ANCC Complete Certification Exam 2026/2027 Update with Questions and
Answers Graded A+
A patient with type1 diabetes mellitus who is NPH and regular insulin split dosing present with
complains of early morning rise finger-stick blood glucose. A review of an at-home glucose test
reveals increased morning levels. After an increase in the evening insulin dose, the problem worsens.
This is most likely an example of:
a) Insulin Resistance
b) Insulin Allergy
c) The Somogyi Effect
d) Hyperglycemia-induced hypoglycemia. - ANSWER a) The Somogyi Effect
A 25-years-old present with a chief complaint of decreased mobility and pain of the right shoulder
exacerbated by movements. The patient reports that he participated in extensive house painting 24
hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No redness or
ecchymosis is present. What is the next step to be taken in order to make a Diagnosis?
a) Palpate the structure around the shoulder
b) Obtain an MIR to evaluate the shoulder
c) Order and X-Ray of the shoulder
d) Request an EMG
Apply SOAPE - ANSWER a) Palpate the structure around the shoulder
Apply SOAPE
A 65 years-old male presents to his clinic complaining of increasing fatigue, dyspnea on exertion ,and
ankle edema during the day. He has a history of mild hypertension, for which he saw his physician
years ago. The physician advised the patient to decrease his salt intake .On physician examination the
patient is tachycardia positive for jugular venous distension, and positive for S3 with a systolic
murmur chest X-ray reveals cardiomegaly with vascular redistribution .The nurse practitioner
diagnosis is :
a) Myocardial infarction
b) Pneumonia
c) Congestive heart failure
,d) Pleural effusion - ANSWER c) Congestive heart failure
A 67-year old patient with type 2 DM, congestive heart failure (CHF), and a mild artery disease is
currently taking daily hydrochlorothiazide 25 mg daily, glipizide 10 mg daily; and atorvastatin
(Lipitor), 20 mg h.s. Which of the following is an accurate statement regarding this regimen?
a) The glipizide will increase the risk of potassium depletion....
b) The digoxin will increase the risk of hypoglycemia.
c) The hydrochlorothiazide will predispose the patient to digoxin toxicity
d) The atorvastin will worsen the diabetes - ANSWER c) The hydrochlorothiazide will predispose the
patient to digoxin toxicity
A 14 year-old who fell on her outstretched hand complains of proximal forearm pain X-ray reveals a
positive fat pad sign ,and the fully extend the elbow. No definitive bony changes are seen on X-ray.
The most likely working diagnosis is:
a) Upper extremely sprain.
b) Lateral epiconditis.
c) Radial head fracture
d) Olecranon bursitis - ANSWER c) Radial head fracture
A 17 year-old female is suspected to have a Polycystic Ovary Syndrome. In addition to testosterone
the most appropriate diagnostic test will be:
a) BUN, creatinine, electrolytes, and denydroeplandrosterone (DHEA).
b) Complete blood count (BUN) ,creatinine and estrone
c) Fasting blood sugar(FBS) ,CBC, BUN and sex hormone binding globuline
d) Follicle stimulating hormone (FSH) luteinizing hormone, prolactin, and thyroid stimulating
hormone (TSH) - ANSWER d) Follicle stimulating hormone (FSH) luteinizing hormone, prolactin, and
thyroid stimulating hormone (TSH)
To assess spinal function at S1-level, which deep tendon reflex should be tested?
a) Achilles
,b) Cremasteric
c) Anal wink
d) Patelar - ANSWER a) Achilles
A 20 year-old male present with a month history of a "bump on my testicle." He reports being
sexually active, with frequent intercourse with multiple partners, which condition should be
suspected?
a) Cancer of testicles
b) Torsion of the testicles
c) Acute epididymitis
d) Gonorrhea - ANSWER a) Cancer of testicles
An 88 year-old male presents with concerns about memory loss .He feels good, takes aspirin daily
,and has no chronic diseases ,he drives his own car ,and manages his financial affairs .To evaluate his
memory ,which of the fallowing tests would you choose?
