ANCC FNP EXAM VERSION 2 FAMILY NURSE PRACTITIONER 2026/2027 – 350 QUESTIONS AND
ANSWERS | 100% VERIFIED | DETAILED RATIONALES – PASS GUARANTEED – A+ GRADED
Course: ANCC FNP Family Nurse Practitioner Version 2 2026/2027 | 350 Questions Mixed: A=95 B=76 C=89 D=90 | 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 V2] Bipolar mania - first-line maintenance?
A. Lithium, valproate, atypical antipsychotic - monitor levels, kidney/thyroid/metabolic
B. SSRI only
C. Benzos only
D. No meds
Answer: A
Rationale: Bipolar maintenance lithium gold standard, valproate, atypicals.
2. [FNP V2] DM2 - metformin contraindication?
A. eGFR <30 contraindicated, <45 caution, hold for contrast/AKI - lactic acidosis risk
B. No renal check
C. eGFR 90 contraindicated
D. No contraindication
Answer: A
Rationale: Metformin eGFR <30 contraindicated, 30-45 max 1000mg, hold contrast.
3. [FNP V2] Prostate screening PSA - shared decision?
A. All men screen
B. Age 55-69 shared decision per USPSTF, high risk black men or family hx consider earlier
C. No screening
D. Screen at 40 all
Answer: B
Rationale: PSA 55-69 shared decision.
4. [FNP V2] A 45yo with HTN, BP 160/95 on lisinopril. Next step per JNC 8?
A. Stop lisinopril
B. No action
C. Double lisinopril only
D. Add thiazide diuretic or CCB, assess adherence, diet, check BMP/K+
Answer: D
Rationale: JNC 8: If BP not at goal on ACE, add thiazide or CCB, check adherence, BMP for K+/creatinine.
5. [FNP V2] STI - chlamydia treatment?
A. Only azithro
B. Doxycycline 100mg BID 7d first-line, or azithromycin - treat partners, retest 3 months
C. No partner treatment
D. No treatment
Answer: B
Rationale: Chlamydia doxycycline first-line 7d, partner treatment, retest 3mo.
6. [FNP V2] Heart failure - ACE cough switch to?
A. Double ACE
B. ARB (losartan) - less cough, monitor K+/creatinine
C. Stop all
D. No switch
Answer: B
Rationale: ACE cough -> ARB.
7. [FNP V2] Child vaccine - MMR schedule?
A. 12-15 months first, 4-6 years second
B. Birth
C. At 6 months
D. Only 1 dose
Answer: A
Rationale: MMR 12-15mo and 4-6y.
8. [FNP V2] STI - chlamydia treatment?
A. Doxycycline 100mg BID 7d first-line, or azithromycin - treat partners, retest 3 months
B. Only azithro
C. No partner treatment
D. No treatment
Answer: A
Rationale: Chlamydia doxycycline first-line 7d, partner treatment, retest 3mo.
9. [FNP V2] Hypothyroidism labs?
, A. High T3 only
B. Low TSH high T4
C. High TSH low free T4 - primary, low TSH low T4 secondary
D. No labs
Answer: C
Rationale: Primary hypo high TSH low free T4.
10. [FNP V2] A 45yo with HTN, BP 160/95 on lisinopril. Next step per JNC 8?
A. Add thiazide diuretic or CCB, assess adherence, diet, check BMP/K+
B. No action
C. Stop lisinopril
D. Double lisinopril only
Answer: A
Rationale: JNC 8: If BP not at goal on ACE, add thiazide or CCB, check adherence, BMP for K+/creatinine.
11. [FNP V2] Geriatric - Beers criteria - avoid?
A. Metformin
B. Acetaminophen
C. Lisinopril
D. Meperidine, diphenhydramine, benzodiazepines, muscle relaxants - falls, cognitive
Answer: D
Rationale: Beers avoid anticholinergics, benzos, meperidine, muscle relaxants in elderly.
12. [FNP V2] AOM in child - when to watchful waiting?
A. All need antibiotics immediately
B. Age >6mo mild unilateral, age >2 mild bilateral can observe 48-72h if follow-up assured
C. All observe
D. No observation ever
Answer: B
Rationale: AOM watchful waiting >6mo mild unilateral, >2y mild bilateral if follow-up.
