ANCC FNP EXAM COMPREHENSIVE
STUDY GUIDE QUESTIONS AND
ANSWERS
1. A 65-year-old patient with a history of heart failure and an ejection fraction of 35%
presents for a routine visit. Which of the following medication classes is considered the gold
standard for reducing mortality and inhibiting cardiac remodeling in this patient?
A. Calcium Channel Blockers
B. Loop Diuretics
C. Alpha-1 Antagonists
D. ACE Inhibitors
Answer: D
Conceptual Explanation: ACE Inhibitors are fundamental in treating HFrEF as they block
the renin-angiotensin-aldosterone system, reducing afterload and preventing detrimental
cardiac remodeling.
,2. A 45-year-old female presents with a new onset of palpitations and heat intolerance.
Laboratory results show a TSH of <0.01 mIU/L and an elevated Free T4. What is the most
likely diagnosis?
A. Hashimoto’s Thyroiditis
B. Graves’ Disease
C. Myxedema Crisis
D. Subacute Thyroiditis
Answer: B
Conceptual Explanation: Graves’ disease is the most common cause of hyperthyroidism,
characterized by suppressed TSH and elevated thyroid hormones due to stimulating
antibodies.
3. During a physical examination of a 72-year-old male, you auscultate a harsh, crescendo-
decrescendo systolic murmur at the second intercostal space, right sternal border, radiating
to the carotids. What is the most likely valvular disorder?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
, Conceptual Explanation: Aortic stenosis typically presents as a systolic ejection murmur
heard best at the right upper sternal border with radiation to the neck.
4. A patient with Type 2 Diabetes is currently taking Metformin 1000mg BID. Their latest A1C
is 8.2%. The patient has a history of atherosclerotic cardiovascular disease (ASCVD). Which
medication should be added next according to ADA guidelines?
A. GLP-1 Receptor Agonist
B. DPP-4 Inhibitor
C. Sulfonylurea
D. Basal Insulin
Answer: A
Conceptual Explanation: For patients with established ASCVD, GLP-1 receptor agonists
with proven cardiovascular benefit are recommended as a second-line agent after
metformin.
5. According to the JNC 8 guidelines, what is the goal blood pressure for a 62-year-old patient
with no history of diabetes or chronic kidney disease?
A. < 140/90 mmHg
B. < 150/90 mmHg
C. < 130/80 mmHg
D. < 120/70 mmHg
STUDY GUIDE QUESTIONS AND
ANSWERS
1. A 65-year-old patient with a history of heart failure and an ejection fraction of 35%
presents for a routine visit. Which of the following medication classes is considered the gold
standard for reducing mortality and inhibiting cardiac remodeling in this patient?
A. Calcium Channel Blockers
B. Loop Diuretics
C. Alpha-1 Antagonists
D. ACE Inhibitors
Answer: D
Conceptual Explanation: ACE Inhibitors are fundamental in treating HFrEF as they block
the renin-angiotensin-aldosterone system, reducing afterload and preventing detrimental
cardiac remodeling.
,2. A 45-year-old female presents with a new onset of palpitations and heat intolerance.
Laboratory results show a TSH of <0.01 mIU/L and an elevated Free T4. What is the most
likely diagnosis?
A. Hashimoto’s Thyroiditis
B. Graves’ Disease
C. Myxedema Crisis
D. Subacute Thyroiditis
Answer: B
Conceptual Explanation: Graves’ disease is the most common cause of hyperthyroidism,
characterized by suppressed TSH and elevated thyroid hormones due to stimulating
antibodies.
3. During a physical examination of a 72-year-old male, you auscultate a harsh, crescendo-
decrescendo systolic murmur at the second intercostal space, right sternal border, radiating
to the carotids. What is the most likely valvular disorder?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
, Conceptual Explanation: Aortic stenosis typically presents as a systolic ejection murmur
heard best at the right upper sternal border with radiation to the neck.
4. A patient with Type 2 Diabetes is currently taking Metformin 1000mg BID. Their latest A1C
is 8.2%. The patient has a history of atherosclerotic cardiovascular disease (ASCVD). Which
medication should be added next according to ADA guidelines?
A. GLP-1 Receptor Agonist
B. DPP-4 Inhibitor
C. Sulfonylurea
D. Basal Insulin
Answer: A
Conceptual Explanation: For patients with established ASCVD, GLP-1 receptor agonists
with proven cardiovascular benefit are recommended as a second-line agent after
metformin.
5. According to the JNC 8 guidelines, what is the goal blood pressure for a 62-year-old patient
with no history of diabetes or chronic kidney disease?
A. < 140/90 mmHg
B. < 150/90 mmHg
C. < 130/80 mmHg
D. < 120/70 mmHg
