ANCC FNP EXAM V3 NEWEST 2025/2026 ACTUAL
EXAM TEST BANK | COMPLETE 100 REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+ | ANCC
FAMILY NURSE PRACTITIONER EXAM 3 (BRAND
NEW!!)
Section 1: Assessment (Questions 1–19)
Question 1: A 68-year-old male patient presents with a 2-month
history of progressive dysphagia, initially to solids and now to
liquids. He also reports a 15-pound unintentional weight loss and
hoarseness. He has a 40 pack-year smoking history and drinks 3–4
alcoholic beverages daily. Which of the following is the most
appropriate next step in the evaluation?
A. Prescribe a proton pump inhibitor and schedule a follow-up in 4 weeks
B. Order a barium swallow study
C. Refer the patient for an urgent esophagogastroduodenoscopy (EGD)
D. Order a CT scan of the chest
Answer: C
Rationale: This patient's symptoms of progressive dysphagia, weight loss, and
hoarseness in the context of significant tobacco and alcohol use are highly concerning
for esophageal malignancy. The recommended diagnostic approach for dysphagia with
alarm symptoms is direct visualization with EGD, which allows for both inspection and
biopsy of suspicious lesions . Barium swallow is less sensitive for mucosal lesions and
cannot provide tissue diagnosis . CT scan may be useful for staging but is not the initial
,diagnostic test. Empiric PPI therapy without diagnostic evaluation would delay diagnosis
of a potentially curable cancer.
Question 2: A 28-year-old female patient presents with a 3-week
history of fatigue, joint pain, and a malar rash that spares the
nasolabial folds. She also reports photosensitivity. Her vital signs
are within normal limits. Laboratory studies reveal a positive
antinuclear antibody (ANA) titer of 1:640 (speckled pattern),
elevated erythrocyte sedimentation rate (ESR), and proteinuria on
urinalysis. Which of the following is the most specific test to
confirm the suspected diagnosis?
A. Anti-dsDNA antibody
B. Rheumatoid factor
C. Anti-SSA/Ro antibody
D. Complement levels (C3, C4)
Answer: A
Rationale: The patient's presentation of malar rash, photosensitivity, joint pain, fatigue,
and proteinuria is consistent with systemic lupus erythematosus (SLE). The ANA is a
sensitive but nonspecific screening test. Anti-dsDNA antibodies are highly specific for
SLE and are included in the diagnostic criteria, particularly in the presence of renal
involvement (proteinuria) . Rheumatoid factor is associated with rheumatoid arthritis.
Anti-SSA/Ro is associated with Sjögren's syndrome and subacute cutaneous lupus. Low
complement levels support SLE diagnosis but are less specific than anti-dsDNA.
Question 3: A 4-year-old child is brought to the clinic for a well-
child visit. The parent reports that the child has been "stuttering"
for the past 6 months and is concerned this may indicate a
,developmental problem. The child's speech is characterized by
repetition of initial syllables and occasional prolongation of
sounds. Which of the following is the most appropriate response?
A. Refer the child immediately to a speech-language pathologist
B. Reassure the parent that this is a normal phase of speech development that typically
resolves spontaneously
C. Obtain a hearing evaluation
D. Recommend a developmental-behavioral pediatrician consultation
Answer: B
Rationale: Developmental stuttering is common in preschool-aged children (ages 2–5
years) and typically peaks around age 4. It often resolves spontaneously within 6–12
months. Reassurance is the appropriate initial management when the stuttering is mild
and the child is not distressed. Referral to a speech-language pathologist is indicated if
the stuttering persists beyond 6 months, is worsening, causes the child distress, or is
accompanied by other developmental concerns . Hearing evaluation may be part of the
routine assessment but is not specifically indicated for this complaint.
Question 4: A 55-year-old female patient with a history of
hypertension and type 2 diabetes presents for a routine annual
physical. Her blood pressure is 138/86 mmHg, and her BMI is 32
kg/m². Laboratory studies show a fasting blood glucose of 118
mg/dL and an HbA1c of 6.2%. Which of the following is the most
appropriate next step in management?
A. Start metformin therapy
B. Start insulin therapy
C. Recheck fasting blood glucose in 3 months
D. Perform an oral glucose tolerance test
Answer: A
, Rationale: The patient's HbA1c of 6.2% and fasting glucose of 118 mg/dL indicate
prediabetes. For patients with prediabetes who have additional risk factors such as
obesity (BMI >30), hypertension, or a history of gestational diabetes, metformin therapy
is recommended for diabetes prevention. The American Diabetes Association (ADA)
recommends metformin for patients with prediabetes who are at highest risk of
progression . Lifestyle modification should also be initiated. Rechecking in 3 months
without intervention would miss an opportunity for prevention.
Question 5: A 72-year-old male patient presents with a 6-month
history of progressive bilateral hand tremor that worsens with
intention and improves with rest. He also reports difficulty with
fine motor tasks such as buttoning his shirt. Which of the
following findings would most strongly suggest essential tremor
rather than Parkinson's disease?
A. Resting tremor in both hands
B. Rigidity and bradykinesia
C. Improvement of tremor with alcohol consumption
D. Unilateral onset
Answer: C
Rationale: Essential tremor (ET) is characterized by action tremor (postural and intention
tremor) that improves with rest. Improvement of tremor with alcohol consumption is a
classic feature of ET and helps distinguish it from Parkinson's disease. Parkinson's
disease typically presents with a resting tremor (4–6 Hz, "pill-rolling"), rigidity,
bradykinesia, and often unilateral onset . ET can be bilateral and affects the hands, head,
and voice. ET does not typically present with rigidity or bradykinesia.
