AANP CERTIFICATION EXAM COMPREHENSIVE
ACTUAL EXAM WITH 70+ HIGH-YIELD ACTUAL
QUESTIONS, DETAILED ANSWER EXPLANATIONS,
CLINICAL REASONING STRATEGIES, PRIMARY CARE
REVIEW, TEST-TAKING TIPS, AND COMPLETE EXAM
SUCCESS TOOLKIT | UPDATED FOR 2026/2027 |
LATEST EDITION
A 65-year-old woman presents for a follow-up examination after a new
patient visit. She has not seen a healthcare provider for several years.
She is a smoker and her hypertension is now adequately controlled
with medication. Her mother died at age 40 from a heart attack. The
fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL =
200. In addition to starting Therapeutic Lifestyle Changes, the nurse
practitioner should start the patient on:
1.bile acid sequestrant.
2. a statin drug.
3. a cholesterol absorption inhibitor.
4. low-dose aspirin. - ANSWER-A statin drug
A 13-year-old is concerned because she has not yet begun to
menstruate. Physical examination indicates that the patient is at Tanner
stage IV and is of average height and weight. Which of the following
would be the most appropriate response to this patient?
,1. "We'll need to refer you to an endocrinologist for a complete
workup."
2. "We'll need to do some tests to find out why you are not having
periods."
3. "I'll give you some pills that will make your periods start."
4. "Your development is exactly as expected for your age; you'll
probably begin to have periods within a year." - ANSWER-"Your
development is exactly as expected for your age; you'll probably
begin to have periods within a year."
The most common bacterial cause of cellulitis in patients with diabetes
mellitus is:
1. Pseudomonas aeruginosa.
2. group B beta-hemolytic Streptococcus.
3. Staphylococcus aureus.
4. Staphylococcus saprophyticus. - ANSWER-Staphylococcus aureus
A 46-year-old female found a lump in her breast this morning. History
includes: no prior breast disease; G2P2 (first birth, age 22); maternal
aunt diagnosed with breast cancer at age 72; last menstrual period was
2.5 weeks ago. On examination, a nurse practitioner palpates a 2-cm
round, soft, mobile, tender lesion in the upper outer quadrant of the
,right breast. Mammogram is negative. Which of the following actions is
most appropriate?
1. Reassure the patient that no further action is necessary.
2. Repeat unilateral right mammogram in 3 months.
3. Schedule a right-breast ultrasound.
4. Refer for genetic testing if the lump increases in size. -
ANSWERschedule a right breast ultrasound
Risk factors for genital herpes include:
1. multiple sexual partners and years of sexual activity.
2. genetic transmission.
3. infection with other sexually transmitted diseases before the age of
12.
4. multiple sexual partners and frequent use of public spas. -
ANSWERmultiple sexual partners and years of sexual activity
On physically assessing a newborn's head, you note an enlarged,
fluidfilled area that is subperiosteal and does not cross suture lines. This
finding indicates the presence of:
1. macrocephaly.
2. subgaleal hemorrhage.
, 3. congenital hypothyroidism.
4. cephalohematoma. - ANSWER-cephalohematoma
A 65-year-old patient being treated with digoxin (Lanoxin) for chronic
heart failure (HF) presents with complaints of palpitations. Three days
ago, the patient was placed on clarithromycin (Biaxin) by another
provider for community-acquired pneumonia. The appropriate course
of action at this point would be to:
1. increase the digoxin dosage by 25%.
2. obtain a digoxin level and change the antibiotic to azithromycin
(Zithromax).
3. obtain a chest X-ray.
4. obtain a serum potassium level and perform a 12-lead EKG. -
ANSWER-obtain a digoxin level and change the antibiotic to
azithromycin (zithromax)
A 54-year-old male who is 30 pounds overweight states that he
awakens at night with heartburn and the taste of hot acid in his mouth.
Stress makes his condition worse, yet baking soda seems to provide
some relief. Findings on examination are normal and the stool for
occult blood is negative. The preliminary diagnosis(es) should be:
1. esophagitis.
