ANCC FNP EXAM VERSION 5 FAMILY NURSE PRACTITIONER 2026/2027 – 350 QUESTIONS AND
ANSWERS | 100% VERIFIED | DETAILED RATIONALES – PASS GUARANTEED – A+ GRADED
Course: ANCC FNP Family Nurse Practitioner Version 5 2026/2027 | 350 Questions Mixed: A=86 B=89 C=94 D=81 | 100%
Verified | Pass Guaranteed
TABLE OF CONTENT
1. I. Assessment & Physical Examination - HEENT, Cardiac, Respiratory, GI, GU, Musculoskeletal, Neuro
2. II. Health Promotion & Disease Prevention - USPSTF Screening Guidelines - Cervical, Breast, Prostate, Colorectal
3. III. Cardiovascular - HTN JNC 8, HF, Afib CHA2DS2-VASc, Chest Pain, Hyperlipidemia
4. IV. Respiratory - Asthma, COPD GOLD, Croup, Epiglottitis, Pneumonia, Centor Criteria Strep
5. V. Endocrine & Metabolic - DM2 Metformin, HHS vs DKA, Thyroid, PCOS Rotterdam, Obesity
6. VI. Pediatrics - Vaccines MMR Schedule, AOM Watchful Waiting, Lead Screening, Growth & Development
7. VII. Women's Health - Contraception OCP Contraindications, Menopause HRT, Pap Guidelines, STI Chlamydia Treatment
8. VIII. Geriatrics - Beers Criteria, Delirium vs Dementia, Polypharmacy, Falls
9. IX. Hematology & Anemia - Microcytic Differential Iron Deficiency vs Thalassemia, Labs
10. X. Genitourinary & Renal - UTI Uncomplicated First-Line, BPH, AKI, eGFR Metformin
11. XI. Psychiatric & Mental Health - Depression PHQ-9, Bipolar Maintenance, Anxiety, PHQ-9 Scoring
12. XII. Neurology - Headache, Seizures, Stroke, Dizziness
13. XIII. Musculoskeletal - Osteoarthritis, Rheumatoid, Back Pain, Gout
14. XIV. Pharmacology - Antibiotics, Antidepressants, Antihypertensives, Antidiabetics, Vaccines
15. XV. Practice Questions - 350 Verified Questions with Rationales - Each Question Asked Like Real ANCC Exam
16. XVI. Answer Key with Detailed Rationales & Guidelines JNC 8, GOLD, USPSTF, CDC
17. XVII. Study Guide - Currently Updated 2026/2027 - Pass Guaranteed - A+ Graded
,ANCC FNP EXAM - PRACTICE QUESTIONS - EACH QUESTION ASKED LIKE REAL EXAM - 350 QUESTIONS
Based on ANCC FNP Blueprint 2026/2027 - Assessment, Diagnosis, Planning, Evaluation - JNC 8, GOLD, USPSTF, CDC Guidelines. 100% Verified.
1. [FNP V5] COPD GOLD - when to add ICS?
A. All COPD
B. Frequent exacerbations >=2/year or 1 hospitalized, eosinophils >=300, or asthma-COPD overlap
C. Only mild
D. Never
Answer: B
Rationale: COPD add ICS if exacerbator phenotype, eosinophils high, or ACO.
2. [FNP V5] DM2 - metformin contraindication?
A. No renal check
B. eGFR <30 contraindicated, <45 caution, hold for contrast/AKI - lactic acidosis risk
C. eGFR 90 contraindicated
D. No contraindication
Answer: B
Rationale: Metformin eGFR <30 contraindicated, 30-45 max 1000mg, hold contrast.
3. [FNP V5] Heart failure - ACE cough switch to?
A. No switch
B. Double ACE
C. Stop all
D. ARB (losartan) - less cough, monitor K+/creatinine
Answer: D
Rationale: ACE cough -> ARB.
4. [FNP V5] Auscultation - S3 in 70yo with HF means?
A. Normal
B. Healthy athlete
C. Volume overload, HF exacerbation - assess weight, crackles, JVD, edema, BNP
D. No significance
Answer: C
Rationale: S3 in older adult = volume overload HF, not normal like in young athlete.
5. [FNP V5] UTI in elderly woman - uncomplicated - first-line?
A. IV antibiotics
B. No treatment
C. Cipro always
D. Nitrofurantoin or TMP-SMX if susceptible - avoid cipro first-line per guidelines
Answer: D
Rationale: Uncomplicated cystitis first-line nitrofurantoin or TMP-SMX if local resistance <20%.
