1|Page
AANP FNP CERTIFICATION EXAM NEWEST 2025
TEST BANK| COMPLETE 350 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+| AANP FNP
CERTIFICATION EXAM REVIEW 2025 (BRAND NEW!!)
A patient with shortness of breath has suspected heart failure. What
diagnostic test would best help determine this?
a. Echocardiogram
b. B type natriuretic peptide (BNP)
c. EKG
d. Chest x-ray - Correct Answer - b. B type natriuretic peptide (BNP)
Rationale:
BNP is a hormone involved in regulation of blood pressure and fluid
volume. When the BNP level is 80 pg/mL or greater, the sensitivity and
specificity is 98% and 92%, favoring a diagnosis of heart failure.
Alternatively, BNP level less than 80 pg/mL strongly suggest that heart
failure is not present (some U.S. institutions use 100 pg/mL). Other
conditions may cause elevated BNP levels: thoracic and abdominal
surgery, renal failure, and subarachnoid hemorrhage. Consequently,
careful assessment of the patient is prudent. Echocardiograms
mechanically evaluate the heart and establish an ejection fraction. If
<35-40%, then CHF can usually be diagnosed. Ejection fractions do not
always correlate with patient symptoms. EKG evaluates the electrical
activity of the heart. Chest x-ray can indicate heart failure, but a BNP is
a more sensitive measure.
pg. 1
,2|Page
Which class of medication id frequently used to improve long-term
outcomes in patients with systolic dysfunction?
a. Loop diuretics
b. Calcium channel blockers
c. ACE inhibitors
d. Thiazide diuretics - Correct Answer - c. ACE inhibitors
Rationale:
ACE inhibitors are commonly used in patients with systolic dysfunction
because they reduce morbidity and mortality, i.e. these medications alter
prognosis. They also improve symptoms of fatigue, shortness of breath,
and exercise intolerance. Loop and thiazide diuretics improve
symptoms, but do not alter long-term prognosis with heart failure. Beta
blockers should be used in conjunction with ACE inhibitors and
diuretics, but not as solo agents. Beta blockers can potentially worsen
heart failure, so their use in patients with heart failure should be
monitored carefully.
Ramipril has been initiated at a low dose in a patient with heart failure.
What is most important to monitor in about one week?
a. Heart rate
b. Blood pressure
c. EKG
d. Potassium level - Correct Answer - d. Potassium level
Rationale:
ACE inhibitors work in the kidney in the renin angiotensin aldosterone
system and can impair renal excretion of potassium in patients with
normal kidney function. In patients with impaired renal blood flow
pg. 2
,3|Page
and/or function, the risk of hyperkalemia is increased. Common practice
is to monitor potassium, BUN, and Cr at about one week after initiation
of an ACE inhibitor and with each increase in dosage.
Which medication listed below could potentially exacerbate heart failure
in a susceptible individual?
a. Metoprolol
b. Furosemide
c. Metformin
d. Acetaminophen - Correct Answer - a. Metoprolol
Rationale:
Metoprolol is a cardioselective beta blocker that decreases heart rate. A
patient with heart failure wil compensate for heart failure by increasing
heart rate to maintain cardiac output (CO). Metoprolol impairs the
patient's ability to increase heart rate when needed to maintain cardiac
output (CO=stroke volume x heart rate). Consequently, the use of beta
blockers in patients with heart failure should be monitored carefully.
Furosemide may actually improve shortness of breath in a patient with
heart failure. Metformin and acetaminophen have no direct effect on
cardiac output on a patient with heart failure.
A 75-year-old patient with longstanding hypertension takes a
combination ACE inhibitor/thiazide diuretic and amlodipine daily. Today
his diastolic blood pressure and heart rate are elevated. He has
developed dyspnea on exertion and peripheral edema over the past
several days. These symptoms demonstrate:
a. primary renal dysfunction
pg. 3
, 4|Page
b. development of heart failure
c. failure of HCTZ
d. dietary indiscretions - Correct Answer - b. development of heart
failure
Rationale:
The symptoms of increased heart rate in the presence of dyspnea on
exertion and peripheral edema are symptoms of heart failure.
Longstanding hypertension is a major risk factor for development of
heart failure. Dietary indiscretion, like sodium/fluid excess may produce
peripheral edema, but should not produce dyspnea and peripheral edema
in the absence of heart failure.
A medication which may produce exercise intolerance in a patient with
hypertension is
a. hydrochlorothiazide
b. amlodipine
c. metoprolol
d. fosinopril - Correct Answer - c. metoprolol
Rationale:
Metoprolol is a cardioselective beta blocker. It will produce bradycardia
that is responsible for exercise intolerance. As a patient exercises,
concomitant increase in heart rate allows for an increase in cardiac
output. If the heart rate is not able to increase because of beta blocker
influence, neither can the cardiac output. The patient will necessarily
slow down his physical activity. Choices a and d have no direct effect on
heart rate. Amlodipine is a calcium channel blocker that does not
decrease heart rate.
pg. 4
AANP FNP CERTIFICATION EXAM NEWEST 2025
TEST BANK| COMPLETE 350 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+| AANP FNP
CERTIFICATION EXAM REVIEW 2025 (BRAND NEW!!)
