SARAH MICHELLE AANP BOARD EXAM 2026/2027 |
NP Certification Study Guide | Pass Guaranteed - A+
Graded
Section 1: Health Promotion & Disease Prevention (Questions 1–25)
Q1: A 45-year-old African American male presents for his annual physical. He has no
significant medical history, but his father died of a myocardial infarction at age 52.
According to USPSTF guidelines, at what age should aspirin primary prevention be
considered for this patient?
A. Age 40 years, given his family history and race
B. Age 50 years, with shared decision-making regarding cardiovascular risk
C. Age 60 years, as routine aspirin is no longer recommended before this age
D. Aspirin is not recommended for primary prevention in any adult without established
cardiovascular disease [CORRECT]
Correct Answer: D
Rationale: The 2022 USPSTF recommendation states that aspirin use for the primary
prevention of cardiovascular disease in adults 40 years or older has a small net benefit
,and should be an individual decision, but the 2019 ASPREE trial and subsequent data
showed no mortality benefit with increased bleeding risk. Current guidelines emphasize
that aspirin should NOT be routinely recommended for primary prevention; instead,
focus on risk factor modification (BP, lipids, smoking cessation). Options A, B, and C all
incorrectly suggest aspirin initiation at specific ages for primary prevention.
Q2: A 28-year-old transgender woman (male-to-female) on feminizing hormone therapy
with estradiol and spironolactone presents for preventive care. Which screening
recommendation is MOST appropriate?
A. Begin mammography at age 40, same as cisgender women
B. Screen for breast cancer based on risk factors and duration of hormone use, with
shared decision-making
C. No breast cancer screening is needed as she does not have breast tissue
D. Perform colonoscopy at age 45 due to increased CRC risk from hormone therapy
[CORRECT]
Correct Answer: D
Rationale: Transgender women on long-term feminizing hormones have increased risk
of venous thromboembolism and some data suggest increased cardiovascular risk, but
breast cancer screening should follow risk-stratified approaches considering duration of
hormone use and individual risk factors—not automatic age 40 screening. Colonoscopy
at age 45 aligns with USPSTF 2021 recommendation for average-risk adults. Option A is
incorrect because automatic mammography at 40 is not universally recommended even
for cisgender women (USPSTF recommends biennial screening 40-74 with
,individualized decision-making). Option C is incorrect because transgender women do
develop breast tissue on hormones and require screening. Option B is partially correct
but less comprehensive than D.
Q3: During a telehealth visit, a 35-year-old patient in a rural area asks about starting
prenatal vitamins before conception. Which component of prenatal vitamins is MOST
critical for neural tube defect prevention, and when should supplementation begin?
A. Iron 27 mg, beginning at first prenatal visit
B. Calcium 1000 mg, beginning in the first trimester
C. Folic acid 400 mcg, beginning at least 1 month before conception [CORRECT]
D. Vitamin D 600 IU, beginning in the second trimester
Correct Answer: C
Rationale: The neural tube closes by 28 days post-conception, often before a woman
knows she is pregnant. CDC and ACOG recommend all women of reproductive age
consume 400 mcg folic acid daily, beginning at least 1 month before conception and
continuing through the first trimester. Iron is important for anemia prevention but not
neural tube defects. Calcium and vitamin D support bone health but are not critical for
neural tube closure. Option C is the only evidence-based recommendation for neural
tube defect primary prevention.
, Q4: A 55-year-old Hispanic woman with Type 2 diabetes presents for her annual
wellness visit. Her last Pap test was 3 years ago, and she has had normal results for 20
years. She asks if she still needs cervical cancer screening. What is the MOST
appropriate recommendation?
A. Continue Pap testing every 3 years until age 65, then stop if all prior tests normal
B. Transition to HPV testing every 5 years or co-testing every 5 years until age 65
[CORRECT]
C. She may stop screening now since she has had 20 years of normal Pap tests
D. Continue annual Pap testing due to her diabetes increasing cervical cancer risk
Correct Answer: B
Rationale: USPSTF 2018 guidelines recommend cervical cancer screening in women
21-65 with either cytology every 3 years, HPV testing every 5 years, or co-testing every 5
years. For women 30-65, HPV primary testing every 5 years or co-testing every 5 years is
preferred. Diabetes does not increase cervical cancer risk. Option A is acceptable but
not the preferred method. Option C is incorrect because screening should continue until
age 65 with adequate prior screening. Option D is incorrect because annual testing is
not recommended and diabetes is not an indication for more frequent screening.
Q5: A 16-year-old patient presents for a sports physical. The patient identifies as
non-binary and uses they/them pronouns. During the confidential portion of the visit,
they disclose vaping THC daily. Which harm reduction strategy is MOST appropriate?
