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FNP Certification Exam Practice Questions (2026/2027)
Based on the current exam blueprints from both AANPCB and ANCC, the following 100
practice questions cover the core domains: Assessment, Diagnosis, Planning,
Implementation, and Evaluation across the lifespan.
Exam Format Notes:
• AANPCB FNP-C Exam: 150 questions (135 scored, 15 pretest), 3 hours, 4 domains
• ANCC FNP-BC Exam: 175 questions (150 scored, 25 pretest), 3.5 hours, 5 domains
Section 1: Assessment & Health Promotion (Questions 1–20)
1. A 45-year-old male presents for a routine visit. According to the USPSTF, at what age
should colorectal cancer screening begin for average-risk adults?
A. 40 years
B. 45 years
C. 50 years
D. 55 years
Answer: B
2. A 28-year-old female asks about HPV vaccination. What is the recommended upper age
limit for catch-up HPV vaccination in females?
A. 18 years
B. 21 years
C. 26 years
D. 45 years
Answer: C
3. A 32-year-old G2P1 woman at 10 weeks gestation presents for her first prenatal visit.
Which supplement is most critical to prevent neural tube defects?
A. Iron
B. Calcium
C. Folic acid
D. Vitamin D
Answer: C
4. A 55-year-old postmenopausal woman presents with a new onset of vaginal bleeding.
What is the most appropriate initial step in evaluation?
A. Reassurance and observation
B. Transvaginal ultrasound
C. Endometrial biopsy
,2
D. Hysterectomy referral
Answer: B
5. A 6-month-old infant is brought in for a well-child visit. Which developmental milestone
should the FNP expect to observe?
A. Sitting without support
B. Rolling over both ways
C. Pincer grasp
D. Walking independently
Answer: B
6. A 72-year-old male presents for a Medicare annual wellness visit. Which screening test
is recommended for abdominal aortic aneurysm (AAA) in men aged 65–75 who have ever
smoked?
A. CT scan
B. Abdominal ultrasound
C. MRI
D. Physical examination only
Answer: B
7. A 16-year-old female presents for a sports physical. According to the CDC, which vaccine
is routinely recommended for adolescents at age 11–12?
A. Hepatitis A
B. Meningococcal conjugate
C. Pneumococcal
D. Influenza only
Answer: B
8. A 50-year-old female with a BMI of 32 asks about breast cancer screening. According to
ACOG, when should average-risk women begin mammography?
A. 35 years
B. 40 years
C. 45 years
D. 50 years
Answer: B
9. A 65-year-old male presents with hearing loss. Which type of hearing loss is most
common in older adults?
A. Conductive hearing loss
B. Sensorineural hearing loss
C. Mixed hearing loss
D. Central auditory processing disorder
Answer: B
, 3
10. A 24-year-old female presents with a 2-day history of dysuria and urinary frequency.
Which finding on urinalysis is most consistent with a urinary tract infection?
A. pH 5.0
B. Positive nitrites and leukocyte esterase
C. Specific gravity 1.010
D. Trace protein
Answer: B
11. A 3-year-old child is brought in with a barky cough, inspiratory stridor, and hoarseness
that started at night. What is the most likely diagnosis?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Asthma
Answer: B
12. A 30-year-old female presents with a 3-day history of unilateral throbbing headache,
nausea, and photophobia. She reports similar episodes twice monthly. What type of
headache is this?
A. Tension headache
B. Cluster headache
C. Migraine without aura
D. Migraine with aura
Answer: C
13. A 68-year-old male presents with progressive shortness of breath and a history of 40
pack-years of smoking. Which finding on pulmonary function testing suggests COPD?
A. FEV1/FVC ratio > 0.70
B. FEV1/FVC ratio < 0.70
C. Increased DLCO
D. Normal spirometry
Answer: B
14. A 4-week-old infant is brought in for a well-baby visit. Which finding would be
considered a red flag requiring further evaluation?
A. Weight gain of 20 g/day
B. Two episodes of projectile vomiting after feeding
C. Sleeps 16 hours per day
D. Passes meconium stool
Answer: B
15. A 40-year-old female with a family history of breast cancer asks about genetic testing.
Which criteria would warrant a referral for BRCA testing?
