1
Family Nurse Practitioner Certification
Examination (FNP-C)
Questions 1–200 with detailed
explanations | ANCC & AANPCB Style
Practice | 100% Pass Guaranteed |
Graded A+
1. A 68-year-old male presents with palpitations and lightheadedness.
His pulse is irregularly irregular at 92 bpm. ECG reveals absence of P
waves with an irregularly irregular R-R interval. Based on the
CHA₂DS₂-VASc scoring system, the most critical next step in
evaluation is determining the need for:
A. Anticoagulation therapy based on stroke risk stratification
B. Immediate direct current cardioversion
C. Radiofrequency catheter ablation
D. Permanent pacemaker implantation
Correct Answer: A
Explanation: The CHA₂DS₂-VASc score stratifies stroke risk in atrial
fibrillation and guides anticoagulation decisions. Cardioversion is reserved
for hemodynamically unstable patients .
2. A 42-year-old female presents with fatigue, weight gain,
constipation, and cold intolerance. TSH is 68 mIU/L and free T4 is 0.3
, 2
ng/dL. Elevated anti-thyroid peroxidase antibodies most specifically
confirms:
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Iodine deficiency
Correct Answer: A
Explanation: Anti-TPO antibodies are the hallmark of Hashimoto
thyroiditis, an autoimmune destruction causing primary hypothyroidism .
3. A 55-year-old male with a 30-pack-year smoking history presents
with cough and dyspnea. Spirometry shows FEV1/FVC of 0.58 and
FEV1 of 62% predicted. Bronchodilator response is 8%. These findings
are most consistent with:
A. Moderate (GOLD Stage II) COPD
B. Mild persistent asthma
C. Severe (GOLD Stage III) COPD
D. Restrictive lung disease
Correct Answer: A
Explanation: FEV1/FVC <0.70 confirms obstruction; FEV1 60-79% is GOLD
Stage II. Response <12% distinguishes COPD from asthma .
, 3
4. A 65-year-old woman has LDL 200 mg/dL, HDL 30 mg/dL, and is a
smoker. Her mother died at age 40 from MI. In addition to lifestyle
changes, the most appropriate initial pharmacologic treatment is:
A. Bile acid sequestrant
B. Statin drug
C. Cholesterol absorption inhibitor
D. Low-dose aspirin
Correct Answer: B
Explanation: Statins are first-line for LDL ≥190 mg/dL and high-risk
primary prevention .
5. A 3-year-old presents with URI, fever 100.4°F, and nasal congestion.
The most appropriate treatment is:
A. Amoxicillin
B. Azithromycin
C. Supportive care with fluids and rest
D. Oseltamivir
Correct Answer: C
Explanation: Most URIs are viral; supportive care is standard unless
bacterial infection is suspected .
6. The most common sign of cervical cancer in a 45-year-old woman is:
A. Postcoital bleeding
B. Strong odor from vaginal discharge
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C. Itching in the vaginal area
D. Molluscum contagiosum
Correct Answer: A
Explanation: Postcoital bleeding is the most common presenting sign due
to friable neoplastic tissue .
7. A patient with type 2 diabetes reports neuropathic pain. Which
medication is most appropriate to initiate?
A. Azathioprine
B. Ibuprofen
C. Amitriptyline
D. Cyclophosphamide
Correct Answer: C
Explanation: Amitriptyline, a TCA, is first-line for neuropathic pain due to
nerve pain modulation .
8. A 28-year-old woman started St. John's wort. Which medication, if
taken concurrently, requires immediate discontinuation to avoid
serotonin syndrome?
A. Benadryl
B. Famotidine
C. Metformin
D. Sumatriptan
Family Nurse Practitioner Certification
Examination (FNP-C)
Questions 1–200 with detailed
explanations | ANCC & AANPCB Style
Practice | 100% Pass Guaranteed |
Graded A+
1. A 68-year-old male presents with palpitations and lightheadedness.
His pulse is irregularly irregular at 92 bpm. ECG reveals absence of P
waves with an irregularly irregular R-R interval. Based on the
CHA₂DS₂-VASc scoring system, the most critical next step in
evaluation is determining the need for:
A. Anticoagulation therapy based on stroke risk stratification
B. Immediate direct current cardioversion
C. Radiofrequency catheter ablation
D. Permanent pacemaker implantation
Correct Answer: A
Explanation: The CHA₂DS₂-VASc score stratifies stroke risk in atrial
fibrillation and guides anticoagulation decisions. Cardioversion is reserved
for hemodynamically unstable patients .
2. A 42-year-old female presents with fatigue, weight gain,
constipation, and cold intolerance. TSH is 68 mIU/L and free T4 is 0.3
, 2
ng/dL. Elevated anti-thyroid peroxidase antibodies most specifically
confirms:
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Iodine deficiency
Correct Answer: A
Explanation: Anti-TPO antibodies are the hallmark of Hashimoto
thyroiditis, an autoimmune destruction causing primary hypothyroidism .
3. A 55-year-old male with a 30-pack-year smoking history presents
with cough and dyspnea. Spirometry shows FEV1/FVC of 0.58 and
FEV1 of 62% predicted. Bronchodilator response is 8%. These findings
are most consistent with:
A. Moderate (GOLD Stage II) COPD
B. Mild persistent asthma
C. Severe (GOLD Stage III) COPD
D. Restrictive lung disease
Correct Answer: A
Explanation: FEV1/FVC <0.70 confirms obstruction; FEV1 60-79% is GOLD
Stage II. Response <12% distinguishes COPD from asthma .
, 3
4. A 65-year-old woman has LDL 200 mg/dL, HDL 30 mg/dL, and is a
smoker. Her mother died at age 40 from MI. In addition to lifestyle
changes, the most appropriate initial pharmacologic treatment is:
A. Bile acid sequestrant
B. Statin drug
C. Cholesterol absorption inhibitor
D. Low-dose aspirin
Correct Answer: B
Explanation: Statins are first-line for LDL ≥190 mg/dL and high-risk
primary prevention .
5. A 3-year-old presents with URI, fever 100.4°F, and nasal congestion.
The most appropriate treatment is:
A. Amoxicillin
B. Azithromycin
C. Supportive care with fluids and rest
D. Oseltamivir
Correct Answer: C
Explanation: Most URIs are viral; supportive care is standard unless
bacterial infection is suspected .
6. The most common sign of cervical cancer in a 45-year-old woman is:
A. Postcoital bleeding
B. Strong odor from vaginal discharge
, 4
C. Itching in the vaginal area
D. Molluscum contagiosum
Correct Answer: A
Explanation: Postcoital bleeding is the most common presenting sign due
to friable neoplastic tissue .
7. A patient with type 2 diabetes reports neuropathic pain. Which
medication is most appropriate to initiate?
A. Azathioprine
B. Ibuprofen
C. Amitriptyline
D. Cyclophosphamide
Correct Answer: C
Explanation: Amitriptyline, a TCA, is first-line for neuropathic pain due to
nerve pain modulation .
8. A 28-year-old woman started St. John's wort. Which medication, if
taken concurrently, requires immediate discontinuation to avoid
serotonin syndrome?
A. Benadryl
B. Famotidine
C. Metformin
D. Sumatriptan
