2026 FNP-BC Exam Prep: Family Nurse
Practitioner Practice Questions, Answer
Rationales, Primary Care, Diagnosis,
Pharmacology, Health Promotion & Clinical
Management Study Guide
SECTION 1: HEALTH PROMOTION & DISEASE PREVENTION
Q1. A 50-year-old female with no risk factors asks when she should begin
colonoscopy screening for colorectal cancer. According to the USPSTF 2025/2026
guidelines, what is the most appropriate recommendation?
A. Begin at age 40
B. Begin at age 45
C. Begin at age 50
D. Begin at age 55
Answer: B
Rationale: The USPSTF updated its recommendation in 2021 to begin colorectal
cancer screening at age 45 for average-risk adults (previously 50). This was due to
the rising incidence of colorectal cancer in younger adults. Screening options
include colonoscopy every 10 years, FIT annually, or Cologuard every 3 years.
Option A is too early for average risk. Option C reflects the outdated guideline.
Option D is too late and would miss early detection opportunities.
Q2. A 65-year-old male with a 40-pack-year smoking history asks about lung
cancer screening. He currently smokes but is interested in quitting. What is the
most appropriate screening recommendation?
A. No screening is recommended for current smokers
B. Annual low-dose CT (LDCT) scan
,C. Annual chest X-ray
D. Sputum cytology every 2 years
Answer: B
Rationale: The USPSTF recommends annual low-dose CT (LDCT) for adults aged
50–80 who have a 20-pack-year smoking history and currently smoke or have quit
within the past 15 years. This patient meets criteria (65 years, 40-pack-year,
current smoker). Option A is incorrect because current smokers are eligible.
Option C (chest X-ray) is not recommended for screening. Option D (sputum
cytology) is not recommended as a screening tool.
Q3. A 35-year-old female presents for her annual well-woman exam. She has no
family history of breast cancer and no genetic mutations. When should the FNP
recommend she begin mammography screening?
A. Age 30
B. Age 35
C. Age 40
D. Age 50
Answer: C
Rationale: The USPSTF 2024/2025 recommendation states that average-risk
women should begin biennial mammography at age 40 and continue through age
74. The ACS also recommends starting at 40 but annually. Option A is too early for
average risk. Option B is not supported by major guidelines for average risk.
Option D reflects the older guideline and would delay detection.
Q4. A 2-month-old infant presents for a well-child visit. The mother reports the
baby is feeding well and has no acute issues. Which of the following vaccines
should the FNP administer at this visit?
A. DTaP, IPV, Hib, PCV13, Rotavirus (2nd dose)
B. MMR, Varicella, Hepatitis A
C. Tdap, HPV, Meningococcal
D. Influenza, Hepatitis B (3rd dose)
,Answer: A
Rationale: At 2 months, the CDC immunization schedule recommends: DTaP
(1st), IPV (1st), Hib (1st), PCV13 (1st), Rotavirus (1st), and Hepatitis B (2nd) if not
given at birth. Option B (MMR, Varicella) is given at 12–15 months. Option C
(Tdap, HPV, Meningococcal) is for adolescents. Option D (Influenza) starts at 6
months; Hepatitis B (3rd dose) is at 6–18 months.
Q5. A 45-year-old male with a BMI of 32 and a sedentary lifestyle asks about
screening for diabetes. He has no symptoms. According to the ADA guidelines,
which of the following is the most appropriate recommendation?
A. No screening needed until age 50
B. Fasting plasma glucose (FPG) or HbA1c every 3 years
C. Oral glucose tolerance test (OGTT) annually
D. Screen only if he has a first-degree relative with diabetes
Answer: B
Rationale: The ADA recommends screening for prediabetes and type 2 diabetes in
all adults beginning at age 35. However, screening should be considered in adults
of any age with overweight/obesity (BMI ≥25) and one or more risk factors. This
patient has a BMI of 32 (obesity) and sedentary lifestyle. If results are normal,
repeat screening at a minimum of 3-year intervals. Option A is incorrect because
his BMI triggers earlier screening. Option C is excessive frequency. Option D is too
restrictive; BMI alone is a risk factor.