6. [FNP V5] Anemia - microcytic differential?
A. Macrocytic only
B. Iron deficiency, thalassemia, anemia of chronic disease, lead - check ferritin, TIBC
C. No differential
D. B12 deficiency
Answer: B
Rationale: Microcytic: iron deficiency low ferritin high TIBC, thalassemia, ACD, sideroblastic.
7. [FNP V5] A 45yo with HTN, BP 160/95 on lisinopril. Next step per JNC 8?
A. Double lisinopril only
B. Add thiazide diuretic or CCB, assess adherence, diet, check BMP/K+
C. No action
D. Stop lisinopril
Answer: B
Rationale: JNC 8: If BP not at goal on ACE, add thiazide or CCB, check adherence, BMP for K+/creatinine.
8. [FNP V5] Hypothyroidism labs?
A. No labs
B. High T3 only
C. Low TSH high T4
D. High TSH low free T4 - primary, low TSH low T4 secondary
Answer: D
Rationale: Primary hypo high TSH low free T4.
9. [FNP V5] Bipolar mania - first-line maintenance?
, A. SSRI only
B. Benzos only
C. Lithium, valproate, atypical antipsychotic - monitor levels, kidney/thyroid/metabolic
D. No meds
Answer: C
Rationale: Bipolar maintenance lithium gold standard, valproate, atypicals.
10. [FNP V5] Heart failure - ACE cough switch to?
A. No switch
B. Double ACE
C. ARB (losartan) - less cough, monitor K+/creatinine
D. Stop all
Answer: C
Rationale: ACE cough -> ARB.
11. [FNP V5] STI - chlamydia treatment?
A. No treatment
B. No partner treatment
C. Only azithro
D. Doxycycline 100mg BID 7d first-line, or azithromycin - treat partners, retest 3 months
Answer: D
Rationale: Chlamydia doxycycline first-line 7d, partner treatment, retest 3mo.
12. [FNP V5] Auscultation - S3 in 70yo with HF means?
A. Volume overload, HF exacerbation - assess weight, crackles, JVD, edema, BNP
B. Normal
C. No significance
D. Healthy athlete
Answer: A
Rationale: S3 in older adult = volume overload HF, not normal like in young athlete.
13. [FNP V5] Afib - CHA2DS2-VASc when to anticoagulate?
A. Never
B. All afib no anticoag
C. Men >=2, Women >=3 anticoagulate, 1 men/2 women consider, 0 no - use DOAC or warfarin
D. Only valvular
Answer: C
Rationale: CHA2DS2-VASc guides anticoagulation.
14. [FNP V5] AOM in child - when to watchful waiting?
A. Age >6mo mild unilateral, age >2 mild bilateral can observe 48-72h if follow-up assured
B. All need antibiotics immediately
C. No observation ever
D. All observe
Answer: A
Rationale: AOM watchful waiting >6mo mild unilateral, >2y mild bilateral if follow-up.
15. [FNP V5] Pap screening guidelines USPSTF 2026?
A. Every year from age 18
B. Never screen
C. Every 5 years from 18
D. Age 21-29 cytology q3y, 30-65 HPV co-test q5y or cytology q3y, >65 stop if adequate prior
Answer: D
Rationale: USPSTF cervical: 21-29 cytology q3y, 30-65 co-test q5y or cytology q3y.
16. [FNP V5] Pap screening guidelines USPSTF 2026?
A. Never screen
B. Every year from age 18
C. Every 5 years from 18
D. Age 21-29 cytology q3y, 30-65 HPV co-test q5y or cytology q3y, >65 stop if adequate prior
Answer: D
Rationale: USPSTF cervical: 21-29 cytology q3y, 30-65 co-test q5y or cytology q3y.
17. [FNP V5] Geriatric - Beers criteria - avoid?
A. Metformin
B. Lisinopril
C. Acetaminophen
D. Meperidine, diphenhydramine, benzodiazepines, muscle relaxants - falls, cognitive
, Answer: D
Rationale: Beers avoid anticholinergics, benzos, meperidine, muscle relaxants in elderly.
18. [FNP V5] Depression screening - PHQ-9 score 20 means?
A. Minimal
B. Severe depression - PHQ-9 20-27 severe, assess suicide, consider therapy + SSRI + referral
C. Mild
D. No depression
Answer: B
Rationale: PHQ-9: 5-9 mild, 10-14 moderate, 15-19 mod-severe, 20-27 severe.
19. [FNP V5] Geriatric - delirium vs dementia?
