ANCC FNP EXAM COMPLETE STUDY GUIDE
NEWEST 2026 | ANCC FAMILY NURSE
PRACTITIONER TEST BANK | PRACTICE
QUESTIONS AND DETAILED RATIONALES
|2026 EDITION
Question
A client with HIV-positive status presents with characteristic purple areas on the nose. This
finding is most consistent with which condition?
A) Kaposi sarcoma
B) Herpes zoster
C) Basal cell carcinoma
D) Actinic keratosis
Expert Rationale: Kaposi sarcoma is a type of cancer that can form in the skin, lymph
nodes, or other organs, and is associated with HIV/AIDS. The skin lesions are typically
purple in color and commonly appear on the face, nose, and lower extremities. Herpes
zoster presents with vesicular rash; basal cell carcinoma appears as waxy, pearly lesions;
actinic keratosis is scaly and flat.
Question
A child presents with malodorous discharge from a single nare. The nurse suspects which
of the following?
A) Allergic rhinitis
B) Sinusitis
C) Foreign body
D) Nasal polyps
Expert Rationale: Malodorous discharge from a single nare in a child is highly suggestive of
a foreign body in the nasal passage. This is a common pediatric emergency. Allergic rhinitis
typically involves both nares with clear discharge; sinusitis may cause bilateral or unilateral
but often with fever and facial pain; nasal polyps are soft, non-malodorous growths.
,Question
A client reports a sudden increase in floaters, flashes of light, and a shadow in the
peripheral visual field. Which condition should the nurse suspect?
A) Retinal detachment
B) Open-angle glaucoma
C) Conjunctivitis
D) Blepharitis
Expert Rationale: Retinal detachment symptoms include a sudden increase in floaters,
flashes of light, and a dark curtain or shadow over the visual field. This is an ocular
emergency requiring immediate referral. Open-angle glaucoma causes gradual peripheral
vision loss; conjunctivitis causes redness and discharge; blepharitis causes eyelid
inflammation.
Question
An adolescent with friable nasal turbinates is most likely exhibiting signs of which
substance use?
A) Cocaine use
B) Alcohol use
C) Tobacco use
D) Marijuana use
Expert Rationale: Friable nasal turbinates with septal perforation or chronic nasal irritation
are classic signs of chronic cocaine use due to vasoconstriction and local ischemia.
Alcohol, tobacco, and marijuana do not cause this specific finding. The nurse should
assess for other signs of substance use and provide education.
Question
A client presents with a recurrent round sore inside the mouth on an area where the skin is
not tightly bound to the underlying bone. This is most consistent with:
A) Aphthous ulcer
B) Herpes simplex
C) Oral thrush
D) Koplik spots
, Expert Rationale: Aphthous ulcers (canker sores) are recurrent round or oval ulcers that
occur inside the mouth on movable mucosa (inside lips, cheeks, under tongue). They can
also affect the genitalia. Herpes simplex typically presents on the lips; oral thrush is white
plaques; Koplik spots are associated with measles.
Question
A client with acid reflux symptoms is started on a first-line medication. According to the
guideline, which of the following is the correct first-line treatment for GERD?
A) Proton pump inhibitor (PPI)
B) H2 blocker, then PPI if ineffective
C) Antacid only
D) Metoclopramide
Expert Rationale: The first-line treatment for GERD is an H2 blocker (e.g., famotidine),
followed by a PPI (e.g., omeprazole) if symptoms do not improve. PPIs are more potent but
are often used as second-line therapy. Antacids provide only short-term relief;
metoclopramide is a prokinetic used in specific cases.
Question
A client with maxillary sinusitis is most likely to report which associated symptom?
A) Dental pain
B) Ear pain
C) Frontal headache
D) Postnasal drip
Expert Rationale: Maxillary sinusitis often presents with dental pain because the maxillary
sinuses are located above the upper teeth. Pressure and inflammation can cause referred
pain to the teeth. Ear pain suggests otitis media; frontal headache suggests frontal
sinusitis; postnasal drip can occur with any sinusitis.
Question
Anterior epistaxis is most commonly located in which area of the nose?
