AANP FNP CERTIFICATION EXAM STUDY
GUIDE 2026 – COMPLETE CONCEPT
REVIEW & PRACTICE MATERIALS (LATEST
EDITION)
1. A 65-year-old patient with hypertension and diabetes develops a dry, persistent
cough. Which medication is most likely causing this?
A. Lisinopril
B. Losartan
C. Amlodipine
D. HCTZ
Answer: A (ACE inhibitor-induced cough)
2. First-line therapy for uncomplicated hypertension in an African American patient?
A. ACE Inhibitor
B. Thiazide Diuretic or CCB
C. Beta-blocker
D. Alpha-blocker
Answer: B
3. Medication that requires monitoring of potassium and creatinine 1-2 weeks after
initiation or dose change?
A. Furosemide
B. Spironolactone
C. Metoprolol
D. Nitroglycerin
Answer: B (K+ sparing diuretic)
4. Preferred initial long-term control medication for persistent asthma?
A. SABA (albuterol)
B. Oral steroid
C. Inhaled corticosteroid (ICS)
D. Theophylline
Answer: C
,5. A patient on warfarin presents with an INR of 8.5, no bleeding. What is the
immediate management?
A. Give fresh frozen plasma
B. Give vitamin K orally
C. Hold warfarin, give vitamin K (oral or IV based on urgency), monitor
D. Increase warfarin dose
Answer: C
6. First-line antibiotic for community-acquired pneumonia in a healthy adult?
A. Azithromycin
B. Doxycycline or Respiratory Fluoroquinolone or Macrolide (depends on local resistance)
C. Amoxicillin-clavulanate
D. Cefdinir
Answer: B (Per current IDSA guidelines - often Doxycycline or Macrolide first-line)
7. Drug of choice for treating Trichomonas vaginalis?
A. Fluconazole
B. Clindamycin cream
C. Metronidazole or Tinidazole
D. Acyclovir
Answer: C
8. Which diabetes medication is associated with a risk of lactic acidosis and should be
avoided in renal/hepatic impairment?
A. SGLT2 inhibitor
B. DPP-4 inhibitor
C. Metformin
D. GLP-1 agonist
Answer: C
9. A patient on an SSRI presents with agitation, hyperthermia, tachycardia, and rigidity.
Suspect?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic crisis
D. Diabetic ketoacidosis
Answer: B
10. Medication used for opioid overdose reversal?
A. Flumazenil
,B. Naloxone
C. Naltrexone
D. Atropine
Answer: B
11. Which antibiotic class is contraindicated in pregnancy and children <8 due to tooth
discoloration?
A. Tetracyclines
B. Penicillins
C. Cephalosporins
D. Macrolides
Answer: A
12. First-line pharmacotherapy for Generalized Anxiety Disorder (GAD)?
A. Benzodiazepine (e.g., alprazolam)
B. SSRI/SNRI (e.g., sertraline, escitalopram)
C. Antipsychotic
D. Beta-blocker
Answer: B
13. Which statin has the highest myopathy risk and significant drug interactions?
A. Atorvastatin
B. Rosuvastatin
C. Simvastatin
D. Pravastatin
Answer: C
14. A patient with CHF exacerbation and reduced ejection fraction should be on which
core medication classes? (Select all)
A. Beta-blocker (carvedilol, metoprolol succinate)
B. ACEI/ARB/ARNI
C. MRA (spironolactone)
D. CCB
Answer: A, B, C
15. Topical medication of choice for scabies in adults?
A. Clotrimazole cream
B. Permethrin 5% cream
C. Ketoconazole cream
, D. Mupirocin ointment
Answer: B
DIAGNOSIS & ASSESSMENT (20 Qs)
16. A 50-year-old male with epigastric pain that improves with food. Most likely
diagnosis?
A. Gastric ulcer
B. Duodenal ulcer
C. GERD
D. Pancreatitis
Answer: B
17. Sudden, severe tearing back pain in a hypertensive patient. Suspect?
A. Renal colic
B. Pancreatitis
C. Aortic dissection
D. Myocardial infarction
Answer: C
18. Hutchinson’s sign (vesicle on tip of nose) indicates?
A. Impetigo
B. Basal cell carcinoma
C. Herpes Zoster Ophthalmicus
D. Melanoma
Answer: C
19. Most common cause of community-acquired pneumonia?
A. Haemophilus influenzae
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Legionella
Answer: B
20. A 30-year-old female with butterfly rash on face, joint pain, fever. Likely diagnosis?
A. Rheumatoid arthritis
B. Systemic Lupus Erythematosus (SLE)
C. Psoriasis
GUIDE 2026 – COMPLETE CONCEPT
REVIEW & PRACTICE MATERIALS (LATEST
EDITION)
1. A 65-year-old patient with hypertension and diabetes develops a dry, persistent
cough. Which medication is most likely causing this?
