ANCC FNP EXAM V2 LATEST 2025/ 2026
ACTUAL EXAM| COMPLETE 150 REAL
EXAM
**Question 1**
The NP is performing a funduscopic exam on a 65-year-old patient with diabetes. Which finding
indicates pre-proliferative diabetic retinopathy?
- A) Microaneurysms only
- B) Cotton-wool spots and venous beading
- C) Neovascularization of the optic disc
- D) Macular edema with hard exudates
,**Correct Answer: B) Cotton-wool spots and venous beading**
**Rationale:** Cotton-wool spots (soft exudates) and venous beading indicate retinal ischemia and are
hallmarks of moderate-to-severe non-proliferative (pre-proliferative) diabetic retinopathy.
Microaneurysms characterize mild non-proliferative disease. Neovascularization indicates proliferative
retinopathy, a later stage. Macular edema can occur at any stage but does not define pre-proliferative
disease .
---
**Question 2**
A 70-year-old patient reports difficulty hearing conversations in a noisy restaurant. Rinne test: air
conduction > bone conduction bilaterally. Weber test lateralizes to the left ear. Which type of hearing
loss is most likely in the left ear?
- A) Conductive hearing loss
- B) Sensorineural hearing loss
- C) Mixed hearing loss
- D) Normal hearing
**Correct Answer: B) Sensorineural hearing loss**
**Rationale:** A Rinne test with air conduction greater than bone conduction (positive Rinne) is normal
or indicates sensorineural loss. In sensorineural hearing loss, the Weber test lateralizes to the *better*
ear. Since Weber lateralizes to the left, the left ear has better function, indicating the right ear has
greater sensorineural loss; however, the left ear also demonstrates sensorineural involvement .
---
**Question 3**
, A 45-year-old female presents with right wrist pain and numbness in the thumb and index finger. Which
test involves tapping on the volar surface of the wrist to reproduce symptoms?
- A) Phalen maneuver
- B) Tinel sign
- C) Finkelstein test
- D) Allen test
**Correct Answer: B) Tinel sign**
**Rationale:** Tinel sign is performed by tapping gently over the median nerve at the volar surface of
the wrist. A positive test (tingling or electric shock sensation in the thumb, index, and middle fingers)
suggests carpal tunnel syndrome. Phalen maneuver involves wrist flexion; Finkelstein test is for De
Quervain tenosynovitis; Allen test evaluates arterial blood flow to the hand .
---
**Question 4**
During a sports physical for a 14-year-old athlete, you auscultate a split S2 heart sound that varies with
respiration (widens on inspiration, disappears on expiration). There are no murmurs. What is your
assessment?
- A) This is suspicious for an atrial septal defect and requires an echocardiogram
- B) This is a normal physiological finding in children and young adults
- C) This indicates pulmonic stenosis and requires cardiology referral
- D) This is an expected finding of hypertrophic cardiomyopathy
**Correct Answer: B) This is a normal physiological finding in children and young adults**
ACTUAL EXAM| COMPLETE 150 REAL
EXAM
**Question 1**
The NP is performing a funduscopic exam on a 65-year-old patient with diabetes. Which finding
indicates pre-proliferative diabetic retinopathy?
- A) Microaneurysms only
- B) Cotton-wool spots and venous beading
- C) Neovascularization of the optic disc
- D) Macular edema with hard exudates
,**Correct Answer: B) Cotton-wool spots and venous beading**
**Rationale:** Cotton-wool spots (soft exudates) and venous beading indicate retinal ischemia and are
hallmarks of moderate-to-severe non-proliferative (pre-proliferative) diabetic retinopathy.
Microaneurysms characterize mild non-proliferative disease. Neovascularization indicates proliferative
retinopathy, a later stage. Macular edema can occur at any stage but does not define pre-proliferative
disease .
---
**Question 2**
A 70-year-old patient reports difficulty hearing conversations in a noisy restaurant. Rinne test: air
conduction > bone conduction bilaterally. Weber test lateralizes to the left ear. Which type of hearing
loss is most likely in the left ear?
- A) Conductive hearing loss
- B) Sensorineural hearing loss
- C) Mixed hearing loss
- D) Normal hearing
**Correct Answer: B) Sensorineural hearing loss**
**Rationale:** A Rinne test with air conduction greater than bone conduction (positive Rinne) is normal
or indicates sensorineural loss. In sensorineural hearing loss, the Weber test lateralizes to the *better*
ear. Since Weber lateralizes to the left, the left ear has better function, indicating the right ear has
greater sensorineural loss; however, the left ear also demonstrates sensorineural involvement .
---
**Question 3**
, A 45-year-old female presents with right wrist pain and numbness in the thumb and index finger. Which
test involves tapping on the volar surface of the wrist to reproduce symptoms?
- A) Phalen maneuver
- B) Tinel sign
- C) Finkelstein test
- D) Allen test
**Correct Answer: B) Tinel sign**
**Rationale:** Tinel sign is performed by tapping gently over the median nerve at the volar surface of
the wrist. A positive test (tingling or electric shock sensation in the thumb, index, and middle fingers)
suggests carpal tunnel syndrome. Phalen maneuver involves wrist flexion; Finkelstein test is for De
Quervain tenosynovitis; Allen test evaluates arterial blood flow to the hand .
---
**Question 4**
During a sports physical for a 14-year-old athlete, you auscultate a split S2 heart sound that varies with
respiration (widens on inspiration, disappears on expiration). There are no murmurs. What is your
assessment?
- A) This is suspicious for an atrial septal defect and requires an echocardiogram
- B) This is a normal physiological finding in children and young adults
- C) This indicates pulmonic stenosis and requires cardiology referral
- D) This is an expected finding of hypertrophic cardiomyopathy
**Correct Answer: B) This is a normal physiological finding in children and young adults**
