ANCC FNP EXAM PRACTICE (2026/2027)
QUESTIONS AND ANSWERS
1. A 65-year-old male presents with a harsh, crescendo-decrescendo systolic murmur heard
best at the second right intercostal space, radiating to the carotids. What is the most likely
diagnosis?
A. Mitral Regurgitation
B. Tricuspid Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: C
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur at the right
upper sternal border that radiates to the neck. Mitral regurgitation is usually holosystolic
at the apex.
2. Which of the following is the gold standard for diagnosing Chronic Obstructive Pulmonary
Disease (COPD)?
A. Chest X-ray
,B. Arterial Blood Gas (ABG)
C. Computed Tomography (CT) scan
D. Spirometry
Answer: D
Conceptual Explanation: Spirometry showing a post-bronchodilator FEV1/FVC ratio of
less than 0.70 is the gold standard for confirming a COPD diagnosis.
3. In a patient with suspected Primary Hypothyroidism, which laboratory pattern is expected?
A. High TSH, High Free T4
B. Low TSH, High Free T4
C. Low TSH, Low Free T4
D. High TSH, Low Free T4
Answer: D
Conceptual Explanation: Primary hypothyroidism involves failure of the thyroid gland,
leading to low T4 levels, which stimulates the pituitary to produce high levels of TSH.
4. According to JNC-8, what is the blood pressure goal for a 62-year-old patient with Diabetes
Mellitus?
A. <140/90 mmHg
B. <130/80 mmHg
, C. <120/80 mmHg
D. <150/90 mmHg
Answer: A
Conceptual Explanation: For patients of all ages with diabetes or chronic kidney disease,
JNC-8 recommends a target blood pressure of less than 140/90 mmHg.
5. A 4-week-old infant presents with projectile, non-bilious vomiting and a palpable olive-
shaped mass in the epigastrium. What is the most likely diagnosis?
A. Gastroesophageal Reflux
B. Pyloric Stenosis
C. Intussusception
D. Hirschsprung’s Disease
Answer: B
Conceptual Explanation: Pyloric stenosis typically presents between 3-6 weeks of age
with projectile vomiting and a palpable olive-shaped mass due to hypertrophy of the
pylorus.
6. Which antibiotic is first-line treatment for an adult with Community-Acquired Pneumonia
and no comorbidities?
A. Amoxicillin or Doxycycline
B. Levofloxacin
QUESTIONS AND ANSWERS
1. A 65-year-old male presents with a harsh, crescendo-decrescendo systolic murmur heard
best at the second right intercostal space, radiating to the carotids. What is the most likely
diagnosis?
A. Mitral Regurgitation
B. Tricuspid Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: C
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur at the right
upper sternal border that radiates to the neck. Mitral regurgitation is usually holosystolic
at the apex.
2. Which of the following is the gold standard for diagnosing Chronic Obstructive Pulmonary
Disease (COPD)?
A. Chest X-ray
,B. Arterial Blood Gas (ABG)
C. Computed Tomography (CT) scan
D. Spirometry
Answer: D
Conceptual Explanation: Spirometry showing a post-bronchodilator FEV1/FVC ratio of
less than 0.70 is the gold standard for confirming a COPD diagnosis.
3. In a patient with suspected Primary Hypothyroidism, which laboratory pattern is expected?
A. High TSH, High Free T4
B. Low TSH, High Free T4
C. Low TSH, Low Free T4
D. High TSH, Low Free T4
Answer: D
Conceptual Explanation: Primary hypothyroidism involves failure of the thyroid gland,
leading to low T4 levels, which stimulates the pituitary to produce high levels of TSH.
4. According to JNC-8, what is the blood pressure goal for a 62-year-old patient with Diabetes
Mellitus?
A. <140/90 mmHg
B. <130/80 mmHg
, C. <120/80 mmHg
D. <150/90 mmHg
Answer: A
Conceptual Explanation: For patients of all ages with diabetes or chronic kidney disease,
JNC-8 recommends a target blood pressure of less than 140/90 mmHg.
5. A 4-week-old infant presents with projectile, non-bilious vomiting and a palpable olive-
shaped mass in the epigastrium. What is the most likely diagnosis?
A. Gastroesophageal Reflux
B. Pyloric Stenosis
C. Intussusception
D. Hirschsprung’s Disease
Answer: B
Conceptual Explanation: Pyloric stenosis typically presents between 3-6 weeks of age
with projectile vomiting and a palpable olive-shaped mass due to hypertrophy of the
pylorus.
6. Which antibiotic is first-line treatment for an adult with Community-Acquired Pneumonia
and no comorbidities?
A. Amoxicillin or Doxycycline
B. Levofloxacin