a) Folstein Mini- Mental-State Examination.
b) Geriatric Depression Scale
c) Minnesota Multiphasic personality inventory
d) Myers -Briggs Test - ANSWER a) Folstein Mini- Mental-State Examination
Nonviral Microorganisms most frequently found to cause acute sinusitis are:
a) Streptococcus pneumonie and Haemophilus influenzae
b) Streptococcus pneumonie and staphylococcus aureus
c) Staphylococcus aureus and Pseudomonas aeruginosa
d) Streptococcus pneumonie and Pseudomonas aeruginosa - ANSWER a) Streptococcus pneumonie
and Haemophilus influenzae
A 65-year old female presents with shoulder and pelvic girdle pain for the past 6 months .She reports
recent unintentional weigh loss. On physical examination, there is pain on ROM with no weakness
noted. Laboratory studies show low hemoglobin and elevated sedimentation rate.Which of the
fallowing is the most likely diagnosis?
, a) Polymyosistis
b) Osteoarthritis
c) Polymyalgia rheumatic
d) Fibromyalgia - ANSWER c) Polymyalgia rheumatic
A 17 year-old female has never had her menses. She is at tanner stage III of sexual development. Her
physical and her weight is appropriate for her age and height. What is the most likely diagnosis?
a) Secondary amenorrhea
b) Primary amenorrhea
c) Dysmenorrhea
d) Ovarian digenesis - ANSWER b) Primary amenorrhea
A nurse practitioner is suturing a simple laceration on a 11-year old patient. The use of lidocaine with
epinephrine is not used in the following areas except the:
a) Scalp
b) Nose
c) Fingers
d) Earlobe - ANSWER a) Scalp
Which of the following is not an indication of preeclampsia?
a) Visual disturbance
b) Glycosuria
c) Edema of face and hands
d) Headaches - ANSWER b) Glycosuria
A 10- month-old presents with a rash, runny nose, and cough. Examination reveals a cluster of tiny of
white papules with an erythematous a buccal mucosa. What does this suggest?
Answers Graded A+
A patient with type1 diabetes mellitus who is NPH and regular insulin split dosing present with
complains of early morning rise finger-stick blood glucose. A review of an at-home glucose test
reveals increased morning levels. After an increase in the evening insulin dose, the problem worsens.
This is most likely an example of:
a) Insulin Resistance
b) Insulin Allergy
c) The Somogyi Effect
d) Hyperglycemia-induced hypoglycemia. - ANSWER a) The Somogyi Effect
A 25-years-old present with a chief complaint of decreased mobility and pain of the right shoulder
exacerbated by movements. The patient reports that he participated in extensive house painting 24
hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No redness or
ecchymosis is present. What is the next step to be taken in order to make a Diagnosis?
a) Palpate the structure around the shoulder
b) Obtain an MIR to evaluate the shoulder
c) Order and X-Ray of the shoulder
d) Request an EMG
Apply SOAPE - ANSWER a) Palpate the structure around the shoulder
Apply SOAPE
A 65 years-old male presents to his clinic complaining of increasing fatigue, dyspnea on exertion ,and
ankle edema during the day. He has a history of mild hypertension, for which he saw his physician
years ago. The physician advised the patient to decrease his salt intake .On physician examination the
patient is tachycardia positive for jugular venous distension, and positive for S3 with a systolic
murmur chest X-ray reveals cardiomegaly with vascular redistribution .The nurse practitioner
diagnosis is :
a) Myocardial infarction
b) Pneumonia
c) Congestive heart failure
,d) Pleural effusion - ANSWER c) Congestive heart failure
A 67-year old patient with type 2 DM, congestive heart failure (CHF), and a mild artery disease is
currently taking daily hydrochlorothiazide 25 mg daily, glipizide 10 mg daily; and atorvastatin
(Lipitor), 20 mg h.s. Which of the following is an accurate statement regarding this regimen?
a) The glipizide will increase the risk of potassium depletion....
b) The digoxin will increase the risk of hypoglycemia.
c) The hydrochlorothiazide will predispose the patient to digoxin toxicity
d) The atorvastin will worsen the diabetes - ANSWER c) The hydrochlorothiazide will predispose the
patient to digoxin toxicity
A 14 year-old who fell on her outstretched hand complains of proximal forearm pain X-ray reveals a
positive fat pad sign ,and the fully extend the elbow. No definitive bony changes are seen on X-ray.
