrhea - correct answer Primary amenorrhea: NO menarche by 15 y.
with or w/o secondary sex characteristics.
Aphthous stomatitis - correct answer Cancer sores. Aphthous stomatitis: painful
shallow ulcers heal 7-10 days. Magic mouthwash.
Temporal arteritis - correct answer Temporal arteritis- one temple indurated cord like
gold stand. Biopsy. Abrupt visual changes blindness, inc. ESR. CPR. Most have
POLYMYALGIA RHEUMATICA. Treat high dose steroids.
Atopic Dermatitis (eczema) - correct answer Inherited. Extremely itchy. On flexural
folds, neck, hands. Inc. IgE. "small vesicles that rupture leaving painful, bright-red,
weepy lesions" they become lichenified from itching. First line: Topical steroids. Avoid
hot water/soaps. PO antihistamines. EXAM
Tinea Corporis - correct answer ring like itchy rash, slowly enlarge central clearing"-
Treatment: most respond to topical antifungals, if severe do oral Lamisil. EXAM AZOLE
ending
, Cellulitis - correct answer Deep dermis poor demarcated low legs. EXAM/ MULTIPLE
QUESTIONS. DVT RISK, DM WITH CELLULITIS WATCH FOR OSTEOMYLITIS.
Erysipelas - correct answer Group A strep, painful, Upper dermis, clear demarcated,
cheeks, shins.
TREATMENT- Dicloxacillin QID x10d. Cephalexin, Clinda. PCN ALLERGY? Do Azithro
x5d.
MRSA TREATMENT: Bactrim, doxy, mino, clinda. If sulfa allergy do not use Bactrim.
Varicella Zoster - correct answer "contagious 48 h. before, until all lesions crusted
over" low grade fever, generalized lymphadenopathy, intense itching, erythematous
macules, papules develop over macules, then vesicles erupt. "initially on trunk, then
scalp and face" TREATMENT supportive, antihistamines, acyclovir 20mg/kg 5xd. If
given first 24 hours works best. EXAM
Impetigo - correct answer Impetigo-Gram positive. Itchy pink-red lesions, evolve into
vesiculopustules that rupture. If bullous-large blisters. Severe- Keflex, dicloxacillin. PCN
Allergic-Azithro, clinda. If NO BULLAE- Bactroban. EXAM
Scarlet fever- scarlantina - correct answer "sandpaper textured-pink rash with sore
throat" strawberry tongue, rash starts on head and neck, spreads to trunk. The skin
THEN desquamates. EXAM
Lichen planus - correct answer LICHEN PLANUS: SMALL FLAT TOPPED, RED TO
PURPLE BUMPS THAT MAY HAVE WHITE SCALES/FLAKES.. WHISPY GREY
WHITE STREAKS CALLED WICHHAMS STRIAE. INNER WRISTS FOREARMS, AND
ANKLES. IF ON SCALP CAUSE HAIR LOSS. Causes hep C, medications, contact with
chemicals. EXAM
Spider bite - correct answer fever chills, n/v, located arms, upper legs, or the trunk.
Biten area becomes swollen, red, and tender, and blisters appear within 24-48 hours.
Necrotic in center, which kills the tissue. Ice packs to wound and cold inactivates the
toxin, tx like cellulitis of the skin, abx ointment at first, watch etc. Exam
