ANCC FAMILY NURSE PRACTITIONER
EXAM BOARD EXAM LATEST ACTUAL
EXAM TEST BANK QUESTIONS AND
CORRECT ANSWERS
Question 1
A 50-year-old man presents for evaluation of hypersomnolence. He falls asleep at
his desk and while watching TV despite 8 hours of sleep nightly. He drinks coffee
to "wake up." BP 160/100, BMI 38 kg/m². Neuro exam normal. What is the best
next step?
A. Ambulatory ECG monitoring
B. CT scan of the head
C. Nocturnal polysomnography
D. Sleep hygiene education
Correct Answer: C. Nocturnal polysomnography
Rationale: This patient with hypersomnolence, obesity, and resistant hypertension
most likely has obstructive sleep apnea (OSA). Nocturnal polysomnography (sleep
study) is the gold standard for diagnosis. Sleep hygiene education (D) is inadequate
when sleep insufficiency is due to poor quality rather than quantity .
Question 2
A 3-year-old male is brought in with a rash that has brownish-yellow crusting. He
is afebrile, active, and up-to-date on vaccines. No lymphadenopathy. Most likely
diagnosis?
A. Strawberry hemangioma
,B. Impetigo
C. Erysipelas
D. Herpes Simplex Virus-1 Infection
Correct Answer: B. Impetigo
Rationale: Impetigo is a superficial skin infection common in children, usually
caused by Staphylococcus aureus or Streptococcus pyogenes. Classic presentation
is a red base with honey-colored crusting. Topical mupirocin is sufficient for small
lesions .
Question 3
Which lab value is most important to monitor in a patient taking lithium?
A. Liver enzymes
B. Hemoglobin A1c
C. Serum creatinine and sodium
D. White blood cell count
Correct Answer: C. Serum creatinine and sodium
Rationale: Lithium is excreted by the kidneys and can cause nephrogenic diabetes
insipidus and renal impairment. Sodium levels affect lithium reabsorption—
hyponatremia increases lithium levels, risking toxicity. Renal function and
electrolytes must be monitored regularly .
Question 4
A 45-year-old man presents for routine preventive exam. He has many pigmented
lesions on his back, including a flat, dark 9-mm lesion with irregular borders. Best
next step?
A. Excisional biops y
B. Incisional biopsy
,C. Photographic documentation and comparison in 6-12 months
D. Reassurance and routine follow up only
Correct Answer: A. Excisional biopsy
Rationale: This lesion has features suspicious for melanoma: size >6mm, border
irregularity. Excisional biopsy with 1-3 mm margins is preferred as lesion thickness
is the most important prognostic factor. Incisional biopsy (B) is not recommended
as it prevents accurate thickness measurement .
Question 5
A 68-year-old patient presents with new-onset confusion, fever, and productive
cough. Which of the following is the most likely cause?
A. Alzheimer's disease
B. Delirium secondary to pneumonia
C. Vascular dementia
D. Generalized anxiety disorder
Correct Answer: B. Delirium secondary to pneumonia
Rationale: Delirium is a sudden change in mental status caused by an underlying
medical condition. Pneumonia is a common cause of delirium in older adults due
to systemic infection . Unlike dementia (Alzheimer's or vascular), which develops
gradually, delirium has an acute onset and is often reversible once the underlying
cause is treated.
Question 6
A 45-year-old female with no significant past medical problems presents with a
4day history of fever and a cough productive of yellow-green sputum. She had a
runny nose, sore throat, and dry cough for 2 weeks, which seemed to improve
, before progressing. Physical exam: T 102°F, RR 22. Chest auscultation would most
likely yield crackles in which area?
A. Right Lower Lobe
B. Right Upper Lobe
C. Left Upper Lobe D. Left Lower Lobe
Correct Answer: D. Left Lower Lobe
Rationale: This clinical vignette describes a classic progression from viral URI to
bacterial pneumonia. To standardize localization in chest imaging, the clinician
views the image with the patient facing them—therefore, the patient's left side
appears on the right side of the image. The opacified region adjacent to the heart
corresponds to the left lower lobe, where crackles would be heard on auscultation
.
Question 7
Which of the following best describes the concept of autonomy in nursing ethics?
A. Doing no harm to the patient
B. Providing equal treatment to all
C. Respecting the patient's right to make decisions
D. Acting in the patient's best interest
Correct Answer: C. Respecting the patient's right to make decisions
Rationale: Autonomy refers to the patient's right to self-determination, including
making informed choices about their own care . Nonmaleficence is "doing no
harm" (A). Justice is providing equal treatment (B). Beneficence is acting in the
patient's best interest (D).