A) Kiesselbach's plexus
B) Posterior nasal cavity
NEWEST 2026 | ANCC FAMILY NURSE
PRACTITIONER TEST BANK | PRACTICE
QUESTIONS AND DETAILED RATIONALES
|2026 EDITION
Question
A client with HIV-positive status presents with characteristic purple areas on the nose. This
finding is most consistent with which condition?
A) Kaposi sarcoma
B) Herpes zoster
C) Basal cell carcinoma
D) Actinic keratosis
Expert Rationale: Kaposi sarcoma is a type of cancer that can form in the skin, lymph
nodes, or other organs, and is associated with HIV/AIDS. The skin lesions are typically
purple in color and commonly appear on the face, nose, and lower extremities. Herpes
zoster presents with vesicular rash; basal cell carcinoma appears as waxy, pearly lesions;
actinic keratosis is scaly and flat.
Question
A child presents with malodorous discharge from a single nare. The nurse suspects which
of the following?
A) Allergic rhinitis
B) Sinusitis
C) Foreign body
D) Nasal polyps
Expert Rationale: Malodorous discharge from a single nare in a child is highly suggestive of
a foreign body in the nasal passage. This is a common pediatric emergency. Allergic rhinitis
typically involves both nares with clear discharge; sinusitis may cause bilateral or unilateral
but often with fever and facial pain; nasal polyps are soft, non-malodorous growths.
,Question
A client reports a sudden increase in floaters, flashes of light, and a shadow in the
peripheral visual field. Which condition should the nurse suspect?
A) Retinal detachment
B) Open-angle glaucoma
C) Conjunctivitis
D) Blepharitis
Expert Rationale: Retinal detachment symptoms include a sudden increase in floaters,
flashes of light, and a dark curtain or shadow over the visual field. This is an ocular
emergency requiring immediate referral. Open-angle glaucoma causes gradual peripheral
vision loss; conjunctivitis causes redness and discharge; blepharitis causes eyelid
inflammation.
Question
An adolescent with friable nasal turbinates is most likely exhibiting signs of which
substance use?
A) Cocaine use
B) Alcohol use
C) Tobacco use
D) Marijuana use
Expert Rationale: Friable nasal turbinates with septal perforation or chronic nasal irritation
are classic signs of chronic cocaine use due to vasoconstriction and local ischemia.
Alcohol, tobacco, and marijuana do not cause this specific finding. The nurse should
assess for other signs of substance use and provide education.
Question
A client presents with a recurrent round sore inside the mouth on an area where the skin is
not tightly bound to the underlying bone. This is most consistent with:
A) Aphthous ulcer
B) Herpes simplex
C) Oral thrush
D) Koplik spots
, Expert Rationale: Aphthous ulcers (canker sores) are recurrent round or oval ulcers that
occur inside the mouth on movable mucosa (inside lips, cheeks, under tongue). They can
also affect the genitalia. Herpes simplex typically presents on the lips; oral thrush is white
plaques; Koplik spots are associated with measles.
Question
A client with acid reflux symptoms is started on a first-line medication. According to the
guideline, which of the following is the correct first-line treatment for GERD?
A) Proton pump inhibitor (PPI)
B) H2 blocker, then PPI if ineffective
C) Antacid only
D) Metoclopramide
Expert Rationale: The first-line treatment for GERD is an H2 blocker (e.g., famotidine),
followed by a PPI (e.g., omeprazole) if symptoms do not improve. PPIs are more potent but
are often used as second-line therapy. Antacids provide only short-term relief;
metoclopramide is a prokinetic used in specific cases.
Question
A client with maxillary sinusitis is most likely to report which associated symptom?
A) Dental pain
B) Ear pain
C) Frontal headache
D) Postnasal drip
Expert Rationale: Maxillary sinusitis often presents with dental pain because the maxillary
sinuses are located above the upper teeth. Pressure and inflammation can cause referred
pain to the teeth. Ear pain suggests otitis media; frontal headache suggests frontal
sinusitis; postnasal drip can occur with any sinusitis.
Question
Anterior epistaxis is most commonly located in which area of the nose?
A) Kiesselbach's plexus
B) Posterior nasal cavity
