AANP FNP Certification Practice Original) EXAM | Latest Update | Original
Questions & Answers with Detailed Rationales | Graded A+
Exam Focus: Assessment, Diagnosis, Planning, and Evaluation
across the lifespan, covering cardiovascular, respiratory,
endocrine, gastrointestinal, psychiatric, women's health,
pediatric, and geriatric care.
Section 1: Cardiovascular System
Q1. A 68-year-old male with a history of hypertension and
type 2 diabetes presents with chest pain that radiates to his
left arm. What is the most important diagnostic factor in
evaluating angina pectoris?
A) King of Heart's monitor
B) Physical examination
C) History
D) Echocardiogram
Answer: C
Rationale: The most important diagnostic factor in evaluating
angina pectoris is the patient's history. The description of the
pain (quality, location, radiation, triggers, relieving factors)
provides the most critical diagnostic information.
,Q2. T-wave inversion with a normal ST segment on a 12-lead
EKG may represent:
A) Acute coronary ischemia
B) Right ventricular hypertrophy
C) Atrial hypertrophy
D) Hyperkalemia
Answer: A
Rationale: T-wave inversion with a normal ST segment on a 12-
lead EKG may represent acute coronary ischemia.
Q3. Therapeutic INR values below _____ increase stroke risk
sixfold.
A) 1
B) 2
C) 3
D) 4
Answer: B
Rationale: Therapeutic INR values below 2 increase stroke risk
sixfold in patients on warfarin therapy.
Q4. A patient on warfarin (Coumadin) therapy for recurrent
DVT is about to have lumbar spinal fusion surgery. The nurse
practitioner knows that the patient's postoperative warfarin
dose should be restarted based on the:
,A) Value of her morning Prothrombin time
B) Loading dose of 10 mg, plus the previous warfarin dose
C) Baseline PT and INR values
D) Target INR of 2
Answer: C
Rationale: The patient's postoperative warfarin dose should be
restarted based on the baseline PT and INR values.
Q5. A 62-year-old man presents with sudden onset of severe
chest pain. He is diaphoretic and nauseated. His ECG shows ST
elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Left main coronary artery
Answer: C
Rationale: ST elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction, which is most commonly
caused by occlusion of the right coronary artery.
Q6. Which of the following is the most common cause of heart
failure with preserved ejection fraction (HFpEF)?
A) Coronary artery disease
B) Hypertension
, C) Valvular heart disease
D) Cardiomyopathy
Answer: B
Rationale: Hypertension is the most common cause of HFpEF,
leading to left ventricular hypertrophy and diastolic dysfunction.
Q7. A 72-year-old female presents with dyspnea on exertion,
orthopnea, and bilateral lower extremity edema. Which of the
following is the most likely diagnosis?
A) COPD
B) Heart failure
C) Pneumonia
D) Pulmonary embolism
Answer: B
Rationale: The combination of dyspnea on exertion, orthopnea,
and bilateral lower extremity edema is classic for heart failure.
Q8. Which medication is first-line for a patient with heart
failure with reduced ejection fraction (HFrEF) and
hypertension?
A) Metoprolol
B) Lisinopril
C) Amlodipine
D) Hydrochlorothiazide
Questions & Answers with Detailed Rationales | Graded A+
Exam Focus: Assessment, Diagnosis, Planning, and Evaluation
across the lifespan, covering cardiovascular, respiratory,
endocrine, gastrointestinal, psychiatric, women's health,
pediatric, and geriatric care.
Section 1: Cardiovascular System
Q1. A 68-year-old male with a history of hypertension and
type 2 diabetes presents with chest pain that radiates to his
left arm. What is the most important diagnostic factor in
evaluating angina pectoris?
A) King of Heart's monitor
B) Physical examination
C) History
D) Echocardiogram
Answer: C
Rationale: The most important diagnostic factor in evaluating
angina pectoris is the patient's history. The description of the
pain (quality, location, radiation, triggers, relieving factors)
provides the most critical diagnostic information.
,Q2. T-wave inversion with a normal ST segment on a 12-lead
EKG may represent:
A) Acute coronary ischemia
B) Right ventricular hypertrophy
C) Atrial hypertrophy
D) Hyperkalemia
Answer: A
Rationale: T-wave inversion with a normal ST segment on a 12-
lead EKG may represent acute coronary ischemia.
Q3. Therapeutic INR values below _____ increase stroke risk
sixfold.
A) 1
B) 2
C) 3
D) 4
Answer: B
Rationale: Therapeutic INR values below 2 increase stroke risk
sixfold in patients on warfarin therapy.
Q4. A patient on warfarin (Coumadin) therapy for recurrent
DVT is about to have lumbar spinal fusion surgery. The nurse
practitioner knows that the patient's postoperative warfarin
dose should be restarted based on the:
,A) Value of her morning Prothrombin time
B) Loading dose of 10 mg, plus the previous warfarin dose
C) Baseline PT and INR values
D) Target INR of 2
Answer: C
Rationale: The patient's postoperative warfarin dose should be
restarted based on the baseline PT and INR values.
Q5. A 62-year-old man presents with sudden onset of severe
chest pain. He is diaphoretic and nauseated. His ECG shows ST
elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Left main coronary artery
Answer: C
Rationale: ST elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction, which is most commonly
caused by occlusion of the right coronary artery.
Q6. Which of the following is the most common cause of heart
failure with preserved ejection fraction (HFpEF)?
A) Coronary artery disease
B) Hypertension
, C) Valvular heart disease
D) Cardiomyopathy
Answer: B
Rationale: Hypertension is the most common cause of HFpEF,
leading to left ventricular hypertrophy and diastolic dysfunction.
Q7. A 72-year-old female presents with dyspnea on exertion,
orthopnea, and bilateral lower extremity edema. Which of the
following is the most likely diagnosis?
A) COPD
B) Heart failure
C) Pneumonia
D) Pulmonary embolism
Answer: B
Rationale: The combination of dyspnea on exertion, orthopnea,
and bilateral lower extremity edema is classic for heart failure.
Q8. Which medication is first-line for a patient with heart
failure with reduced ejection fraction (HFrEF) and
hypertension?
A) Metoprolol
B) Lisinopril
C) Amlodipine
D) Hydrochlorothiazide
