ANCC Family Nurse Practitioner FNP Board Exam Actual
Exam 2026/2027 | Questions with Verified Answers |
100% Correct | Pass Guaranteed
SECTION 1: Health Promotion & Disease Prevention
Q1: A 45-year-old woman presents for a routine wellness visit. She has no chronic
conditions and takes no medications. Her BMI is 26 kg/m², BP 118/76 mmHg, and she
reports regular menses. Which screening test is MOST appropriate at this visit?
A. Fasting lipid panel every 2 years
B. Cervical cancer screening with HPV test alone every 5 years
C. Annual low-dose CT for lung cancer
D. Colonoscopy every 10 years starting now
Correct Answer: B
Rationale: Per USPSTF Grade A, cervical cancer screening with high-risk HPV test alone
every 5 years is recommended for ages 30–65. Lipid panel (A) starts at 45 for men, 55
for low-risk women. LDCT (C) is only for high-risk smokers 50–80. Colonoscopy (D)
starts at 45 per USPSTF Grade B, but HPV test is still the priority today.
Q2: A 16-year-old presents for a sports physical. Immunizations are up-to-date through
age 11. Which vaccine is routinely recommended today?
A. Meningococcal ACWY booster
B. Meningococcal B
,C. HPV 2-dose series (if starting before 15)
D. Tdap again
Correct Answer: A
Rationale: CDC ACIP recommends a single MenACWY booster at 16 years after the
11–12 dose. MenB (B) is optional (Category B). HPV (C) is recommended but catch-up
starts at 15 as 3-dose; today’s priority is MenACWY. Tdap (D) is every 10 years, not now.
Q3: A 24-year-old G0 woman requests contraception. She has migraine without aura,
BMI 22, and smokes ½ ppd. Which method is SAFEST?
A. Combined oral contraceptive
B. Depot medroxyprogesterone
C. Vaginal ring
D. Copper IUD
Correct Answer: D
Rationale: CDC MEC Category 4 for estrogen in smokers ≥35; at 24 estrogen is Category
3 due to migraine, making non-hormonal copper IUD (Category 1) safest. DMPA (B) and
ring (C) are acceptable but copper IUD has no systemic hormones.
Q4: A 58-year-old man with 30 pack-year history, quit 5 years ago, asks about
lung-cancer screening. Chest CT last year was normal. Which interval is correct?
A. Repeat LDCT annually until age 70
B. Repeat LDCT annually until age 80
C. No further screening needed
,D. Repeat in 3 years
Correct Answer: B
Rationale: USPSTF recommends annual LDCT for ages 50–80 in former smokers with
≥20 pack-years who quit ≤15 years. Age 58 + annual screening continues to 80.
Q5: A 70-year-old woman falls in the clinic parking lot but denies injury. She had
dual-energy x-ray absorptiometry (DXA) at age 65 showing T-score –1.8. Which action is
MOST appropriate?
A. Repeat DXA today
B. Start alendronate 70 mg weekly
C. Prescribe vitamin D 800 IU + calcium 1200 mg daily
D. Order spinal MRI
Correct Answer: C
Rationale: USPSTF Grade B recommends daily vitamin D ≥800 IU and calcium 1200 mg
for women ≥65 for fracture prevention. Repeat DXA (A) is not indicated before 5 years
unless risk changes; drug therapy (B) starts at T-score ≤ –2.5 or FRAX major ≥20%. MRI
(D) is unnecessary without focal pain.
SECTION 2: Assessment & Diagnosis
Q6: A 28-year-old woman complains of 3 days of dysuria, frequency, and mild left-flank
pain. Temp 37.2 °C, costovertebral angle tenderness absent. Urinalysis shows 15 WBC,
positive leukocyte esterase, negative nitrite. Which is the BEST initial diagnosis?
A. Uncomplicated lower UTI
B. Pyelonephritis
, C. Interstitial cystitis
D. Asymptomatic bacteriuria
Correct Answer: A
Rationale: Absence of fever, CVA tenderness, and systemic symptoms places this in
lower UTI. Nitrite-negative suggests possible Staphylococcus or Enterococcus, still
treated as uncomplicated cystitis. Pyelonephritis (B) requires fever/CVA tenderness; IC
(C) is chronic pain syndrome; asymptomatic (D) lacks dysuria.
Q7: A 45-year-old man with HTN presents with 2 weeks of early-morning headache and
blurred vision. BP 180/110 mmHg bilaterally, retinal hemorrhages on fundoscopy,
creatinine 1.4 mg/dL (baseline 0.9). Which test is MOST important now?
A. 24-hour urine for metanephrines
B. Renal duplex ultrasound
C. Echocardiogram
D. Brain MRI
Correct Answer: B
Rationale: Severe HTN with acute kidney injury suggests renal-artery stenosis; duplex
screens for flow obstruction. Metanephrines (A) evaluate secondary HTN but not urgent
with renal deterioration. Echo (C) assesses end-organ damage but doesn’t explain AKI;
MRI (D) is low-yield without neurologic deficits.
Q8: A 6-year-old boy is brought for 2 days of limping and refusal to bear weight on right
leg. Temp 38.5 °C, WBC 15 000, ESR 55 mm/h. Hip ultrasound shows effusion. Which is
NEXT?
