Family Nurse Practitioner (FNP Exam) by ANCC
New Latest Version with All 175 Questions from
Actual Past Exams, Correct Answers and Rationale
Section 1: Assessment (Questions 1–18)
1. A 45-year-old female presents with fatigue, weight gain, and cold intolerance. What is
the most appropriate initial assessment tool?
A) Thyroid-stimulating hormone (TSH) level.
B) Complete blood count (CBC).
C) Electrocardiogram (ECG).
D) Chest X-ray. Correct Answer: A) Thyroid-stimulating hormone (TSH) level.
Rationale: Symptoms suggest hypothyroidism; TSH is the initial screening test per
American Thyroid Association guidelines. ANCC Domain 1: Assessment of endocrine
disorders in adults.
2. A 2-year-old child is brought in for a well-child visit. What is the recommended
screening for developmental milestones?
A) Ages and Stages Questionnaire (ASQ).
B) Denver Developmental Screening Test.
C) No screening needed.
D) Vision test only. Correct Answer: A) Ages and Stages Questionnaire (ASQ).
Rationale: ASQ is a standardized tool for assessing development in toddlers. ANCC
Domain 1: Pediatric developmental assessment.
3. An 80-year-old male reports chronic low back pain. What physical exam maneuver
assesses for lumbar radiculopathy?
A) Straight-leg raise test.
B) McMurray's test.
C) Phalen's test.
D) Tinel's test. Correct Answer: A) Straight-leg raise test.
Rationale: Positive straight-leg raise indicates nerve root irritation. ANCC Domain 1:
Musculoskeletal assessment in geriatrics.
4. A 25-year-old pregnant female at 12 weeks gestation presents for prenatal care. What is
the initial assessment for fetal viability?
A) Transvaginal ultrasound.
B) Urine hCG.
C) Serum progesterone.
D) No assessment needed. Correct Answer: A) Transvaginal ultrasound.
Rationale: Confirms intrauterine pregnancy and heartbeat. ANCC Domain 1: Obstetrical
assessment in early pregnancy.
5. A 10-year-old boy has recurrent ear infections. What is the appropriate diagnostic test?
A) Tympanometry.
B) Sinus X-ray.
C) Allergy testing.
D) CBC. Correct Answer: A) Tympanometry.
Rationale: Assesses middle ear function. ANCC Domain 1: Pediatric ENT assessment.
,6. A 55-year-old male with hypertension reports headaches. What initial assessment?
A) Fundoscopic exam for retinopathy.
B) ECG.
C) Lipid panel.
D) No exam needed. Correct Answer: A) Fundoscopic exam for retinopathy.
Rationale: Screens for end-organ damage. ANCC Domain 1: Cardiovascular assessment
in adults.
7. A 6-month-old infant has failure to thrive. What growth chart assessment?
A) Plot weight-for-length percentile.
B) Head circumference only.
C) No charting.
D) Height only. Correct Answer: A) Plot weight-for-length percentile.
Rationale: Identifies undernutrition. ANCC Domain 1: Infant growth assessment.
8. A 30-year-old female with dysuria. What physical exam finding?
A) Costovertebral angle tenderness.
B) Abdominal tenderness.
C) No exam.
D) Rectal exam. Correct Answer: A) Costovertebral angle tenderness.
Rationale: Suggests pyelonephritis. ANCC Domain 1: GU assessment in adults.
9. An adolescent with acne has scarring. What assessment for psychosocial impact?
A) Screen for depression using PHQ-9.
B) No screening.
C) Dermatology referral only.
D) Physical exam only. Correct Answer: A) Screen for depression using PHQ-9.
Rationale: Acne affects mental health. ANCC Domain 1: Dermatological assessment in
adolescents.
10. A 70-year-old with falls. What assessment tool?
A) Timed Up and Go (TUG) test.
B) No tool.
C) Vision test only.
D) BP only. Correct Answer: A) Timed Up and Go (TUG) test.
Rationale: Evaluates mobility. ANCC Domain 1: Geriatric fall risk assessment.
11. A newborn with jaundice. What initial assessment?
A) Transcutaneous bilirubin (TcB).
B) No assessment.
C) CBC.
D) Ultrasound. Correct Answer: A) Transcutaneous bilirubin (TcB).
Rationale: Non-invasive screening. ANCC Domain 1: Neonatal assessment.
12. A 40-year-old with abdominal pain. What exam for appendicitis?
A) McBurney's point tenderness.
B) No exam.
C) Rectal exam only.
D) Pelvic exam. Correct Answer: A) McBurney's point tenderness.
Rationale: Indicates inflammation. ANCC Domain 1: Abdominal assessment in adults.
13. A 15-year-old with irregular menses. What assessment?
A) Pregnancy test and hCG.
, B) No test.
C) Thyroid function.
D) All of the above. Correct Answer: D) All of the above.
Rationale: Differential diagnosis. ANCC Domain 1: Adolescent gynecology.
14. A 50-year-old with dyspnea. What lung exam?
A) Auscultation for wheezes.
B) No exam.
C) Abdominal exam only.
D) Rectal exam. Correct Answer: A) Auscultation for wheezes.
Rationale: Assesses respiratory function. ANCC Domain 1: Pulmonary assessment.
15. A toddler with rash. What assessment for measles?
A) Koplik spots in mouth.
B) No assessment.
C) CBC.
D) Allergy test. Correct Answer: A) Koplik spots in mouth.
Rationale: Pathognomonic sign. ANCC Domain 1: Pediatric dermatology.
16. A 60-year-old with memory loss. What screening?
A) Mini-Mental State Examination (MMSE).
B) No screening.
C) Vision test only.
D) Hearing test. Correct Answer: A) Mini-Mental State Examination (MMSE).
Rationale: Cognitive assessment. ANCC Domain 1: Geriatric neuro assessment.
17. A pregnant female at 28 weeks with edema. What assessment?
A) Check for proteinuria.
B) No check.
C) BP only.
D) Ultrasound. Correct Answer: A) Check for proteinuria.
Rationale: Screens for preeclampsia. ANCC Domain 1: Obstetrical assessment.
18. A 20-year-old with knee pain. What exam?
A) Lachman test for ACL.
B) No exam.
C) X-ray only.
D) MRI. Correct Answer: A) Lachman test for ACL.
Rationale: Assesses stability. ANCC Domain 1: Musculoskeletal assessment.
Section 2: Diagnosis (Questions 19–50)
19. A 35-year-old male with fatigue and polyuria. What diagnosis?
A) Type 2 diabetes mellitus.
B) Hypothyroidism.
C) Anemia.
D) Depression.
Correct Answer: A) Type 2 diabetes mellitus.
Rationale: Classic symptoms with risk factors. ANCC Domain 2: Endocrine diagnosis in adults.
20. A 5-year-old with fever and sore throat. What rapid test?
A) Strep antigen test.
B) Influenza test.
C) COVID test.
New Latest Version with All 175 Questions from
Actual Past Exams, Correct Answers and Rationale
Section 1: Assessment (Questions 1–18)
1. A 45-year-old female presents with fatigue, weight gain, and cold intolerance. What is
the most appropriate initial assessment tool?
A) Thyroid-stimulating hormone (TSH) level.
B) Complete blood count (CBC).
C) Electrocardiogram (ECG).
D) Chest X-ray. Correct Answer: A) Thyroid-stimulating hormone (TSH) level.
Rationale: Symptoms suggest hypothyroidism; TSH is the initial screening test per
American Thyroid Association guidelines. ANCC Domain 1: Assessment of endocrine
disorders in adults.
2. A 2-year-old child is brought in for a well-child visit. What is the recommended
screening for developmental milestones?
A) Ages and Stages Questionnaire (ASQ).
B) Denver Developmental Screening Test.
C) No screening needed.
D) Vision test only. Correct Answer: A) Ages and Stages Questionnaire (ASQ).
Rationale: ASQ is a standardized tool for assessing development in toddlers. ANCC
Domain 1: Pediatric developmental assessment.
3. An 80-year-old male reports chronic low back pain. What physical exam maneuver
assesses for lumbar radiculopathy?
A) Straight-leg raise test.
B) McMurray's test.
C) Phalen's test.
D) Tinel's test. Correct Answer: A) Straight-leg raise test.
Rationale: Positive straight-leg raise indicates nerve root irritation. ANCC Domain 1:
Musculoskeletal assessment in geriatrics.
4. A 25-year-old pregnant female at 12 weeks gestation presents for prenatal care. What is
the initial assessment for fetal viability?
A) Transvaginal ultrasound.
B) Urine hCG.
C) Serum progesterone.
D) No assessment needed. Correct Answer: A) Transvaginal ultrasound.
Rationale: Confirms intrauterine pregnancy and heartbeat. ANCC Domain 1: Obstetrical
assessment in early pregnancy.
5. A 10-year-old boy has recurrent ear infections. What is the appropriate diagnostic test?
A) Tympanometry.
B) Sinus X-ray.
C) Allergy testing.
D) CBC. Correct Answer: A) Tympanometry.
Rationale: Assesses middle ear function. ANCC Domain 1: Pediatric ENT assessment.
