ANCC Family Nurse Practitioner (FNP) Full-
Actual Exam: 100 Questions with Answers and
Explanations
Overview:
This comprehensive 100-question practice exam is designed for FNP candidates preparing for
the ANCC Family Nurse Practitioner certification. Questions reflect the breadth of topics
covered on the exam, including:
Adult and Geriatric Primary Care: Cardiovascular, pulmonary, endocrine, GI, renal,
and musculoskeletal disorders.
Women’s Health: Reproductive health, pregnancy, and gynecological disorders.
Pediatrics: Growth, development, common pediatric illnesses, and preventive care.
Mental Health: Depression, anxiety, and psychiatric conditions.
Diagnostics and Screening: Laboratory interpretation, imaging, and preventive health
guidelines.
Pharmacology and Therapeutics: First-line medications, dosing considerations, and
adverse effects.
Acute and Chronic Care Management: Evidence-based interventions for common
acute and chronic conditions.
Question 1
A 32-year-old woman presents with dysuria, frequency, and urgency. Urinalysis
shows positive nitrites and leukocyte esterase. First-line treatment?
A) Ciprofloxacin
B) Nitrofurantoin
C) Amoxicillin
D) TMP alone
Answer: B) Nitrofurantoin
Explanation: Nitrofurantoin is first-line for uncomplicated urinary tract infections
in women.
,Question 2
A 60-year-old patient presents with fatigue, pallor, and spoon-shaped nails. Labs:
microcytic anemia. Most likely cause?
A) Vitamin B12 deficiency
B) Iron deficiency anemia
C) Thalassemia
D) Anemia of chronic disease
Answer: B) Iron deficiency anemia
Explanation: Microcytic anemia with fatigue and pallor, especially with spoon
nails, is classic for iron deficiency.
Question 3
Which vaccine is live attenuated and contraindicated in pregnancy?
A) Tdap
B) MMR
C) Hepatitis B
D) Inactivated influenza
Answer: B) MMR
Explanation: MMR is live; live vaccines should be avoided in pregnancy.
Question 4
A patient presents with acute onset fever, productive cough, and right lower lobe
consolidation on X-ray. Most likely pathogen?
A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Legionella pneumophila
,Answer: B) Streptococcus pneumoniae
Explanation: Sudden-onset fever, productive cough, and lobar consolidation are
classic for pneumococcal pneumonia.
Question 5
A patient presents with fatigue, constipation, and weight gain. Labs: elevated TSH,
normal free T4. Diagnosis?
A) Subclinical hypothyroidism
B) Overt hypothyroidism
C) Hyperthyroidism
D) Euthyroid sick syndrome
Answer: A) Subclinical hypothyroidism
Explanation: Elevated TSH with normal free T4 indicates subclinical
hypothyroidism.
Question 6
A patient presents with sudden-onset severe headache, nausea, vomiting, and neck
stiffness. Most urgent test?
A) MRI
B) Lumbar puncture
C) Non-contrast CT
D) Blood cultures
Answer: C) Non-contrast CT
Explanation: Sudden “worst headache of life” raises concern for subarachnoid
hemorrhage; non-contrast CT is first-line.
Question 7
, A 28-year-old woman presents with vaginal discharge, dysuria, and itching. Wet
mount shows motile, flagellated organisms. Diagnosis?
A) Bacterial vaginosis
B) Trichomoniasis
C) Candidiasis
D) Gonorrhea
Answer: B) Trichomoniasis
Explanation: Motile, flagellated protozoa on wet mount indicate Trichomonas
vaginalis.
Question 8
Which antihypertensive is first-line in pregnancy?
A) ACE inhibitor
B) Methyldopa
C) Lisinopril
D) ARB
Answer: B) Methyldopa
Explanation: Methyldopa is safe in pregnancy; ACE inhibitors and ARBs are
contraindicated.
Question 9
A patient presents with fatigue, pruritus, and jaundice. Labs: elevated ALP, GGT,
positive p-ANCA. Most likely diagnosis?
