1
ANCC FNP 600+ Questions Bank — CONSOLIDATED MASTER
DOCUMENT Verified UPDATED!!!!! Questions Bank with
Rationales | Pass Guarantee
All Questions and Organized by ANCC domain.
SECTION 1: ASSESSMENT DOMAIN
1.1 Cardiovascular Assessment
Q1. A 16-year-old male presents for a sports physical. He has a harsh
systolic ejection murmur at the left upper sternal border that increases
with Valsalva and decreases with squatting. What is the most likely
diagnosis?
A) Aortic stenosis
B) Hypertrophic cardiomyopathy
C) Mitral regurgitation
D) Ventricular septal defect
Correct Answer: B
Rationale: HCM murmur increases with Valsalva (decreased preload)
and decreases with squatting (increased preload). It is the leading
cause of sudden cardiac death in young athletes.
Q2. A 42-year-old female presents with palpitations and
lightheadedness. Her ECG shows an irregularly irregular rhythm with
, 2
no discernible P waves and a ventricular rate of 110 bpm. What is the
most important immediate assessment?
A) Complete blood count
B) TSH
C) Blood pressure and hemodynamic stability
D) Serum electrolytes
Correct Answer: C
Rationale: The ECG describes atrial fibrillation. Immediate
hemodynamic assessment determines whether urgent cardioversion
is needed.
Q3. A 58-year-old male with new-onset atrial fibrillation. Which finding
most strongly indicates the need for urgent cardioversion?
A) Heart rate of 110 bpm
B) BP 78/50 mmHg with altered mental status
C) Palpitations
D) Fatigue
Correct Answer: B
Rationale: Hemodynamic instability with atrial fibrillation requires
urgent synchronized cardioversion.
Q4. A 62-year-old male presents with acute tearing chest pain
radiating to the back. Which ECG finding is most consistent with
STEMI?
A) ST-segment depression
B) ST-segment elevation
C) T-wave inversion
D) Q waves
, 3
Correct Answer: B
Rationale: ST elevation is the hallmark of acute STEMI.
Q5. A 68-year-old male with a 40-pack-year smoking history presents
for a routine visit with no respiratory symptoms. Which screening is
most appropriate?
A) Low-dose CT chest
B) Chest X-ray
C) Pulmonary function tests
D) Sputum cytology
Correct Answer: A
Rationale: USPSTF recommends annual low-dose CT for adults
50–80 with 20-pack-year history who currently smoke or quit within
15 years.
1.2 Respiratory Assessment
Q6. A 45-year-old male presents with progressive exertional dyspnea
and chronic productive cough with a 30-pack-year smoking history.
Which finding is most consistent with COPD?
A) Inspiratory crackles at the bases
B) Prolonged expiratory phase with wheezing
C) Egophony over the right lower lobe
D) Dullness to percussion at the left base
Correct Answer: B
Rationale: Prolonged expiration with wheezing is a hallmark of
airflow obstruction in COPD.
, 4
Q7. A 68-year-old male with COPD, FEV1 45%. Which maintenance
therapy is preferred?
A) SABA alone
B) LAMA + LABA combination
C) ICS alone
D) Oral prednisone
Correct Answer: B
Rationale: LAMA + LABA is preferred for COPD with FEV1 <50% and
frequent exacerbations.
Q8. A 28-year-old female with asthma and nighttime symptoms. What
is the preferred controller medication?
A) SABA prn
B) Low-dose ICS
C) Montelukast
D) Theophylline
Correct Answer: B
Rationale: Low-dose ICS is first-line controller therapy for persistent
asthma.
1.3 Neurological Assessment
Q9. A 55-year-old male presents with sudden severe headache
described as "the worst of my life." What is the priority diagnostic test?
A) Lumbar puncture
B) Non-contrast CT head
C) MRI brain
D) EEG
ANCC FNP 600+ Questions Bank — CONSOLIDATED MASTER
DOCUMENT Verified UPDATED!!!!! Questions Bank with
Rationales | Pass Guarantee
All Questions and Organized by ANCC domain.
SECTION 1: ASSESSMENT DOMAIN
1.1 Cardiovascular Assessment
Q1. A 16-year-old male presents for a sports physical. He has a harsh
systolic ejection murmur at the left upper sternal border that increases
with Valsalva and decreases with squatting. What is the most likely
diagnosis?
A) Aortic stenosis
B) Hypertrophic cardiomyopathy
C) Mitral regurgitation
D) Ventricular septal defect
Correct Answer: B
Rationale: HCM murmur increases with Valsalva (decreased preload)
and decreases with squatting (increased preload). It is the leading
cause of sudden cardiac death in young athletes.
Q2. A 42-year-old female presents with palpitations and
lightheadedness. Her ECG shows an irregularly irregular rhythm with
, 2
no discernible P waves and a ventricular rate of 110 bpm. What is the
most important immediate assessment?
A) Complete blood count
B) TSH
C) Blood pressure and hemodynamic stability
D) Serum electrolytes
Correct Answer: C
Rationale: The ECG describes atrial fibrillation. Immediate
hemodynamic assessment determines whether urgent cardioversion
is needed.
Q3. A 58-year-old male with new-onset atrial fibrillation. Which finding
most strongly indicates the need for urgent cardioversion?
A) Heart rate of 110 bpm
B) BP 78/50 mmHg with altered mental status
C) Palpitations
D) Fatigue
Correct Answer: B
Rationale: Hemodynamic instability with atrial fibrillation requires
urgent synchronized cardioversion.
Q4. A 62-year-old male presents with acute tearing chest pain
radiating to the back. Which ECG finding is most consistent with
STEMI?
A) ST-segment depression
B) ST-segment elevation
C) T-wave inversion
D) Q waves
, 3
Correct Answer: B
Rationale: ST elevation is the hallmark of acute STEMI.
Q5. A 68-year-old male with a 40-pack-year smoking history presents
for a routine visit with no respiratory symptoms. Which screening is
most appropriate?
A) Low-dose CT chest
B) Chest X-ray
C) Pulmonary function tests
D) Sputum cytology
Correct Answer: A
Rationale: USPSTF recommends annual low-dose CT for adults
50–80 with 20-pack-year history who currently smoke or quit within
15 years.
1.2 Respiratory Assessment
Q6. A 45-year-old male presents with progressive exertional dyspnea
and chronic productive cough with a 30-pack-year smoking history.
Which finding is most consistent with COPD?
A) Inspiratory crackles at the bases
B) Prolonged expiratory phase with wheezing
C) Egophony over the right lower lobe
D) Dullness to percussion at the left base
Correct Answer: B
Rationale: Prolonged expiration with wheezing is a hallmark of
airflow obstruction in COPD.
, 4
Q7. A 68-year-old male with COPD, FEV1 45%. Which maintenance
therapy is preferred?
A) SABA alone
B) LAMA + LABA combination
C) ICS alone
D) Oral prednisone
Correct Answer: B
Rationale: LAMA + LABA is preferred for COPD with FEV1 <50% and
frequent exacerbations.
Q8. A 28-year-old female with asthma and nighttime symptoms. What
is the preferred controller medication?
A) SABA prn
B) Low-dose ICS
C) Montelukast
D) Theophylline
Correct Answer: B
Rationale: Low-dose ICS is first-line controller therapy for persistent
asthma.
1.3 Neurological Assessment
Q9. A 55-year-old male presents with sudden severe headache
described as "the worst of my life." What is the priority diagnostic test?
A) Lumbar puncture
B) Non-contrast CT head
C) MRI brain
D) EEG