A. Immediately inform the parents due to the patient's minor status
NP Certification Study Guide | Pass Guaranteed - A+
Graded
Section 1: Health Promotion & Disease Prevention (Questions 1–25)
Q1: A 45-year-old African American male presents for his annual physical. He has no
significant medical history, but his father died of a myocardial infarction at age 52.
According to USPSTF guidelines, at what age should aspirin primary prevention be
considered for this patient?
A. Age 40 years, given his family history and race
B. Age 50 years, with shared decision-making regarding cardiovascular risk
C. Age 60 years, as routine aspirin is no longer recommended before this age
D. Aspirin is not recommended for primary prevention in any adult without established
cardiovascular disease [CORRECT]
Correct Answer: D
Rationale: The 2022 USPSTF recommendation states that aspirin use for the primary
prevention of cardiovascular disease in adults 40 years or older has a small net benefit
,and should be an individual decision, but the 2019 ASPREE trial and subsequent data
showed no mortality benefit with increased bleeding risk. Current guidelines emphasize
that aspirin should NOT be routinely recommended for primary prevention; instead,
focus on risk factor modification (BP, lipids, smoking cessation). Options A, B, and C all
incorrectly suggest aspirin initiation at specific ages for primary prevention.
Q2: A 28-year-old transgender woman (male-to-female) on feminizing hormone therapy
with estradiol and spironolactone presents for preventive care. Which screening
recommendation is MOST appropriate?
A. Begin mammography at age 40, same as cisgender women
B. Screen for breast cancer based on risk factors and duration of hormone use, with
shared decision-making
C. No breast cancer screening is needed as she does not have breast tissue
D. Perform colonoscopy at age 45 due to increased CRC risk from hormone therapy
[CORRECT]
Correct Answer: D
Rationale: Transgender women on long-term feminizing hormones have increased risk
of venous thromboembolism and some data suggest increased cardiovascular risk, but
breast cancer screening should follow risk-stratified approaches considering duration of
hormone use and individual risk factors—not automatic age 40 screening. Colonoscopy
at age 45 aligns with USPSTF 2021 recommendation for average-risk adults. Option A is
incorrect because automatic mammography at 40 is not universally recommended even
for cisgender women (USPSTF recommends biennial screening 40-74 with
,individualized decision-making). Option C is incorrect because transgender women do
develop breast tissue on hormones and require screening. Option B is partially correct
but less comprehensive than D.
Q3: During a telehealth visit, a 35-year-old patient in a rural area asks about starting
prenatal vitamins before conception. Which component of prenatal vitamins is MOST
critical for neural tube defect prevention, and when should supplementation begin?
A. Iron 27 mg, beginning at first prenatal visit
B. Calcium 1000 mg, beginning in the first trimester
C. Folic acid 400 mcg, beginning at least 1 month before conception [CORRECT]
D. Vitamin D 600 IU, beginning in the second trimester
Correct Answer: C
Rationale: The neural tube closes by 28 days post-conception, often before a woman
knows she is pregnant. CDC and ACOG recommend all women of reproductive age
consume 400 mcg folic acid daily, beginning at least 1 month before conception and
continuing through the first trimester. Iron is important for anemia prevention but not
neural tube defects. Calcium and vitamin D support bone health but are not critical for
neural tube closure. Option C is the only evidence-based recommendation for neural
tube defect primary prevention.
, Q4: A 55-year-old Hispanic woman with Type 2 diabetes presents for her annual
wellness visit. Her last Pap test was 3 years ago, and she has had normal results for 20
years. She asks if she still needs cervical cancer screening. What is the MOST
appropriate recommendation?
A. Continue Pap testing every 3 years until age 65, then stop if all prior tests normal
B. Transition to HPV testing every 5 years or co-testing every 5 years until age 65
[CORRECT]
C. She may stop screening now since she has had 20 years of normal Pap tests
D. Continue annual Pap testing due to her diabetes increasing cervical cancer risk
Correct Answer: B
Rationale: USPSTF 2018 guidelines recommend cervical cancer screening in women
21-65 with either cytology every 3 years, HPV testing every 5 years, or co-testing every 5
years. For women 30-65, HPV primary testing every 5 years or co-testing every 5 years is
preferred. Diabetes does not increase cervical cancer risk. Option A is acceptable but
not the preferred method. Option C is incorrect because screening should continue until
age 65 with adequate prior screening. Option D is incorrect because annual testing is
not recommended and diabetes is not an indication for more frequent screening.
Q5: A 16-year-old patient presents for a sports physical. The patient identifies as
non-binary and uses they/them pronouns. During the confidential portion of the visit,
they disclose vaping THC daily. Which harm reduction strategy is MOST appropriate?
A. Immediately inform the parents due to the patient's minor status