,6. A 55-year-old male with hypertension reports headaches. What initial assessment?
A) Fundoscopic exam for retinopathy.
B) ECG.
C) Lipid panel.
D) No exam needed. Correct Answer: A) Fundoscopic exam for retinopathy.
Rationale: Screens for end-organ damage. ANCC Domain 1: Cardiovascular assessment
in adults.
7. A 6-month-old infant has failure to thrive. What growth chart assessment?
A) Plot weight-for-length percentile.
B) Head circumference only.
C) No charting.
D) Height only. Correct Answer: A) Plot weight-for-length percentile.
Rationale: Identifies undernutrition. ANCC Domain 1: Infant growth assessment.
8. A 30-year-old female with dysuria. What physical exam finding?
A) Costovertebral angle tenderness.
B) Abdominal tenderness.
C) No exam.
D) Rectal exam. Correct Answer: A) Costovertebral angle tenderness.
Rationale: Suggests pyelonephritis. ANCC Domain 1: GU assessment in adults.
9. An adolescent with acne has scarring. What assessment for psychosocial impact?
A) Screen for depression using PHQ-9.
B) No screening.
C) Dermatology referral only.
D) Physical exam only. Correct Answer: A) Screen for depression using PHQ-9.
Rationale: Acne affects mental health. ANCC Domain 1: Dermatological assessment in
adolescents.
10. A 70-year-old with falls. What assessment tool?
A) Timed Up and Go (TUG) test.
B) No tool.
C) Vision test only.
D) BP only. Correct Answer: A) Timed Up and Go (TUG) test.
Rationale: Evaluates mobility. ANCC Domain 1: Geriatric fall risk assessment.
11. A newborn with jaundice. What initial assessment?
A) Transcutaneous bilirubin (TcB).
B) No assessment.
C) CBC.
D) Ultrasound. Correct Answer: A) Transcutaneous bilirubin (TcB).
Rationale: Non-invasive screening. ANCC Domain 1: Neonatal assessment.
12. A 40-year-old with abdominal pain. What exam for appendicitis?
A) McBurney's point tenderness.
B) No exam.
C) Rectal exam only.
D) Pelvic exam. Correct Answer: A) McBurney's point tenderness.
Rationale: Indicates inflammation. ANCC Domain 1: Abdominal assessment in adults.
13. A 15-year-old with irregular menses. What assessment?
A) Pregnancy test and hCG.
, B) No test.
C) Thyroid function.
D) All of the above. Correct Answer: D) All of the above.
Rationale: Differential diagnosis. ANCC Domain 1: Adolescent gynecology.
14. A 50-year-old with dyspnea. What lung exam?
A) Auscultation for wheezes.
B) No exam.
C) Abdominal exam only.
D) Rectal exam. Correct Answer: A) Auscultation for wheezes.
Rationale: Assesses respiratory function. ANCC Domain 1: Pulmonary assessment.
15. A toddler with rash. What assessment for measles?
A) Koplik spots in mouth.
B) No assessment.
C) CBC.
D) Allergy test. Correct Answer: A) Koplik spots in mouth.
Rationale: Pathognomonic sign. ANCC Domain 1: Pediatric dermatology.
16. A 60-year-old with memory loss. What screening?
A) Mini-Mental State Examination (MMSE).
B) No screening.
C) Vision test only.
D) Hearing test. Correct Answer: A) Mini-Mental State Examination (MMSE).
Rationale: Cognitive assessment. ANCC Domain 1: Geriatric neuro assessment.
17. A pregnant female at 28 weeks with edema. What assessment?
A) Check for proteinuria.
B) No check.
C) BP only.
D) Ultrasound. Correct Answer: A) Check for proteinuria.
Rationale: Screens for preeclampsia. ANCC Domain 1: Obstetrical assessment.
18. A 20-year-old with knee pain. What exam?
A) Lachman test for ACL.
B) No exam.
C) X-ray only.
D) MRI. Correct Answer: A) Lachman test for ACL.
Rationale: Assesses stability. ANCC Domain 1: Musculoskeletal assessment.
Section 2: Diagnosis (Questions 19–50)
19. A 35-year-old male with fatigue and polyuria. What diagnosis?
A) Type 2 diabetes mellitus.
B) Hypothyroidism.
C) Anemia.
D) Depression.
Correct Answer: A) Type 2 diabetes mellitus.
Rationale: Classic symptoms with risk factors. ANCC Domain 2: Endocrine diagnosis in adults.
20. A 5-year-old with fever and sore throat. What rapid test?
A) Strep antigen test.
B) Influenza test.
C) COVID test.