EXAM BOARD EXAM LATEST ACTUAL
EXAM TEST BANK QUESTIONS AND
CORRECT ANSWERS
Question 1
A 50-year-old man presents for evaluation of hypersomnolence. He falls asleep at
his desk and while watching TV despite 8 hours of sleep nightly. He drinks coffee
to "wake up." BP 160/100, BMI 38 kg/m². Neuro exam normal. What is the best
next step?
A. Ambulatory ECG monitoring
B. CT scan of the head
C. Nocturnal polysomnography
D. Sleep hygiene education
Correct Answer: C. Nocturnal polysomnography
Rationale: This patient with hypersomnolence, obesity, and resistant hypertension
most likely has obstructive sleep apnea (OSA). Nocturnal polysomnography (sleep
study) is the gold standard for diagnosis. Sleep hygiene education (D) is inadequate
when sleep insufficiency is due to poor quality rather than quantity .
Question 2
A 3-year-old male is brought in with a rash that has brownish-yellow crusting. He
is afebrile, active, and up-to-date on vaccines. No lymphadenopathy. Most likely
diagnosis?
A. Strawberry hemangioma
,B. Impetigo
C. Erysipelas
D. Herpes Simplex Virus-1 Infection
Correct Answer: B. Impetigo
Rationale: Impetigo is a superficial skin infection common in children, usually
caused by Staphylococcus aureus or Streptococcus pyogenes. Classic presentation
is a red base with honey-colored crusting. Topical mupirocin is sufficient for small
lesions .
Question 3
Which lab value is most important to monitor in a patient taking lithium?
A. Liver enzymes
B. Hemoglobin A1c
C. Serum creatinine and sodium
D. White blood cell count
Correct Answer: C. Serum creatinine and sodium
Rationale: Lithium is excreted by the kidneys and can cause nephrogenic diabetes
insipidus and renal impairment. Sodium levels affect lithium reabsorption—
hyponatremia increases lithium levels, risking toxicity. Renal function and
electrolytes must be monitored regularly .
Question 4
A 45-year-old man presents for routine preventive exam. He has many pigmented
lesions on his back, including a flat, dark 9-mm lesion with irregular borders. Best
next step?
A. Excisional biops y
B. Incisional biopsy
,C. Photographic documentation and comparison in 6-12 months
D. Reassurance and routine follow up only
Correct Answer: A. Excisional biopsy
Rationale: This lesion has features suspicious for melanoma: size >6mm, border
irregularity. Excisional biopsy with 1-3 mm margins is preferred as lesion thickness
is the most important prognostic factor. Incisional biopsy (B) is not recommended
as it prevents accurate thickness measurement .
Question 5
A 68-year-old patient presents with new-onset confusion, fever, and productive
cough. Which of the following is the most likely cause?
A. Alzheimer's disease
B. Delirium secondary to pneumonia
C. Vascular dementia
D. Generalized anxiety disorder
Correct Answer: B. Delirium secondary to pneumonia
Rationale: Delirium is a sudden change in mental status caused by an underlying
medical condition. Pneumonia is a common cause of delirium in older adults due
to systemic infection . Unlike dementia (Alzheimer's or vascular), which develops
gradually, delirium has an acute onset and is often reversible once the underlying
cause is treated.
Question 6
A 45-year-old female with no significant past medical problems presents with a
4day history of fever and a cough productive of yellow-green sputum. She had a
runny nose, sore throat, and dry cough for 2 weeks, which seemed to improve
, before progressing. Physical exam: T 102°F, RR 22. Chest auscultation would most
likely yield crackles in which area?
A. Right Lower Lobe
B. Right Upper Lobe
C. Left Upper Lobe D. Left Lower Lobe
Correct Answer: D. Left Lower Lobe
Rationale: This clinical vignette describes a classic progression from viral URI to
bacterial pneumonia. To standardize localization in chest imaging, the clinician
views the image with the patient facing them—therefore, the patient's left side
appears on the right side of the image. The opacified region adjacent to the heart
corresponds to the left lower lobe, where crackles would be heard on auscultation
.
Question 7
Which of the following best describes the concept of autonomy in nursing ethics?
A. Doing no harm to the patient
B. Providing equal treatment to all
C. Respecting the patient's right to make decisions
D. Acting in the patient's best interest
Correct Answer: C. Respecting the patient's right to make decisions
Rationale: Autonomy refers to the patient's right to self-determination, including
making informed choices about their own care . Nonmaleficence is "doing no
harm" (A). Justice is providing equal treatment (B). Beneficence is acting in the
patient's best interest (D).