Question 6: A 34-year-old female patient with a family history of
breast cancer (mother diagnosed at age 48) requests BRCA
EXAM TEST BANK | COMPLETE 100 REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+ | ANCC
FAMILY NURSE PRACTITIONER EXAM 3 (BRAND
NEW!!)
Section 1: Assessment (Questions 1–19)
Question 1: A 68-year-old male patient presents with a 2-month
history of progressive dysphagia, initially to solids and now to
liquids. He also reports a 15-pound unintentional weight loss and
hoarseness. He has a 40 pack-year smoking history and drinks 3–4
alcoholic beverages daily. Which of the following is the most
appropriate next step in the evaluation?
A. Prescribe a proton pump inhibitor and schedule a follow-up in 4 weeks
B. Order a barium swallow study
C. Refer the patient for an urgent esophagogastroduodenoscopy (EGD)
D. Order a CT scan of the chest
Answer: C
Rationale: This patient's symptoms of progressive dysphagia, weight loss, and
hoarseness in the context of significant tobacco and alcohol use are highly concerning
for esophageal malignancy. The recommended diagnostic approach for dysphagia with
alarm symptoms is direct visualization with EGD, which allows for both inspection and
biopsy of suspicious lesions . Barium swallow is less sensitive for mucosal lesions and
cannot provide tissue diagnosis . CT scan may be useful for staging but is not the initial
,diagnostic test. Empiric PPI therapy without diagnostic evaluation would delay diagnosis
of a potentially curable cancer.
Question 2: A 28-year-old female patient presents with a 3-week
history of fatigue, joint pain, and a malar rash that spares the
nasolabial folds. She also reports photosensitivity. Her vital signs
are within normal limits. Laboratory studies reveal a positive
antinuclear antibody (ANA) titer of 1:640 (speckled pattern),
elevated erythrocyte sedimentation rate (ESR), and proteinuria on
urinalysis. Which of the following is the most specific test to
confirm the suspected diagnosis?
A. Anti-dsDNA antibody
B. Rheumatoid factor
C. Anti-SSA/Ro antibody
D. Complement levels (C3, C4)
Answer: A
Rationale: The patient's presentation of malar rash, photosensitivity, joint pain, fatigue,
and proteinuria is consistent with systemic lupus erythematosus (SLE). The ANA is a
sensitive but nonspecific screening test. Anti-dsDNA antibodies are highly specific for
SLE and are included in the diagnostic criteria, particularly in the presence of renal
involvement (proteinuria) . Rheumatoid factor is associated with rheumatoid arthritis.
Anti-SSA/Ro is associated with Sjögren's syndrome and subacute cutaneous lupus. Low
complement levels support SLE diagnosis but are less specific than anti-dsDNA.
Question 3: A 4-year-old child is brought to the clinic for a well-
child visit. The parent reports that the child has been "stuttering"
for the past 6 months and is concerned this may indicate a
,developmental problem. The child's speech is characterized by
repetition of initial syllables and occasional prolongation of
sounds. Which of the following is the most appropriate response?
A. Refer the child immediately to a speech-language pathologist
B. Reassure the parent that this is a normal phase of speech development that typically
resolves spontaneously
C. Obtain a hearing evaluation
D. Recommend a developmental-behavioral pediatrician consultation
Answer: B
Rationale: Developmental stuttering is common in preschool-aged children (ages 2–5
years) and typically peaks around age 4. It often resolves spontaneously within 6–12
months. Reassurance is the appropriate initial management when the stuttering is mild
and the child is not distressed. Referral to a speech-language pathologist is indicated if
the stuttering persists beyond 6 months, is worsening, causes the child distress, or is
accompanied by other developmental concerns . Hearing evaluation may be part of the
routine assessment but is not specifically indicated for this complaint.
Question 4: A 55-year-old female patient with a history of
hypertension and type 2 diabetes presents for a routine annual
physical. Her blood pressure is 138/86 mmHg, and her BMI is 32
kg/m². Laboratory studies show a fasting blood glucose of 118
mg/dL and an HbA1c of 6.2%. Which of the following is the most
appropriate next step in management?
A. Start metformin therapy
B. Start insulin therapy
C. Recheck fasting blood glucose in 3 months
D. Perform an oral glucose tolerance test
Answer: A
, Rationale: The patient's HbA1c of 6.2% and fasting glucose of 118 mg/dL indicate
prediabetes. For patients with prediabetes who have additional risk factors such as
obesity (BMI >30), hypertension, or a history of gestational diabetes, metformin therapy
is recommended for diabetes prevention. The American Diabetes Association (ADA)
recommends metformin for patients with prediabetes who are at highest risk of
progression . Lifestyle modification should also be initiated. Rechecking in 3 months
without intervention would miss an opportunity for prevention.
Question 5: A 72-year-old male patient presents with a 6-month
history of progressive bilateral hand tremor that worsens with
intention and improves with rest. He also reports difficulty with
fine motor tasks such as buttoning his shirt. Which of the
following findings would most strongly suggest essential tremor
rather than Parkinson's disease?
A. Resting tremor in both hands
B. Rigidity and bradykinesia
C. Improvement of tremor with alcohol consumption
D. Unilateral onset
Answer: C
Rationale: Essential tremor (ET) is characterized by action tremor (postural and intention
tremor) that improves with rest. Improvement of tremor with alcohol consumption is a
classic feature of ET and helps distinguish it from Parkinson's disease. Parkinson's
disease typically presents with a resting tremor (4–6 Hz, "pill-rolling"), rigidity,
bradykinesia, and often unilateral onset . ET can be bilateral and affects the hands, head,
and voice. ET does not typically present with rigidity or bradykinesia.
Question 6: A 34-year-old female patient with a family history of
breast cancer (mother diagnosed at age 48) requests BRCA
