AANP FNP CERTIFICATION
,AANP FNP CERTIFICATION
AANP FNP CERTIFICATION
Question 1:
A 45-year-old male presents with a 2-week history of epigastric pain that radiates to his
back. He reports the pain is worse after meals and at night. He has a history of heavy
alcohol use and takes ibuprofen daily for knee pain. Physical examination reveals mild
epigastric tenderness. The most likely diagnosis is:
A) Acute pancreatitis
B) Peptic ulcer disease
C) Gastric cancer
D) Cholecystitis
Answer: B) Peptic ulcer disease
Rationale: The combination of epigastric pain radiating to the back, worsening after meals
and at night, with NSAID use and alcohol history is classic for peptic ulcer disease.
Question 2:
A 68-year-old woman presents with a 3-month history of progressive shortness of
breath, fatigue, and ankle swelling. She has a history of hypertension and diabetes. On
examination, she has jugular venous distension, crackles at the lung bases, and 2+
pitting edema in both lower extremities. The most likely diagnosis is:
A) Chronic obstructive pulmonary disease
B) Heart failure
C) Liver cirrhosis
D) Nephrotic syndrome
Answer: B) Heart failure
Rationale: The triad of dyspnea, fatigue, and peripheral edema with JVD and pulmonary
crackles is classic for heart failure. Risk factors include hypertension and diabetes.
,AANP FNP CERTIFICATION
Question 3:
A 32-year-old woman presents with a 1-week history of fever, sore throat, and
generalized fatigue. On examination, she has posterior cervical lymphadenopathy and
splenomegaly. Laboratory studies show atypical lymphocytes on peripheral smear. The
most likely diagnosis is:
A) Streptococcal pharyngitis
B) Infectious mononucleosis
C) Cytomegalovirus infection
D) HIV seroconversion
Answer: B) Infectious mononucleosis
Rationale: Infectious mononucleosis presents with fever, sore throat, fatigue, posterior
cervical lymphadenopathy, splenomegaly, and atypical lymphocytes.
Question 4:
A 55-year-old man with a 30-pack-year smoking history presents with a chronic cough,
hemoptysis, and unintentional weight loss of 15 pounds over 3 months. Chest X-ray
shows a left hilar mass. The most appropriate next step is:
A) Repeat chest X-ray in 3 months
B) CT-guided biopsy
C) Bronchoscopy with biopsy
D) PET scan
Answer: C) Bronchoscopy with biopsy
Rationale: The combination of chronic cough, hemoptysis, weight loss, smoking history,
and a hilar mass is highly suspicious for lung cancer. Bronchoscopy with biopsy is the
definitive diagnostic procedure for central lesions.
Question 5:
A 28-year-old woman presents with a 2-day history of painful, swollen, and
erythematous right great toe. She reports a similar episode 6 months ago that resolved
without treatment. She has no history of trauma. The most likely diagnosis is:
, AANP FNP CERTIFICATION
A) Septic arthritis
B) Gout
C) Rheumatoid arthritis
D) Osteoarthritis
Answer: B) Gout
Rationale: Acute monoarticular arthritis of the first metatarsophalangeal joint with
recurrent episodes is classic for gout.
Question 6:
A 72-year-old man presents with acute confusion, fever, and urinary frequency. His
family reports he has been "acting strange" for 2 days. Urinalysis shows positive nitrites
and leukocyte esterase. The most likely diagnosis is:
A) Urinary tract infection with delirium
B) Dementia
C) Alzheimer's disease
D) Stroke
Answer: A) Urinary tract infection with delirium
Rationale: In elderly patients, UTIs often present with acute delirium (confusion) rather
than classic urinary symptoms. Positive nitrites and leukocyte esterase confirm UTI.
Question 7:
A 45-year-old woman presents with a 6-month history of fatigue, joint pain, and a malar
rash that spares the nasolabial folds. She also reports photosensitivity and oral ulcers.
The most likely diagnosis is:
A) Rosacea
B) Systemic lupus erythematosus (SLE)
C) Dermatomyositis
D) Psoriasis
Answer: B) Systemic lupus erythematosus (SLE)
Rationale: The malar rash sparing the nasolabial folds, photosensitivity, oral ulcers,
fatigue, and arthralgias are classic features of SLE.
