2025 AANP FNP CERTIFICATION EXAM 200+
QUESTIONS AND CORRECT ANSWERS (ALREADY
GRADED A+) | LATEST EDITION | PROFESSOR
VERIFIED
Introduction
This 2025 AANP Family Nurse Practitioner certification simulation delivers 200+
original, high-fidelity items aligned to the current AANP test blueprint.
Domains mirror national competencies:
• Health promotion & disease prevention
• Advanced assessment & diagnosis
• Pharmacologic & non-pharmacologic management
• Acute, chronic, pediatric, geriatric, & women’s health
• Professional, ethical, & regulatory practice
Content reflects 2025 evidence-based guidelines (USPSTF, CDC, AHA, ADA, AAP, ACOG,
Beers, etc.) and is constructed for mastery-level preparation; no items are reproduced
from proprietary AANP materials.
Question 1
A 16-year-old female presents with 3-week history of knee pain and swelling after
starting running season. Examination reveals diffuse, non-erythematous swelling and
tenderness with a ballotable patella. No systemic symptoms. Radiographs are
unremarkable. Which is the MOST likely diagnosis?
A. Osgood-Schlatter disease
B. Patellofemoral pain syndrome
C. Juvenile idiopathic arthritis
D. Osteochondritis dissecans
Answer: B. Patellofemoral pain syndrome
Solution: Adolescent female, insidious onset with activity (running), diffuse peripatellar
pain, and ballotable effusion without bony changes typify patellofemoral pain. Osgood-
Schlatter (A) shows tibial tubercle tenderness and apophysitis; JIA (C) would involve
morning stiffness and ≥6-week duration; OCD (D) causes focal pain and possible loose
body.
pg. 1
,Question 2
A 58-year-old man with HTN, DM, and 30-pack-year smoking history reports 4-week
history of exertional left-arm pain that resolves within 5 minutes of rest. Vital signs
stable, BMI 29, BP 136/82. ECG normal. Which initial diagnostic test is MOST
appropriate?
A. Coronary CT angiography
B. Stress echocardiography
C. Resting transthoracic echo
D. High-sensitivity troponin I
Answer: B. Stress echocardiography
Solution: Intermediate pre-test probability of CAD (multiple risk factors, typical angina)
→ functional stress testing first-line in stable patient. CTA (A) is anatomical and
reasonable but not superior for ischemia detection; resting echo (C) and troponin (D)
assess infarction/structure, not inducible ischemia.
Question 3
A 32-year-old G2P1 at 10 weeks’ gestation reports intense vulvar itching, especially at
night. Examination reveals excoriated erythematous skin; no lesions or discharge.
Which is the MOST appropriate next step?
A. Oral fluconazole 150 mg once
B. Topical clotrimazole for 7 days
C. Permethrin 5% cream to entire body
D. 10% povidone-iodine wash
Answer: C. Permethrin 5% cream to entire body
Solution: Nocturnal pruritus with excoriations is classic for scabies (Sarcoptes).
Permethrin is first-line in pregnancy. Fluconazole/clotrimazole treat candidiasis, usually
with thick discharge and erythema; iodine wash has no role.
Question 4
A 4-day-old exclusively breastfed infant presents with poor feeding, jaundice (TcB 18
mg/dL), and weight loss of 9% from birth. Labs: total bilirubin 19 mg/dL (indirect 17.5),
Na 142, K 5.1, Cl 104, glucose 52 mg/dL. Which is the MOST likely diagnosis?
A. Breast milk jaundice
B. ABO incompatibility
C. Dehydration with insufficient intake
D. Biliary atresia
Answer: C. Dehydration with insufficient intake
Solution: >7% weight loss, high indirect bilirubin, low-normal glucose, and poor
feeding indicate inadequate milk transfer ( starvation jaundice). Breast-milk jaundice
pg. 2
,(A) occurs later (day 5–7) without significant weight loss; ABO (B) shows positive direct
Coombs; biliary atresia (D) presents with direct/conjugated hyperbilirubinemia.
Question 5
A 77-year-old woman with Alzheimer’s (MMSE 18/30) lives with daughter who
manages medications. BP 158/88, HR 78. Current meds: metoprolol 50 mg BID,
donepezil 10 mg daily, ASA 81 mg. Which is the MOST appropriate BP goal?
A. <130/80 mmHg
B. <140/90 mmHg
C. <150/90 mmHg
D. SBP 100–120 mmHg
Answer: C. <150/90 mmHg
Solution: Per 2025 Beers & AHA, adults ≥65 with dementia or limited life expectancy
benefit from relaxed targets to avoid hypotension and falls; SBP <150 mmHg acceptable.
Intensive targets (<130/80) offer no additional benefit and increase harm.
Question 6
A 24-year-old man with asthma uses budesonide-formoterol 160/4.5 2 puffs BID and
albuterol PRN (3×/week). ACT score 22. Which action is BEST?
A. Add LAMA
B. Increase ICS-formoterol to 4 puffs BID
C. Continue current therapy; asthma well-controlled
D. Step down to low-dose ICS only
Answer: C. Continue current therapy; asthma well-controlled
Solution: ACT ≥20 and rescue use ≤2×/week indicate good control; no need to escalate.
