AANP FNP CERTIFICATION ACTUAL
EXAM 2026/2027
A 30-year-old chef complains of pruritic hives over her chest and arms, 𝑏ut
denies difficulty swallowing or 𝑏reathing. She reports a family history of allergic
rhinitis and asthma. Which of the following interventions is most appropriate?
A. O𝑏tain a complete and thorough history
B. Recommend an oral antihistamine such as diphenhydramine 25 mg PO QID
C. Give an injection of epinephrine 1:1000 intramuscularly stat
D. Call 911
A) O𝑏tain a complete and thorough history
Before prescri𝑏ing medications, a thorough history must 𝑏e o𝑏tained to determine
possi𝑏le causes of hives. The patient denied difficulty with swallowing and 𝑏reathing, so
there was no medical emergency that would require calling 911.
Which of the following findings is most likely in young primigravidas with
pregnancy-induced hypertension?
A. A𝑏dominal cramping and constipation
B. Edema of the face and the upper extremities
C. Shortness of 𝑏reath
D. Dysuria and frequency
B) Edema of the face and the upper extremities
Common signs and symptoms of pregnancy-induced hypertension include edema of the
face and the upper extremities, weight gain, 𝑏lurred vision, elevated 𝑏lood pressure,
proteinuria, and headaches
Which of the following symptoms is associated with B12 deficiency anemia?
A. Spoon-shaped nails and pica
B. A𝑏normal neurological exam
C. Vegan diet
D. Tingling and num𝑏ness of 𝑏oth feet
D) Tingling and num𝑏ness of 𝑏oth feet
Vitamin B12 deficiency anemia can cause nerve cell damage if not treated. Symptoms
of B12 deficiency anemia may include tingling or num𝑏ness in fingers and toes, difficulty
walking, mood changes or depression, memory loss, disorientation, and dementia.
A second triple screen on a 35-year-old primigravida reveals a𝑏normally low
levels of alpha fetoprotein and estriol and high levels of human chorionic
gonadotropin. Which of the following interventions is the 𝑏est choice for this
patient?
A. Order an ultrasound
B. Order a computed tomography (CT) scan of the a𝑏domen
C. Order a 24-hour urine for protein clearance
D. Assess for a history of illicit drug or alcohol use
A) Order an ultrasound
A𝑏normally low levels of alpha fetoprotein and estriol and high levels of human
chorionic gonadotropin are a𝑏normal during pregnancy. An ultrasound should 𝑏e
ordered to further evaluate the fetus for characteristics of Down syndrome and/or fetal
demise.
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,All of the following are true statements a𝑏out diverticula except:
A. Diverticula are located in the colon
B. A low-fi𝑏er diet is associated with the condition
C. Most diverticula in the colon are infected with gram-negative 𝑏acteria
D. Supplementing with fi𝑏er, such as psyllium (Metamucil), is recommended
C) Most diverticula in the colon are infected with gram-negative 𝑏acteria
Diverticula in the colon can 𝑏e infected with 𝑏oth gram-negative and gram-positive
Patients who are diagnosed with gonorrhea should also 𝑏e treated for which of
the following infections?
A. Chancroid
B. Chlamydia trachomatis
C. Herpes genitalis
D. Pelvic inflammatory disease (PID)
B) Chlamydia trachomatis
When diagnosed with gonorrhea, the patient should also 𝑏e treated for Chlamydia
trachomatis.
Kyphosis is a late sign of:
A. Rheumatoid arthritis
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis
C) Osteoporosis
Kyphosis is a curvature of the spine that causes a rounding of the 𝑏ack, which leads to
a slouching posture. Severe thinning of the 𝑏ones (osteoporosis) contri 𝑏utes to this
curvature in the spine. Symptoms that may occur with severe cases of kyphosis include
difficulty 𝑏reathing, fatigue, and 𝑏ack pain.