A) Primary biliary cholangitis
B) Primary sclerosing cholangitis
C) Autoimmune hepatitis
D) Hepatitis B
Actual Exam: 100 Questions with Answers and
Explanations
Overview:
This comprehensive 100-question practice exam is designed for FNP candidates preparing for
the ANCC Family Nurse Practitioner certification. Questions reflect the breadth of topics
covered on the exam, including:
Adult and Geriatric Primary Care: Cardiovascular, pulmonary, endocrine, GI, renal,
and musculoskeletal disorders.
Women’s Health: Reproductive health, pregnancy, and gynecological disorders.
Pediatrics: Growth, development, common pediatric illnesses, and preventive care.
Mental Health: Depression, anxiety, and psychiatric conditions.
Diagnostics and Screening: Laboratory interpretation, imaging, and preventive health
guidelines.
Pharmacology and Therapeutics: First-line medications, dosing considerations, and
adverse effects.
Acute and Chronic Care Management: Evidence-based interventions for common
acute and chronic conditions.
Question 1
A 32-year-old woman presents with dysuria, frequency, and urgency. Urinalysis
shows positive nitrites and leukocyte esterase. First-line treatment?
A) Ciprofloxacin
B) Nitrofurantoin
C) Amoxicillin
D) TMP alone
Answer: B) Nitrofurantoin
Explanation: Nitrofurantoin is first-line for uncomplicated urinary tract infections
in women.
,Question 2
A 60-year-old patient presents with fatigue, pallor, and spoon-shaped nails. Labs:
microcytic anemia. Most likely cause?
A) Vitamin B12 deficiency
B) Iron deficiency anemia
C) Thalassemia
D) Anemia of chronic disease
Answer: B) Iron deficiency anemia
Explanation: Microcytic anemia with fatigue and pallor, especially with spoon
nails, is classic for iron deficiency.
Question 3
Which vaccine is live attenuated and contraindicated in pregnancy?
A) Tdap
B) MMR
C) Hepatitis B
D) Inactivated influenza
Answer: B) MMR
Explanation: MMR is live; live vaccines should be avoided in pregnancy.
Question 4
A patient presents with acute onset fever, productive cough, and right lower lobe
consolidation on X-ray. Most likely pathogen?
A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Legionella pneumophila
,Answer: B) Streptococcus pneumoniae
Explanation: Sudden-onset fever, productive cough, and lobar consolidation are
classic for pneumococcal pneumonia.
Question 5
A patient presents with fatigue, constipation, and weight gain. Labs: elevated TSH,
normal free T4. Diagnosis?
A) Subclinical hypothyroidism
B) Overt hypothyroidism
C) Hyperthyroidism
D) Euthyroid sick syndrome
Answer: A) Subclinical hypothyroidism
Explanation: Elevated TSH with normal free T4 indicates subclinical
hypothyroidism.
Question 6
A patient presents with sudden-onset severe headache, nausea, vomiting, and neck
stiffness. Most urgent test?
A) MRI
B) Lumbar puncture
C) Non-contrast CT
D) Blood cultures
Answer: C) Non-contrast CT
Explanation: Sudden “worst headache of life” raises concern for subarachnoid
hemorrhage; non-contrast CT is first-line.
Question 7
, A 28-year-old woman presents with vaginal discharge, dysuria, and itching. Wet
mount shows motile, flagellated organisms. Diagnosis?
A) Bacterial vaginosis
B) Trichomoniasis
C) Candidiasis
D) Gonorrhea
Answer: B) Trichomoniasis
Explanation: Motile, flagellated protozoa on wet mount indicate Trichomonas
vaginalis.
Question 8
Which antihypertensive is first-line in pregnancy?
A) ACE inhibitor
B) Methyldopa
C) Lisinopril
D) ARB
Answer: B) Methyldopa
Explanation: Methyldopa is safe in pregnancy; ACE inhibitors and ARBs are
contraindicated.
Question 9
A patient presents with fatigue, pruritus, and jaundice. Labs: elevated ALP, GGT,
positive p-ANCA. Most likely diagnosis?
A) Primary biliary cholangitis
B) Primary sclerosing cholangitis
C) Autoimmune hepatitis
D) Hepatitis B
