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ANCC FNP Certification Exam – Full-Length Practice Exam (100 SURE Questions
Original Practice Questions with Answers & Detailed Rationales )
This full-length practice exam simulates the ANCC Family Nurse Practitioner certification exam
format. It includes 100 Sure questions with detailed rationales across all domains:
Assessment, Diagnosis, Clinical Management, and Professional Role. Use this to assess your
readiness.
Section 1: Assessment and Diagnosis (Questions 1–25)
1. A 55-year-old male presents with acute chest pain,
diaphoresis, and nausea. ECG shows ST elevation in leads II,
III, and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending
B. Right coronary artery
C. Left circumflex
D. Left main
Answer: B
Rationale: Inferior STEMI (leads II, III, aVF) is typically caused
by right coronary artery occlusion.
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2. A 30-year-old female presents with a 2-week history of
fever, sore throat, and fatigue. Physical exam reveals
posterior cervical lymphadenopathy and splenomegaly.
Which laboratory test is most specific for confirming the
suspected diagnosis?
A. Monospot (heterophile antibody) test
B. Complete blood count with differential
C. Liver function tests
D. Throat culture
Answer: A
Rationale: The clinical picture suggests infectious
mononucleosis. The Monospot test is a rapid, specific test
for heterophile antibodies.
3. A 70-year-old male presents with progressive memory
loss, word-finding difficulty, and impaired executive function
over 3 years. Which of the following differentiates
Alzheimer's disease from delirium?
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A. Gradual onset and stable course
B. Fluctuating consciousness
C. Acute onset
D. Visual hallucinations
Answer: A
Rationale: Alzheimer's disease has an insidious onset and
progressive decline, whereas delirium is acute and
fluctuating.
4. A 45-year-old female presents with a thyroid nodule and
hoarseness. Which finding is most concerning for
malignancy?
A. Fixed, hard nodule with cervical lymphadenopathy
B. Soft, mobile nodule
C. Multiple nodules on ultrasound
D. Normal thyroid function tests
Answer: A
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Rationale: A fixed, hard nodule with lymphadenopathy
suggests thyroid cancer; other features may be benign.
5. A 60-year-old male with a 40 pack-year smoking history
presents with new-onset cough and hemoptysis. Chest X-ray
shows a 3 cm mass. What is the most appropriate next step?
A. CT chest and referral for biopsy
B. Repeat chest X-ray in 6 months
C. Start antibiotics and re-evaluate
D. No further workup
Answer: A
Rationale: A lung mass with hemoptysis in a smoker is highly
suspicious for lung cancer; CT and tissue diagnosis are
required.
6. A 35-year-old female presents with recurrent episodes of
palpitations, sweating, and headache. Blood pressure is
180/110 during an episode. Which diagnostic test is most
appropriate?
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ANCC FNP Certification Exam – Full-Length Practice Exam (100 SURE Questions
Original Practice Questions with Answers & Detailed Rationales )
This full-length practice exam simulates the ANCC Family Nurse Practitioner certification exam
format. It includes 100 Sure questions with detailed rationales across all domains:
Assessment, Diagnosis, Clinical Management, and Professional Role. Use this to assess your
readiness.
Section 1: Assessment and Diagnosis (Questions 1–25)
1. A 55-year-old male presents with acute chest pain,
diaphoresis, and nausea. ECG shows ST elevation in leads II,
III, and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending
B. Right coronary artery
C. Left circumflex
D. Left main
Answer: B
Rationale: Inferior STEMI (leads II, III, aVF) is typically caused
by right coronary artery occlusion.
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, Page |2
2. A 30-year-old female presents with a 2-week history of
fever, sore throat, and fatigue. Physical exam reveals
posterior cervical lymphadenopathy and splenomegaly.
Which laboratory test is most specific for confirming the
suspected diagnosis?
A. Monospot (heterophile antibody) test
B. Complete blood count with differential
C. Liver function tests
D. Throat culture
Answer: A
Rationale: The clinical picture suggests infectious
mononucleosis. The Monospot test is a rapid, specific test
for heterophile antibodies.
3. A 70-year-old male presents with progressive memory
loss, word-finding difficulty, and impaired executive function
over 3 years. Which of the following differentiates
Alzheimer's disease from delirium?
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, Page |3
A. Gradual onset and stable course
B. Fluctuating consciousness
C. Acute onset
D. Visual hallucinations
Answer: A
Rationale: Alzheimer's disease has an insidious onset and
progressive decline, whereas delirium is acute and
fluctuating.
4. A 45-year-old female presents with a thyroid nodule and
hoarseness. Which finding is most concerning for
malignancy?
A. Fixed, hard nodule with cervical lymphadenopathy
B. Soft, mobile nodule
C. Multiple nodules on ultrasound
D. Normal thyroid function tests
Answer: A
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Rationale: A fixed, hard nodule with lymphadenopathy
suggests thyroid cancer; other features may be benign.
5. A 60-year-old male with a 40 pack-year smoking history
presents with new-onset cough and hemoptysis. Chest X-ray
shows a 3 cm mass. What is the most appropriate next step?
A. CT chest and referral for biopsy
B. Repeat chest X-ray in 6 months
C. Start antibiotics and re-evaluate
D. No further workup
Answer: A
Rationale: A lung mass with hemoptysis in a smoker is highly
suspicious for lung cancer; CT and tissue diagnosis are
required.
6. A 35-year-old female presents with recurrent episodes of
palpitations, sweating, and headache. Blood pressure is
180/110 during an episode. Which diagnostic test is most
appropriate?
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