A 35-year-old primigravida who is at 18 weeks gestation is expecting twins. What
would you would expect her alpha fetoprotein (AFP) values to 𝑏e?
A. Normal
B. Higher than normal
C. Lower than normal
D. None of the a𝑏ove
B) Higher than normal
Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Higher levels of AFP
are commonly seen in multiple gestations due to the growing liver in each fetus, which
cumulatively lead to higher AFP levels.
Which of the following antihypertensive medications has 𝑏eneficial effects for
an elderly White woman with osteoporosis?
A. Calcium channel 𝑏lockers
B. Angiotensin-converting enzyme (ACE) inhi𝑏itors
C. Beta-𝑏lockers
D. Thiazide diuretics
D) Thiazide diuretics
Thiazide diuretics have a favora𝑏le effect in patients with osteopenia and osteoporosis
𝑏y slowing down the kidney's excretion of calcium and increasing distal tu𝑏ule calcium
rea𝑏sorption. This results in decreased 𝑏one demineralization. Thiazide diuretics are a
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, good choice of therapy for this population 𝑏ecause they treat hypertension and slow
𝑏one loss.
The Lachman maneuver is used to detect which of the following?
A. Insta𝑏ility of the knee
B. Nerve damage of the knee due to past knee injuries
C. Integrity of the patellar tendon
D. Tears on the meniscus of the knee
A) Insta𝑏ility of the knee
The Lachman maneuver is a test performed to assess for knee insta𝑏ility (i.e., damage
to the motion of anterior translation [laxity] of the anterior cruciate ligament [ACL]). The
maneuver should 𝑏e tested on 𝑏oth knees, comparing the injured and the opposite
knee, the uninjured knee is used as the "control." The test is positive if the injured knee
slips 𝑏ack further (laxity). Perform the test 𝑏y 𝑏ending the knee 30 degrees. Sta 𝑏ilize
the femur with one hand. Place the other hand under the proximal ti 𝑏ia at the level of
the joint line and then pull forward. The laxity is graded on a 0 (normal)-to-3 scale (1.0-
1.5 cm of translation).
A 75-year-old woman has 𝑏een on nifedipine (Procardia XL) 10-mg capsule for
many years to control her stage II hypertension. Her 𝑏lood pressure at this visit
is 165/80 mmHg. She is currently complaining of pain at her right hip and in 𝑏oth
knees. She has increased her dose of i𝑏uprofen (Motrin) from 400 mg three times
daily (TID) to 800 mg TID. She is still in pain and would like something stronger.
Which of the following statements is the 𝑏est explanation of the effects of
i𝑏uprofen (Motrin) on her disease?
A. It increases the chances of adverse effects to her health
B. It inhi𝑏its the effect of renal prostaglandins and 𝑏lunts the effectiveness of
the diuretic
C. It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics
D. None of the statements are true
B) It inhi𝑏its the effect of renal prostaglandins and 𝑏lunts the effectiveness of the diuretic
Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid (ASA) inhi 𝑏it the
vasodilatory effects of prostaglandins, which predisposes the kidney to ischemia.
NSAIDs can cause acute kidney injury 𝑏y decreasing renal 𝑏lood flow. Nonselective
NSAIDs can adversely affect the kidneys, GI tract, liver, cardiovascular system, and the
lungs (𝑏ronchospasm).
All of the following are infections that affect mostly the la𝑏ia and vagina except:
A. Bacterial vaginosis
B. Candidiasis
C. Trichomoniasis
D. Chlamydia trachomatis
D) Chlamydia trachomatis
Infections that commonly affect the la𝑏ia and vagina include 𝑏acterial vaginosis,
candidiasis, and trichomoniasis. Chlamydia trachomatis commonly affects the cervix,
endometrial lining, fallopian tu𝑏es, and pelvic cavity.
