LEIK (AANP) FNP PRACTICE ACTUAL EXAM TEST
BANK QUESTIONS AND DETAILED ANSWERS / 640+
Q&A (A+ GUIDE SOLUTION)
• CORE DOMAINS *
• Health Assessment and Diagnostic Reasoning *
• Pathophysiology and Disease Management *
• Pharmacological and Non-Pharmacological Therapeutics*
• Health Promotion, Screening, and Disease Prevention*
• Legal, Ethical, and Professional Practice *
• Pediatric and Adolescent Care *
• Adult and Geriatric Primary Care *
• Women's and Men's Health *
• Mental Health and Behavioral Integration *
• Evidence-Informed Practice and Clinical Decision-Making*
• INTRODUCTION *
• The LEIK (AANP) FNP Practice Exam is the definitive study resource for
candidates preparing for the American Association of Nurse Practitioners
(AANP) Family Nurse Practitioner certification examination. This
comprehensive question bank, derived from Leik's FNP Certification
Intensive Review and aligned with the latest AANPCB blueprint, contains
over 640 exam-style questions with detailed, evidence-based rationales.
The AANP FNP-C exam consists of 150 multiple-choice questions (135
scored, 15 pretest) administered over 3 hours. The exam is organized into
four domains: Assess (32%), Diagnose (26.5%), Plan (26.5%), and Evaluate
, (15%), with content spanning patient age ranges from newborn through
older adult and knowledge areas including pathophysiology, therapeutics,
evidence-informed practice, and legal-ethical issues. Each question in this
test bank is designed to reinforce clinical reasoning, differential diagnosis,
and prioritization skills essential for autonomous primary care practice. *
NOTE REGARDING EXAM LENGTH: The requested 640-question assessment
exceeds the maximum output length possible in a single response. To maintain
the strict quality, originality, and formatting requirements you have specified, a
comprehensive representative section of 40 high-yield, exam-level questions is
provided below. This sample demonstrates the required structure, difficulty
distribution, and clinical depth across all four AANP domains. You may request
subsequent sections to build the full question bank incrementally.
SECTION ONE: QUESTIONS 1–40
1. A 72-year-old woman has been on hydrochlorothiazide 12.5 mg for many
years to control her Stage II hypertension. Her blood pressure (BP) at this visit is
168/96. She is currently complaining of pain on her right hip and on both knees.
She has increased her dose of ibuprofen (Motrin) from 400 mg 3 times day (TID)
to 800 mg TID. She is still in pain and would like something stronger. Which of
the following statements is TRUE regarding the increase in her ibuprofen dose?
A. The higher dose of ibuprofen will have a synergistic effect with
hydrochlorothiazide.
B. It will increase the antihypertensive effect of hydrochlorothiazide.
C. It inhibits the effect of renal prostaglandins and blunts the effectiveness of
the diuretic.
D. It will have no effect on blood pressure or diuretic effectiveness.
RATIONALE: NSAIDs and aspirin inhibit the vasodilatory effects of
prostaglandins, which predisposes the kidney to ischemia. NSAIDs and diuretics
can cause acute prerenal failure by decreasing renal blood flow. The ibuprofen is
blunting the effectiveness of the hydrochlorothiazide, contributing to her
elevated blood pressure. The nurse practitioner should consider discontinuing the
NSAID or adjusting the antihypertensive regimen.
,2. The best screening test for detecting and monitoring both hyperthyroidism
and hypothyroidism is:
A. The total T3-4
B. Thyroid-stimulating hormone (TSH)
C. Thyroid profile
D. Palpation of the thyroid gland
RATIONALE: The TSH is the most sensitive and specific screening test for
thyroid dysfunction. In primary hypothyroidism, the TSH will be elevated. In
primary hyperthyroidism, the TSH will be suppressed. The total T3-4 and thyroid
profile are less sensitive for screening purposes. Palpation is a physical exam
technique, not a laboratory screening test.
3. A 21-year-old woman has had urinary frequency and urgency for the past 2
days. She has also noticed scant vaginal discharge. A urine sample is sent for
urinalysis and culture. Which of the following additional findings would be most
suggestive of a diagnosis of pyelonephritis?
A. Bacteriuria
B. Leukocytosis
C. Microscopic hematuria
D. White blood cell casts
RATIONALE: Both upper (pyelonephritis) and lower (cystitis) urinary tract
infections can show hematuria, pyuria, and bacteriuria on urinalysis. However,
the presence of white blood cell (WBC) casts on urinalysis differentiates between
upper and lower UTIs and can confirm the diagnosis of pyelonephritis. This is
because WBC casts are formed only in renal tubules.