13. [FNP V2] Elderly with confusion, polyuria, polydipsia, glucose 600 - what?
A. DKA
B. Normal
C. Hypoglycemia
D. HHS - Hyperosmolar Hyperglycemic State, elderly, glucose >600, no ketosis, dehydration
Answer: D
Rationale: HHS: elderly type 2, glucose >600, hyperosmolar, dehydration, no ketosis, altered mental.
14. [FNP V2] Lead screening - when?
A. Risk assessment at 6,9,12,18,24mo and 3-6y, test if risk
B. Only adults
C. Only once
D. Never
Answer: A
Rationale: Lead risk assessment at well child visits.
15. [FNP V2] COPD GOLD - when to add ICS?
A. Only mild
B. Never
C. All COPD
D. Frequent exacerbations >=2/year or 1 hospitalized, eosinophils >=300, or asthma-COPD overlap
Answer: D
Rationale: COPD add ICS if exacerbator phenotype, eosinophils high, or ACO.
16. [FNP V2] AOM in child - when to watchful waiting?
A. All need antibiotics immediately
B. All observe
C. No observation ever
D. Age >6mo mild unilateral, age >2 mild bilateral can observe 48-72h if follow-up assured
Answer: D
Rationale: AOM watchful waiting >6mo mild unilateral, >2y mild bilateral if follow-up.
17. [FNP V2] Child with barky cough, inspiratory stridor worse at night - diagnosis?
A. Bronchiolitis
B. Epiglottitis
C. Asthma
D. Croup (laryngotracheobronchitis) - racemic epi, steroids, humidified air
, Answer: D
Rationale: Croup: barky cough, stridor, worse night, steeple sign. Treat racemic epi, dexamethasone.
18. [FNP V2] A 45yo with HTN, BP 160/95 on lisinopril. Next step per JNC 8?
A. No action
B. Stop lisinopril
C. Add thiazide diuretic or CCB, assess adherence, diet, check BMP/K+
D. Double lisinopril only
Answer: C
Rationale: JNC 8: If BP not at goal on ACE, add thiazide or CCB, check adherence, BMP for K+/creatinine.
19. [FNP V2] Geriatric - delirium vs dementia?
A. Both chronic
B. Delirium acute fluctuating inattention, altered LOC, reversible cause - dementia chronic progressive memory, normal LOC
C. Same
D. Both acute
Answer: B
Rationale: Delirium acute fluctuating, dementia chronic progressive.
20. [FNP V2] Child with barky cough, inspiratory stridor worse at night - diagnosis?
A. Epiglottitis
B. Croup (laryngotracheobronchitis) - racemic epi, steroids, humidified air
C. Asthma
D. Bronchiolitis
Answer: B
Rationale: Croup: barky cough, stridor, worse night, steeple sign. Treat racemic epi, dexamethasone.
21. [FNP V2] Heart failure - ACE cough switch to?
A. Double ACE
B. Stop all
C. ARB (losartan) - less cough, monitor K+/creatinine
D. No switch
Answer: C
Rationale: ACE cough -> ARB.
22. [FNP V2] COPD GOLD - when to add ICS?
A. Never
B. Frequent exacerbations >=2/year or 1 hospitalized, eosinophils >=300, or asthma-COPD overlap
C. All COPD
D. Only mild
Answer: B
Rationale: COPD add ICS if exacerbator phenotype, eosinophils high, or ACO.
23. [FNP V2] HTN emergency vs urgency?
A. No difference
B. Same
C. Emergency BP high + acute target organ damage - need IV, Urgency high BP no organ damage - oral meds, close f/u
D. Only emergency has high BP
Answer: C
Rationale: Emergency = organ damage (chest pain, neuro, AKI, pulmonary edema), Urgency = no organ damage.
24. [FNP V2] Hypothyroidism labs?
A. High T3 only
B. No labs
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.
25. [FNP V2] Bipolar mania - first-line maintenance?
A. Lithium, valproate, atypical antipsychotic - monitor levels, kidney/thyroid/metabolic
B. SSRI only
C. No meds
D. Benzos only
Answer: A
Rationale: Bipolar maintenance lithium gold standard, valproate, atypicals.
26. [FNP V2] Afib - CHA2DS2-VASc when to anticoagulate?
