ANCC FAMILY NURSE PRACTITIONER (FNP) BOARD
EXAM TEST BANK 2026/2027: COMPLETE WITH
VERIFIED ANSWERS
SECTION 1: Health Promotion & Disease Prevention
Q1: A 55-year-old woman presents for an annual wellness visit. She is healthy, takes no
medications, and has a 20-pack-year smoking history but quit 5 years ago. Which
USPSTF screening recommendation should the FNP prioritize today?
A. Low-dose CT (LDCT) lung cancer screening annually
B. Chest X-ray every 2 years
C. Spirometry screening for COPD
D. No additional lung screening; counsel on diet only
Correct Answer: A
Rationale: USPSTF Grade B recommends annual LDCT for adults 50–80 with ≥20
pack-years who quit ≤15 years ago. Chest X-ray (B) is not recommended; spirometry (C)
is not a screening test for asymptomatic adults; diet counseling (D) is insufficient.
Q2: A 16-year-old presents for a sports physical. Immunizations are up to date except
for meningococcal and HPV series. Which statement best reflects current ACIP/CDC
guidelines?
A. Give MenACWY now and start 9-valent HPV series today
B. Defer HPV until college; give MenACWY only
,C. Give MenB today; HPV is optional
D. Only influenza vaccine is required pre-sports
Correct Answer: A
Rationale: ACIP recommends routine MenACWY at 11–12 y with booster at 16 y and
9vHPV series starting at 9–12 y; both can be given together. MenB (C) is not required
for sports; HPV is not optional (B,D).
Q3: A 38-year-old G2P1 at 12 weeks gestation asks about aneuploidy screening. Which
option offers the highest detection rate for trisomy 21 at this gestation?
A. First-trimester combined screen (NT + PAPP-A + β-hCG)
B. Cell-free DNA (NIPT)
C. Quad screen at 15 weeks
D. Chorionic-villus sampling
Correct Answer: B
Rationale: Cell-free DNA has >99% sensitivity/specificity for trisomy 21 at 10+ weeks
(ACOG). First-trimester combined (A) is 85–90%; quad (C) is 75%; CVS (D) is diagnostic,
not screening.
Q4: A 72-year-old man with HTN and DM asks about aspirin for primary CVD prevention.
His BP is 128/78 mmHg, no bleeding history. Per USPSTF 2022, which action is correct?
A. Start aspirin 81 mg daily; benefit outweighs bleed risk ≥65 y
B. Initiate aspirin 325 mg every other day
,C. Do not start aspirin; counsel on lifestyle & statin
D. Prescribe clopidogrel instead
Correct Answer: C
Rationale: USPSTF 2022 (Grade D) recommends against aspirin for primary prevention
in adults ≥60 y due to bleeding risk. Lifestyle + statin (if indicated) preferred. Dual
antiplatelet (D) is inappropriate.
Q5: A 24-year-old woman presents for well-woman exam. Last Pap 3 years ago normal.
Which cervical-cancer screening interval is evidence-based (USPSTF/ACOG 2023)?
A. Pap alone every 3 years (21–29 y)
B. HPV test alone today
C. Co-test every 3 years starting now
D. Defer until 30 y
Correct Answer: A
Rationale: USPSTF: cytology alone Q3y ages 21–29. HPV alone (B) starts at 30; co-test
(C) not until 30; deferring (D) violates guideline.
Q6: A 14-month-old is brought for check-up. Which developmental screening tool is
validated and recommended by AAP for this age?
A. M-CHAT-R at 18 & 24 m only
B. Ages & Stages Questionnaire (ASQ) today
C. Denver-II every visit
, D. No screening until 30 m
Correct Answer: B
Rationale: AAP recommends standardized tools like ASQ at 9, 18, 30 m (and whenever
concern). M-CHAT-R (A) is autism-specific at 18 & 24 m; Denver-II (C) is outdated;
deferring (D) is substandard.
Q7: A 45-year-old African-American man presents as new patient. Family history: father
MI at 54 y. Which lipid screening interval is evidence-based (USPSTF)?
A. Screen now; if normal repeat every 5 years
B. Screen at 50 y regardless
C. Only if 10-y ASCVD >20%
D. Lipid panel optional; focus on BP
Correct Answer: A
Rationale: USPSTF Grade A: screen men 20–35 y if risk factors; 35+ every 5 y. Earlier for
African-American race + family history. Waiting until 50 (B) or only with ASCVD >20% (C)
is incorrect.
Q8: A 60-year-old woman with BMI 31 kg/m² asks about diabetes prevention. Which
USPSTF intervention is Grade A?
A. Refer to intensive lifestyle modification (DPP)
B. Start metformin 500 mg BID immediately
C. Annual fasting glucose only
EXAM TEST BANK 2026/2027: COMPLETE WITH
VERIFIED ANSWERS
SECTION 1: Health Promotion & Disease Prevention
Q1: A 55-year-old woman presents for an annual wellness visit. She is healthy, takes no
medications, and has a 20-pack-year smoking history but quit 5 years ago. Which
USPSTF screening recommendation should the FNP prioritize today?
A. Low-dose CT (LDCT) lung cancer screening annually
B. Chest X-ray every 2 years
C. Spirometry screening for COPD
D. No additional lung screening; counsel on diet only
Correct Answer: A
Rationale: USPSTF Grade B recommends annual LDCT for adults 50–80 with ≥20
pack-years who quit ≤15 years ago. Chest X-ray (B) is not recommended; spirometry (C)
is not a screening test for asymptomatic adults; diet counseling (D) is insufficient.
Q2: A 16-year-old presents for a sports physical. Immunizations are up to date except
for meningococcal and HPV series. Which statement best reflects current ACIP/CDC
guidelines?
A. Give MenACWY now and start 9-valent HPV series today
B. Defer HPV until college; give MenACWY only
,C. Give MenB today; HPV is optional
D. Only influenza vaccine is required pre-sports
Correct Answer: A
Rationale: ACIP recommends routine MenACWY at 11–12 y with booster at 16 y and
9vHPV series starting at 9–12 y; both can be given together. MenB (C) is not required
for sports; HPV is not optional (B,D).
Q3: A 38-year-old G2P1 at 12 weeks gestation asks about aneuploidy screening. Which
option offers the highest detection rate for trisomy 21 at this gestation?
A. First-trimester combined screen (NT + PAPP-A + β-hCG)
B. Cell-free DNA (NIPT)
C. Quad screen at 15 weeks
D. Chorionic-villus sampling
Correct Answer: B
Rationale: Cell-free DNA has >99% sensitivity/specificity for trisomy 21 at 10+ weeks
(ACOG). First-trimester combined (A) is 85–90%; quad (C) is 75%; CVS (D) is diagnostic,
not screening.
Q4: A 72-year-old man with HTN and DM asks about aspirin for primary CVD prevention.
His BP is 128/78 mmHg, no bleeding history. Per USPSTF 2022, which action is correct?
A. Start aspirin 81 mg daily; benefit outweighs bleed risk ≥65 y
B. Initiate aspirin 325 mg every other day
,C. Do not start aspirin; counsel on lifestyle & statin
D. Prescribe clopidogrel instead
Correct Answer: C
Rationale: USPSTF 2022 (Grade D) recommends against aspirin for primary prevention
in adults ≥60 y due to bleeding risk. Lifestyle + statin (if indicated) preferred. Dual
antiplatelet (D) is inappropriate.
Q5: A 24-year-old woman presents for well-woman exam. Last Pap 3 years ago normal.
Which cervical-cancer screening interval is evidence-based (USPSTF/ACOG 2023)?
A. Pap alone every 3 years (21–29 y)
B. HPV test alone today
C. Co-test every 3 years starting now
D. Defer until 30 y
Correct Answer: A
Rationale: USPSTF: cytology alone Q3y ages 21–29. HPV alone (B) starts at 30; co-test
(C) not until 30; deferring (D) violates guideline.
Q6: A 14-month-old is brought for check-up. Which developmental screening tool is
validated and recommended by AAP for this age?
A. M-CHAT-R at 18 & 24 m only
B. Ages & Stages Questionnaire (ASQ) today
C. Denver-II every visit
, D. No screening until 30 m
Correct Answer: B
Rationale: AAP recommends standardized tools like ASQ at 9, 18, 30 m (and whenever
concern). M-CHAT-R (A) is autism-specific at 18 & 24 m; Denver-II (C) is outdated;
deferring (D) is substandard.
Q7: A 45-year-old African-American man presents as new patient. Family history: father
MI at 54 y. Which lipid screening interval is evidence-based (USPSTF)?
A. Screen now; if normal repeat every 5 years
B. Screen at 50 y regardless
C. Only if 10-y ASCVD >20%
D. Lipid panel optional; focus on BP
Correct Answer: A
Rationale: USPSTF Grade A: screen men 20–35 y if risk factors; 35+ every 5 y. Earlier for
African-American race + family history. Waiting until 50 (B) or only with ASCVD >20% (C)
is incorrect.
Q8: A 60-year-old woman with BMI 31 kg/m² asks about diabetes prevention. Which
USPSTF intervention is Grade A?
A. Refer to intensive lifestyle modification (DPP)
B. Start metformin 500 mg BID immediately
C. Annual fasting glucose only
