AANP BOARD EXAM — STUDY GUIDE | LATEST
UPDATE 2026/2027 | ACTUAL EXAM | PRACTICE
QUESTIONS AND ANSWERS | EXAM REVIEW | 100%
CORRECT ANSWERS | VERIFIED SOLUTIONS
1.
A 55-year-old male presents with fatigue and a blood pressure of
150/95 mm Hg on two separate visits. Which of the following is the
most appropriate initial diagnostic test?
A) Renal artery ultrasound
B) Basic metabolic panel, urinalysis, and ECG
C) 24-hour urine catecholamines
D) Sleep study
Correct Answer: B
Initial evaluation of newly diagnosed hypertension includes basic
metabolic panel (potassium, creatinine), urinalysis, and ECG to assess
target organ damage and secondary causes. Renal artery ultrasound,
catecholamines, and sleep study are reserved for specific clinical
suspicion.
2.
A 45-year-old woman reports a 3-month history of fatigue, weight gain,
and constipation. Physical examination reveals dry skin and delayed
reflexes. Which laboratory test is most appropriate first?
A) Serum calcium
B) Thyroid-stimulating hormone (TSH)
,C) Fasting glucose
D) Complete blood count
Correct Answer: B
Symptoms of fatigue, weight gain, constipation, dry skin, and delayed
reflexes suggest hypothyroidism; TSH is the initial screening test.
Calcium, glucose, and CBC may be adjunctive but do not directly
evaluate thyroid function.
3.
Which of the following is the most reliable indicator of a patient’s risk
for developing type 2 diabetes?
A) Fasting blood glucose of 110 mg/dL
B) Hemoglobin A1c of 5.8%
C) Body mass index of 27 kg/m²
D) History of gestational diabetes
Correct Answer: B
A1c of 5.7–6.4% indicates prediabetes and increased risk for type 2
diabetes. Fasting glucose of 110 is elevated but less specific; BMI and
gestational diabetes are risk factors but not the most reliable indicator
alone.
4.
A patient presents with sudden onset of severe headache described as
"the worst headache of my life." What is the priority action?
A) Prescribe sumatriptan and follow up in 1 week
B) Order a noncontrast head CT immediately
C) Refer to physical therapy
D) Reassure and observe at home
,Correct Answer: B
A sudden, severe headache may indicate subarachnoid hemorrhage.
Immediate noncontrast head CT is necessary. Triptan prescription,
physical therapy, or observation without evaluation is unsafe and delays
diagnosis.
5.
Which of the following physical examination findings is most consistent
with left-sided heart failure?
A) Jugular venous distention and peripheral edema
B) Crackles in the lung bases and an S3 gallop
C) Hepatomegaly and ascites
D) Bounding pulses with warm extremities
Correct Answer: B
Left-sided heart failure causes pulmonary congestion (crackles) and an
S3 gallop. JVD, peripheral edema, hepatomegaly, and ascites are signs
of right-sided failure. Bounding pulses are hyperdynamic, not heart
failure.
6.
A 60-year-old man with a 40-pack-year smoking history presents with a
chronic cough and unintentional weight loss. Which diagnostic test is
most appropriate first?
A) Chest X-ray
B) CT pulmonary angiogram
C) Sputum cytology only
D) Pulmonary function tests
, Correct Answer: A
Chest X-ray is the initial imaging for suspected lung cancer in a high-risk
patient with chronic cough and weight loss. CT pulmonary angiogram is
for PE; sputum cytology is adjunctive; PFTs assess function, not
malignancy.
7.
Which of the following is the correct technique for examining the
thyroid gland?
A) Percuss the anterior neck
B) Palpate the gland while the patient swallows
C) Auscultate for bowel sounds
D) Observe only without palpation
Correct Answer: B
The thyroid is best palpated while the patient swallows, as the gland
moves with swallowing. Percussion and bowel sound auscultation are
not used; observation alone is incomplete.
8.
A patient has an elevated prostate-specific antigen (PSA) of 8 ng/mL.
What is the next step?