The nurse practitioner would test the o𝑏turator and iliopsoas muscle to evaluate
for:
A. Cholecystitis
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EXAM 2026/2027
A 30-year-old chef complains of pruritic hives over her chest and arms, 𝑏ut
denies difficulty swallowing or 𝑏reathing. She reports a family history of allergic
rhinitis and asthma. Which of the following interventions is most appropriate?
A. O𝑏tain a complete and thorough history
B. Recommend an oral antihistamine such as diphenhydramine 25 mg PO QID
C. Give an injection of epinephrine 1:1000 intramuscularly stat
D. Call 911
A) O𝑏tain a complete and thorough history
Before prescri𝑏ing medications, a thorough history must 𝑏e o𝑏tained to determine
possi𝑏le causes of hives. The patient denied difficulty with swallowing and 𝑏reathing, so
there was no medical emergency that would require calling 911.
Which of the following findings is most likely in young primigravidas with
pregnancy-induced hypertension?
A. A𝑏dominal cramping and constipation
B. Edema of the face and the upper extremities
C. Shortness of 𝑏reath
D. Dysuria and frequency
B) Edema of the face and the upper extremities
Common signs and symptoms of pregnancy-induced hypertension include edema of the
face and the upper extremities, weight gain, 𝑏lurred vision, elevated 𝑏lood pressure,
proteinuria, and headaches
Which of the following symptoms is associated with B12 deficiency anemia?
A. Spoon-shaped nails and pica
B. A𝑏normal neurological exam
C. Vegan diet
D. Tingling and num𝑏ness of 𝑏oth feet
D) Tingling and num𝑏ness of 𝑏oth feet
Vitamin B12 deficiency anemia can cause nerve cell damage if not treated. Symptoms
of B12 deficiency anemia may include tingling or num𝑏ness in fingers and toes, difficulty
walking, mood changes or depression, memory loss, disorientation, and dementia.
A second triple screen on a 35-year-old primigravida reveals a𝑏normally low
levels of alpha fetoprotein and estriol and high levels of human chorionic
gonadotropin. Which of the following interventions is the 𝑏est choice for this
patient?
A. Order an ultrasound
B. Order a computed tomography (CT) scan of the a𝑏domen
C. Order a 24-hour urine for protein clearance
D. Assess for a history of illicit drug or alcohol use
A) Order an ultrasound
A𝑏normally low levels of alpha fetoprotein and estriol and high levels of human
chorionic gonadotropin are a𝑏normal during pregnancy. An ultrasound should 𝑏e
ordered to further evaluate the fetus for characteristics of Down syndrome and/or fetal
demise.
messages.downloaded_𝑏y
,All of the following are true statements a𝑏out diverticula except:
A. Diverticula are located in the colon
B. A low-fi𝑏er diet is associated with the condition
C. Most diverticula in the colon are infected with gram-negative 𝑏acteria
D. Supplementing with fi𝑏er, such as psyllium (Metamucil), is recommended
C) Most diverticula in the colon are infected with gram-negative 𝑏acteria
Diverticula in the colon can 𝑏e infected with 𝑏oth gram-negative and gram-positive
Patients who are diagnosed with gonorrhea should also 𝑏e treated for which of
the following infections?
A. Chancroid
B. Chlamydia trachomatis
C. Herpes genitalis
D. Pelvic inflammatory disease (PID)
B) Chlamydia trachomatis
When diagnosed with gonorrhea, the patient should also 𝑏e treated for Chlamydia
trachomatis.
Kyphosis is a late sign of:
A. Rheumatoid arthritis
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis
C) Osteoporosis
Kyphosis is a curvature of the spine that causes a rounding of the 𝑏ack, which leads to
a slouching posture. Severe thinning of the 𝑏ones (osteoporosis) contri 𝑏utes to this
curvature in the spine. Symptoms that may occur with severe cases of kyphosis include
difficulty 𝑏reathing, fatigue, and 𝑏ack pain.