Step-down (D) risks loss of control.
Question 7
A 16-month-old has had watery diarrhea for 10 days, 4–5 stools/day, no blood, thriving,
no fever. Stool reduces with fasting. Which is the MOST likely cause?
A. Rotavirus
B. Lactose overload
C. Celiac disease
D. Shigella
Answer: B. Lactose overload
Solution: Chronic watery non-bloody diarrhea that improves with fasting (reducing
substrate) suggests osmotic diarrhea—commonly lactose. Rotavirus (A) is acute; celiac
(C) presents later with failure to thrive; Shigella (D) is inflammatory.
pg. 3
, Question 8
A 42-year-old woman with fibromyalgia requests refill of tramadol 50 mg (30 tabs, 1–2
daily). She has no mood changes or aberrant behaviors. Which is MOST appropriate?
A. Continue tramadol with 3-month follow-up
B. Switch to hydrocodone-acetaminophen 5/325
C. Taper tramadol over 2 weeks and start duloxetine
D. Refer to pain specialist only
Answer: A. Continue tramadol with 3-month follow-up
Solution: Tramadol is acceptable for fibromyalgia when effective and no misuse;
switching to stronger opioid (B) increases risk; taper (C) unnecessary if functional;
specialist (D) if refractory.
Question 9
A 3-year-old boy has fever 39°C × 2 days, refusal to move right knee, and WBC 18,000
with left shift. Knee X-ray normal. Which is the NEXT best step?
A. Reassure and prescribe PO amoxicillin
B. Order Lyme serology
C. Hip ultrasound
D. Blood culture and orthopedic consult for aspiration
Answer: D. Blood culture and orthopedic consult for aspiration
Solution: Acute non-weight bearing + high fever + leukocytosis → septic arthritis until
proven otherwise; immediate aspiration and empiric IV antibiotics required. Lyme (B)
would present more indolently.
Question 10
A 31-year-old G1 at 28 weeks reports sudden onset of severe constant abdominal pain,
no vaginal bleeding. BP 150/95, HR 110, fundal tenderness, contractions every 3 min.
FHR 170 with minimal variability. Which is the MOST likely diagnosis?
A. Placental abruption
B. Preterm labor
C. Chorioamnionitis
D. Round-ligament spasm
Answer: A. Placental abruption
Solution: Constant pain, uterine hypertonus, fetal tachycardia, and hypertension
suggest abruption even without bleeding (concealed). Preterm labor (B) causes
rhythmic cramps; chorio (C) usually with fever and malodorous discharge.
pg. 4
QUESTIONS AND CORRECT ANSWERS (ALREADY
GRADED A+) | LATEST EDITION | PROFESSOR
VERIFIED
Introduction
This 2025 AANP Family Nurse Practitioner certification simulation delivers 200+
original, high-fidelity items aligned to the current AANP test blueprint.
Domains mirror national competencies:
• Health promotion & disease prevention
• Advanced assessment & diagnosis
• Pharmacologic & non-pharmacologic management
• Acute, chronic, pediatric, geriatric, & women’s health
• Professional, ethical, & regulatory practice
Content reflects 2025 evidence-based guidelines (USPSTF, CDC, AHA, ADA, AAP, ACOG,
Beers, etc.) and is constructed for mastery-level preparation; no items are reproduced
from proprietary AANP materials.
Question 1
A 16-year-old female presents with 3-week history of knee pain and swelling after
starting running season. Examination reveals diffuse, non-erythematous swelling and
tenderness with a ballotable patella. No systemic symptoms. Radiographs are
unremarkable. Which is the MOST likely diagnosis?
A. Osgood-Schlatter disease
B. Patellofemoral pain syndrome
C. Juvenile idiopathic arthritis
D. Osteochondritis dissecans
Answer: B. Patellofemoral pain syndrome
Solution: Adolescent female, insidious onset with activity (running), diffuse peripatellar
pain, and ballotable effusion without bony changes typify patellofemoral pain. Osgood-
Schlatter (A) shows tibial tubercle tenderness and apophysitis; JIA (C) would involve
morning stiffness and ≥6-week duration; OCD (D) causes focal pain and possible loose
body.
pg. 1
,Question 2
A 58-year-old man with HTN, DM, and 30-pack-year smoking history reports 4-week
history of exertional left-arm pain that resolves within 5 minutes of rest. Vital signs
stable, BMI 29, BP 136/82. ECG normal. Which initial diagnostic test is MOST
appropriate?
A. Coronary CT angiography
B. Stress echocardiography
C. Resting transthoracic echo
D. High-sensitivity troponin I
Answer: B. Stress echocardiography
Solution: Intermediate pre-test probability of CAD (multiple risk factors, typical angina)
→ functional stress testing first-line in stable patient. CTA (A) is anatomical and
reasonable but not superior for ischemia detection; resting echo (C) and troponin (D)
assess infarction/structure, not inducible ischemia.
Question 3
A 32-year-old G2P1 at 10 weeks’ gestation reports intense vulvar itching, especially at
night. Examination reveals excoriated erythematous skin; no lesions or discharge.