A. Start oral amoxicillin and follow up in 2 days
Exam 2026/2027 | Questions with Verified Answers |
100% Correct | Pass Guaranteed
SECTION 1: Health Promotion & Disease Prevention
Q1: A 45-year-old woman presents for a routine wellness visit. She has no chronic
conditions and takes no medications. Her BMI is 26 kg/m², BP 118/76 mmHg, and she
reports regular menses. Which screening test is MOST appropriate at this visit?
A. Fasting lipid panel every 2 years
B. Cervical cancer screening with HPV test alone every 5 years
C. Annual low-dose CT for lung cancer
D. Colonoscopy every 10 years starting now
Correct Answer: B
Rationale: Per USPSTF Grade A, cervical cancer screening with high-risk HPV test alone
every 5 years is recommended for ages 30–65. Lipid panel (A) starts at 45 for men, 55
for low-risk women. LDCT (C) is only for high-risk smokers 50–80. Colonoscopy (D)
starts at 45 per USPSTF Grade B, but HPV test is still the priority today.
Q2: A 16-year-old presents for a sports physical. Immunizations are up-to-date through
age 11. Which vaccine is routinely recommended today?
A. Meningococcal ACWY booster
B. Meningococcal B
,C. HPV 2-dose series (if starting before 15)
D. Tdap again
Correct Answer: A
Rationale: CDC ACIP recommends a single MenACWY booster at 16 years after the
11–12 dose. MenB (B) is optional (Category B). HPV (C) is recommended but catch-up
starts at 15 as 3-dose; today’s priority is MenACWY. Tdap (D) is every 10 years, not now.
Q3: A 24-year-old G0 woman requests contraception. She has migraine without aura,
BMI 22, and smokes ½ ppd. Which method is SAFEST?
A. Combined oral contraceptive
B. Depot medroxyprogesterone
C. Vaginal ring
D. Copper IUD
Correct Answer: D
Rationale: CDC MEC Category 4 for estrogen in smokers ≥35; at 24 estrogen is Category
3 due to migraine, making non-hormonal copper IUD (Category 1) safest. DMPA (B) and
ring (C) are acceptable but copper IUD has no systemic hormones.
Q4: A 58-year-old man with 30 pack-year history, quit 5 years ago, asks about
lung-cancer screening. Chest CT last year was normal. Which interval is correct?
A. Repeat LDCT annually until age 70
B. Repeat LDCT annually until age 80
C. No further screening needed
,D. Repeat in 3 years
Correct Answer: B
Rationale: USPSTF recommends annual LDCT for ages 50–80 in former smokers with
≥20 pack-years who quit ≤15 years. Age 58 + annual screening continues to 80.
Q5: A 70-year-old woman falls in the clinic parking lot but denies injury. She had
dual-energy x-ray absorptiometry (DXA) at age 65 showing T-score –1.8. Which action is
MOST appropriate?
A. Repeat DXA today
B. Start alendronate 70 mg weekly
C. Prescribe vitamin D 800 IU + calcium 1200 mg daily
D. Order spinal MRI
Correct Answer: C
Rationale: USPSTF Grade B recommends daily vitamin D ≥800 IU and calcium 1200 mg
for women ≥65 for fracture prevention. Repeat DXA (A) is not indicated before 5 years
unless risk changes; drug therapy (B) starts at T-score ≤ –2.5 or FRAX major ≥20%. MRI
(D) is unnecessary without focal pain.
SECTION 2: Assessment & Diagnosis
Q6: A 28-year-old woman complains of 3 days of dysuria, frequency, and mild left-flank
pain. Temp 37.2 °C, costovertebral angle tenderness absent. Urinalysis shows 15 WBC,
positive leukocyte esterase, negative nitrite. Which is the BEST initial diagnosis?
A. Uncomplicated lower UTI
B. Pyelonephritis
, C. Interstitial cystitis
D. Asymptomatic bacteriuria
Correct Answer: A
Rationale: Absence of fever, CVA tenderness, and systemic symptoms places this in
lower UTI. Nitrite-negative suggests possible Staphylococcus or Enterococcus, still
treated as uncomplicated cystitis. Pyelonephritis (B) requires fever/CVA tenderness; IC
(C) is chronic pain syndrome; asymptomatic (D) lacks dysuria.
Q7: A 45-year-old man with HTN presents with 2 weeks of early-morning headache and
blurred vision. BP 180/110 mmHg bilaterally, retinal hemorrhages on fundoscopy,
creatinine 1.4 mg/dL (baseline 0.9). Which test is MOST important now?
A. 24-hour urine for metanephrines
B. Renal duplex ultrasound
C. Echocardiogram
D. Brain MRI
Correct Answer: B
Rationale: Severe HTN with acute kidney injury suggests renal-artery stenosis; duplex
screens for flow obstruction. Metanephrines (A) evaluate secondary HTN but not urgent
with renal deterioration. Echo (C) assesses end-organ damage but doesn’t explain AKI;
MRI (D) is low-yield without neurologic deficits.
Q8: A 6-year-old boy is brought for 2 days of limping and refusal to bear weight on right
leg. Temp 38.5 °C, WBC 15 000, ESR 55 mm/h. Hip ultrasound shows effusion. Which is
NEXT?
A. Start oral amoxicillin and follow up in 2 days