The most likely working diagnosis is:
a) Upper extremely sprain.
b) Lateral epiconditis.
c) Radial head fracture
d) Olecranon bursitis - ANSWER c) Radial head fracture
A 17 year-old female is suspected to have a Polycystic Ovary Syndrome. In addition to testosterone
the most appropriate diagnostic test will be:
a) BUN, creatinine, electrolytes, and denydroeplandrosterone (DHEA).
b) Complete blood count (BUN) ,creatinine and estrone
c) Fasting blood sugar(FBS) ,CBC, BUN and sex hormone binding globuline
d) Follicle stimulating hormone (FSH) luteinizing hormone, prolactin, and thyroid stimulating
hormone (TSH) - ANSWER d) Follicle stimulating hormone (FSH) luteinizing hormone, prolactin, and
thyroid stimulating hormone (TSH)
To assess spinal function at S1-level, which deep tendon reflex should be tested?
a) Achilles
,b) Cremasteric
c) Anal wink
d) Patelar - ANSWER a) Achilles
A 20 year-old male present with a month history of a "bump on my testicle." He reports being
sexually active, with frequent intercourse with multiple partners, which condition should be
suspected?
a) Cancer of testicles
b) Torsion of the testicles
c) Acute epididymitis
d) Gonorrhea - ANSWER a) Cancer of testicles
An 88 year-old male presents with concerns about memory loss .He feels good, takes aspirin daily
,and has no chronic diseases ,he drives his own car ,and manages his financial affairs .To evaluate his
memory ,which of the fallowing tests would you choose?
a) Folstein Mini- Mental-State Examination.
b) Geriatric Depression Scale
c) Minnesota Multiphasic personality inventory
d) Myers -Briggs Test - ANSWER a) Folstein Mini- Mental-State Examination
Nonviral Microorganisms most frequently found to cause acute sinusitis are:
a) Streptococcus pneumonie and Haemophilus influenzae
b) Streptococcus pneumonie and staphylococcus aureus
c) Staphylococcus aureus and Pseudomonas aeruginosa
d) Streptococcus pneumonie and Pseudomonas aeruginosa - ANSWER a) Streptococcus pneumonie
and Haemophilus influenzae
A 65-year old female presents with shoulder and pelvic girdle pain for the past 6 months .She reports
recent unintentional weigh loss. On physical examination, there is pain on ROM with no weakness
noted. Laboratory studies show low hemoglobin and elevated sedimentation rate.Which of the
fallowing is the most likely diagnosis?
, a) Polymyosistis
b) Osteoarthritis
c) Polymyalgia rheumatic
d) Fibromyalgia - ANSWER c) Polymyalgia rheumatic
A 17 year-old female has never had her menses. She is at tanner stage III of sexual development. Her
physical and her weight is appropriate for her age and height. What is the most likely diagnosis?
a) Secondary amenorrhea
b) Primary amenorrhea
c) Dysmenorrhea
d) Ovarian digenesis - ANSWER b) Primary amenorrhea
A nurse practitioner is suturing a simple laceration on a 11-year old patient. The use of lidocaine with
epinephrine is not used in the following areas except the:
a) Scalp
b) Nose
c) Fingers
d) Earlobe - ANSWER a) Scalp
Which of the following is not an indication of preeclampsia?
a) Visual disturbance
b) Glycosuria
c) Edema of face and hands
d) Headaches - ANSWER b) Glycosuria
A 10- month-old presents with a rash, runny nose, and cough. Examination reveals a cluster of tiny of
white papules with an erythematous a buccal mucosa. What does this suggest?
