AANP FNP Exam Actual Questions and Answers |Fall
2025/2026 Update | 100% Correct Latest
QUESTION 1:
A 45-year-old female presents with fatigue, pallor, and spoon-shaped nails. Her CBC shows
microcytic, hypochromic anemia. Which is the most likely underlying cause?
A. Vitamin B12 deficiency
B. Iron deficiency
C. Chronic liver disease
D. Aplastic anemia
CORRECT ANSWER: B. Iron deficiency
RATIONALE: Iron deficiency leads to decreased hemoglobin synthesis, producing microcytic,
hypochromic red cells. Spoon-shaped nails (koilonychia) are a classic feature. Vitamin B12
deficiency produces macrocytic anemia, not microcytic.
QUESTION 2:
A patient with Type 2 diabetes mellitus presents with burning pain and numbness in both feet.
Which medication provides symptomatic relief of neuropathic pain?
A. Lisinopril
B. Metformin
C. Duloxetine
D. Glipizide
CORRECT ANSWER: C. Duloxetine
RATIONALE: Duloxetine is an SNRI effective for diabetic neuropathy. ACE inhibitors like lisinopril
control blood pressure but do not relieve neuropathic pain.
QUESTION 3:
Which physical exam finding most strongly suggests bacterial pneumonia?
A. Diffuse wheezing
B. Crackles and bronchial breath sounds over one lobe
C. Hyperresonance to percussion
D. Pleural friction rub
,CORRECT ANSWER: B. Crackles and bronchial breath sounds over one lobe
RATIONALE: Localized crackles and bronchial breath sounds indicate alveolar consolidation
typical of bacterial pneumonia.
QUESTION 4:
A 23-year-old woman presents with dysuria and urinary frequency. UA shows positive nitrites
and leukocyte esterase. The first-line treatment is:
A. Ciprofloxacin for 10 days
B. Trimethoprim-sulfamethoxazole for 3 days
C. Nitrofurantoin for 5 days
D. Amoxicillin for 7 days
CORRECT ANSWER: C. Nitrofurantoin for 5 days
RATIONALE: Nitrofurantoin is a first-line treatment for uncomplicated cystitis due to low
resistance. Fluoroquinolones are reserved for complicated infections.
QUESTION 5:
A 17-year-old presents with sore throat, fever, and posterior cervical lymphadenopathy. A
Monospot test is positive. Which drug should be avoided?
A. Acetaminophen
B. Amoxicillin
C. Ibuprofen
D. Acyclovir
CORRECT ANSWER: B. Amoxicillin
RATIONALE: Amoxicillin in patients with Epstein-Barr Virus infection (mononucleosis) commonly
produces a maculopapular rash, thus it should be avoided.
QUESTION 6:
Which of the following lipid-lowering agents can cause myopathy, especially when combined
with statins?
A. Ezetimibe
B. Fibrates
,C. Niacin
D. Bile acid sequestrants
CORRECT ANSWER: B. Fibrates
RATIONALE: Gemfibrozil and other fibrates interfere with statin metabolism via CYP pathways,
increasing myopathy risk.
QUESTION 7:
A 3-year-old boy presents with a barking cough and inspiratory stridor. Which diagnosis is most
likely?
A. Epiglottitis
B. Croup (laryngotracheobronchitis)
C. Bronchiolitis
D. Asthma
CORRECT ANSWER: B. Croup (laryngotracheobronchitis)
RATIONALE: Viral croup causes subglottic inflammation leading to the characteristic “barking”
cough and inspiratory stridor.
QUESTION 8:
A patient’s ECG shows peaked T waves and a widened QRS complex. Which electrolyte
abnormality is most consistent?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
D. Hypokalemia
CORRECT ANSWER: B. Hyperkalemia
RATIONALE: Hyperkalemia causes characteristic ECG changes—peaked T waves, prolonged PR
interval, and widened QRS.
QUESTION 9:
A 60-year-old male smoker has a chronic productive cough for the past three years. Diagnosis?
A. Chronic bronchitis
B. Bronchiectasis
, C. COPD—emphysema type
D. Asthma
CORRECT ANSWER: A. Chronic bronchitis
RATIONALE: Defined clinically as productive cough >3 months per year for 2 consecutive years,
often related to smoking.
QUESTION 10:
Which childhood vaccine is recommended at birth?
A. MMR
B. Varicella
C. Hepatitis B
D. Hib
CORRECT ANSWER: C. Hepatitis B
RATIONALE: The first Hepatitis B vaccine dose is given at birth, regardless of maternal status.
QUESTION 11:
A patient being treated with warfarin has a new prescription for trimethoprim-
sulfamethoxazole. What should the FNP do?
A. Continue both medications without adjustment
B. Decrease the warfarin dose and monitor INR closely
C. Increase the warfarin dose
D. Switch warfarin to aspirin
CORRECT ANSWER: B. Decrease the warfarin dose and monitor INR closely
RATIONALE: Trimethoprim-sulfamethoxazole inhibits warfarin metabolism via CYP2C9,
increasing INR and bleeding risk.
QUESTION 12:
In an adult with community-acquired pneumonia, which of the following organisms is most
likely?
