ANCC Certification Exam Question Bank (2026/2027) | Questions with
Detailed Answers | Graded A+
A 43-year-old male recently underwent three months worth of lifestyle interventions but only had a
moderate change in overall blood pressure readings at home. At today's visit, his blood pressure is
consistent with his home readings, and is 138/85. The nurse practitioner knows that according to the
AHA guidelines, we should begin initiating medications for a stage 1 hypertensive patient at what
ASCVD cutoff point?
A.
7.5%
Incorrect
B.
10%
Correct
C.
15%
Incorrect
D.
20% - ANSWER 10%
A middle-aged female presents to your clinic today. She has a history of smoking, hypertension, type
II diabetes, and osteoporosis. She has been on lisinopril (Prinvil) 10 mg daily for the past five years
and metformin (Glucophage) 500 mg twice daily. Upon your physical exam you notice asymmetric,
non-pitting swelling around her upper lip which the patient states started yesterday night and is
painless. She also reports diffuse abdominal pain and diarrhea. The rest of the physical exam was
benign. Her fasting blood glucose is 130. Her vital signs are as follows: BP: 141/87 mmHg, HR: 92
bpm, RR: 12 breaths per minute, O2: 96% on room air. What is the most important thing for the
nurse practitioner to do?
A.
Assess her readiness for smoking cessation
Incorrect
B.
Add chlorthalidone (Chlorthalid) for hypertension control because she has osteoporosis
Incorrect
C.
,Order abdominal CT scan
Incorrect
D.
Discontinue her lisin - ANSWER Discontinue her lisinopril (Prinivil)
A patient calls the office complaining of a sudden onset of "cobweb like lines" moving in and out of
her central vision in the right eye. She is not in any pain and is asking if she needs to come in and be
seen. What should the nurse practitioner advise her to do?
A.
Refer to ophthalmology immediately
Correct
B.
Lay down in a dark room, close her eyes, and wait for it to improve
Incorrect
C.
Come into your office to be assessed this afternoon
Incorrect
D.
Pick up prescription for antibiotic eye drops at her pharmacy - ANSWER Refer to ophthalmology
immediately
A group of new nurse practitioners are evaluating the strength of evidence of some new asthma
guidelines. Which of the following would be at the bottom of the hierarchy of evidence?
A.
Systematic review
Incorrect
B.
Editorial
Correct
C.
Cohort study
Incorrect
,D.
Randomized controlled trial - ANSWER Editorial
A 55-year-old male patient reports increasing issues with erectile dysfunction over the last six
months. He is requesting to be placed on tadalafil (Cialis) for control of this condition. Which of the
following is critical for the nurse practitioner to order prior to prescribing this medication?
A.
Complete metabolic profile
Incorrect
B.
Echocardiogram
Incorrect
C.
EKG
Correct
D.
Complete blood count - ANSWER EKG
You are performing an annual exam and pap smear on a 39-year-old woman who states she has
never had a mammogram before. A close friend of hers was just diagnosed with breast cancer and
she is wanting to know more about her risk and when she should begin screening. What in her
history would be considered a risk factor for breast cancer?
A.
She is 39 years old
Incorrect
B.
Her only child is a step daughter
Correct
C.
She started menarche at age 13
Incorrect
D.
, Her great grandmother was diagnosed with breast cancer at age 68 - ANSWER Her only child is a step
daughter
You recently diagnosed your patient with sciatica. You ask the patient to perform the squat and rise
exam, and you found that there is a diminished knee jerk. Which of the following is the root cause of
his sciatica based on this finding?
A.
L3
Incorrect
B.
L4
Correct
C.
L5
Incorrect
D.
S1 - ANSWER L4
You are assessing a patient for acute abdominal pain. With the patient supine and right knee flexed,
you perform inward rotation on the patient's hip. What maneuver is this and what are you assessing
for?
A.
Iliopsoas/psoas sign to assess for appendicitis
Incorrect
B.
Obturator sign to assess for cholecystitis
Incorrect
C.
Rovsing's sign to assess for appendicitis
Incorrect
D.
