2026 AANP FNP CERTIFICATION LATEST 2024 WITH 200+ REAL
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |AGRADE
AANP FNP Certification Practice Questions (Based on Your Study Notes)
Cardiovascular (Questions 1-15)
Question 1
All diastolic murmurs are:
A) Innocent findings in athletes
B) Pathological and require evaluation ✓
C) Normal in elderly patients
D) Always associated with fever
Explanation: All diastolic murmurs are pathological and require further
evaluation. Murmur grading: I-barely audible, II-audible, III-clearly audible, IV-first
time thrill palpable, V-audible with stethoscope edge, VI-audible with entire
stethoscope off the chest. Grade III is the first time a murmur is clearly audible,
and Grade IV is the first time a thrill is palpable.
Question 2
A heart murmur that radiates to the axilla is most likely:
A) Aortic stenosis
B) Mitral regurgitation (MR) ✓
,C) Pulmonic stenosis
D) Tricuspid regurgitation
Explanation: Mitral regurgitation (MR) is a holosystolic or pansystolic murmur
that radiates to the axilla and is best heard at the 5th intercostal space,
midclavicular line (apex). Aortic stenosis (AS) is a mid-systolic murmur that
radiates to the neck and is best heard at the 2nd intercostal space, right sternal
border. Remember "MR ASSH" - MR radiates to Axilla, AS radiates to neck.
Question 3
A patient with hypertension and coronary artery disease has palpable femoral
pulses but absent pedal pulses. This finding is most consistent with:
A) Chronic venous insufficiency
B) Peripheral arterial disease (PAD) ✓
C) Deep vein thrombosis
D) Neurogenic claudication
Explanation: Peripheral arterial disease (PAD) presents with diminished or absent
pulses distal to the blockage, intermittent claudication (pain with walking),
nocturnal pain relieved by dangling legs, dependent rubor, and shiny, hairless
skin. Diagnosis is confirmed with Doppler and ABI <0.9.
Question 4
A bounding radial pulse with a weak femoral pulse suggests:
A) Aortic stenosis
B) Coarctation of the aorta (COA) ✓
C) Patent ductus arteriosus
D) Mitral valve prolapse
Explanation: Coarctation of the aorta (COA) presents with bounding radial pulses
and weak or delayed femoral pulses, along with increased blood pressure in the
arms and lower pressure in the legs. It is a congenital cardiac condition
characterized by narrowing of the aorta.
,Question 5
Jugular vein distention (JVD) can be caused by all of the following EXCEPT:
A) Tension pneumothorax
B) Right-sided heart failure
C) Cardiac tamponade
D) Hypovolemic shock ✓
Explanation: JVD results from increased central venous pressure. Causes include
tension pneumothorax, right-sided heart failure, cardiac tamponade, and
traumatic asphyxia. Hypovolemic shock causes decreased venous pressure and
flat neck veins, not distention.
Question 6
An S3 heart sound is associated with:
A) Left ventricular hypertrophy
B) Heart failure (HF) ✓
C) Mitral valve prolapse
D) Aortic stenosis
Explanation: S3 (ventricular gallop) occurs in early diastole and is associated with
heart failure (HF). It is abnormal after age 35. Use the mnemonic "S3-Kentucky"
(sounds like "Ken-tuc-ky"). S4 (atrial gallop) occurs in late diastole, is associated
with left ventricular hypertrophy (LVH) and stiffening, and sounds like "Ten-nes-
see."
Question 7
Pulsus paradoxus is defined as:
A) Increase in systolic pressure during inspiration
B) Decrease in systolic pressure >10 mm Hg during inspiration ✓
C) Decrease in diastolic pressure during expiration
D) Widened pulse pressure during inspiration
, Explanation: Pulsus paradoxus is an exaggerated decrease in systolic blood
pressure (>10 mm Hg) during inspiration. It occurs in conditions that impair
diastolic filling, such as cardiac tamponade, constrictive pericarditis, severe
asthma, and tension pneumothorax. The apical pulse may still be heard when the
radial pulse is not palpable.
Question 8
First-line treatment for isolated systolic hypertension is:
A) ACE inhibitor
B) Beta blocker
C) Calcium channel blocker (CCB) ✓
D) Thiazide diuretic
Explanation: Calcium channel blockers (CCBs) are first-line for isolated systolic
hypertension. CCBs can cause peripheral edema, which may be managed by
encouraging the patient to walk around.
Question 9
Before starting a statin medication, which laboratory test must be checked?
A) Creatinine
B) Liver function tests (LFTs) ✓
C) Thyroid stimulating hormone
D) Complete blood count
Explanation: Liver function tests (LFTs) must be checked before initiating statin
therapy and monitored periodically thereafter. Statins are initiated based on
cardiovascular risk assessment, and the decision between moderate-dose and
high-dose statins depends on the patient's risk factors and LDL level.
Question 10
A patient with hypertension has a blood pressure reading of 150/94 mm Hg.
