FNP ANCC BOARDS EXAM 2025 PREPARE WITH CONFIDENCE
USING THE LATEST EXAM QUESTIONS AND DETAILED RATIONALES—
DESIGNED TO REFLECT THE CURRENT EXAM AND SUPPORT YOUR
SUCCESS.
Which type of vaccine boosts immune response better? conjugate vs. polysaccharide - correct
answer✔✔ conjugate (example: prevnar)
Live attenuated (weaned) vaccines - correct answer✔✔ MMR, Varicella and intranasal Flu-mist.
Zostavax is also live. Shingrix is NOT live.
When is rotavirus vaccine contraindicated? - correct answer✔✔ SCID (severe combined
immunodeficiency) or hx intussusception
Precautions after rotavirus - correct answer✔✔ hand washing!; viral shed in stool in first week post-
vaccination
Shingrix: timing and dosing - correct answer✔✔ =/> 50 y/o, 2 doses, 2nd dose two to six months after
1st dose.
Under age 50 y/o gets shingles; think immunocompromise vs. stress.
What month does the CDC release a new vaccination schedule each year? - correct answer✔✔ Feb
What s/s are associated with leukemia? - correct answer✔✔ fever, wt loss, fatigue, bone pain,
bleeding, bruising.
,What bloodwork should be obtained in suspected leukemia? - correct answer✔✔ WBCs >20,000
(think through common causes of leukocytosis: infection, stress, inflammation) --> get a peripheral
smear (AKA manual diff)
if WBCs >20,000 and with associated anemia; thrombocytopenia; thrombocytosis; enlarged liver, spleen,
or lymph nodes; or constitutional symptoms.
Which 2 chronic childhood diagnoses are associated with ALL and AML? - correct answer✔✔ Downs
syndrome and neurofibromatosis
What are 3 main risk factors for leukemia - correct answer✔✔ radiation (equivalent to 2 to 3 CTs),
toxin /household pesticide exposure in utero/early childhood.
Acute Leukemia: ALL or AML cancer and symptoms/PE findings - correct answer✔✔ 2 types: Acute
Lymphoblastic Leukemia or Acute Myelogenous Leukemia.
BLASTs on peripheral smear/bone aspiration in both ALL and AML.
AML also presents with
Auer rods on peripheral smear.
Acute leukemia can also present with leukopenia, combined with anemia or thrombocytopenia
Children: fever, lethargy, bleeding, potentially spinal or long bone pain. enlarged spleen, liver,
lymphandenopathy.
Adults (typically young): fever, fatigue, wt loss. May have anemia related symptoms (chest pain, SOB)
Chronic Leukemia - correct answer✔✔ Presents in adulthood. predominant cell is mature but does
not function normally, CML (chronic myelogenous leukemia) and CLL (chronic lymphocytic leukemia)
, Look for hepatosplenomegaly and splenomegaly. ; some adults are asymptomatic. WBCs 20,000 to
100,000
Which type of leukemia presents with the Philadelphia chromosome (BCR-ABL1 fusion gene)? - correct
answer✔✔ Chronic myelogenous leukemia
Which type of leukemia is most likely to present in older adults >/= 65y/o? - correct answer✔✔ CLL
(chronic lymphocytic leukemia)
In suspected leukemia, what lab work other than CBC should you obtain? - correct answer✔✔ Serum
electrolyte and creatinine levels, LFTs, and coagulation studies.
If the patient appears ill or is febrile, the physician should evaluate for infection with urinalysis, urine
culture, blood cultures, and chest radiography.
The next step in diagnosis involves a peripheral blood smear and usually a bone marrow specimen (an
aspirate or core biopsy).
Normal results for TIBC are... - correct answer✔✔ 250 to 450 mcg/dL for men and women.
A normal platelet count ranges - correct answer✔✔ 150,000 to 450,000 platelets per microliter of
blood.
Non-Hodgkin's Lymphoma (NHL) s/s - correct answer✔✔ enlarged lymph nodes, fatigue, weight loss
and fever
More than 67 types of non-Hodgkin lymphoma; more common than Hodgkins.
Impacts lymphocytes. Most cases present >/= 55 y/o, can present in children. typically diagnosed at a
later stage than non-hodgkins, NO Reed-Sternberg cells are identified.
USING THE LATEST EXAM QUESTIONS AND DETAILED RATIONALES—
DESIGNED TO REFLECT THE CURRENT EXAM AND SUPPORT YOUR
SUCCESS.
Which type of vaccine boosts immune response better? conjugate vs. polysaccharide - correct
answer✔✔ conjugate (example: prevnar)
Live attenuated (weaned) vaccines - correct answer✔✔ MMR, Varicella and intranasal Flu-mist.
Zostavax is also live. Shingrix is NOT live.
When is rotavirus vaccine contraindicated? - correct answer✔✔ SCID (severe combined
immunodeficiency) or hx intussusception
Precautions after rotavirus - correct answer✔✔ hand washing!; viral shed in stool in first week post-
vaccination
Shingrix: timing and dosing - correct answer✔✔ =/> 50 y/o, 2 doses, 2nd dose two to six months after
1st dose.
Under age 50 y/o gets shingles; think immunocompromise vs. stress.
What month does the CDC release a new vaccination schedule each year? - correct answer✔✔ Feb
What s/s are associated with leukemia? - correct answer✔✔ fever, wt loss, fatigue, bone pain,
bleeding, bruising.
,What bloodwork should be obtained in suspected leukemia? - correct answer✔✔ WBCs >20,000
(think through common causes of leukocytosis: infection, stress, inflammation) --> get a peripheral
smear (AKA manual diff)
if WBCs >20,000 and with associated anemia; thrombocytopenia; thrombocytosis; enlarged liver, spleen,
or lymph nodes; or constitutional symptoms.
Which 2 chronic childhood diagnoses are associated with ALL and AML? - correct answer✔✔ Downs
syndrome and neurofibromatosis
What are 3 main risk factors for leukemia - correct answer✔✔ radiation (equivalent to 2 to 3 CTs),
toxin /household pesticide exposure in utero/early childhood.
Acute Leukemia: ALL or AML cancer and symptoms/PE findings - correct answer✔✔ 2 types: Acute
Lymphoblastic Leukemia or Acute Myelogenous Leukemia.
BLASTs on peripheral smear/bone aspiration in both ALL and AML.
AML also presents with
Auer rods on peripheral smear.
Acute leukemia can also present with leukopenia, combined with anemia or thrombocytopenia
Children: fever, lethargy, bleeding, potentially spinal or long bone pain. enlarged spleen, liver,
lymphandenopathy.
Adults (typically young): fever, fatigue, wt loss. May have anemia related symptoms (chest pain, SOB)
Chronic Leukemia - correct answer✔✔ Presents in adulthood. predominant cell is mature but does
not function normally, CML (chronic myelogenous leukemia) and CLL (chronic lymphocytic leukemia)
, Look for hepatosplenomegaly and splenomegaly. ; some adults are asymptomatic. WBCs 20,000 to
100,000
Which type of leukemia presents with the Philadelphia chromosome (BCR-ABL1 fusion gene)? - correct
answer✔✔ Chronic myelogenous leukemia
Which type of leukemia is most likely to present in older adults >/= 65y/o? - correct answer✔✔ CLL
(chronic lymphocytic leukemia)
In suspected leukemia, what lab work other than CBC should you obtain? - correct answer✔✔ Serum
electrolyte and creatinine levels, LFTs, and coagulation studies.
If the patient appears ill or is febrile, the physician should evaluate for infection with urinalysis, urine
culture, blood cultures, and chest radiography.
The next step in diagnosis involves a peripheral blood smear and usually a bone marrow specimen (an
aspirate or core biopsy).
Normal results for TIBC are... - correct answer✔✔ 250 to 450 mcg/dL for men and women.
A normal platelet count ranges - correct answer✔✔ 150,000 to 450,000 platelets per microliter of
blood.
Non-Hodgkin's Lymphoma (NHL) s/s - correct answer✔✔ enlarged lymph nodes, fatigue, weight loss
and fever
More than 67 types of non-Hodgkin lymphoma; more common than Hodgkins.
Impacts lymphocytes. Most cases present >/= 55 y/o, can present in children. typically diagnosed at a
later stage than non-hodgkins, NO Reed-Sternberg cells are identified.