A patient with shortness of breath has suspected heart failure. What
diagnostic test would best help determine this?
a. Echocardiogram
b. B type natriuretic peptide (BNP)
c. EKG
d. Chest x-ray - Correct Answer - b. B type natriuretic peptide (BNP)
Rationale:
BNP is a hormone involved in regulation of blood pressure and fluid
volume. When the BNP level is 80 pg/mL or greater, the sensitivity and
specificity is 98% and 92%, favoring a diagnosis of heart failure.
Alternatively, BNP level less than 80 pg/mL strongly suggest that heart
failure is not present (some U.S. institutions use 100 pg/mL). Other
conditions may cause elevated BNP levels: thoracic and abdominal
surgery, renal failure, and subarachnoid hemorrhage. Consequently,
careful assessment of the patient is prudent. Echocardiograms
mechanically evaluate the heart and establish an ejection fraction. If
<35-40%, then CHF can usually be diagnosed. Ejection fractions do not
always correlate with patient symptoms. EKG evaluates the electrical
activity of the heart. Chest x-ray can indicate heart failure, but a BNP is
a more sensitive measure.
pg. 1
,2|Page
Which class of medication id frequently used to improve long-term
outcomes in patients with systolic dysfunction?
a. Loop diuretics
b. Calcium channel blockers
c. ACE inhibitors
d. Thiazide diuretics - Correct Answer - c. ACE inhibitors
Rationale:
ACE inhibitors are commonly used in patients with systolic dysfunction
because they reduce morbidity and mortality, i.e. these medications alter
prognosis. They also improve symptoms of fatigue, shortness of breath,
and exercise intolerance. Loop and thiazide diuretics improve
symptoms, but do not alter long-term prognosis with heart failure. Beta
blockers should be used in conjunction with ACE inhibitors and
diuretics, but not as solo agents. Beta blockers can potentially worsen
heart failure, so their use in patients with heart failure should be
monitored carefully.
Ramipril has been initiated at a low dose in a patient with heart failure.
What is most important to monitor in about one week?
a. Heart rate
b. Blood pressure
c. EKG
d. Potassium level - Correct Answer - d. Potassium level
Rationale:
ACE inhibitors work in the kidney in the renin angiotensin aldosterone
system and can impair renal excretion of potassium in patients with
normal kidney function. In patients with impaired renal blood flow
pg. 2
,3|Page
and/or function, the risk of hyperkalemia is increased. Common practice
is to monitor potassium, BUN, and Cr at about one week after initiation
of an ACE inhibitor and with each increase in dosage.
Which medication listed below could potentially exacerbate heart failure
in a susceptible individual?
a. Metoprolol
b. Furosemide
c. Metformin
d. Acetaminophen - Correct Answer - a. Metoprolol
Rationale:
Metoprolol is a cardioselective beta blocker that decreases heart rate. A
patient with heart failure wil compensate for heart failure by increasing
heart rate to maintain cardiac output (CO). Metoprolol impairs the
patient's ability to increase heart rate when needed to maintain cardiac
output (CO=stroke volume x heart rate). Consequently, the use of beta
blockers in patients with heart failure should be monitored carefully.
Furosemide may actually improve shortness of breath in a patient with
heart failure. Metformin and acetaminophen have no direct effect on
cardiac output on a patient with heart failure.
A 75-year-old patient with longstanding hypertension takes a
combination ACE inhibitor/thiazide diuretic and amlodipine daily. Today
his diastolic blood pressure and heart rate are elevated. He has
developed dyspnea on exertion and peripheral edema over the past
several days. These symptoms demonstrate:
a. primary renal dysfunction
pg. 3
, 4|Page
b. development of heart failure
c. failure of HCTZ
d. dietary indiscretions - Correct Answer - b. development of heart
failure
Rationale:
The symptoms of increased heart rate in the presence of dyspnea on
exertion and peripheral edema are symptoms of heart failure.
Longstanding hypertension is a major risk factor for development of
heart failure. Dietary indiscretion, like sodium/fluid excess may produce
peripheral edema, but should not produce dyspnea and peripheral edema
in the absence of heart failure.
A medication which may produce exercise intolerance in a patient with
hypertension is
a. hydrochlorothiazide
b. amlodipine
c. metoprolol
d. fosinopril - Correct Answer - c. metoprolol
Rationale:
Metoprolol is a cardioselective beta blocker. It will produce bradycardia
that is responsible for exercise intolerance. As a patient exercises,
concomitant increase in heart rate allows for an increase in cardiac
output. If the heart rate is not able to increase because of beta blocker
influence, neither can the cardiac output. The patient will necessarily
slow down his physical activity. Choices a and d have no direct effect on
heart rate. Amlodipine is a calcium channel blocker that does not
decrease heart rate.
pg. 4