According to staging guidelines, this is classified as:
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |AGRADE
AANP FNP Certification Practice Questions (Based on Your Study Notes)
Cardiovascular (Questions 1-15)
Question 1
All diastolic murmurs are:
A) Innocent findings in athletes
B) Pathological and require evaluation ✓
C) Normal in elderly patients
D) Always associated with fever
Explanation: All diastolic murmurs are pathological and require further
evaluation. Murmur grading: I-barely audible, II-audible, III-clearly audible, IV-first
time thrill palpable, V-audible with stethoscope edge, VI-audible with entire
stethoscope off the chest. Grade III is the first time a murmur is clearly audible,
and Grade IV is the first time a thrill is palpable.
Question 2
A heart murmur that radiates to the axilla is most likely:
A) Aortic stenosis
B) Mitral regurgitation (MR) ✓
,C) Pulmonic stenosis
D) Tricuspid regurgitation
Explanation: Mitral regurgitation (MR) is a holosystolic or pansystolic murmur
that radiates to the axilla and is best heard at the 5th intercostal space,
midclavicular line (apex). Aortic stenosis (AS) is a mid-systolic murmur that
radiates to the neck and is best heard at the 2nd intercostal space, right sternal
border. Remember "MR ASSH" - MR radiates to Axilla, AS radiates to neck.
Question 3
A patient with hypertension and coronary artery disease has palpable femoral
pulses but absent pedal pulses. This finding is most consistent with:
A) Chronic venous insufficiency
B) Peripheral arterial disease (PAD) ✓
C) Deep vein thrombosis
D) Neurogenic claudication
Explanation: Peripheral arterial disease (PAD) presents with diminished or absent
pulses distal to the blockage, intermittent claudication (pain with walking),
nocturnal pain relieved by dangling legs, dependent rubor, and shiny, hairless
skin. Diagnosis is confirmed with Doppler and ABI <0.9.
Question 4
A bounding radial pulse with a weak femoral pulse suggests:
A) Aortic stenosis
B) Coarctation of the aorta (COA) ✓
C) Patent ductus arteriosus
D) Mitral valve prolapse
Explanation: Coarctation of the aorta (COA) presents with bounding radial pulses
and weak or delayed femoral pulses, along with increased blood pressure in the
arms and lower pressure in the legs. It is a congenital cardiac condition
characterized by narrowing of the aorta.
,Question 5
Jugular vein distention (JVD) can be caused by all of the following EXCEPT:
A) Tension pneumothorax
B) Right-sided heart failure
C) Cardiac tamponade
D) Hypovolemic shock ✓
Explanation: JVD results from increased central venous pressure. Causes include
tension pneumothorax, right-sided heart failure, cardiac tamponade, and
traumatic asphyxia. Hypovolemic shock causes decreased venous pressure and
flat neck veins, not distention.
Question 6
An S3 heart sound is associated with:
A) Left ventricular hypertrophy
B) Heart failure (HF) ✓
C) Mitral valve prolapse
D) Aortic stenosis
Explanation: S3 (ventricular gallop) occurs in early diastole and is associated with
heart failure (HF). It is abnormal after age 35. Use the mnemonic "S3-Kentucky"
(sounds like "Ken-tuc-ky"). S4 (atrial gallop) occurs in late diastole, is associated
with left ventricular hypertrophy (LVH) and stiffening, and sounds like "Ten-nes-
see."
Question 7
Pulsus paradoxus is defined as:
A) Increase in systolic pressure during inspiration
B) Decrease in systolic pressure >10 mm Hg during inspiration ✓
C) Decrease in diastolic pressure during expiration
D) Widened pulse pressure during inspiration
, Explanation: Pulsus paradoxus is an exaggerated decrease in systolic blood
pressure (>10 mm Hg) during inspiration. It occurs in conditions that impair
diastolic filling, such as cardiac tamponade, constrictive pericarditis, severe
asthma, and tension pneumothorax. The apical pulse may still be heard when the
radial pulse is not palpable.
Question 8
First-line treatment for isolated systolic hypertension is:
A) ACE inhibitor
B) Beta blocker
C) Calcium channel blocker (CCB) ✓
D) Thiazide diuretic
Explanation: Calcium channel blockers (CCBs) are first-line for isolated systolic
hypertension. CCBs can cause peripheral edema, which may be managed by
encouraging the patient to walk around.
Question 9
Before starting a statin medication, which laboratory test must be checked?
A) Creatinine
B) Liver function tests (LFTs) ✓
C) Thyroid stimulating hormone
D) Complete blood count
Explanation: Liver function tests (LFTs) must be checked before initiating statin
therapy and monitored periodically thereafter. Statins are initiated based on
cardiovascular risk assessment, and the decision between moderate-dose and
high-dose statins depends on the patient's risk factors and LDL level.
Question 10
A patient with hypertension has a blood pressure reading of 150/94 mm Hg.
According to staging guidelines, this is classified as:
