AANP FNP Certification Exam Test Bank | 173 Real
Questions, Verified Answers & Clinical Rationales
(Latest 2025/2026 Board Prep)
,Question 1
A 24-year-old female presents to the clinic complaining of an intense, foul-smelling vaginal
discharge and severe pruritus. On pelvic examination, the nurse practitioner notes a green-
yellow, frothy discharge and a diffuse, petechial "strawberry cervix." Microscopic evaluation
of a wet mount reveals motile, flagellated organisms. Which of the following is the first-line
treatment for this patient?
A) Oral Azithromycin 1 g in a single dose
B) Topical Clindamycin 2% cream for 7 days
C) Oral Metronidazole 500 mg twice daily for 7 days
D) Intramuscular Ceftriaxone 500 mg in a single dose
VERIFIED ANSWER: C) Oral Metronidazole 500 mg twice daily for 7 days
EXPLANATION: This clinical presentation—characterized by a green-yellow, frothy
discharge, a petechial "strawberry cervix," and motile, flagellated protozoa on a wet
mount—is diagnostic for Trichomonas vaginalis. Current CDC guidelines recommend
treating Trichomoniasis in women with oral Metronidazole 500 mg twice daily for 7 days
rather than a single 2 g dose to increase cure rates. Expedited partner therapy (EPT) must
also be initiated to prevent reinfection.
Question 2
An 11-month-old infant is brought to the clinic for a routine well-child check. The mother
mentions that she feeds the infant whole cow's milk because it is more economical than
formula. The nurse practitioner should identify that this dietary choice places the infant at the
highest risk for which of the following hematologic conditions?
A) Folate deficiency anemia
B) Iron deficiency anemia
C) Vitamin B12 deficiency anemia
D) Hemolytic anemia
,VERIFIED ANSWER: B) Iron deficiency anemia
EXPLANATION: Introducing whole cow's milk to infants under 12 months of age is a
major risk factor for iron deficiency anemia. Cow's milk is low in iron, poorly absorbed,
and contains high concentrations of calcium and casein, which inhibit the absorption of
dietary iron. Furthermore, it can cause occult micro-hemorrhages in the immature
gastrointestinal tract of an infant, compounding blood and iron loss.
Question 3
A 68-year-old male with a history of chronic obstructive pulmonary disease (COPD) and
hypertension presents with an acute onset of severe, localized, throbbing left-sided eye pain,
blurred vision, and seeing "halos around lights." Upon physical examination, the nurse
practitioner notes a fixed, mid-dilated left pupil and an injected sclera. What is the immediate
priority action?
A) Administer a topical beta-blocker drop and instruct the patient to follow up with
ophthalmology tomorrow
B) Refer the patient to an emergency department or ophthalmologist immediately
C) Order an urgent non-contrast head CT scan to rule out an ischemic cerebrovascular
accident
D) Prescribe high-dose oral corticosteroids and schedule a temporal artery biopsy
VERIFIED ANSWER: B) Refer the patient to an emergency department or
ophthalmologist immediately
EXPLANATION: The patient's signs and symptoms—acute unilateral eye pain, blurred
vision, halos around lights, fixed mid-dilated pupil, and a red eye—are classic hallmarks of
acute angle-closure glaucoma. This is an ocular emergency caused by a rapid elevation in
intraocular pressure (IOP). Immediate referral is required to prevent permanent blindness.
Delaying care for a next-day appointment or ordering a head CT is inappropriate and
hazardous.
, Question 4
A 32-year-old pregnant patient at 26 weeks gestation presents to the clinic with an
asymptomatic urinary tract infection (UTI), confirmed by a clean-catch urine culture showing
>100,000 CFU/mL of Escherichia coli. Which of the following antimicrobial regimens is
safest and most appropriate for this patient?
A) Ciprofloxacin 500 mg twice daily for 3 days
B) Doxycycline 100 mg twice daily for 7 days
C) Cephalexin 500 mg twice daily for 5 to 7 days
D) Trimethoprim-Sulfamethoxazole DS twice daily for 3 days
VERIFIED ANSWER: C) Cephalexin 500 mg twice daily for 5 to 7 days
EXPLANATION: Asymptomatic bacteriuria in pregnancy must always be treated to
prevent progression to pyelonephritis, which is linked to preterm labor. Cephalexin (a first-
generation cephalosporin) is safe and effective throughout pregnancy. Fluoroquinolones
(Ciprofloxacin) are contraindicated due to risks to fetal cartilage development.
Tetracyclines (Doxycycline) are contraindicated due to staining of fetal teeth and bone
growth suppression. Sulfa drugs are avoided near term due to the risk of neonatal
kernicterus.
Question 5
A 55-year-old female presents with a new onset of severe, unilateral, throbbing headache,
visual disturbances, and intense pain in her jaw when chewing food. Her erythrocyte
sedimentation rate (ESR) is markedly elevated at 102 mm/hr. Which clinical complication is
this patient at highest risk of developing if treatment is delayed?
A) Permanent blindness
B) Acute ischemic stroke
C) Intracranial aneurysm rupture
D) Facial nerve paralysis
VERIFIED ANSWER: A) Permanent blindness
Questions, Verified Answers & Clinical Rationales
(Latest 2025/2026 Board Prep)
,Question 1
A 24-year-old female presents to the clinic complaining of an intense, foul-smelling vaginal
discharge and severe pruritus. On pelvic examination, the nurse practitioner notes a green-
yellow, frothy discharge and a diffuse, petechial "strawberry cervix." Microscopic evaluation
of a wet mount reveals motile, flagellated organisms. Which of the following is the first-line
treatment for this patient?
A) Oral Azithromycin 1 g in a single dose
B) Topical Clindamycin 2% cream for 7 days
C) Oral Metronidazole 500 mg twice daily for 7 days
D) Intramuscular Ceftriaxone 500 mg in a single dose
VERIFIED ANSWER: C) Oral Metronidazole 500 mg twice daily for 7 days
EXPLANATION: This clinical presentation—characterized by a green-yellow, frothy
discharge, a petechial "strawberry cervix," and motile, flagellated protozoa on a wet
mount—is diagnostic for Trichomonas vaginalis. Current CDC guidelines recommend
treating Trichomoniasis in women with oral Metronidazole 500 mg twice daily for 7 days
rather than a single 2 g dose to increase cure rates. Expedited partner therapy (EPT) must
also be initiated to prevent reinfection.
Question 2
An 11-month-old infant is brought to the clinic for a routine well-child check. The mother
mentions that she feeds the infant whole cow's milk because it is more economical than
formula. The nurse practitioner should identify that this dietary choice places the infant at the
highest risk for which of the following hematologic conditions?
A) Folate deficiency anemia
B) Iron deficiency anemia
C) Vitamin B12 deficiency anemia
D) Hemolytic anemia
,VERIFIED ANSWER: B) Iron deficiency anemia
EXPLANATION: Introducing whole cow's milk to infants under 12 months of age is a
major risk factor for iron deficiency anemia. Cow's milk is low in iron, poorly absorbed,
and contains high concentrations of calcium and casein, which inhibit the absorption of
dietary iron. Furthermore, it can cause occult micro-hemorrhages in the immature
gastrointestinal tract of an infant, compounding blood and iron loss.
Question 3
A 68-year-old male with a history of chronic obstructive pulmonary disease (COPD) and
hypertension presents with an acute onset of severe, localized, throbbing left-sided eye pain,
blurred vision, and seeing "halos around lights." Upon physical examination, the nurse
practitioner notes a fixed, mid-dilated left pupil and an injected sclera. What is the immediate
priority action?
A) Administer a topical beta-blocker drop and instruct the patient to follow up with
ophthalmology tomorrow
B) Refer the patient to an emergency department or ophthalmologist immediately
C) Order an urgent non-contrast head CT scan to rule out an ischemic cerebrovascular
accident
D) Prescribe high-dose oral corticosteroids and schedule a temporal artery biopsy
VERIFIED ANSWER: B) Refer the patient to an emergency department or
ophthalmologist immediately
EXPLANATION: The patient's signs and symptoms—acute unilateral eye pain, blurred
vision, halos around lights, fixed mid-dilated pupil, and a red eye—are classic hallmarks of
acute angle-closure glaucoma. This is an ocular emergency caused by a rapid elevation in
intraocular pressure (IOP). Immediate referral is required to prevent permanent blindness.
Delaying care for a next-day appointment or ordering a head CT is inappropriate and
hazardous.
, Question 4
A 32-year-old pregnant patient at 26 weeks gestation presents to the clinic with an
asymptomatic urinary tract infection (UTI), confirmed by a clean-catch urine culture showing
>100,000 CFU/mL of Escherichia coli. Which of the following antimicrobial regimens is
safest and most appropriate for this patient?
A) Ciprofloxacin 500 mg twice daily for 3 days
B) Doxycycline 100 mg twice daily for 7 days
C) Cephalexin 500 mg twice daily for 5 to 7 days
D) Trimethoprim-Sulfamethoxazole DS twice daily for 3 days
VERIFIED ANSWER: C) Cephalexin 500 mg twice daily for 5 to 7 days
EXPLANATION: Asymptomatic bacteriuria in pregnancy must always be treated to
prevent progression to pyelonephritis, which is linked to preterm labor. Cephalexin (a first-
generation cephalosporin) is safe and effective throughout pregnancy. Fluoroquinolones
(Ciprofloxacin) are contraindicated due to risks to fetal cartilage development.
Tetracyclines (Doxycycline) are contraindicated due to staining of fetal teeth and bone
growth suppression. Sulfa drugs are avoided near term due to the risk of neonatal
kernicterus.
Question 5
A 55-year-old female presents with a new onset of severe, unilateral, throbbing headache,
visual disturbances, and intense pain in her jaw when chewing food. Her erythrocyte
sedimentation rate (ESR) is markedly elevated at 102 mm/hr. Which clinical complication is
this patient at highest risk of developing if treatment is delayed?
A) Permanent blindness
B) Acute ischemic stroke
C) Intracranial aneurysm rupture
D) Facial nerve paralysis
VERIFIED ANSWER: A) Permanent blindness