4. A 55-year-old man with type 2 diabetes mellitus presents with severe right
foot pain that started suddenly in the middle of the night after he had a steak
dinner with friends. Physical examination shows swelling and tenderness of the
first metatarsophalangeal joint. Joint aspiration is performed, and microscopic
findings from the synovial fluid reveal the presence of monosodium urate
crystals. Which of the following is the best initial treatment?
A. Allopurinol
B. Non-steroidal anti-inflammatory drugs (NSAIDs)
, C. Prednisone
D. Probenecid
RATIONALE: This patient has acute gouty arthritis confirmed by the presence
of monosodium urate crystals in the synovial fluid. The first-line treatment for an
acute gout flare is NSAIDs, colchicine, or corticosteroids. Allopurinol and
probenecid are used for chronic urate-lowering therapy and should not be
initiated during an acute flare as they can worsen symptoms.
5. All of the following patients are at higher risk for suicide EXCEPT:
A. A 66-year-old White male whose wife of 40 years recently died
B. A high school student with a history of bipolar disorder
C. A depressed 45-year-old female with family history of suicide
D. A 17-year-old teen who has only 1 close friend in school
RATIONALE: Risk factors for suicide include elderly white males (especially
after the death of a spouse), past history of suicide, family history of suicide, plans
for use of a lethal weapon, female gender (higher attempt rate), and personal
history of bipolar disorder or depression. Having only one close friend in school is
not a recognized high-risk factor for suicide.
6. A 70-year-old male patient complains of a bright red spot in his left eye for 2
days. He denies eye pain, visual changes, or headaches. He has a new onset of
cough from a recent viral upper respiratory infection. The only medicine he is on
is Bayer aspirin 1 tablet a day. Which of the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
D. Subconjunctival hemorrhage
RATIONALE: Subconjunctival hemorrhage is a benign disorder that occurs
from an increase in intraocular pressure that may be caused by coughing,
vomiting, forceful exertion, straining during a bowel movement, weight lifting, or
lifting a heavy object. It presents as a bright red spot on the sclera without pain or
vision changes.
7. What is the appropriate follow-up for this 70-year-old patient with
subconjunctival hemorrhage?
BANK QUESTIONS AND DETAILED ANSWERS / 640+
Q&A (A+ GUIDE SOLUTION)
• CORE DOMAINS *
• Health Assessment and Diagnostic Reasoning *
• Pathophysiology and Disease Management *
• Pharmacological and Non-Pharmacological Therapeutics*
• Health Promotion, Screening, and Disease Prevention*
• Legal, Ethical, and Professional Practice *
• Pediatric and Adolescent Care *
• Adult and Geriatric Primary Care *
• Women's and Men's Health *
• Mental Health and Behavioral Integration *
• Evidence-Informed Practice and Clinical Decision-Making*
• INTRODUCTION *
• The LEIK (AANP) FNP Practice Exam is the definitive study resource for
candidates preparing for the American Association of Nurse Practitioners
(AANP) Family Nurse Practitioner certification examination. This
comprehensive question bank, derived from Leik's FNP Certification
Intensive Review and aligned with the latest AANPCB blueprint, contains
over 640 exam-style questions with detailed, evidence-based rationales.
The AANP FNP-C exam consists of 150 multiple-choice questions (135
scored, 15 pretest) administered over 3 hours. The exam is organized into
four domains: Assess (32%), Diagnose (26.5%), Plan (26.5%), and Evaluate
, (15%), with content spanning patient age ranges from newborn through
older adult and knowledge areas including pathophysiology, therapeutics,
evidence-informed practice, and legal-ethical issues. Each question in this
test bank is designed to reinforce clinical reasoning, differential diagnosis,
and prioritization skills essential for autonomous primary care practice. *
NOTE REGARDING EXAM LENGTH: The requested 640-question assessment
exceeds the maximum output length possible in a single response. To maintain
the strict quality, originality, and formatting requirements you have specified, a
comprehensive representative section of 40 high-yield, exam-level questions is
provided below. This sample demonstrates the required structure, difficulty
distribution, and clinical depth across all four AANP domains. You may request
subsequent sections to build the full question bank incrementally.
SECTION ONE: QUESTIONS 1–40
1. A 72-year-old woman has been on hydrochlorothiazide 12.5 mg for many
years to control her Stage II hypertension. Her blood pressure (BP) at this visit is
168/96. She is currently complaining of pain on her right hip and on both knees.