A. Men >=2, Women >=3 anticoagulate, 1 men/2 women consider, 0 no - use DOAC or warfarin
ANSWERS | 100% VERIFIED | DETAILED RATIONALES – PASS GUARANTEED – A+ GRADED
Course: ANCC FNP Family Nurse Practitioner Version 2 2026/2027 | 350 Questions Mixed: A=95 B=76 C=89 D=90 | 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 V2] Bipolar mania - first-line maintenance?
A. Lithium, valproate, atypical antipsychotic - monitor levels, kidney/thyroid/metabolic
B. SSRI only
C. Benzos only
D. No meds
Answer: A
Rationale: Bipolar maintenance lithium gold standard, valproate, atypicals.
2. [FNP V2] DM2 - metformin contraindication?
A. eGFR <30 contraindicated, <45 caution, hold for contrast/AKI - lactic acidosis risk
B. No renal check
C. eGFR 90 contraindicated
D. No contraindication
Answer: A
Rationale: Metformin eGFR <30 contraindicated, 30-45 max 1000mg, hold contrast.
3. [FNP V2] Prostate screening PSA - shared decision?
A. All men screen
B. Age 55-69 shared decision per USPSTF, high risk black men or family hx consider earlier
C. No screening
D. Screen at 40 all
Answer: B
Rationale: PSA 55-69 shared decision.
4. [FNP V2] A 45yo with HTN, BP 160/95 on lisinopril. Next step per JNC 8?
A. Stop lisinopril
B. No action
C. Double lisinopril only
D. Add thiazide diuretic or CCB, assess adherence, diet, check BMP/K+
Answer: D
Rationale: JNC 8: If BP not at goal on ACE, add thiazide or CCB, check adherence, BMP for K+/creatinine.
5. [FNP V2] STI - chlamydia treatment?
A. Only azithro
B. Doxycycline 100mg BID 7d first-line, or azithromycin - treat partners, retest 3 months
C. No partner treatment
D. No treatment
Answer: B
Rationale: Chlamydia doxycycline first-line 7d, partner treatment, retest 3mo.
6. [FNP V2] Heart failure - ACE cough switch to?
A. Double ACE
B. ARB (losartan) - less cough, monitor K+/creatinine
C. Stop all
D. No switch
Answer: B
Rationale: ACE cough -> ARB.
7. [FNP V2] Child vaccine - MMR schedule?
A. 12-15 months first, 4-6 years second
B. Birth
C. At 6 months
D. Only 1 dose
Answer: A
Rationale: MMR 12-15mo and 4-6y.
8. [FNP V2] STI - chlamydia treatment?
A. Doxycycline 100mg BID 7d first-line, or azithromycin - treat partners, retest 3 months
B. Only azithro
C. No partner treatment
D. No treatment
Answer: A
Rationale: Chlamydia doxycycline first-line 7d, partner treatment, retest 3mo.
9. [FNP V2] Hypothyroidism labs?
, A. High T3 only
B. Low TSH high T4
C. High TSH low free T4 - primary, low TSH low T4 secondary
D. No labs
Answer: C
Rationale: Primary hypo high TSH low free T4.
10. [FNP V2] A 45yo with HTN, BP 160/95 on lisinopril. Next step per JNC 8?
A. Add thiazide diuretic or CCB, assess adherence, diet, check BMP/K+
B. No action
C. Stop lisinopril
D. Double lisinopril only
Answer: A
Rationale: JNC 8: If BP not at goal on ACE, add thiazide or CCB, check adherence, BMP for K+/creatinine.
11. [FNP V2] Geriatric - Beers criteria - avoid?
A. Metformin
B. Acetaminophen
C. Lisinopril
D. Meperidine, diphenhydramine, benzodiazepines, muscle relaxants - falls, cognitive
Answer: D
Rationale: Beers avoid anticholinergics, benzos, meperidine, muscle relaxants in elderly.
12. [FNP V2] AOM in child - when to watchful waiting?
A. All need antibiotics immediately
B. Age >6mo mild unilateral, age >2 mild bilateral can observe 48-72h if follow-up assured
C. All observe
D. No observation ever
Answer: B
Rationale: AOM watchful waiting >6mo mild unilateral, >2y mild bilateral if follow-up.
13. [FNP V2] Elderly with confusion, polyuria, polydipsia, glucose 600 - what?