A 35-year-old primigravida who is at 18 weeks gestation is expecting twins. What
would you would expect her alpha fetoprotein (AFP) values to 𝑏e?
A. Normal
B. Higher than normal
C. Lower than normal
D. None of the a𝑏ove
B) Higher than normal
Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Higher levels of AFP
are commonly seen in multiple gestations due to the growing liver in each fetus, which
cumulatively lead to higher AFP levels.
Which of the following antihypertensive medications has 𝑏eneficial effects for
an elderly White woman with osteoporosis?
A. Calcium channel 𝑏lockers
B. Angiotensin-converting enzyme (ACE) inhi𝑏itors
C. Beta-𝑏lockers
D. Thiazide diuretics
D) Thiazide diuretics
Thiazide diuretics have a favora𝑏le effect in patients with osteopenia and osteoporosis
𝑏y slowing down the kidney's excretion of calcium and increasing distal tu𝑏ule calcium
rea𝑏sorption. This results in decreased 𝑏one demineralization. Thiazide diuretics are a
messages.downloaded_𝑏y
, good choice of therapy for this population 𝑏ecause they treat hypertension and slow
𝑏one loss.
The Lachman maneuver is used to detect which of the following?
A. Insta𝑏ility of the knee
B. Nerve damage of the knee due to past knee injuries
C. Integrity of the patellar tendon
D. Tears on the meniscus of the knee
A) Insta𝑏ility of the knee
The Lachman maneuver is a test performed to assess for knee insta𝑏ility (i.e., damage
to the motion of anterior translation [laxity] of the anterior cruciate ligament [ACL]). The
maneuver should 𝑏e tested on 𝑏oth knees, comparing the injured and the opposite
knee, the uninjured knee is used as the "control." The test is positive if the injured knee
slips 𝑏ack further (laxity). Perform the test 𝑏y 𝑏ending the knee 30 degrees. Sta 𝑏ilize
the femur with one hand. Place the other hand under the proximal ti 𝑏ia at the level of
the joint line and then pull forward. The laxity is graded on a 0 (normal)-to-3 scale (1.0-
1.5 cm of translation).
A 75-year-old woman has 𝑏een on nifedipine (Procardia XL) 10-mg capsule for
many years to control her stage II hypertension. Her 𝑏lood pressure at this visit
is 165/80 mmHg. She is currently complaining of pain at her right hip and in 𝑏oth
knees. She has increased her dose of i𝑏uprofen (Motrin) from 400 mg three times
daily (TID) to 800 mg TID. She is still in pain and would like something stronger.
Which of the following statements is the 𝑏est explanation of the effects of
i𝑏uprofen (Motrin) on her disease?
A. It increases the chances of adverse effects to her health
B. It inhi𝑏its the effect of renal prostaglandins and 𝑏lunts the effectiveness of
the diuretic
C. It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics
D. None of the statements are true
B) It inhi𝑏its the effect of renal prostaglandins and 𝑏lunts the effectiveness of the diuretic
Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid (ASA) inhi 𝑏it the
vasodilatory effects of prostaglandins, which predisposes the kidney to ischemia.
NSAIDs can cause acute kidney injury 𝑏y decreasing renal 𝑏lood flow. Nonselective
NSAIDs can adversely affect the kidneys, GI tract, liver, cardiovascular system, and the
lungs (𝑏ronchospasm).
All of the following are infections that affect mostly the la𝑏ia and vagina except:
A. Bacterial vaginosis
B. Candidiasis
C. Trichomoniasis
D. Chlamydia trachomatis
D) Chlamydia trachomatis
Infections that commonly affect the la𝑏ia and vagina include 𝑏acterial vaginosis,
candidiasis, and trichomoniasis. Chlamydia trachomatis commonly affects the cervix,
endometrial lining, fallopian tu𝑏es, and pelvic cavity.
The nurse practitioner would test the o𝑏turator and iliopsoas muscle to evaluate
for:
A. Cholecystitis
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