A. Mycoplasma tuberculosis
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Pseudomonas aeruginosa
2025/2026 Update | 100% Correct Latest
QUESTION 1:
A 45-year-old female presents with fatigue, pallor, and spoon-shaped nails. Her CBC shows
microcytic, hypochromic anemia. Which is the most likely underlying cause?
A. Vitamin B12 deficiency
B. Iron deficiency
C. Chronic liver disease
D. Aplastic anemia
CORRECT ANSWER: B. Iron deficiency
RATIONALE: Iron deficiency leads to decreased hemoglobin synthesis, producing microcytic,
hypochromic red cells. Spoon-shaped nails (koilonychia) are a classic feature. Vitamin B12
deficiency produces macrocytic anemia, not microcytic.
QUESTION 2:
A patient with Type 2 diabetes mellitus presents with burning pain and numbness in both feet.
Which medication provides symptomatic relief of neuropathic pain?
A. Lisinopril
B. Metformin
C. Duloxetine
D. Glipizide
CORRECT ANSWER: C. Duloxetine
RATIONALE: Duloxetine is an SNRI effective for diabetic neuropathy. ACE inhibitors like lisinopril
control blood pressure but do not relieve neuropathic pain.
QUESTION 3:
Which physical exam finding most strongly suggests bacterial pneumonia?
A. Diffuse wheezing
B. Crackles and bronchial breath sounds over one lobe
C. Hyperresonance to percussion
D. Pleural friction rub
,CORRECT ANSWER: B. Crackles and bronchial breath sounds over one lobe
RATIONALE: Localized crackles and bronchial breath sounds indicate alveolar consolidation
typical of bacterial pneumonia.
QUESTION 4:
A 23-year-old woman presents with dysuria and urinary frequency. UA shows positive nitrites
and leukocyte esterase. The first-line treatment is:
A. Ciprofloxacin for 10 days
B. Trimethoprim-sulfamethoxazole for 3 days
C. Nitrofurantoin for 5 days
D. Amoxicillin for 7 days
CORRECT ANSWER: C. Nitrofurantoin for 5 days
RATIONALE: Nitrofurantoin is a first-line treatment for uncomplicated cystitis due to low
resistance. Fluoroquinolones are reserved for complicated infections.
QUESTION 5:
A 17-year-old presents with sore throat, fever, and posterior cervical lymphadenopathy. A
Monospot test is positive. Which drug should be avoided?
A. Acetaminophen
B. Amoxicillin
C. Ibuprofen
D. Acyclovir
CORRECT ANSWER: B. Amoxicillin
RATIONALE: Amoxicillin in patients with Epstein-Barr Virus infection (mononucleosis) commonly
produces a maculopapular rash, thus it should be avoided.
QUESTION 6:
Which of the following lipid-lowering agents can cause myopathy, especially when combined
with statins?
A. Ezetimibe
B. Fibrates
,C. Niacin
D. Bile acid sequestrants
CORRECT ANSWER: B. Fibrates
RATIONALE: Gemfibrozil and other fibrates interfere with statin metabolism via CYP pathways,
increasing myopathy risk.
QUESTION 7:
A 3-year-old boy presents with a barking cough and inspiratory stridor. Which diagnosis is most
likely?
A. Epiglottitis
B. Croup (laryngotracheobronchitis)
C. Bronchiolitis
D. Asthma
CORRECT ANSWER: B. Croup (laryngotracheobronchitis)
RATIONALE: Viral croup causes subglottic inflammation leading to the characteristic “barking”
cough and inspiratory stridor.
QUESTION 8:
A patient’s ECG shows peaked T waves and a widened QRS complex. Which electrolyte
abnormality is most consistent?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
D. Hypokalemia
CORRECT ANSWER: B. Hyperkalemia
RATIONALE: Hyperkalemia causes characteristic ECG changes—peaked T waves, prolonged PR
interval, and widened QRS.
QUESTION 9:
A 60-year-old male smoker has a chronic productive cough for the past three years. Diagnosis?
A. Chronic bronchitis
B. Bronchiectasis
, C. COPD—emphysema type
D. Asthma
CORRECT ANSWER: A. Chronic bronchitis
RATIONALE: Defined clinically as productive cough >3 months per year for 2 consecutive years,
often related to smoking.
QUESTION 10:
Which childhood vaccine is recommended at birth?
A. MMR
B. Varicella
C. Hepatitis B
D. Hib
CORRECT ANSWER: C. Hepatitis B
RATIONALE: The first Hepatitis B vaccine dose is given at birth, regardless of maternal status.
QUESTION 11:
A patient being treated with warfarin has a new prescription for trimethoprim-
sulfamethoxazole. What should the FNP do?
A. Continue both medications without adjustment
B. Decrease the warfarin dose and monitor INR closely
C. Increase the warfarin dose
D. Switch warfarin to aspirin
CORRECT ANSWER: B. Decrease the warfarin dose and monitor INR closely
RATIONALE: Trimethoprim-sulfamethoxazole inhibits warfarin metabolism via CYP2C9,
increasing INR and bleeding risk.
QUESTION 12:
In an adult with community-acquired pneumonia, which of the following organisms is most
likely?
A. Mycoplasma tuberculosis
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Pseudomonas aeruginosa
