GUA RA N T EED
A N C C B O A R D C E R T I F I C AT I O N · F N P E X A M R E V I E W
PASS.
FNP Board Exam
Comprehensive Question Bank
Family Nurse Practitioner Certification Review
COMPREHENSIVE B OARD REVIEW:
Diabetes · Thyroid · Respiratory · Hematology · Neurology
— Musculoskeletal · GI · Pediatrics · Immunizations
Edition 1 · July 2026
EXAM FOCUSED HIGH-YIELD CONFIDENCE RATIONALES
ANCC FNP Content Maximize score Practice smarter Clear explanations
P r e pa r e · P r a c t i c e · Pa s s
Excellence in Advanced Practice Nursing
, ANCC FNP · BOARD REVIEW DIABETES & THYROID
Diabetes Mellitus & Thyroid Disorders
SECTION 1: DIABETES — DIAGNOSIS & MA NAGEMENT
1 What A1C value confirms the diagnosis of type 2 diabetes?
A > 6.5%
B > 5.7%
C > 7.0%
D > 8.0%
Why A is correct: Diabetes is diagnosed by A1C ≥6.5%, fasting plasma glucose ≥126 mg/dL, 2-hour OGTT ≥200 mg/dL, or random glucose
≥200 mg/dL with symptoms. Prediabetes: A1C 5.7-6.4%, fasting 100-125, OGTT 140-199. Screening begins every 3 years starting at age 45.
2 What is the first-line drug of choice for type 2 diabetes in the absence of contraindications?
A Metformin (Glucophage) — a biguanide
B Glipizide (sulfonylurea)
C Sitagliptin (DPP-4 inhibitor)
D Pioglitazone (TZD)
Why A is correct: Metformin is first-line — it inhibits hepatic glucose production (biguanide class), has low hypoglycemic risk, is weight-
neutral, and low cost. Contraindications include liver cirrhosis, alcohol use disorder, and significantly elevated serum creatinine (eGFR <30). Most
common side effects: diarrhea and flatulence.
3 When should basal insulin be considered in a type 2 diabetes patient?
A A1C > 9% and fasting glucose > 250 mg/dL
B A1C > 7% regardless of fasting glucose
C Only after triple oral therapy failure
D At initial diagnosis for all patients
Why A is correct: Basal insulin (e.g., Lantus/insulin glargine) should be initiated when A1C >9% and fasting glucose >250, indicating
significant beta-cell dysfunction. It is given once daily at the same time. "Lantus is once a day." Target fasting BG is 70-130 mg/dL; postprandial <180
mg/dL.
4 Which insulin lasts from breakfast to dinner and covers the postprandial spike after lunch?
A NPH insulin (Humulin N, Novolin N)
B Regular insulin (Humulin R, Novolin R)
C Rapid-acting insulin (Humalog/Lispro)
D Basal insulin (Lantus/Glargine)
Why A is correct: NPH is intermediate-acting insulin that "lasts from breakfast to dinner." Regular insulin "lasts from meal to meal." Rapid-
acting "covers one meal at a time." Lantus is "once a day" with no peak. NPH peaks at 6-14 hours, covering the afternoon post-lunch glucose elevation.
SECTION 2: THYROID DISORDERS
A N C C B O A R D C E R T I F I C AT I O N · F N P E X A M R E V I E W
PASS.
FNP Board Exam
Comprehensive Question Bank
Family Nurse Practitioner Certification Review
COMPREHENSIVE B OARD REVIEW:
Diabetes · Thyroid · Respiratory · Hematology · Neurology
— Musculoskeletal · GI · Pediatrics · Immunizations
Edition 1 · July 2026
EXAM FOCUSED HIGH-YIELD CONFIDENCE RATIONALES
ANCC FNP Content Maximize score Practice smarter Clear explanations
P r e pa r e · P r a c t i c e · Pa s s
Excellence in Advanced Practice Nursing
, ANCC FNP · BOARD REVIEW DIABETES & THYROID
Diabetes Mellitus & Thyroid Disorders
SECTION 1: DIABETES — DIAGNOSIS & MA NAGEMENT
1 What A1C value confirms the diagnosis of type 2 diabetes?
A > 6.5%
B > 5.7%
C > 7.0%
D > 8.0%
Why A is correct: Diabetes is diagnosed by A1C ≥6.5%, fasting plasma glucose ≥126 mg/dL, 2-hour OGTT ≥200 mg/dL, or random glucose
≥200 mg/dL with symptoms. Prediabetes: A1C 5.7-6.4%, fasting 100-125, OGTT 140-199. Screening begins every 3 years starting at age 45.
2 What is the first-line drug of choice for type 2 diabetes in the absence of contraindications?
A Metformin (Glucophage) — a biguanide
B Glipizide (sulfonylurea)
C Sitagliptin (DPP-4 inhibitor)
D Pioglitazone (TZD)
Why A is correct: Metformin is first-line — it inhibits hepatic glucose production (biguanide class), has low hypoglycemic risk, is weight-
neutral, and low cost. Contraindications include liver cirrhosis, alcohol use disorder, and significantly elevated serum creatinine (eGFR <30). Most
common side effects: diarrhea and flatulence.
3 When should basal insulin be considered in a type 2 diabetes patient?
A A1C > 9% and fasting glucose > 250 mg/dL
B A1C > 7% regardless of fasting glucose
C Only after triple oral therapy failure
D At initial diagnosis for all patients
Why A is correct: Basal insulin (e.g., Lantus/insulin glargine) should be initiated when A1C >9% and fasting glucose >250, indicating
significant beta-cell dysfunction. It is given once daily at the same time. "Lantus is once a day." Target fasting BG is 70-130 mg/dL; postprandial <180
mg/dL.
4 Which insulin lasts from breakfast to dinner and covers the postprandial spike after lunch?
A NPH insulin (Humulin N, Novolin N)
B Regular insulin (Humulin R, Novolin R)
C Rapid-acting insulin (Humalog/Lispro)
D Basal insulin (Lantus/Glargine)
Why A is correct: NPH is intermediate-acting insulin that "lasts from breakfast to dinner." Regular insulin "lasts from meal to meal." Rapid-
acting "covers one meal at a time." Lantus is "once a day" with no peak. NPH peaks at 6-14 hours, covering the afternoon post-lunch glucose elevation.
SECTION 2: THYROID DISORDERS