A. Delirium acute fluctuating inattention, altered LOC, reversible cause - dementia chronic progressive memory, normal LOC
B. Both chronic
C. Same
D. Both acute
Answer: A
Rationale: Delirium acute fluctuating, dementia chronic progressive.
20. [FNP V5] STI - chlamydia treatment?
A. No treatment
B. Doxycycline 100mg BID 7d first-line, or azithromycin - treat partners, retest 3 months
C. Only azithro
D. No partner treatment
Answer: B
Rationale: Chlamydia doxycycline first-line 7d, partner treatment, retest 3mo.
21. [FNP V5] Depression screening - PHQ-9 score 20 means?
A. Mild
B. Severe depression - PHQ-9 20-27 severe, assess suicide, consider therapy + SSRI + referral
C. Minimal
D. No depression
Answer: B
Rationale: PHQ-9: 5-9 mild, 10-14 moderate, 15-19 mod-severe, 20-27 severe.
22. [FNP V5] Strep pharyngitis Centor criteria - which needs testing?
A. Centor 2-3 test with RADT, 4+ consider empiric + test - fever, tonsil exudates, tender anterior cervical nodes, no cough
B. No testing
C. All sore throats antibiotics
D. Cough present treat
Answer: A
Rationale: Centor: fever, exudates, anterior cervical nodes, no cough. 0-1 no test, 2-3 RADT, 4 empiric.
23. [FNP V5] Menopause - when to give HRT?
A. No HRT ever
B. Moderate-severe vasomotor symptoms, <60yo and <10y since menopause, no contraindication - lowest dose shortest duration
C. All women
D. All >60
Answer: B
Rationale: HRT for vasomotor symptoms <60 and <10y since menopause, no hx breast cancer/VTE.
24. [FNP V5] PCOS criteria Rotterdam?
A. 2 of 3: oligo/anovulation, hyperandrogenism clinical/lab, polycystic ovaries US - exclude other causes
B. One criteria
C. Only hyperandrogenism
D. Only US
Answer: A
Rationale: Rotterdam PCOS 2 of 3.
25. [FNP V5] Child vaccine - MMR schedule?
A. 12-15 months first, 4-6 years second
B. At 6 months
C. Only 1 dose
D. Birth
Answer: A
Rationale: MMR 12-15mo and 4-6y.
26. [FNP V5] AOM in child - when to watchful waiting?
A. All need antibiotics immediately
ANSWERS | 100% VERIFIED | DETAILED RATIONALES – PASS GUARANTEED – A+ GRADED
Course: ANCC FNP Family Nurse Practitioner Version 5 2026/2027 | 350 Questions Mixed: A=86 B=89 C=94 D=81 | 100%
Verified | Pass Guaranteed
TABLE OF CONTENT
1. I. Assessment & Physical Examination - HEENT, Cardiac, Respiratory, GI, GU, Musculoskeletal, Neuro
2. II. Health Promotion & Disease Prevention - USPSTF Screening Guidelines - Cervical, Breast, Prostate, Colorectal
3. III. Cardiovascular - HTN JNC 8, HF, Afib CHA2DS2-VASc, Chest Pain, Hyperlipidemia
4. IV. Respiratory - Asthma, COPD GOLD, Croup, Epiglottitis, Pneumonia, Centor Criteria Strep
5. V. Endocrine & Metabolic - DM2 Metformin, HHS vs DKA, Thyroid, PCOS Rotterdam, Obesity
6. VI. Pediatrics - Vaccines MMR Schedule, AOM Watchful Waiting, Lead Screening, Growth & Development
7. VII. Women's Health - Contraception OCP Contraindications, Menopause HRT, Pap Guidelines, STI Chlamydia Treatment
8. VIII. Geriatrics - Beers Criteria, Delirium vs Dementia, Polypharmacy, Falls
9. IX. Hematology & Anemia - Microcytic Differential Iron Deficiency vs Thalassemia, Labs
10. X. Genitourinary & Renal - UTI Uncomplicated First-Line, BPH, AKI, eGFR Metformin
11. XI. Psychiatric & Mental Health - Depression PHQ-9, Bipolar Maintenance, Anxiety, PHQ-9 Scoring
12. XII. Neurology - Headache, Seizures, Stroke, Dizziness
13. XIII. Musculoskeletal - Osteoarthritis, Rheumatoid, Back Pain, Gout
14. XIV. Pharmacology - Antibiotics, Antidepressants, Antihypertensives, Antidiabetics, Vaccines
15. XV. Practice Questions - 350 Verified Questions with Rationales - Each Question Asked Like Real ANCC Exam
16. XVI. Answer Key with Detailed Rationales & Guidelines JNC 8, GOLD, USPSTF, CDC
17. XVII. Study Guide - Currently Updated 2026/2027 - Pass Guaranteed - A+ Graded
,ANCC FNP EXAM - PRACTICE QUESTIONS - EACH QUESTION ASKED LIKE REAL EXAM - 350 QUESTIONS
Based on ANCC FNP Blueprint 2026/2027 - Assessment, Diagnosis, Planning, Evaluation - JNC 8, GOLD, USPSTF, CDC Guidelines. 100% Verified.