Which is the MOST appropriate next step?
A. Oral fluconazole 150 mg once
B. Topical clotrimazole for 7 days
C. Permethrin 5% cream to entire body
D. 10% povidone-iodine wash
Answer: C. Permethrin 5% cream to entire body
Solution: Nocturnal pruritus with excoriations is classic for scabies (Sarcoptes).
Permethrin is first-line in pregnancy. Fluconazole/clotrimazole treat candidiasis, usually
with thick discharge and erythema; iodine wash has no role.
Question 4
A 4-day-old exclusively breastfed infant presents with poor feeding, jaundice (TcB 18
mg/dL), and weight loss of 9% from birth. Labs: total bilirubin 19 mg/dL (indirect 17.5),
Na 142, K 5.1, Cl 104, glucose 52 mg/dL. Which is the MOST likely diagnosis?
A. Breast milk jaundice
B. ABO incompatibility
C. Dehydration with insufficient intake
D. Biliary atresia
Answer: C. Dehydration with insufficient intake
Solution: >7% weight loss, high indirect bilirubin, low-normal glucose, and poor
feeding indicate inadequate milk transfer ( starvation jaundice). Breast-milk jaundice
pg. 2
,(A) occurs later (day 5–7) without significant weight loss; ABO (B) shows positive direct
Coombs; biliary atresia (D) presents with direct/conjugated hyperbilirubinemia.
Question 5
A 77-year-old woman with Alzheimer’s (MMSE 18/30) lives with daughter who
manages medications. BP 158/88, HR 78. Current meds: metoprolol 50 mg BID,
donepezil 10 mg daily, ASA 81 mg. Which is the MOST appropriate BP goal?
A. <130/80 mmHg
B. <140/90 mmHg
C. <150/90 mmHg
D. SBP 100–120 mmHg
Answer: C. <150/90 mmHg
Solution: Per 2025 Beers & AHA, adults ≥65 with dementia or limited life expectancy
benefit from relaxed targets to avoid hypotension and falls; SBP <150 mmHg acceptable.
Intensive targets (<130/80) offer no additional benefit and increase harm.
Question 6
A 24-year-old man with asthma uses budesonide-formoterol 160/4.5 2 puffs BID and
albuterol PRN (3×/week). ACT score 22. Which action is BEST?
A. Add LAMA
B. Increase ICS-formoterol to 4 puffs BID
C. Continue current therapy; asthma well-controlled
D. Step down to low-dose ICS only
Answer: C. Continue current therapy; asthma well-controlled
Solution: ACT ≥20 and rescue use ≤2×/week indicate good control; no need to escalate.
Step-down (D) risks loss of control.
Question 7
A 16-month-old has had watery diarrhea for 10 days, 4–5 stools/day, no blood, thriving,
no fever. Stool reduces with fasting. Which is the MOST likely cause?
A. Rotavirus
B. Lactose overload
C. Celiac disease
D. Shigella
Answer: B. Lactose overload
Solution: Chronic watery non-bloody diarrhea that improves with fasting (reducing
substrate) suggests osmotic diarrhea—commonly lactose. Rotavirus (A) is acute; celiac
(C) presents later with failure to thrive; Shigella (D) is inflammatory.
pg. 3
, Question 8
A 42-year-old woman with fibromyalgia requests refill of tramadol 50 mg (30 tabs, 1–2
daily). She has no mood changes or aberrant behaviors. Which is MOST appropriate?
A. Continue tramadol with 3-month follow-up
B. Switch to hydrocodone-acetaminophen 5/325
C. Taper tramadol over 2 weeks and start duloxetine
D. Refer to pain specialist only
Answer: A. Continue tramadol with 3-month follow-up
Solution: Tramadol is acceptable for fibromyalgia when effective and no misuse;
switching to stronger opioid (B) increases risk; taper (C) unnecessary if functional;
specialist (D) if refractory.
Question 9
A 3-year-old boy has fever 39°C × 2 days, refusal to move right knee, and WBC 18,000
with left shift. Knee X-ray normal. Which is the NEXT best step?
A. Reassure and prescribe PO amoxicillin
B. Order Lyme serology
C. Hip ultrasound
D. Blood culture and orthopedic consult for aspiration
Answer: D. Blood culture and orthopedic consult for aspiration
Solution: Acute non-weight bearing + high fever + leukocytosis → septic arthritis until
proven otherwise; immediate aspiration and empiric IV antibiotics required. Lyme (B)
would present more indolently.
Question 10
A 31-year-old G1 at 28 weeks reports sudden onset of severe constant abdominal pain,
no vaginal bleeding. BP 150/95, HR 110, fundal tenderness, contractions every 3 min.
FHR 170 with minimal variability. Which is the MOST likely diagnosis?
A. Placental abruption
B. Preterm labor
C. Chorioamnionitis
D. Round-ligament spasm
Answer: A. Placental abruption
Solution: Constant pain, uterine hypertonus, fetal tachycardia, and hypertension
suggest abruption even without bleeding (concealed). Preterm labor (B) causes
rhythmic cramps; chorio (C) usually with fever and malodorous discharge.
pg. 4
