COMPREHENSIVE ANCC FAMILY NURSE PRACTITIONER (FNP) EXAM 2
PRACTICE TEST: 100 QUESTIONS WITH BOLD ANSWERS AND DETAILED
EXPLANATIONS FOR RAPID REVIEW AND MASTERY OF CORE CLINICAL
CONCEPTS ACROSS ADULT, PEDIATRIC, WOMEN’S HEALTH, PRIMARY
CARE, AND ACUTE CARE TOPICS
Question 1
A 60-year-old patient presents with sudden onset of unilateral weakness and
slurred speech. What is the most appropriate first step?
A) MRI
B) CT scan without contrast
C) Administer aspirin
D) Start anticoagulation
Answer: B) CT scan without contrast
Explanation: Rapid non-contrast CT is first to differentiate ischemic vs
hemorrhagic stroke before initiating treatment.
Question 2
Which antihypertensive is first-line for a patient with chronic kidney disease and
proteinuria?
A) Calcium channel blocker
B) ACE inhibitor
C) Beta-blocker
D) Thiazide diuretic
Answer: B) ACE inhibitor
Explanation: ACE inhibitors reduce proteinuria and slow progression of CKD.
Question 3
,A 7-year-old child presents with fever, cough, and a “barking” cough. What is the
most likely diagnosis?
A) Epiglottitis
B) Croup (laryngotracheobronchitis)
C) Pneumonia
D) Bronchiolitis
Answer: B) Croup (laryngotracheobronchitis)
Explanation: Barking cough and stridor in a child are classic for viral croup.
Question 4
A patient with chronic COPD is short of breath. Which oxygen saturation is
considered hypoxemic and may need supplemental oxygen?
A) 92%
B) 94%
C) 88%
D) 95%
Answer: C) 88%
Explanation: SpO₂ ≤ 88% generally warrants supplemental oxygen in COPD
patients.
Question 5
A 30-year-old sexually active woman presents with malodorous vaginal discharge.
Wet mount shows clue cells. Most likely diagnosis?
A) Trichomoniasis
B) Bacterial vaginosis
C) Candidiasis
D) Gonorrhea
Answer: B) Bacterial vaginosis
Explanation: Clue cells on microscopy indicate BV. Trichomoniasis shows motile
protozoa; candidiasis shows hyphae.
,Question 6
Which lab value is most indicative of iron-deficiency anemia?
A) High ferritin, low TIBC
B) Low ferritin, high TIBC
C) Normal ferritin, low TIBC
D) High ferritin, high TIBC
Answer: B) Low ferritin, high TIBC
Explanation: Low ferritin indicates depleted iron stores; TIBC increases as the
body tries to capture more iron.
Question 7
A patient with type 2 diabetes presents with polyuria, polydipsia, and fruity breath.
Blood glucose: 550 mg/dL, pH 7.25. Diagnosis?
A) Hyperosmolar hyperglycemic state
B) Diabetic ketoacidosis
C) Hypoglycemia
D) Lactic acidosis
Answer: B) Diabetic ketoacidosis
Explanation: High glucose + acidosis + ketones → DKA. HHS usually has higher
glucose, no significant ketones, and milder acidosis.
Question 8
Which vaccine is recommended annually for adults?
A) Tdap
B) Influenza
C) MMR
D) Varicella
Answer: B) Influenza
Explanation: Influenza vaccine is updated yearly; Tdap is every 10 years.
, Question 9
A patient has hyperpigmented macules on the buccal mucosa and a family history
of colorectal cancer. Most likely syndrome?
A) Lynch syndrome
B) Peutz-Jeghers syndrome
C) Familial adenomatous polyposis
D) Gardner syndrome
Answer: B) Peutz-Jeghers syndrome
Explanation: Mucocutaneous pigmentation + GI polyps is classic.
Question 10
A patient with hypertension and heart failure with reduced ejection fraction
(HFrEF) should receive which drug class to improve mortality?
A) Beta-blocker
B) Calcium channel blocker
C) Thiazide diuretic
D) Loop diuretic
Answer: A) Beta-blocker
Explanation: Beta-blockers (e.g., carvedilol, metoprolol succinate) improve
survival in HFrEF. Diuretics relieve symptoms but don’t improve mortality.
Question 11
A 45-year-old patient presents with sudden onset chest pain radiating to the left
arm, sweating, and nausea. ECG shows ST-segment elevation in leads II, III, and
aVF. Which coronary artery is most likely involved?
A) Left anterior descending (LAD)
B) Right coronary artery (RCA)
C) Left circumflex (LCx)
D) Posterior descending artery
PRACTICE TEST: 100 QUESTIONS WITH BOLD ANSWERS AND DETAILED
EXPLANATIONS FOR RAPID REVIEW AND MASTERY OF CORE CLINICAL
CONCEPTS ACROSS ADULT, PEDIATRIC, WOMEN’S HEALTH, PRIMARY
CARE, AND ACUTE CARE TOPICS
Question 1
A 60-year-old patient presents with sudden onset of unilateral weakness and
slurred speech. What is the most appropriate first step?
A) MRI
B) CT scan without contrast
C) Administer aspirin
D) Start anticoagulation
Answer: B) CT scan without contrast
Explanation: Rapid non-contrast CT is first to differentiate ischemic vs
hemorrhagic stroke before initiating treatment.
Question 2
Which antihypertensive is first-line for a patient with chronic kidney disease and
proteinuria?
A) Calcium channel blocker
B) ACE inhibitor
C) Beta-blocker
D) Thiazide diuretic
Answer: B) ACE inhibitor
Explanation: ACE inhibitors reduce proteinuria and slow progression of CKD.
Question 3
,A 7-year-old child presents with fever, cough, and a “barking” cough. What is the
most likely diagnosis?
A) Epiglottitis
B) Croup (laryngotracheobronchitis)
C) Pneumonia
D) Bronchiolitis
Answer: B) Croup (laryngotracheobronchitis)
Explanation: Barking cough and stridor in a child are classic for viral croup.
Question 4
A patient with chronic COPD is short of breath. Which oxygen saturation is
considered hypoxemic and may need supplemental oxygen?
A) 92%
B) 94%
C) 88%
D) 95%
Answer: C) 88%
Explanation: SpO₂ ≤ 88% generally warrants supplemental oxygen in COPD
patients.
Question 5
A 30-year-old sexually active woman presents with malodorous vaginal discharge.
Wet mount shows clue cells. Most likely diagnosis?
A) Trichomoniasis
B) Bacterial vaginosis
C) Candidiasis
D) Gonorrhea
Answer: B) Bacterial vaginosis
Explanation: Clue cells on microscopy indicate BV. Trichomoniasis shows motile
protozoa; candidiasis shows hyphae.
,Question 6
Which lab value is most indicative of iron-deficiency anemia?
A) High ferritin, low TIBC
B) Low ferritin, high TIBC
C) Normal ferritin, low TIBC
D) High ferritin, high TIBC
Answer: B) Low ferritin, high TIBC
Explanation: Low ferritin indicates depleted iron stores; TIBC increases as the
body tries to capture more iron.
Question 7
A patient with type 2 diabetes presents with polyuria, polydipsia, and fruity breath.
Blood glucose: 550 mg/dL, pH 7.25. Diagnosis?
A) Hyperosmolar hyperglycemic state
B) Diabetic ketoacidosis
C) Hypoglycemia
D) Lactic acidosis
Answer: B) Diabetic ketoacidosis
Explanation: High glucose + acidosis + ketones → DKA. HHS usually has higher
glucose, no significant ketones, and milder acidosis.
Question 8
Which vaccine is recommended annually for adults?
A) Tdap
B) Influenza
C) MMR
D) Varicella
Answer: B) Influenza
Explanation: Influenza vaccine is updated yearly; Tdap is every 10 years.
, Question 9
A patient has hyperpigmented macules on the buccal mucosa and a family history
of colorectal cancer. Most likely syndrome?
A) Lynch syndrome
B) Peutz-Jeghers syndrome
C) Familial adenomatous polyposis
D) Gardner syndrome
Answer: B) Peutz-Jeghers syndrome
Explanation: Mucocutaneous pigmentation + GI polyps is classic.
Question 10
A patient with hypertension and heart failure with reduced ejection fraction
(HFrEF) should receive which drug class to improve mortality?
A) Beta-blocker
B) Calcium channel blocker
C) Thiazide diuretic
D) Loop diuretic
Answer: A) Beta-blocker
Explanation: Beta-blockers (e.g., carvedilol, metoprolol succinate) improve
survival in HFrEF. Diuretics relieve symptoms but don’t improve mortality.
Question 11
A 45-year-old patient presents with sudden onset chest pain radiating to the left
arm, sweating, and nausea. ECG shows ST-segment elevation in leads II, III, and
aVF. Which coronary artery is most likely involved?
A) Left anterior descending (LAD)
B) Right coronary artery (RCA)
C) Left circumflex (LCx)
D) Posterior descending artery