FNP Certification Exam Practice Questions (2026/2027)
Based on the current exam blueprints from both AANPCB and ANCC, the following 100
practice questions cover the core domains: Assessment, Diagnosis, Planning,
Implementation, and Evaluation across the lifespan.
Exam Format Notes:
• AANPCB FNP-C Exam: 150 questions (135 scored, 15 pretest), 3 hours, 4 domains
• ANCC FNP-BC Exam: 175 questions (150 scored, 25 pretest), 3.5 hours, 5 domains
Section 1: Assessment & Health Promotion (Questions 1–20)
1. A 45-year-old male presents for a routine visit. According to the USPSTF, at what age
should colorectal cancer screening begin for average-risk adults?
A. 40 years
B. 45 years
C. 50 years
D. 55 years
Answer: B
2. A 28-year-old female asks about HPV vaccination. What is the recommended upper age
limit for catch-up HPV vaccination in females?
A. 18 years
B. 21 years
C. 26 years
D. 45 years
Answer: C
3. A 32-year-old G2P1 woman at 10 weeks gestation presents for her first prenatal visit.
Which supplement is most critical to prevent neural tube defects?
A. Iron
B. Calcium
C. Folic acid
D. Vitamin D
Answer: C
4. A 55-year-old postmenopausal woman presents with a new onset of vaginal bleeding.
What is the most appropriate initial step in evaluation?
A. Reassurance and observation
B. Transvaginal ultrasound
C. Endometrial biopsy
,2
D. Hysterectomy referral
Answer: B
5. A 6-month-old infant is brought in for a well-child visit. Which developmental milestone
should the FNP expect to observe?
A. Sitting without support
B. Rolling over both ways
C. Pincer grasp
D. Walking independently
Answer: B
6. A 72-year-old male presents for a Medicare annual wellness visit. Which screening test
is recommended for abdominal aortic aneurysm (AAA) in men aged 65–75 who have ever
smoked?
A. CT scan
B. Abdominal ultrasound
C. MRI
D. Physical examination only
Answer: B
7. A 16-year-old female presents for a sports physical. According to the CDC, which vaccine
is routinely recommended for adolescents at age 11–12?
A. Hepatitis A
B. Meningococcal conjugate
C. Pneumococcal
D. Influenza only
Answer: B
8. A 50-year-old female with a BMI of 32 asks about breast cancer screening. According to
ACOG, when should average-risk women begin mammography?
A. 35 years
B. 40 years
C. 45 years
D. 50 years
Answer: B
9. A 65-year-old male presents with hearing loss. Which type of hearing loss is most
common in older adults?
A. Conductive hearing loss
B. Sensorineural hearing loss
C. Mixed hearing loss
D. Central auditory processing disorder
Answer: B
, 3
10. A 24-year-old female presents with a 2-day history of dysuria and urinary frequency.
Which finding on urinalysis is most consistent with a urinary tract infection?
A. pH 5.0
B. Positive nitrites and leukocyte esterase
C. Specific gravity 1.010
D. Trace protein
Answer: B
11. A 3-year-old child is brought in with a barky cough, inspiratory stridor, and hoarseness
that started at night. What is the most likely diagnosis?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Asthma
Answer: B
12. A 30-year-old female presents with a 3-day history of unilateral throbbing headache,
nausea, and photophobia. She reports similar episodes twice monthly. What type of
headache is this?
A. Tension headache
B. Cluster headache
C. Migraine without aura
D. Migraine with aura
Answer: C
13. A 68-year-old male presents with progressive shortness of breath and a history of 40
pack-years of smoking. Which finding on pulmonary function testing suggests COPD?
A. FEV1/FVC ratio > 0.70
B. FEV1/FVC ratio < 0.70
C. Increased DLCO
D. Normal spirometry
Answer: B
14. A 4-week-old infant is brought in for a well-baby visit. Which finding would be
considered a red flag requiring further evaluation?
A. Weight gain of 20 g/day
B. Two episodes of projectile vomiting after feeding
C. Sleeps 16 hours per day
D. Passes meconium stool
Answer: B
15. A 40-year-old female with a family history of breast cancer asks about genetic testing.
Which criteria would warrant a referral for BRCA testing?