A) Repeat PSA in 1 year without further evaluation
B) Refer for urology evaluation and possible biopsy
C) Prescribe antibiotics and recheck in 3 months
D) Order an abdominal ultrasound only
Correct Answer: B
PSA >4 ng/mL requires urology referral for consideration of biopsy,
UPDATE 2026/2027 | ACTUAL EXAM | PRACTICE
QUESTIONS AND ANSWERS | EXAM REVIEW | 100%
CORRECT ANSWERS | VERIFIED SOLUTIONS
1.
A 55-year-old male presents with fatigue and a blood pressure of
150/95 mm Hg on two separate visits. Which of the following is the
most appropriate initial diagnostic test?
A) Renal artery ultrasound
B) Basic metabolic panel, urinalysis, and ECG
C) 24-hour urine catecholamines
D) Sleep study
Correct Answer: B
Initial evaluation of newly diagnosed hypertension includes basic
metabolic panel (potassium, creatinine), urinalysis, and ECG to assess
target organ damage and secondary causes. Renal artery ultrasound,
catecholamines, and sleep study are reserved for specific clinical
suspicion.
2.
A 45-year-old woman reports a 3-month history of fatigue, weight gain,
and constipation. Physical examination reveals dry skin and delayed
reflexes. Which laboratory test is most appropriate first?
A) Serum calcium
B) Thyroid-stimulating hormone (TSH)
,C) Fasting glucose
D) Complete blood count
Correct Answer: B
Symptoms of fatigue, weight gain, constipation, dry skin, and delayed
reflexes suggest hypothyroidism; TSH is the initial screening test.
Calcium, glucose, and CBC may be adjunctive but do not directly
evaluate thyroid function.
3.
Which of the following is the most reliable indicator of a patient’s risk
for developing type 2 diabetes?
A) Fasting blood glucose of 110 mg/dL
B) Hemoglobin A1c of 5.8%
C) Body mass index of 27 kg/m²
D) History of gestational diabetes
Correct Answer: B
A1c of 5.7–6.4% indicates prediabetes and increased risk for type 2
diabetes. Fasting glucose of 110 is elevated but less specific; BMI and
gestational diabetes are risk factors but not the most reliable indicator
alone.
4.
A patient presents with sudden onset of severe headache described as
"the worst headache of my life." What is the priority action?
A) Prescribe sumatriptan and follow up in 1 week
B) Order a noncontrast head CT immediately
C) Refer to physical therapy
D) Reassure and observe at home
,Correct Answer: B
A sudden, severe headache may indicate subarachnoid hemorrhage.
Immediate noncontrast head CT is necessary. Triptan prescription,
physical therapy, or observation without evaluation is unsafe and delays
diagnosis.
5.
Which of the following physical examination findings is most consistent
with left-sided heart failure?
A) Jugular venous distention and peripheral edema
B) Crackles in the lung bases and an S3 gallop
C) Hepatomegaly and ascites
D) Bounding pulses with warm extremities
Correct Answer: B
Left-sided heart failure causes pulmonary congestion (crackles) and an
S3 gallop. JVD, peripheral edema, hepatomegaly, and ascites are signs
of right-sided failure. Bounding pulses are hyperdynamic, not heart
failure.
6.
A 60-year-old man with a 40-pack-year smoking history presents with a
chronic cough and unintentional weight loss. Which diagnostic test is
most appropriate first?
A) Chest X-ray
B) CT pulmonary angiogram
C) Sputum cytology only
D) Pulmonary function tests
, Correct Answer: A
Chest X-ray is the initial imaging for suspected lung cancer in a high-risk
patient with chronic cough and weight loss. CT pulmonary angiogram is
for PE; sputum cytology is adjunctive; PFTs assess function, not
malignancy.
7.
Which of the following is the correct technique for examining the
thyroid gland?
A) Percuss the anterior neck
B) Palpate the gland while the patient swallows
C) Auscultate for bowel sounds
D) Observe only without palpation
Correct Answer: B
The thyroid is best palpated while the patient swallows, as the gland
moves with swallowing. Percussion and bowel sound auscultation are
not used; observation alone is incomplete.
8.
A patient has an elevated prostate-specific antigen (PSA) of 8 ng/mL.
What is the next step?
A) Repeat PSA in 1 year without further evaluation
B) Refer for urology evaluation and possible biopsy
C) Prescribe antibiotics and recheck in 3 months
D) Order an abdominal ultrasound only
Correct Answer: B
PSA >4 ng/mL requires urology referral for consideration of biopsy,
