ANCC FNP ACTUAL EXAM 2026/2027 | 200
Questions & Detailed Answers | A+ Graded |
Pass Guaranteed
1. A 50-year-old asymptomatic client asks which cancer screening tests are
recommended. The FNP should recommend all of the following EXCEPT:
A) Colorectal cancer screening beginning at age 45
B) Prostate-specific antigen (PSA) testing for all men at age 50
C) Biennial mammography for women aged 50–74
D) Lung cancer screening with low-dose CT for high-risk adults
Answer: B
Rationale: The USPSTF recommends shared decision-making for PSA screening in men
aged 55–69 (Grade C), not routine screening for all men at age 50. Colorectal screening at
45, biennial mammography for 50–74, and lung screening for high-risk adults are
evidence-based recommendations.
2. An FNP is performing a well-child examination on a 3-year-old. Which
developmental milestone is expected at this age?
A) Walking independently
B) Riding a tricycle
C) Tying shoelaces
D) Jumping rope
Answer: B
Rationale: At age 3, children typically can ride a tricycle, stand on one foot, and walk up
stairs with alternating feet.
3. A 65-year-old patient presents with a resting tremor in the right hand described
as "pill-rolling," cogwheel rigidity in the right arm, and bradykinesia. Which
diagnosis is most likely?
,A) Essential tremor
B) Parkinson disease
C) Huntington disease
D) Lewy body dementia
Answer: B
Rationale: The classic triad of Parkinson disease is resting tremor (pill-rolling type),
cogwheel rigidity, and bradykinesia. Essential tremor is typically bilateral, action-related,
and not associated with rigidity or bradykinesia.
4. A 28-year-old client presents with 2 weeks of low-grade fever, sore throat, and
fatigue. Examination reveals bilateral posterior cervical lymphadenopathy and
splenomegaly. CBC shows lymphocytosis with atypical lymphocytes. What is the
most likely diagnosis?
A) Streptococcal pharyngitis
B) Infectious mononucleosis (Epstein-Barr virus)
C) Acute HIV infection
D) Cytomegalovirus infection
Answer: B
Rationale: The triad of fever, pharyngitis, and posterior cervical lymphadenopathy with
splenomegaly and lymphocytosis with atypical lymphocytes is classic for infectious
mononucleosis caused by Epstein-Barr virus.
5. A patient's BMI is calculated as 23. Which category does this fall into?
A) Underweight
B) Normal weight
C) Overweight
D) Obese
Answer: B
Rationale: A BMI of 18.5 to 24.9 is considered normal weight. Overweight is 25–29.9, and
obese is 30 or greater.
,6. The Romberg test is used to evaluate which system?
A) Cerebellar system
B) Vestibular system
C) Proprioceptive system
D) Both B and C
Answer: D
Rationale: The Romberg test evaluates the cerebellar system for balance and
proprioception. Tandem gait is also used for testing the cerebellar system.
7. A patient reports a "racing heart," sweating, and a sense of impending doom
that began abruptly 20 minutes ago. ECG shows sinus tachycardia at 120 bpm
without ischemic changes. Which condition should the FNP suspect first?
A) Generalized anxiety disorder
B) Panic attack
C) Hyperthyroidism
D) Pheochromocytoma
Answer: B
Rationale: A panic attack is characterized by abrupt onset of intense fear with symptoms
including palpitations, diaphoresis, and a sense of impending doom, peaking within
minutes. The abrupt onset, brief duration, and absence of ECG abnormalities distinguish
this from myocardial ischemia.
8. Upon examination, a patient has unequal pupil size and the pupils are reactive
to light and accommodation. This indicates:
A) CN III palsy
B) Anisocoria
C) Horner syndrome
D) Adie's pupil
, Answer: B
Rationale: Anisocoria is unequal pupil size. If pupils are reactive to light and
accommodation, it is likely benign. Nonreactive pupils or associated
ptosis/ophthalmoplegia suggest neurologic pathology.
9. A 35-year-old patient presents with a superficial skin lesion that is elevated, less
than 1 cm in diameter, and filled with serous fluid. Which skin lesion is this?
A) Vesicle
B) Bulla
C) Pustule
D) Papule
Answer: A
Rationale: A vesicle is an elevated, fluid-filled lesion less than 1 cm filled with serous fluid.
Bulla is >1 cm. Pustules contain purulent material.
10. A 45-year-old patient presents with coin-shaped, pruritic plaques on the
extremities. Which diagnosis is most likely?
A) Nummular eczema
B) Granuloma annulare
C) Tinea corporis
D) Psoriasis
Answer: A
Rationale: Nummular eczema presents as coin-shaped plaques that are often pruritic.
Granuloma annulare is typically non-pruritic.
11. Which assessment finding is most characteristic of Alzheimer disease when
distinguishing it from vascular dementia?