A. Lisinopril
B. Losartan
C. Amlodipine
D. HCTZ
Answer: A (ACE inhibitor-induced cough)
2. First-line therapy for uncomplicated hypertension in an African American patient?
A. ACE Inhibitor
B. Thiazide Diuretic or CCB
C. Beta-blocker
D. Alpha-blocker
Answer: B
3. Medication that requires monitoring of potassium and creatinine 1-2 weeks after
initiation or dose change?
A. Furosemide
B. Spironolactone
C. Metoprolol
D. Nitroglycerin
Answer: B (K+ sparing diuretic)
4. Preferred initial long-term control medication for persistent asthma?
A. SABA (albuterol)
B. Oral steroid
C. Inhaled corticosteroid (ICS)
D. Theophylline
Answer: C
,5. A patient on warfarin presents with an INR of 8.5, no bleeding. What is the
immediate management?
A. Give fresh frozen plasma
B. Give vitamin K orally
C. Hold warfarin, give vitamin K (oral or IV based on urgency), monitor
D. Increase warfarin dose
Answer: C
6. First-line antibiotic for community-acquired pneumonia in a healthy adult?
A. Azithromycin
B. Doxycycline or Respiratory Fluoroquinolone or Macrolide (depends on local resistance)
C. Amoxicillin-clavulanate
D. Cefdinir
Answer: B (Per current IDSA guidelines - often Doxycycline or Macrolide first-line)
7. Drug of choice for treating Trichomonas vaginalis?
A. Fluconazole
B. Clindamycin cream
C. Metronidazole or Tinidazole
D. Acyclovir
Answer: C
8. Which diabetes medication is associated with a risk of lactic acidosis and should be
avoided in renal/hepatic impairment?
A. SGLT2 inhibitor
B. DPP-4 inhibitor
C. Metformin
D. GLP-1 agonist
Answer: C
9. A patient on an SSRI presents with agitation, hyperthermia, tachycardia, and rigidity.
Suspect?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic crisis
D. Diabetic ketoacidosis
Answer: B
10. Medication used for opioid overdose reversal?
A. Flumazenil
,B. Naloxone
C. Naltrexone
D. Atropine
Answer: B
11. Which antibiotic class is contraindicated in pregnancy and children <8 due to tooth
discoloration?
A. Tetracyclines
B. Penicillins
C. Cephalosporins
D. Macrolides
Answer: A
12. First-line pharmacotherapy for Generalized Anxiety Disorder (GAD)?
A. Benzodiazepine (e.g., alprazolam)
B. SSRI/SNRI (e.g., sertraline, escitalopram)
C. Antipsychotic
D. Beta-blocker
Answer: B
13. Which statin has the highest myopathy risk and significant drug interactions?
A. Atorvastatin
B. Rosuvastatin
C. Simvastatin
D. Pravastatin
Answer: C
14. A patient with CHF exacerbation and reduced ejection fraction should be on which
core medication classes? (Select all)
A. Beta-blocker (carvedilol, metoprolol succinate)
B. ACEI/ARB/ARNI
C. MRA (spironolactone)
D. CCB
Answer: A, B, C
15. Topical medication of choice for scabies in adults?
A. Clotrimazole cream
B. Permethrin 5% cream
C. Ketoconazole cream
, D. Mupirocin ointment
Answer: B
DIAGNOSIS & ASSESSMENT (20 Qs)
16. A 50-year-old male with epigastric pain that improves with food. Most likely
diagnosis?
A. Gastric ulcer
B. Duodenal ulcer
C. GERD
D. Pancreatitis
Answer: B
17. Sudden, severe tearing back pain in a hypertensive patient. Suspect?
A. Renal colic
B. Pancreatitis
C. Aortic dissection
D. Myocardial infarction
Answer: C
18. Hutchinson’s sign (vesicle on tip of nose) indicates?
A. Impetigo
B. Basal cell carcinoma
C. Herpes Zoster Ophthalmicus
D. Melanoma
Answer: C
19. Most common cause of community-acquired pneumonia?
A. Haemophilus influenzae
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Legionella
Answer: B
20. A 30-year-old female with butterfly rash on face, joint pain, fever. Likely diagnosis?
A. Rheumatoid arthritis
B. Systemic Lupus Erythematosus (SLE)
C. Psoriasis