2. esophageal spasm.
ACTUAL EXAM WITH 70+ HIGH-YIELD ACTUAL
QUESTIONS, DETAILED ANSWER EXPLANATIONS,
CLINICAL REASONING STRATEGIES, PRIMARY CARE
REVIEW, TEST-TAKING TIPS, AND COMPLETE EXAM
SUCCESS TOOLKIT | UPDATED FOR 2026/2027 |
LATEST EDITION
A 65-year-old woman presents for a follow-up examination after a new
patient visit. She has not seen a healthcare provider for several years.
She is a smoker and her hypertension is now adequately controlled
with medication. Her mother died at age 40 from a heart attack. The
fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL =
200. In addition to starting Therapeutic Lifestyle Changes, the nurse
practitioner should start the patient on:
1.bile acid sequestrant.
2. a statin drug.
3. a cholesterol absorption inhibitor.
4. low-dose aspirin. - ANSWER-A statin drug
A 13-year-old is concerned because she has not yet begun to
menstruate. Physical examination indicates that the patient is at Tanner
stage IV and is of average height and weight. Which of the following
would be the most appropriate response to this patient?
,1. "We'll need to refer you to an endocrinologist for a complete
workup."
2. "We'll need to do some tests to find out why you are not having
periods."
3. "I'll give you some pills that will make your periods start."
4. "Your development is exactly as expected for your age; you'll
probably begin to have periods within a year." - ANSWER-"Your
development is exactly as expected for your age; you'll probably
begin to have periods within a year."
The most common bacterial cause of cellulitis in patients with diabetes
mellitus is:
1. Pseudomonas aeruginosa.
2. group B beta-hemolytic Streptococcus.
3. Staphylococcus aureus.
4. Staphylococcus saprophyticus. - ANSWER-Staphylococcus aureus
A 46-year-old female found a lump in her breast this morning. History
includes: no prior breast disease; G2P2 (first birth, age 22); maternal
aunt diagnosed with breast cancer at age 72; last menstrual period was
2.5 weeks ago. On examination, a nurse practitioner palpates a 2-cm
round, soft, mobile, tender lesion in the upper outer quadrant of the
,right breast. Mammogram is negative. Which of the following actions is
most appropriate?
1. Reassure the patient that no further action is necessary.
2. Repeat unilateral right mammogram in 3 months.
3. Schedule a right-breast ultrasound.
4. Refer for genetic testing if the lump increases in size. -
ANSWERschedule a right breast ultrasound
Risk factors for genital herpes include:
1. multiple sexual partners and years of sexual activity.
2. genetic transmission.
3. infection with other sexually transmitted diseases before the age of
12.
4. multiple sexual partners and frequent use of public spas. -
ANSWERmultiple sexual partners and years of sexual activity
On physically assessing a newborn's head, you note an enlarged,
fluidfilled area that is subperiosteal and does not cross suture lines. This
finding indicates the presence of:
1. macrocephaly.
2. subgaleal hemorrhage.
, 3. congenital hypothyroidism.
4. cephalohematoma. - ANSWER-cephalohematoma
A 65-year-old patient being treated with digoxin (Lanoxin) for chronic
heart failure (HF) presents with complaints of palpitations. Three days
ago, the patient was placed on clarithromycin (Biaxin) by another
provider for community-acquired pneumonia. The appropriate course
of action at this point would be to:
1. increase the digoxin dosage by 25%.
2. obtain a digoxin level and change the antibiotic to azithromycin
(Zithromax).
3. obtain a chest X-ray.
4. obtain a serum potassium level and perform a 12-lead EKG. -
ANSWER-obtain a digoxin level and change the antibiotic to
azithromycin (zithromax)
A 54-year-old male who is 30 pounds overweight states that he
awakens at night with heartburn and the taste of hot acid in his mouth.
Stress makes his condition worse, yet baking soda seems to provide
some relief. Findings on examination are normal and the stool for
occult blood is negative. The preliminary diagnosis(es) should be:
1. esophagitis.
2. esophageal spasm.
