AANP Family Nurse Practitioner (FNP) Certification
Practice Exam 2026 | 100 Board-Style Questions, Verified
Answers & Detailed Rationales
1. A 52-year-old man with type 2 diabetes has an HbA1c of 8.8% despite taking metformin.
His eGFR is 75 mL/min/1.73 m², and he has established cardiovascular disease. Which
medication is the best addition?
A. Glyburide
B. Pioglitazone
C. Empagliflozin
D. Acarbose
Answer: C. Empagliflozin
Rationale: SGLT2 inhibitors such as empagliflozin reduce cardiovascular events and
provide renal protection in patients with diabetes and established cardiovascular disease.
2. A 26-year-old woman presents with dysuria, urinary frequency, and urgency. She has no
fever or flank pain. Urinalysis is positive for leukocyte esterase and nitrites. What is the
most likely diagnosis?
A. Acute pyelonephritis
B. Acute uncomplicated cystitis
C. Interstitial cystitis
D. Urethritis
Answer: B. Acute uncomplicated cystitis
Rationale: Dysuria, frequency, urgency, and positive nitrites/leukocyte esterase indicate
uncomplicated bacterial cystitis.
3. According to current hypertension guidelines, what is the blood pressure goal for most
adults with diabetes?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
,D. <120/70 mmHg
Answer: C. <130/80 mmHg
Rationale: Most adults with diabetes should aim for a blood pressure below 130/80 mmHg
if it can be achieved safely.
4. A patient presents with sudden unilateral facial drooping involving the forehead. The
most likely diagnosis is:
A. Stroke
B. Bell’s palsy
C. Trigeminal neuralgia
D. Temporal arteritis
Answer: B. Bell’s palsy
Rationale: Bell’s palsy causes peripheral facial nerve paralysis affecting the entire side of
the face, including the forehead.
5. Which vaccine is routinely recommended annually for adults aged 65 years and older?
A. MMR
B. Influenza vaccine
C. Varicella vaccine
D. HPV vaccine
Answer: B. Influenza vaccine
Rationale: Annual influenza vaccination is recommended for all adults, especially those
aged 65 years and older.
6. Which laboratory test best monitors long-term glucose control?
A. Fasting glucose
B. Random glucose
C. HbA1c
D. Oral glucose tolerance test
Answer: C. HbA1c
, Rationale: HbA1c reflects average blood glucose over approximately three months.
7. A smoker with a 40-pack-year history should be screened annually for lung cancer if they
are:
A. 35 years old
B. 45 years old
C. 55–80 years old and currently smoke or quit within the past 15 years
D. Any age with chronic cough
Answer: C. 55–80 years old and currently smoke or quit within the past 15 years
Rationale: Annual low-dose CT screening is recommended for eligible high-risk adults
based on age and smoking history.
8. Which thyroid laboratory finding is consistent with primary hypothyroidism?
A. Low TSH, high free T4
B. High TSH, low free T4
C. High TSH, high free T4
D. Low TSH, low free T4
Answer: B. High TSH, low free T4
Rationale: Primary hypothyroidism results from thyroid gland failure, causing elevated TSH
and decreased free T4.
9. A patient has chest pain relieved by rest and nitroglycerin. The most likely diagnosis is:
A. Stable angina
B. Pulmonary embolism
C. Pericarditis
D. Aortic dissection
Answer: A. Stable angina
Rationale: Stable angina is characterized by predictable chest pain with exertion that is
relieved by rest or nitroglycerin.
Practice Exam 2026 | 100 Board-Style Questions, Verified
Answers & Detailed Rationales
1. A 52-year-old man with type 2 diabetes has an HbA1c of 8.8% despite taking metformin.
His eGFR is 75 mL/min/1.73 m², and he has established cardiovascular disease. Which
medication is the best addition?
A. Glyburide
B. Pioglitazone
C. Empagliflozin
D. Acarbose
Answer: C. Empagliflozin
Rationale: SGLT2 inhibitors such as empagliflozin reduce cardiovascular events and
provide renal protection in patients with diabetes and established cardiovascular disease.
2. A 26-year-old woman presents with dysuria, urinary frequency, and urgency. She has no
fever or flank pain. Urinalysis is positive for leukocyte esterase and nitrites. What is the
most likely diagnosis?
A. Acute pyelonephritis
B. Acute uncomplicated cystitis
C. Interstitial cystitis
D. Urethritis
Answer: B. Acute uncomplicated cystitis
Rationale: Dysuria, frequency, urgency, and positive nitrites/leukocyte esterase indicate
uncomplicated bacterial cystitis.
3. According to current hypertension guidelines, what is the blood pressure goal for most
adults with diabetes?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
,D. <120/70 mmHg
Answer: C. <130/80 mmHg
Rationale: Most adults with diabetes should aim for a blood pressure below 130/80 mmHg
if it can be achieved safely.
4. A patient presents with sudden unilateral facial drooping involving the forehead. The
most likely diagnosis is:
A. Stroke
B. Bell’s palsy
C. Trigeminal neuralgia
D. Temporal arteritis
Answer: B. Bell’s palsy
Rationale: Bell’s palsy causes peripheral facial nerve paralysis affecting the entire side of
the face, including the forehead.
5. Which vaccine is routinely recommended annually for adults aged 65 years and older?
A. MMR
B. Influenza vaccine
C. Varicella vaccine
D. HPV vaccine
Answer: B. Influenza vaccine
Rationale: Annual influenza vaccination is recommended for all adults, especially those
aged 65 years and older.
6. Which laboratory test best monitors long-term glucose control?
A. Fasting glucose
B. Random glucose
C. HbA1c
D. Oral glucose tolerance test
Answer: C. HbA1c
, Rationale: HbA1c reflects average blood glucose over approximately three months.
7. A smoker with a 40-pack-year history should be screened annually for lung cancer if they
are:
A. 35 years old
B. 45 years old
C. 55–80 years old and currently smoke or quit within the past 15 years
D. Any age with chronic cough
Answer: C. 55–80 years old and currently smoke or quit within the past 15 years
Rationale: Annual low-dose CT screening is recommended for eligible high-risk adults
based on age and smoking history.
8. Which thyroid laboratory finding is consistent with primary hypothyroidism?
A. Low TSH, high free T4
B. High TSH, low free T4
C. High TSH, high free T4
D. Low TSH, low free T4
Answer: B. High TSH, low free T4
Rationale: Primary hypothyroidism results from thyroid gland failure, causing elevated TSH
and decreased free T4.
9. A patient has chest pain relieved by rest and nitroglycerin. The most likely diagnosis is:
A. Stable angina
B. Pulmonary embolism
C. Pericarditis
D. Aortic dissection
Answer: A. Stable angina
Rationale: Stable angina is characterized by predictable chest pain with exertion that is
relieved by rest or nitroglycerin.