1. [FNP V5] COPD GOLD - when to add ICS?
A. All COPD
B. Frequent exacerbations >=2/year or 1 hospitalized, eosinophils >=300, or asthma-COPD overlap
C. Only mild
D. Never
Answer: B
Rationale: COPD add ICS if exacerbator phenotype, eosinophils high, or ACO.
2. [FNP V5] DM2 - metformin contraindication?
A. No renal check
B. eGFR <30 contraindicated, <45 caution, hold for contrast/AKI - lactic acidosis risk
C. eGFR 90 contraindicated
D. No contraindication
Answer: B
Rationale: Metformin eGFR <30 contraindicated, 30-45 max 1000mg, hold contrast.
3. [FNP V5] Heart failure - ACE cough switch to?
A. No switch
B. Double ACE
C. Stop all
D. ARB (losartan) - less cough, monitor K+/creatinine
Answer: D
Rationale: ACE cough -> ARB.
4. [FNP V5] Auscultation - S3 in 70yo with HF means?
A. Normal
B. Healthy athlete
C. Volume overload, HF exacerbation - assess weight, crackles, JVD, edema, BNP
D. No significance
Answer: C
Rationale: S3 in older adult = volume overload HF, not normal like in young athlete.
5. [FNP V5] UTI in elderly woman - uncomplicated - first-line?
A. IV antibiotics
B. No treatment
C. Cipro always
D. Nitrofurantoin or TMP-SMX if susceptible - avoid cipro first-line per guidelines
Answer: D
Rationale: Uncomplicated cystitis first-line nitrofurantoin or TMP-SMX if local resistance <20%.
6. [FNP V5] Anemia - microcytic differential?
A. Macrocytic only
B. Iron deficiency, thalassemia, anemia of chronic disease, lead - check ferritin, TIBC
C. No differential
D. B12 deficiency
Answer: B
Rationale: Microcytic: iron deficiency low ferritin high TIBC, thalassemia, ACD, sideroblastic.
7. [FNP V5] A 45yo with HTN, BP 160/95 on lisinopril. Next step per JNC 8?
A. Double lisinopril only
B. Add thiazide diuretic or CCB, assess adherence, diet, check BMP/K+
C. No action
D. Stop lisinopril
Answer: B
Rationale: JNC 8: If BP not at goal on ACE, add thiazide or CCB, check adherence, BMP for K+/creatinine.
8. [FNP V5] Hypothyroidism labs?
A. No labs
B. High T3 only
C. Low TSH high T4
D. High TSH low free T4 - primary, low TSH low T4 secondary
Answer: D
Rationale: Primary hypo high TSH low free T4.
9. [FNP V5] Bipolar mania - first-line maintenance?
, A. SSRI only
B. Benzos only
C. Lithium, valproate, atypical antipsychotic - monitor levels, kidney/thyroid/metabolic
D. No meds
Answer: C
Rationale: Bipolar maintenance lithium gold standard, valproate, atypicals.
10. [FNP V5] Heart failure - ACE cough switch to?
A. No switch
B. Double ACE
C. ARB (losartan) - less cough, monitor K+/creatinine
D. Stop all
Answer: C
Rationale: ACE cough -> ARB.
11. [FNP V5] STI - chlamydia treatment?
A. No treatment
B. No partner treatment
C. Only azithro
D. Doxycycline 100mg BID 7d first-line, or azithromycin - treat partners, retest 3 months
Answer: D
Rationale: Chlamydia doxycycline first-line 7d, partner treatment, retest 3mo.
12. [FNP V5] Auscultation - S3 in 70yo with HF means?
A. Volume overload, HF exacerbation - assess weight, crackles, JVD, edema, BNP
B. Normal
C. No significance
D. Healthy athlete
Answer: A
Rationale: S3 in older adult = volume overload HF, not normal like in young athlete.
13. [FNP V5] Afib - CHA2DS2-VASc when to anticoagulate?
