ANCC FNP PRACTICE EXAM 2026/2027
QUESTIONS AND ANSWERS
1. A 65-year-old male presents with sudden onset of severe right upper quadrant pain that
radiates to his right shoulder blade. Physical exam reveals a positive Murphy’s sign. What is
the most likely diagnosis?
A. Acute pancreatitis
B. Appendicitis
C. Peptic ulcer disease
D. Acute cholecystitis
Answer: D
Conceptual Explanation: Murphy’s sign (arrest of inspiration on palpation of the
gallbladder area) is a classic indicator of acute cholecystitis.
2. Which of the following classes of medication is the first-line treatment for a patient newly
diagnosed with Stage 2 Hypertension?
A. Beta-blockers
B. Loop diuretics
,C. Thiazide diuretics
D. Calcium channel blockers
Answer: C
Conceptual Explanation: According to JNC-8 and AHA/ACC guidelines, Thiazide-type
diuretics are considered first-line therapy for most patients with hypertension.
3. An 8-year-old boy presents with a ‘barking’ cough and inspiratory stridor. What is the most
likely diagnosis?
A. Croup
B. Asthma
C. Epiglottitis
D. Bronchiolitis
Answer: A
Conceptual Explanation: Croup (laryngotracheobronchitis) is characterized by a barking
cough and stridor, typically caused by parainfluenza virus.
4. Which physical exam finding is pathognomonic for Psoriasis?
A. Herald patch
B. Target lesions
C. Auspitz sign
, D. Honey-colored crusts
Answer: C
Conceptual Explanation: Auspitz sign is the appearance of pinpoint bleeding after scales
are scraped off a psoriasis plaque.
5. A 24-year-old female presents for a follow-up on a Pap smear that showed HSIL. What is
the next appropriate step?
A. Colposcopy
B. HPV testing
C. Repeat Pap smear in 6 months
D. Routine screening in 3 years
Answer: A
Conceptual Explanation: High-grade squamous intraepithelial lesion (HSIL) requires
immediate further investigation, usually via colposcopy or LEEP.
6. What is the gold standard for diagnosing Chronic Obstructive Pulmonary Disease (COPD)?
A. Spirometry
B. Chest X-ray
C. Arterial Blood Gas (ABG)
D. Peak flow monitoring
QUESTIONS AND ANSWERS
1. A 65-year-old male presents with sudden onset of severe right upper quadrant pain that
radiates to his right shoulder blade. Physical exam reveals a positive Murphy’s sign. What is
the most likely diagnosis?
A. Acute pancreatitis
B. Appendicitis
C. Peptic ulcer disease
D. Acute cholecystitis
Answer: D
Conceptual Explanation: Murphy’s sign (arrest of inspiration on palpation of the
gallbladder area) is a classic indicator of acute cholecystitis.
2. Which of the following classes of medication is the first-line treatment for a patient newly
diagnosed with Stage 2 Hypertension?
A. Beta-blockers
B. Loop diuretics
,C. Thiazide diuretics
D. Calcium channel blockers
Answer: C
Conceptual Explanation: According to JNC-8 and AHA/ACC guidelines, Thiazide-type
diuretics are considered first-line therapy for most patients with hypertension.
3. An 8-year-old boy presents with a ‘barking’ cough and inspiratory stridor. What is the most
likely diagnosis?
A. Croup
B. Asthma
C. Epiglottitis
D. Bronchiolitis
Answer: A
Conceptual Explanation: Croup (laryngotracheobronchitis) is characterized by a barking
cough and stridor, typically caused by parainfluenza virus.
4. Which physical exam finding is pathognomonic for Psoriasis?
A. Herald patch
B. Target lesions
C. Auspitz sign
, D. Honey-colored crusts
Answer: C
Conceptual Explanation: Auspitz sign is the appearance of pinpoint bleeding after scales
are scraped off a psoriasis plaque.
5. A 24-year-old female presents for a follow-up on a Pap smear that showed HSIL. What is
the next appropriate step?
A. Colposcopy
B. HPV testing
C. Repeat Pap smear in 6 months
D. Routine screening in 3 years
Answer: A
Conceptual Explanation: High-grade squamous intraepithelial lesion (HSIL) requires
immediate further investigation, usually via colposcopy or LEEP.
6. What is the gold standard for diagnosing Chronic Obstructive Pulmonary Disease (COPD)?
A. Spirometry
B. Chest X-ray
C. Arterial Blood Gas (ABG)
D. Peak flow monitoring