Q6. A 55-year-old female presents for a routine visit. She has no history of
cardiovascular disease. Her blood pressure is 128/78, and her ASCVD 10-year risk
is 12%. According to the ACC/AHA guidelines, what is the most appropriate
recommendation regarding statin therapy?
A. No statin therapy is indicated
B. Initiate high-intensity statin therapy
C. Initiate moderate-intensity statin therapy
D. Recommend lifestyle modifications only
, Answer: C
Rationale: For patients with an ASCVD 10-year risk of 7.5–19.9% (intermediate
risk), the ACC/AHA recommends initiating moderate-intensity statin therapy
after a clinician-patient risk discussion. This patient's risk is 12%, placing her in the
intermediate category. Option A is incorrect because risk >7.5%. Option B (high-
intensity) is for high-risk patients (ASCVD ≥20% or diabetes). Option D is
insufficient given her calculated risk.
Q7. A 70-year-old female presents for a wellness visit. She has no history of
osteoporosis but has multiple risk factors including menopause, low body weight,
and smoking. What is the most appropriate screening recommendation?
A. No screening needed unless she has a fracture
B. DEXA scan every 5 years
C. DEXA scan every 2 years
D. Bone turnover markers annually
Answer: B
Rationale: The USPSTF recommends DEXA screening for all women aged 65 and
older and for younger postmenopausal women with risk factors. For women with
normal results and no risk factors, repeat screening every 5 years (some
guidelines suggest up to 15 years for low-risk). Option A is incorrect because
screening is recommended. Option C is too frequent for normal results. Option D
(bone turnover markers) is not recommended for routine screening.
Q8. A 30-year-old female presents for her annual exam. She is sexually active with
one partner and has no history of abnormal Pap smears. According to the USPSTF,
what is the most appropriate cervical cancer screening recommendation?
A. No screening needed until age 35
B. Pap smear alone every 3 years
C. Pap smear + HPV co-testing every 5 years
D. HPV testing alone every 5 years
Practitioner Practice Questions, Answer
Rationales, Primary Care, Diagnosis,
Pharmacology, Health Promotion & Clinical
Management Study Guide
SECTION 1: HEALTH PROMOTION & DISEASE PREVENTION
Q1. A 50-year-old female with no risk factors asks when she should begin
colonoscopy screening for colorectal cancer. According to the USPSTF 2025/2026
guidelines, what is the most appropriate recommendation?
A. Begin at age 40
B. Begin at age 45
C. Begin at age 50
D. Begin at age 55
Answer: B
Rationale: The USPSTF updated its recommendation in 2021 to begin colorectal
cancer screening at age 45 for average-risk adults (previously 50). This was due to
the rising incidence of colorectal cancer in younger adults. Screening options
include colonoscopy every 10 years, FIT annually, or Cologuard every 3 years.
Option A is too early for average risk. Option C reflects the outdated guideline.
Option D is too late and would miss early detection opportunities.
Q2. A 65-year-old male with a 40-pack-year smoking history asks about lung
cancer screening. He currently smokes but is interested in quitting. What is the
most appropriate screening recommendation?
A. No screening is recommended for current smokers
B. Annual low-dose CT (LDCT) scan
,C. Annual chest X-ray
D. Sputum cytology every 2 years
Answer: B
Rationale: The USPSTF recommends annual low-dose CT (LDCT) for adults aged
50–80 who have a 20-pack-year smoking history and currently smoke or have quit
within the past 15 years. This patient meets criteria (65 years, 40-pack-year,
current smoker). Option A is incorrect because current smokers are eligible.
Option C (chest X-ray) is not recommended for screening. Option D (sputum
cytology) is not recommended as a screening tool.
Q3. A 35-year-old female presents for her annual well-woman exam. She has no
family history of breast cancer and no genetic mutations. When should the FNP
recommend she begin mammography screening?