She has increased her dose of ibuprofen (Motrin) from 400 mg 3 times day (TID)
to 800 mg TID. She is still in pain and would like something stronger. Which of
the following statements is TRUE regarding the increase in her ibuprofen dose?
A. The higher dose of ibuprofen will have a synergistic effect with
hydrochlorothiazide.
B. It will increase the antihypertensive effect of hydrochlorothiazide.
C. It inhibits the effect of renal prostaglandins and blunts the effectiveness of
the diuretic.
D. It will have no effect on blood pressure or diuretic effectiveness.
RATIONALE: NSAIDs and aspirin inhibit the vasodilatory effects of
prostaglandins, which predisposes the kidney to ischemia. NSAIDs and diuretics
can cause acute prerenal failure by decreasing renal blood flow. The ibuprofen is
blunting the effectiveness of the hydrochlorothiazide, contributing to her
elevated blood pressure. The nurse practitioner should consider discontinuing the
NSAID or adjusting the antihypertensive regimen.
,2. The best screening test for detecting and monitoring both hyperthyroidism
and hypothyroidism is:
A. The total T3-4
B. Thyroid-stimulating hormone (TSH)
C. Thyroid profile
D. Palpation of the thyroid gland
RATIONALE: The TSH is the most sensitive and specific screening test for
thyroid dysfunction. In primary hypothyroidism, the TSH will be elevated. In
primary hyperthyroidism, the TSH will be suppressed. The total T3-4 and thyroid
profile are less sensitive for screening purposes. Palpation is a physical exam
technique, not a laboratory screening test.
3. A 21-year-old woman has had urinary frequency and urgency for the past 2
days. She has also noticed scant vaginal discharge. A urine sample is sent for
urinalysis and culture. Which of the following additional findings would be most
suggestive of a diagnosis of pyelonephritis?
A. Bacteriuria
B. Leukocytosis
C. Microscopic hematuria
D. White blood cell casts
RATIONALE: Both upper (pyelonephritis) and lower (cystitis) urinary tract
infections can show hematuria, pyuria, and bacteriuria on urinalysis. However,
the presence of white blood cell (WBC) casts on urinalysis differentiates between
upper and lower UTIs and can confirm the diagnosis of pyelonephritis. This is
because WBC casts are formed only in renal tubules.
4. A 55-year-old man with type 2 diabetes mellitus presents with severe right
foot pain that started suddenly in the middle of the night after he had a steak
dinner with friends. Physical examination shows swelling and tenderness of the
first metatarsophalangeal joint. Joint aspiration is performed, and microscopic
findings from the synovial fluid reveal the presence of monosodium urate
crystals. Which of the following is the best initial treatment?
A. Allopurinol
B. Non-steroidal anti-inflammatory drugs (NSAIDs)
, C. Prednisone
D. Probenecid
RATIONALE: This patient has acute gouty arthritis confirmed by the presence
of monosodium urate crystals in the synovial fluid. The first-line treatment for an
acute gout flare is NSAIDs, colchicine, or corticosteroids. Allopurinol and
probenecid are used for chronic urate-lowering therapy and should not be
initiated during an acute flare as they can worsen symptoms.
5. All of the following patients are at higher risk for suicide EXCEPT:
A. A 66-year-old White male whose wife of 40 years recently died
B. A high school student with a history of bipolar disorder
C. A depressed 45-year-old female with family history of suicide
D. A 17-year-old teen who has only 1 close friend in school
RATIONALE: Risk factors for suicide include elderly white males (especially
after the death of a spouse), past history of suicide, family history of suicide, plans
for use of a lethal weapon, female gender (higher attempt rate), and personal
history of bipolar disorder or depression. Having only one close friend in school is
not a recognized high-risk factor for suicide.
6. A 70-year-old male patient complains of a bright red spot in his left eye for 2
days. He denies eye pain, visual changes, or headaches. He has a new onset of
cough from a recent viral upper respiratory infection. The only medicine he is on
is Bayer aspirin 1 tablet a day. Which of the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
D. Subconjunctival hemorrhage
RATIONALE: Subconjunctival hemorrhage is a benign disorder that occurs
from an increase in intraocular pressure that may be caused by coughing,
vomiting, forceful exertion, straining during a bowel movement, weight lifting, or
lifting a heavy object. It presents as a bright red spot on the sclera without pain or
vision changes.
7. What is the appropriate follow-up for this 70-year-old patient with
subconjunctival hemorrhage?
