AANP FAMILY NURSE PRACTITIONER (FNP)
CERTIFICATION EXAM GUIDE
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
1.
A 52-year-old woman presents with fatigue, constipation, and cold intolerance.
Her TSH is 12 mIU/L (normal 0.4–4.0 mIU/L) and free T4 is low. Which is the most
appropriate first-line treatment?
A. Methimazole
B. Levothyroxine
C. Radioactive iodine
D. Propylthiouracil
Answer: B. Levothyroxine
Rationale: The patient has primary hypothyroidism. Levothyroxine is the standard
treatment for hypothyroidism. Methimazole and propylthiouracil are used for
hyperthyroidism, and radioactive iodine is used for hyperthyroidism or toxic
nodules.
,2.
A 65-year-old man with type 2 diabetes presents for routine follow-up. His HbA1c
is 8.5%. He is currently on metformin 1000 mg BID. Which is the next best step?
A. Increase metformin to 1500 mg BID
B. Add a GLP-1 receptor agonist or SGLT2 inhibitor
C. Switch to insulin immediately
D. Discontinue metformin and start sulfonylurea
Answer: B. Add a GLP-1 receptor agonist or SGLT2 inhibitor
Rationale: Current ADA guidelines recommend adding a second agent (GLP-1 RA
or SGLT2 inhibitor) for patients with HbA1c above target despite maximal
tolerated metformin, especially in patients with cardiovascular risk.
3.
A 30-year-old woman presents with acute onset dysuria and urinary frequency.
She has no fever or flank pain. Urine dipstick shows positive nitrites and leukocyte
esterase. What is the most appropriate management?
A. Order renal ultrasound
B. Prescribe a 3-day course of nitrofurantoin
C. Begin empiric IV antibiotics
D. Prescribe a 14-day course of ciprofloxacin
Answer: B. Prescribe a 3-day course of nitrofurantoin
Rationale: Uncomplicated cystitis in non-pregnant women can be treated with
short-course nitrofurantoin or TMP-SMX. Imaging or IV antibiotics are
unnecessary for uncomplicated lower UTI without systemic symptoms.
,4.
A 48-year-old male smoker presents with a chronic cough and 15-pound
unintentional weight loss over 3 months. Chest X-ray reveals a 3-cm solitary
pulmonary nodule. Which is the next best step?
A. Repeat chest X-ray in 3 months
B. Low-dose CT scan for screening
C. Refer for tissue biopsy
D. Start empiric antibiotics
Answer: C. Refer for tissue biopsy
Rationale: A solitary pulmonary nodule with risk factors (smoking, weight loss,
age >40) requires tissue diagnosis. Observation or antibiotics are inappropriate
without evidence of infection.
5.
A 22-year-old woman presents with sudden onset of right lower quadrant
abdominal pain. She is sexually active. Vital signs are stable. Which test should be
obtained first?
A. Abdominal CT with contrast
B. Pelvic ultrasound
C. Urine pregnancy test
D. MRI pelvis
Answer: C. Urine pregnancy test
Rationale: In women of childbearing age, pregnancy must first be ruled out to
avoid missing ectopic pregnancy and to guide imaging safely. Ultrasound is
indicated next if pregnancy test is negative or if ectopic is suspected.
, 6.
A 5-year-old boy presents with barking cough, inspiratory stridor, and low-grade
fever. Which is the most appropriate initial management?
A. Oral antibiotics
B. Inhaled albuterol
C. Humidified air and dexamethasone
D. Immediate intubation
Answer: C. Humidified air and dexamethasone
Rationale: This presentation is consistent with croup. Mild to moderate cases are
managed with supportive care and corticosteroids. Antibiotics are not indicated;
severe respiratory distress may require advanced airway management.
7.
A 40-year-old woman presents with fatigue and shortness of breath. Labs show
hemoglobin 8.5 g/dL, MCV 70 fL, ferritin 8 ng/mL. What is the most likely
diagnosis?
A. Vitamin B12 deficiency
B. Iron-deficiency anemia
C. Anemia of chronic disease
D. Sickle cell anemia
Answer: B. Iron-deficiency anemia
Rationale: Microcytic anemia with low ferritin is consistent with iron-deficiency
anemia. B12 deficiency causes macrocytic anemia. Anemia of chronic disease
usually has normal or high ferritin.