A. Age 30
B. Age 35
C. Age 40
D. Age 50
Answer: C
Rationale: The USPSTF 2024/2025 recommendation states that average-risk
women should begin biennial mammography at age 40 and continue through age
74. The ACS also recommends starting at 40 but annually. Option A is too early for
average risk. Option B is not supported by major guidelines for average risk.
Option D reflects the older guideline and would delay detection.
Q4. A 2-month-old infant presents for a well-child visit. The mother reports the
baby is feeding well and has no acute issues. Which of the following vaccines
should the FNP administer at this visit?
A. DTaP, IPV, Hib, PCV13, Rotavirus (2nd dose)
B. MMR, Varicella, Hepatitis A
C. Tdap, HPV, Meningococcal
D. Influenza, Hepatitis B (3rd dose)
,Answer: A
Rationale: At 2 months, the CDC immunization schedule recommends: DTaP
(1st), IPV (1st), Hib (1st), PCV13 (1st), Rotavirus (1st), and Hepatitis B (2nd) if not
given at birth. Option B (MMR, Varicella) is given at 12–15 months. Option C
(Tdap, HPV, Meningococcal) is for adolescents. Option D (Influenza) starts at 6
months; Hepatitis B (3rd dose) is at 6–18 months.
Q5. A 45-year-old male with a BMI of 32 and a sedentary lifestyle asks about
screening for diabetes. He has no symptoms. According to the ADA guidelines,
which of the following is the most appropriate recommendation?
A. No screening needed until age 50
B. Fasting plasma glucose (FPG) or HbA1c every 3 years
C. Oral glucose tolerance test (OGTT) annually
D. Screen only if he has a first-degree relative with diabetes
Answer: B
Rationale: The ADA recommends screening for prediabetes and type 2 diabetes in
all adults beginning at age 35. However, screening should be considered in adults
of any age with overweight/obesity (BMI ≥25) and one or more risk factors. This
patient has a BMI of 32 (obesity) and sedentary lifestyle. If results are normal,
repeat screening at a minimum of 3-year intervals. Option A is incorrect because
his BMI triggers earlier screening. Option C is excessive frequency. Option D is too
restrictive; BMI alone is a risk factor.
Q6. A 55-year-old female presents for a routine visit. She has no history of
cardiovascular disease. Her blood pressure is 128/78, and her ASCVD 10-year risk
is 12%. According to the ACC/AHA guidelines, what is the most appropriate
recommendation regarding statin therapy?
A. No statin therapy is indicated
B. Initiate high-intensity statin therapy
C. Initiate moderate-intensity statin therapy
D. Recommend lifestyle modifications only
, Answer: C
Rationale: For patients with an ASCVD 10-year risk of 7.5–19.9% (intermediate
risk), the ACC/AHA recommends initiating moderate-intensity statin therapy
after a clinician-patient risk discussion. This patient's risk is 12%, placing her in the
intermediate category. Option A is incorrect because risk >7.5%. Option B (high-
intensity) is for high-risk patients (ASCVD ≥20% or diabetes). Option D is
insufficient given her calculated risk.
Q7. A 70-year-old female presents for a wellness visit. She has no history of
osteoporosis but has multiple risk factors including menopause, low body weight,
and smoking. What is the most appropriate screening recommendation?
A. No screening needed unless she has a fracture
B. DEXA scan every 5 years
C. DEXA scan every 2 years
D. Bone turnover markers annually
Answer: B
Rationale: The USPSTF recommends DEXA screening for all women aged 65 and
older and for younger postmenopausal women with risk factors. For women with
normal results and no risk factors, repeat screening every 5 years (some
guidelines suggest up to 15 years for low-risk). Option A is incorrect because
screening is recommended. Option C is too frequent for normal results. Option D
(bone turnover markers) is not recommended for routine screening.
Q8. A 30-year-old female presents for her annual exam. She is sexually active with
one partner and has no history of abnormal Pap smears. According to the USPSTF,
what is the most appropriate cervical cancer screening recommendation?
A. No screening needed until age 35
B. Pap smear alone every 3 years
C. Pap smear + HPV co-testing every 5 years
D. HPV testing alone every 5 years