A. DKA
B. Normal
C. Hypoglycemia
D. HHS - Hyperosmolar Hyperglycemic State, elderly, glucose >600, no ketosis, dehydration
Answer: D
Rationale: HHS: elderly type 2, glucose >600, hyperosmolar, dehydration, no ketosis, altered mental.
14. [FNP V2] Lead screening - when?
A. Risk assessment at 6,9,12,18,24mo and 3-6y, test if risk
B. Only adults
C. Only once
D. Never
Answer: A
Rationale: Lead risk assessment at well child visits.
15. [FNP V2] COPD GOLD - when to add ICS?
A. Only mild
B. Never
C. All COPD
D. Frequent exacerbations >=2/year or 1 hospitalized, eosinophils >=300, or asthma-COPD overlap
Answer: D
Rationale: COPD add ICS if exacerbator phenotype, eosinophils high, or ACO.
16. [FNP V2] AOM in child - when to watchful waiting?
A. All need antibiotics immediately
B. All observe
C. No observation ever
D. Age >6mo mild unilateral, age >2 mild bilateral can observe 48-72h if follow-up assured
Answer: D
Rationale: AOM watchful waiting >6mo mild unilateral, >2y mild bilateral if follow-up.
17. [FNP V2] Child with barky cough, inspiratory stridor worse at night - diagnosis?
A. Bronchiolitis
B. Epiglottitis
C. Asthma
D. Croup (laryngotracheobronchitis) - racemic epi, steroids, humidified air
, Answer: D
Rationale: Croup: barky cough, stridor, worse night, steeple sign. Treat racemic epi, dexamethasone.
18. [FNP V2] A 45yo with HTN, BP 160/95 on lisinopril. Next step per JNC 8?
A. No action
B. Stop lisinopril
C. Add thiazide diuretic or CCB, assess adherence, diet, check BMP/K+
D. Double lisinopril only
Answer: C
Rationale: JNC 8: If BP not at goal on ACE, add thiazide or CCB, check adherence, BMP for K+/creatinine.
19. [FNP V2] Geriatric - delirium vs dementia?
A. Both chronic
B. Delirium acute fluctuating inattention, altered LOC, reversible cause - dementia chronic progressive memory, normal LOC
C. Same
D. Both acute
Answer: B
Rationale: Delirium acute fluctuating, dementia chronic progressive.
20. [FNP V2] Child with barky cough, inspiratory stridor worse at night - diagnosis?
A. Epiglottitis
B. Croup (laryngotracheobronchitis) - racemic epi, steroids, humidified air
C. Asthma
D. Bronchiolitis
Answer: B
Rationale: Croup: barky cough, stridor, worse night, steeple sign. Treat racemic epi, dexamethasone.
21. [FNP V2] Heart failure - ACE cough switch to?
A. Double ACE
B. Stop all
C. ARB (losartan) - less cough, monitor K+/creatinine
D. No switch
Answer: C
Rationale: ACE cough -> ARB.
22. [FNP V2] COPD GOLD - when to add ICS?
A. Never
B. Frequent exacerbations >=2/year or 1 hospitalized, eosinophils >=300, or asthma-COPD overlap
C. All COPD
D. Only mild
Answer: B
Rationale: COPD add ICS if exacerbator phenotype, eosinophils high, or ACO.
23. [FNP V2] HTN emergency vs urgency?
A. No difference
B. Same
C. Emergency BP high + acute target organ damage - need IV, Urgency high BP no organ damage - oral meds, close f/u
D. Only emergency has high BP
Answer: C
Rationale: Emergency = organ damage (chest pain, neuro, AKI, pulmonary edema), Urgency = no organ damage.
24. [FNP V2] Hypothyroidism labs?
A. High T3 only
B. No labs
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.
25. [FNP V2] Bipolar mania - first-line maintenance?
A. Lithium, valproate, atypical antipsychotic - monitor levels, kidney/thyroid/metabolic
B. SSRI only
C. No meds
D. Benzos only
Answer: A
Rationale: Bipolar maintenance lithium gold standard, valproate, atypicals.
26. [FNP V2] Afib - CHA2DS2-VASc when to anticoagulate?
A. Men >=2, Women >=3 anticoagulate, 1 men/2 women consider, 0 no - use DOAC or warfarin