Obturator sign to assess for appendicitis - ANSWER Obturator sign to assess for appendicitis
Detailed Answers | Graded A+
A 43-year-old male recently underwent three months worth of lifestyle interventions but only had a
moderate change in overall blood pressure readings at home. At today's visit, his blood pressure is
consistent with his home readings, and is 138/85. The nurse practitioner knows that according to the
AHA guidelines, we should begin initiating medications for a stage 1 hypertensive patient at what
ASCVD cutoff point?
A.
7.5%
Incorrect
B.
10%
Correct
C.
15%
Incorrect
D.
20% - ANSWER 10%
A middle-aged female presents to your clinic today. She has a history of smoking, hypertension, type
II diabetes, and osteoporosis. She has been on lisinopril (Prinvil) 10 mg daily for the past five years
and metformin (Glucophage) 500 mg twice daily. Upon your physical exam you notice asymmetric,
non-pitting swelling around her upper lip which the patient states started yesterday night and is
painless. She also reports diffuse abdominal pain and diarrhea. The rest of the physical exam was
benign. Her fasting blood glucose is 130. Her vital signs are as follows: BP: 141/87 mmHg, HR: 92
bpm, RR: 12 breaths per minute, O2: 96% on room air. What is the most important thing for the
nurse practitioner to do?
A.
Assess her readiness for smoking cessation
Incorrect
B.
Add chlorthalidone (Chlorthalid) for hypertension control because she has osteoporosis
Incorrect
C.
,Order abdominal CT scan
Incorrect
D.
Discontinue her lisin - ANSWER Discontinue her lisinopril (Prinivil)
A patient calls the office complaining of a sudden onset of "cobweb like lines" moving in and out of
her central vision in the right eye. She is not in any pain and is asking if she needs to come in and be
seen. What should the nurse practitioner advise her to do?
A.
Refer to ophthalmology immediately
Correct
B.
Lay down in a dark room, close her eyes, and wait for it to improve
Incorrect
C.
Come into your office to be assessed this afternoon
Incorrect
D.
Pick up prescription for antibiotic eye drops at her pharmacy - ANSWER Refer to ophthalmology
immediately
A group of new nurse practitioners are evaluating the strength of evidence of some new asthma
guidelines. Which of the following would be at the bottom of the hierarchy of evidence?
A.
Systematic review
Incorrect
B.
Editorial
Correct
C.
Cohort study
Incorrect
,D.
Randomized controlled trial - ANSWER Editorial
A 55-year-old male patient reports increasing issues with erectile dysfunction over the last six
months. He is requesting to be placed on tadalafil (Cialis) for control of this condition. Which of the
following is critical for the nurse practitioner to order prior to prescribing this medication?
A.
Complete metabolic profile
Incorrect
B.
Echocardiogram
Incorrect
C.
EKG
Correct
D.
Complete blood count - ANSWER EKG
You are performing an annual exam and pap smear on a 39-year-old woman who states she has
never had a mammogram before. A close friend of hers was just diagnosed with breast cancer and
she is wanting to know more about her risk and when she should begin screening. What in her
history would be considered a risk factor for breast cancer?
A.
She is 39 years old
Incorrect
B.
Her only child is a step daughter
Correct
C.
She started menarche at age 13
Incorrect
D.
, Her great grandmother was diagnosed with breast cancer at age 68 - ANSWER Her only child is a step
daughter
You recently diagnosed your patient with sciatica. You ask the patient to perform the squat and rise
exam, and you found that there is a diminished knee jerk. Which of the following is the root cause of
his sciatica based on this finding?
A.
L3
Incorrect
B.
L4
Correct
C.
L5
Incorrect
D.
S1 - ANSWER L4
You are assessing a patient for acute abdominal pain. With the patient supine and right knee flexed,
you perform inward rotation on the patient's hip. What maneuver is this and what are you assessing
for?
A.
Iliopsoas/psoas sign to assess for appendicitis
Incorrect
B.
Obturator sign to assess for cholecystitis
Incorrect
C.
Rovsing's sign to assess for appendicitis
Incorrect
D.
Obturator sign to assess for appendicitis - ANSWER Obturator sign to assess for appendicitis