A) Abrupt onset and stepwise deterioration
B) Early gait disturbance and urinary incontinence
Questions & Detailed Answers | A+ Graded |
Pass Guaranteed
1. A 50-year-old asymptomatic client asks which cancer screening tests are
recommended. The FNP should recommend all of the following EXCEPT:
A) Colorectal cancer screening beginning at age 45
B) Prostate-specific antigen (PSA) testing for all men at age 50
C) Biennial mammography for women aged 50–74
D) Lung cancer screening with low-dose CT for high-risk adults
Answer: B
Rationale: The USPSTF recommends shared decision-making for PSA screening in men
aged 55–69 (Grade C), not routine screening for all men at age 50. Colorectal screening at
45, biennial mammography for 50–74, and lung screening for high-risk adults are
evidence-based recommendations.
2. An FNP is performing a well-child examination on a 3-year-old. Which
developmental milestone is expected at this age?
A) Walking independently
B) Riding a tricycle
C) Tying shoelaces
D) Jumping rope
Answer: B
Rationale: At age 3, children typically can ride a tricycle, stand on one foot, and walk up
stairs with alternating feet.
3. A 65-year-old patient presents with a resting tremor in the right hand described
as "pill-rolling," cogwheel rigidity in the right arm, and bradykinesia. Which
diagnosis is most likely?
,A) Essential tremor
B) Parkinson disease
C) Huntington disease
D) Lewy body dementia
Answer: B
Rationale: The classic triad of Parkinson disease is resting tremor (pill-rolling type),
cogwheel rigidity, and bradykinesia. Essential tremor is typically bilateral, action-related,
and not associated with rigidity or bradykinesia.
4. A 28-year-old client presents with 2 weeks of low-grade fever, sore throat, and
fatigue. Examination reveals bilateral posterior cervical lymphadenopathy and
splenomegaly. CBC shows lymphocytosis with atypical lymphocytes. What is the
most likely diagnosis?
A) Streptococcal pharyngitis
B) Infectious mononucleosis (Epstein-Barr virus)
C) Acute HIV infection
D) Cytomegalovirus infection
Answer: B
Rationale: The triad of fever, pharyngitis, and posterior cervical lymphadenopathy with
splenomegaly and lymphocytosis with atypical lymphocytes is classic for infectious
mononucleosis caused by Epstein-Barr virus.
5. A patient's BMI is calculated as 23. Which category does this fall into?
A) Underweight
B) Normal weight
C) Overweight
D) Obese
Answer: B
Rationale: A BMI of 18.5 to 24.9 is considered normal weight. Overweight is 25–29.9, and
obese is 30 or greater.
,6. The Romberg test is used to evaluate which system?
A) Cerebellar system
B) Vestibular system
C) Proprioceptive system
D) Both B and C
Answer: D
Rationale: The Romberg test evaluates the cerebellar system for balance and
proprioception. Tandem gait is also used for testing the cerebellar system.
7. A patient reports a "racing heart," sweating, and a sense of impending doom
that began abruptly 20 minutes ago. ECG shows sinus tachycardia at 120 bpm
without ischemic changes. Which condition should the FNP suspect first?
A) Generalized anxiety disorder
B) Panic attack
C) Hyperthyroidism
D) Pheochromocytoma
Answer: B
Rationale: A panic attack is characterized by abrupt onset of intense fear with symptoms
including palpitations, diaphoresis, and a sense of impending doom, peaking within
minutes. The abrupt onset, brief duration, and absence of ECG abnormalities distinguish
this from myocardial ischemia.
8. Upon examination, a patient has unequal pupil size and the pupils are reactive
to light and accommodation. This indicates:
A) CN III palsy
B) Anisocoria
C) Horner syndrome
D) Adie's pupil
, Answer: B
Rationale: Anisocoria is unequal pupil size. If pupils are reactive to light and
accommodation, it is likely benign. Nonreactive pupils or associated
ptosis/ophthalmoplegia suggest neurologic pathology.
9. A 35-year-old patient presents with a superficial skin lesion that is elevated, less
than 1 cm in diameter, and filled with serous fluid. Which skin lesion is this?
A) Vesicle
B) Bulla
C) Pustule
D) Papule
Answer: A
Rationale: A vesicle is an elevated, fluid-filled lesion less than 1 cm filled with serous fluid.
Bulla is >1 cm. Pustules contain purulent material.
10. A 45-year-old patient presents with coin-shaped, pruritic plaques on the
extremities. Which diagnosis is most likely?
A) Nummular eczema
B) Granuloma annulare
C) Tinea corporis
D) Psoriasis
Answer: A
Rationale: Nummular eczema presents as coin-shaped plaques that are often pruritic.
Granuloma annulare is typically non-pruritic.
11. Which assessment finding is most characteristic of Alzheimer disease when
distinguishing it from vascular dementia?
A) Abrupt onset and stepwise deterioration
B) Early gait disturbance and urinary incontinence