,AANP FNP CERTIFICATION
AANP FNP CERTIFICATION
Question 1:
A 45-year-old male presents with a 2-week history of epigastric pain that radiates to his
back. He reports the pain is worse after meals and at night. He has a history of heavy
alcohol use and takes ibuprofen daily for knee pain. Physical examination reveals mild
epigastric tenderness. The most likely diagnosis is:
A) Acute pancreatitis
B) Peptic ulcer disease
C) Gastric cancer
D) Cholecystitis
Answer: B) Peptic ulcer disease
Rationale: The combination of epigastric pain radiating to the back, worsening after meals
and at night, with NSAID use and alcohol history is classic for peptic ulcer disease.
Question 2:
A 68-year-old woman presents with a 3-month history of progressive shortness of
breath, fatigue, and ankle swelling. She has a history of hypertension and diabetes. On
examination, she has jugular venous distension, crackles at the lung bases, and 2+
pitting edema in both lower extremities. The most likely diagnosis is:
A) Chronic obstructive pulmonary disease
B) Heart failure
C) Liver cirrhosis
D) Nephrotic syndrome
Answer: B) Heart failure
Rationale: The triad of dyspnea, fatigue, and peripheral edema with JVD and pulmonary
crackles is classic for heart failure. Risk factors include hypertension and diabetes.
,AANP FNP CERTIFICATION
Question 3:
A 32-year-old woman presents with a 1-week history of fever, sore throat, and
generalized fatigue. On examination, she has posterior cervical lymphadenopathy and
splenomegaly. Laboratory studies show atypical lymphocytes on peripheral smear. The
most likely diagnosis is:
A) Streptococcal pharyngitis
B) Infectious mononucleosis
C) Cytomegalovirus infection
D) HIV seroconversion
Answer: B) Infectious mononucleosis
Rationale: Infectious mononucleosis presents with fever, sore throat, fatigue, posterior
cervical lymphadenopathy, splenomegaly, and atypical lymphocytes.
Question 4:
A 55-year-old man with a 30-pack-year smoking history presents with a chronic cough,
hemoptysis, and unintentional weight loss of 15 pounds over 3 months. Chest X-ray
shows a left hilar mass. The most appropriate next step is:
A) Repeat chest X-ray in 3 months
B) CT-guided biopsy
C) Bronchoscopy with biopsy
D) PET scan
Answer: C) Bronchoscopy with biopsy
Rationale: The combination of chronic cough, hemoptysis, weight loss, smoking history,
and a hilar mass is highly suspicious for lung cancer. Bronchoscopy with biopsy is the
definitive diagnostic procedure for central lesions.
Question 5:
A 28-year-old woman presents with a 2-day history of painful, swollen, and
erythematous right great toe. She reports a similar episode 6 months ago that resolved
without treatment. She has no history of trauma. The most likely diagnosis is:
, AANP FNP CERTIFICATION
A) Septic arthritis
B) Gout
C) Rheumatoid arthritis
D) Osteoarthritis
Answer: B) Gout
Rationale: Acute monoarticular arthritis of the first metatarsophalangeal joint with
recurrent episodes is classic for gout.
Question 6:
A 72-year-old man presents with acute confusion, fever, and urinary frequency. His
family reports he has been "acting strange" for 2 days. Urinalysis shows positive nitrites
and leukocyte esterase. The most likely diagnosis is:
A) Urinary tract infection with delirium
B) Dementia
C) Alzheimer's disease
D) Stroke
Answer: A) Urinary tract infection with delirium
Rationale: In elderly patients, UTIs often present with acute delirium (confusion) rather
than classic urinary symptoms. Positive nitrites and leukocyte esterase confirm UTI.
Question 7:
A 45-year-old woman presents with a 6-month history of fatigue, joint pain, and a malar
rash that spares the nasolabial folds. She also reports photosensitivity and oral ulcers.
The most likely diagnosis is:
A) Rosacea
B) Systemic lupus erythematosus (SLE)
C) Dermatomyositis
D) Psoriasis
Answer: B) Systemic lupus erythematosus (SLE)
Rationale: The malar rash sparing the nasolabial folds, photosensitivity, oral ulcers,
fatigue, and arthralgias are classic features of SLE.