A. Never
B. All afib no anticoag
C. Men >=2, Women >=3 anticoagulate, 1 men/2 women consider, 0 no - use DOAC or warfarin
D. Only valvular
Answer: C
Rationale: CHA2DS2-VASc guides anticoagulation.
14. [FNP V5] AOM in child - when to watchful waiting?
A. Age >6mo mild unilateral, age >2 mild bilateral can observe 48-72h if follow-up assured
B. All need antibiotics immediately
C. No observation ever
D. All observe
Answer: A
Rationale: AOM watchful waiting >6mo mild unilateral, >2y mild bilateral if follow-up.
15. [FNP V5] Pap screening guidelines USPSTF 2026?
A. Every year from age 18
B. Never screen
C. Every 5 years from 18
D. Age 21-29 cytology q3y, 30-65 HPV co-test q5y or cytology q3y, >65 stop if adequate prior
Answer: D
Rationale: USPSTF cervical: 21-29 cytology q3y, 30-65 co-test q5y or cytology q3y.
16. [FNP V5] Pap screening guidelines USPSTF 2026?
A. Never screen
B. Every year from age 18
C. Every 5 years from 18
D. Age 21-29 cytology q3y, 30-65 HPV co-test q5y or cytology q3y, >65 stop if adequate prior
Answer: D
Rationale: USPSTF cervical: 21-29 cytology q3y, 30-65 co-test q5y or cytology q3y.
17. [FNP V5] Geriatric - Beers criteria - avoid?
A. Metformin
B. Lisinopril
C. Acetaminophen
D. Meperidine, diphenhydramine, benzodiazepines, muscle relaxants - falls, cognitive
, Answer: D
Rationale: Beers avoid anticholinergics, benzos, meperidine, muscle relaxants in elderly.
18. [FNP V5] Depression screening - PHQ-9 score 20 means?
A. Minimal
B. Severe depression - PHQ-9 20-27 severe, assess suicide, consider therapy + SSRI + referral
C. Mild
D. No depression
Answer: B
Rationale: PHQ-9: 5-9 mild, 10-14 moderate, 15-19 mod-severe, 20-27 severe.
19. [FNP V5] Geriatric - delirium vs dementia?
A. Delirium acute fluctuating inattention, altered LOC, reversible cause - dementia chronic progressive memory, normal LOC
B. Both chronic
C. Same
D. Both acute
Answer: A
Rationale: Delirium acute fluctuating, dementia chronic progressive.
20. [FNP V5] STI - chlamydia treatment?
A. No treatment
B. Doxycycline 100mg BID 7d first-line, or azithromycin - treat partners, retest 3 months
C. Only azithro
D. No partner treatment
Answer: B
Rationale: Chlamydia doxycycline first-line 7d, partner treatment, retest 3mo.
21. [FNP V5] Depression screening - PHQ-9 score 20 means?
A. Mild
B. Severe depression - PHQ-9 20-27 severe, assess suicide, consider therapy + SSRI + referral
C. Minimal
D. No depression
Answer: B
Rationale: PHQ-9: 5-9 mild, 10-14 moderate, 15-19 mod-severe, 20-27 severe.
22. [FNP V5] Strep pharyngitis Centor criteria - which needs testing?
A. Centor 2-3 test with RADT, 4+ consider empiric + test - fever, tonsil exudates, tender anterior cervical nodes, no cough
B. No testing
C. All sore throats antibiotics
D. Cough present treat
Answer: A
Rationale: Centor: fever, exudates, anterior cervical nodes, no cough. 0-1 no test, 2-3 RADT, 4 empiric.
23. [FNP V5] Menopause - when to give HRT?
A. No HRT ever
B. Moderate-severe vasomotor symptoms, <60yo and <10y since menopause, no contraindication - lowest dose shortest duration
C. All women
D. All >60
Answer: B
Rationale: HRT for vasomotor symptoms <60 and <10y since menopause, no hx breast cancer/VTE.
24. [FNP V5] PCOS criteria Rotterdam?
A. 2 of 3: oligo/anovulation, hyperandrogenism clinical/lab, polycystic ovaries US - exclude other causes
B. One criteria
C. Only hyperandrogenism
D. Only US
Answer: A
Rationale: Rotterdam PCOS 2 of 3.
25. [FNP V5] Child vaccine - MMR schedule?
A. 12-15 months first, 4-6 years second
B. At 6 months
C. Only 1 dose
D. Birth
Answer: A
Rationale: MMR 12-15mo and 4-6y.
26. [FNP V5] AOM in child - when to watchful waiting?
A. All need antibiotics immediately