CERTIFICATION EXAM GUIDE
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
1.
A 52-year-old woman presents with fatigue, constipation, and cold intolerance.
Her TSH is 12 mIU/L (normal 0.4–4.0 mIU/L) and free T4 is low. Which is the most
appropriate first-line treatment?
A. Methimazole
B. Levothyroxine
C. Radioactive iodine
D. Propylthiouracil
Answer: B. Levothyroxine
Rationale: The patient has primary hypothyroidism. Levothyroxine is the standard
treatment for hypothyroidism. Methimazole and propylthiouracil are used for
hyperthyroidism, and radioactive iodine is used for hyperthyroidism or toxic
nodules.
,2.
A 65-year-old man with type 2 diabetes presents for routine follow-up. His HbA1c
is 8.5%. He is currently on metformin 1000 mg BID. Which is the next best step?
A. Increase metformin to 1500 mg BID
B. Add a GLP-1 receptor agonist or SGLT2 inhibitor
C. Switch to insulin immediately
D. Discontinue metformin and start sulfonylurea
Answer: B. Add a GLP-1 receptor agonist or SGLT2 inhibitor
Rationale: Current ADA guidelines recommend adding a second agent (GLP-1 RA
or SGLT2 inhibitor) for patients with HbA1c above target despite maximal
tolerated metformin, especially in patients with cardiovascular risk.
3.
A 30-year-old woman presents with acute onset dysuria and urinary frequency.
She has no fever or flank pain. Urine dipstick shows positive nitrites and leukocyte
esterase. What is the most appropriate management?
A. Order renal ultrasound
B. Prescribe a 3-day course of nitrofurantoin
C. Begin empiric IV antibiotics
D. Prescribe a 14-day course of ciprofloxacin
Answer: B. Prescribe a 3-day course of nitrofurantoin
Rationale: Uncomplicated cystitis in non-pregnant women can be treated with
short-course nitrofurantoin or TMP-SMX. Imaging or IV antibiotics are
unnecessary for uncomplicated lower UTI without systemic symptoms.
,4.
A 48-year-old male smoker presents with a chronic cough and 15-pound
unintentional weight loss over 3 months. Chest X-ray reveals a 3-cm solitary
pulmonary nodule. Which is the next best step?
A. Repeat chest X-ray in 3 months
B. Low-dose CT scan for screening
C. Refer for tissue biopsy
D. Start empiric antibiotics
Answer: C. Refer for tissue biopsy
Rationale: A solitary pulmonary nodule with risk factors (smoking, weight loss,
age >40) requires tissue diagnosis. Observation or antibiotics are inappropriate
without evidence of infection.
5.
A 22-year-old woman presents with sudden onset of right lower quadrant
abdominal pain. She is sexually active. Vital signs are stable. Which test should be
obtained first?
A. Abdominal CT with contrast
B. Pelvic ultrasound
C. Urine pregnancy test
D. MRI pelvis
Answer: C. Urine pregnancy test
Rationale: In women of childbearing age, pregnancy must first be ruled out to
avoid missing ectopic pregnancy and to guide imaging safely. Ultrasound is
indicated next if pregnancy test is negative or if ectopic is suspected.
, 6.
A 5-year-old boy presents with barking cough, inspiratory stridor, and low-grade
fever. Which is the most appropriate initial management?
A. Oral antibiotics
B. Inhaled albuterol
C. Humidified air and dexamethasone
D. Immediate intubation
Answer: C. Humidified air and dexamethasone
Rationale: This presentation is consistent with croup. Mild to moderate cases are
managed with supportive care and corticosteroids. Antibiotics are not indicated;
severe respiratory distress may require advanced airway management.
7.
A 40-year-old woman presents with fatigue and shortness of breath. Labs show
hemoglobin 8.5 g/dL, MCV 70 fL, ferritin 8 ng/mL. What is the most likely
diagnosis?
A. Vitamin B12 deficiency
B. Iron-deficiency anemia
C. Anemia of chronic disease
D. Sickle cell anemia
Answer: B. Iron-deficiency anemia
Rationale: Microcytic anemia with low ferritin is consistent with iron-deficiency
anemia. B12 deficiency causes macrocytic anemia. Anemia of chronic disease
usually has normal or high ferritin.
