FNP Board Review 2026 | Advanced Practice Nursing Exam Prep
Bundle
Question 1
A 58-year-old man with hypertension and diabetes presents with chest discomfort radiating
to the left arm. Which diagnostic test should be performed first?
A. Echocardiogram
B. Cardiac catheterization
C. 12-lead ECG
D. Stress test
Answer: C. 12-lead ECG
Rationale:
A 12-lead ECG is the first-line diagnostic tool for suspected acute coronary syndrome
because it rapidly identifies ischemia, infarction, or arrhythmias requiring urgent
intervention.
Question 2
Which medication is considered first-line treatment for Type 2 diabetes mellitus in most
adults?
A. Insulin glargine
B. Metformin
C. Pioglitazone
D. Sitagliptin
Answer: B. Metformin
Rationale:
Metformin decreases hepatic glucose production and improves insulin sensitivity. It is
recommended as first-line therapy unless contraindicated due to renal dysfunction or
intolerance.
Question 3
A patient with asthma develops wheezing after exposure to pollen. Which medication
provides rapid symptom relief?
A. Fluticasone
,B. Montelukast
C. Albuterol
D. Salmeterol
Answer: C. Albuterol
Rationale:
Albuterol is a short-acting beta2-agonist (SABA) that quickly relaxes bronchial smooth
muscle and relieves acute bronchospasm.
Question 4
Which finding is most concerning in a patient diagnosed with bacterial meningitis?
A. Fever
B. Nuchal rigidity
C. Positive Kernig sign
D. Decreased level of consciousness
Answer: D. Decreased level of consciousness
Rationale:
Altered mental status suggests worsening intracranial involvement and possible increased
intracranial pressure, making it a critical finding requiring immediate attention.
Question 5
A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Which
laboratory finding is expected in primary hypothyroidism?
A. Low TSH and high T4
B. High TSH and low T4
C. High TSH and high T4
D. Low TSH and low T4
Answer: B. High TSH and low T4
Rationale:
Primary hypothyroidism occurs when the thyroid gland fails to produce adequate thyroid
hormone, causing elevated TSH due to pituitary compensation.
Question 6
,Which vaccine is recommended annually for all adults over 6 months of age unless
contraindicated?
A. Hepatitis B
B. Influenza vaccine
C. Pneumococcal vaccine
D. Shingles vaccine
Answer: B. Influenza vaccine
Rationale:
Annual influenza vaccination reduces morbidity and mortality associated with seasonal
influenza infections.
Question 7
A patient presents with severe right lower quadrant pain, nausea, and rebound tenderness.
Which condition is most likely?
A. Cholecystitis
B. Appendicitis
C. Pancreatitis
D. Diverticulitis
Answer: B. Appendicitis
Rationale:
Classic appendicitis symptoms include right lower quadrant pain, rebound tenderness, fever,
and nausea.
Question 8
Which antihypertensive medication is contraindicated during pregnancy?
A. Labetalol
B. Methyldopa
C. Nifedipine
D. Lisinopril
Answer: D. Lisinopril
Rationale:
, ACE inhibitors such as lisinopril can cause fetal renal damage and are contraindicated in
pregnancy.
Question 9
A smoker with chronic cough and barrel chest most likely has which condition?
A. Asthma
B. Pneumonia
C. Emphysema
D. Pulmonary fibrosis
Answer: C. Emphysema
Rationale:
Barrel chest and chronic smoking history are characteristic findings of emphysema due to air
trapping and alveolar destruction.
Question 10
Which electrolyte imbalance is commonly associated with loop diuretics?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale:
Loop diuretics increase potassium excretion, commonly causing hypokalemia.
Question 11
A patient with atrial fibrillation is at increased risk for:
A. Pulmonary fibrosis
B. Stroke
C. Peptic ulcer disease
D. Pneumothorax
Answer: B. Stroke
Rationale:
Bundle
Question 1
A 58-year-old man with hypertension and diabetes presents with chest discomfort radiating
to the left arm. Which diagnostic test should be performed first?
A. Echocardiogram
B. Cardiac catheterization
C. 12-lead ECG
D. Stress test
Answer: C. 12-lead ECG
Rationale:
A 12-lead ECG is the first-line diagnostic tool for suspected acute coronary syndrome
because it rapidly identifies ischemia, infarction, or arrhythmias requiring urgent
intervention.
Question 2
Which medication is considered first-line treatment for Type 2 diabetes mellitus in most
adults?
A. Insulin glargine
B. Metformin
C. Pioglitazone
D. Sitagliptin
Answer: B. Metformin
Rationale:
Metformin decreases hepatic glucose production and improves insulin sensitivity. It is
recommended as first-line therapy unless contraindicated due to renal dysfunction or
intolerance.
Question 3
A patient with asthma develops wheezing after exposure to pollen. Which medication
provides rapid symptom relief?
A. Fluticasone
,B. Montelukast
C. Albuterol
D. Salmeterol
Answer: C. Albuterol
Rationale:
Albuterol is a short-acting beta2-agonist (SABA) that quickly relaxes bronchial smooth
muscle and relieves acute bronchospasm.
Question 4
Which finding is most concerning in a patient diagnosed with bacterial meningitis?
A. Fever
B. Nuchal rigidity
C. Positive Kernig sign
D. Decreased level of consciousness
Answer: D. Decreased level of consciousness
Rationale:
Altered mental status suggests worsening intracranial involvement and possible increased
intracranial pressure, making it a critical finding requiring immediate attention.
Question 5
A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Which
laboratory finding is expected in primary hypothyroidism?
A. Low TSH and high T4
B. High TSH and low T4
C. High TSH and high T4
D. Low TSH and low T4
Answer: B. High TSH and low T4
Rationale:
Primary hypothyroidism occurs when the thyroid gland fails to produce adequate thyroid
hormone, causing elevated TSH due to pituitary compensation.
Question 6
,Which vaccine is recommended annually for all adults over 6 months of age unless
contraindicated?
A. Hepatitis B
B. Influenza vaccine
C. Pneumococcal vaccine
D. Shingles vaccine
Answer: B. Influenza vaccine
Rationale:
Annual influenza vaccination reduces morbidity and mortality associated with seasonal
influenza infections.
Question 7
A patient presents with severe right lower quadrant pain, nausea, and rebound tenderness.
Which condition is most likely?
A. Cholecystitis
B. Appendicitis
C. Pancreatitis
D. Diverticulitis
Answer: B. Appendicitis
Rationale:
Classic appendicitis symptoms include right lower quadrant pain, rebound tenderness, fever,
and nausea.
Question 8
Which antihypertensive medication is contraindicated during pregnancy?
A. Labetalol
B. Methyldopa
C. Nifedipine
D. Lisinopril
Answer: D. Lisinopril
Rationale:
, ACE inhibitors such as lisinopril can cause fetal renal damage and are contraindicated in
pregnancy.
Question 9
A smoker with chronic cough and barrel chest most likely has which condition?
A. Asthma
B. Pneumonia
C. Emphysema
D. Pulmonary fibrosis
Answer: C. Emphysema
Rationale:
Barrel chest and chronic smoking history are characteristic findings of emphysema due to air
trapping and alveolar destruction.
Question 10
Which electrolyte imbalance is commonly associated with loop diuretics?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale:
Loop diuretics increase potassium excretion, commonly causing hypokalemia.
Question 11
A patient with atrial fibrillation is at increased risk for:
A. Pulmonary fibrosis
B. Stroke
C. Peptic ulcer disease
D. Pneumothorax
Answer: B. Stroke
Rationale:
