AANP FNP Certification Exam FNP certification Exam
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A 58-year-old patient with hypertension has a blood pressure of 168/96
mm Hg on two separate office visits. The patient has no symptoms of
acute end-organ damage. What is the most appropriate management?
A. Reassure the patient and recheck in 12 months
B. Initiate antihypertensive therapy and lifestyle modification
C. Send the patient immediately to the emergency department
D. Begin aspirin therapy alone
Answer: B. Initiate antihypertensive therapy and lifestyle modification
Rationale: Persistent stage 2 hypertension requires active treatment in
addition to lifestyle modification. In an asymptomatic patient without
evidence of hypertensive emergency, outpatient management is
appropriate. Immediate emergency referral is reserved for severe
hypertension accompanied by acute target-organ injury.
A 45-year-old woman reports fatigue, weight gain, constipation, and
cold intolerance. Laboratory testing shows an elevated TSH and a low
free T4. Which diagnosis is most likely?
A. Primary hypothyroidism
B. Secondary hypothyroidism
,C. Hyperthyroidism
D. Euthyroid sick syndrome
Answer: A. Primary hypothyroidism
Rationale: Primary hypothyroidism results from thyroid gland
dysfunction and is characterized by an elevated TSH with a low free T4.
Secondary hypothyroidism originates from pituitary or hypothalamic
disease and generally produces a low or inappropriately normal TSH.
A 67-year-old patient presents with sudden-onset unilateral weakness,
facial drooping, and difficulty speaking that began 45 minutes ago.
What is the priority action?
A. Administer oral aspirin before imaging
B. Arrange immediate emergency evaluation for suspected stroke
C. Schedule an outpatient MRI
D. observe the patient for spontaneous improvement
Answer: B. Arrange immediate emergency evaluation for suspected
stroke
Rationale: Sudden focal neurologic deficits strongly suggest an acute
cerebrovascular event. The patient requires immediate emergency
evaluation and brain imaging to determine whether ischemic or
hemorrhagic stroke is present and whether reperfusion therapy may be
appropriate. Treatment should not be delayed for outpatient evaluation.
,A 32-year-old woman presents with dysuria, urinary frequency, and
urgency for 2 days. She has no fever, flank pain, vaginal symptoms, or
pregnancy. Which diagnosis is most likely?
A. Acute uncomplicated cystitis
B. Pyelonephritis
C. Vaginitis
D. Nephrolithiasis
Answer: A. Acute uncomplicated cystitis
Rationale: Dysuria, frequency, and urgency without fever, flank pain,
or systemic illness are classic for acute uncomplicated cystitis.
Pyelonephritis is more likely when fever, flank pain, costovertebral-
angle tenderness, or systemic symptoms occur.
A patient with asthma uses a short-acting beta-agonist several times
each week and wakes at night with symptoms. What does this pattern
suggest?
A. Well-controlled asthma
B. Poorly controlled asthma requiring reassessment of controller
therapy
C. COPD
D. Normal disease progression
Answer: B. Poorly controlled asthma requiring reassessment of
controller therapy
, Rationale: Frequent rescue-inhaler use and nighttime symptoms
indicate inadequate asthma control. The clinician should assess
adherence, inhaler technique, triggers, and the need for appropriate
controller therapy rather than relying solely on a short-acting
bronchodilator.
A 29-year-old woman has a Pap test showing atypical squamous cells of
undetermined significance (ASC-US). Which factor is particularly
important when determining management?
A. Blood type
B. HPV testing and the patient's age
C. Serum calcium level
D. Family history of diabetes
Answer: B. HPV testing and the patient's age
Rationale: Management of ASC-US depends substantially on age and
high-risk HPV status. HPV testing helps determine whether further
evaluation, surveillance, or routine screening is appropriate.
A 72-year-old patient taking warfarin develops melena and has a
markedly elevated INR. What is the priority?
A. Increase the warfarin dose
B. Assess for significant bleeding and manage anticoagulation urgently
C. Recommend increased dietary vitamin K without further evaluation
D. Continue warfarin unchanged
Review || Most Recent Exam 2026|2027 Actual Complete
Real Exam Questions And Correct Answers (Verified
Answers) Already Graded A+ | Guaranteed Success!
Newest Exam | Just Released!!
A 58-year-old patient with hypertension has a blood pressure of 168/96
mm Hg on two separate office visits. The patient has no symptoms of
acute end-organ damage. What is the most appropriate management?
A. Reassure the patient and recheck in 12 months
B. Initiate antihypertensive therapy and lifestyle modification
C. Send the patient immediately to the emergency department
D. Begin aspirin therapy alone
Answer: B. Initiate antihypertensive therapy and lifestyle modification
Rationale: Persistent stage 2 hypertension requires active treatment in
addition to lifestyle modification. In an asymptomatic patient without
evidence of hypertensive emergency, outpatient management is
appropriate. Immediate emergency referral is reserved for severe
hypertension accompanied by acute target-organ injury.
A 45-year-old woman reports fatigue, weight gain, constipation, and
cold intolerance. Laboratory testing shows an elevated TSH and a low
free T4. Which diagnosis is most likely?
A. Primary hypothyroidism
B. Secondary hypothyroidism
,C. Hyperthyroidism
D. Euthyroid sick syndrome
Answer: A. Primary hypothyroidism
Rationale: Primary hypothyroidism results from thyroid gland
dysfunction and is characterized by an elevated TSH with a low free T4.
Secondary hypothyroidism originates from pituitary or hypothalamic
disease and generally produces a low or inappropriately normal TSH.
A 67-year-old patient presents with sudden-onset unilateral weakness,
facial drooping, and difficulty speaking that began 45 minutes ago.
What is the priority action?
A. Administer oral aspirin before imaging
B. Arrange immediate emergency evaluation for suspected stroke
C. Schedule an outpatient MRI
D. observe the patient for spontaneous improvement
Answer: B. Arrange immediate emergency evaluation for suspected
stroke
Rationale: Sudden focal neurologic deficits strongly suggest an acute
cerebrovascular event. The patient requires immediate emergency
evaluation and brain imaging to determine whether ischemic or
hemorrhagic stroke is present and whether reperfusion therapy may be
appropriate. Treatment should not be delayed for outpatient evaluation.
,A 32-year-old woman presents with dysuria, urinary frequency, and
urgency for 2 days. She has no fever, flank pain, vaginal symptoms, or
pregnancy. Which diagnosis is most likely?
A. Acute uncomplicated cystitis
B. Pyelonephritis
C. Vaginitis
D. Nephrolithiasis
Answer: A. Acute uncomplicated cystitis
Rationale: Dysuria, frequency, and urgency without fever, flank pain,
or systemic illness are classic for acute uncomplicated cystitis.
Pyelonephritis is more likely when fever, flank pain, costovertebral-
angle tenderness, or systemic symptoms occur.
A patient with asthma uses a short-acting beta-agonist several times
each week and wakes at night with symptoms. What does this pattern
suggest?
A. Well-controlled asthma
B. Poorly controlled asthma requiring reassessment of controller
therapy
C. COPD
D. Normal disease progression
Answer: B. Poorly controlled asthma requiring reassessment of
controller therapy
, Rationale: Frequent rescue-inhaler use and nighttime symptoms
indicate inadequate asthma control. The clinician should assess
adherence, inhaler technique, triggers, and the need for appropriate
controller therapy rather than relying solely on a short-acting
bronchodilator.
A 29-year-old woman has a Pap test showing atypical squamous cells of
undetermined significance (ASC-US). Which factor is particularly
important when determining management?
A. Blood type
B. HPV testing and the patient's age
C. Serum calcium level
D. Family history of diabetes
Answer: B. HPV testing and the patient's age
Rationale: Management of ASC-US depends substantially on age and
high-risk HPV status. HPV testing helps determine whether further
evaluation, surveillance, or routine screening is appropriate.
A 72-year-old patient taking warfarin develops melena and has a
markedly elevated INR. What is the priority?
A. Increase the warfarin dose
B. Assess for significant bleeding and manage anticoagulation urgently
C. Recommend increased dietary vitamin K without further evaluation
D. Continue warfarin unchanged
