FAMILY NURSE PRACTITIONER EXAM
AANP QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
• Assessment and Health History
• Diagnosis and Differential Reasoning
• Pharmacotherapeutics and Prescriptive Authority
• Health Promotion and Disease Prevention
• Pathophysiology Across the Lifespan
• Legal, Regulatory, and Ethical Practice
• Patient Education and Counseling
• Interprofessional Collaboration and Care Coordination
Introduction
The Family Nurse Practitioner certification examination assesses the
entry-level competencies required for advanced nursing practice
across the lifespan. It evaluates clinical judgment, diagnostic
reasoning, and the safe application of evidence-informed care. The
test emphasizes real-world decision-making through multiple-choice
and scenario-based items that reflect primary care encounters.
Candidates must demonstrate proficiency in assessment, diagnosis,
,planning, and evaluation while integrating legal, ethical, and patient-
centered principles into practice.
Section One: Questions 1–100
Question 1
A 58-year-old male with a history of type 2 diabetes presents for a
routine visit. His most recent hemoglobin A1c is 7.8%. He is
currently taking metformin 1000 mg twice daily. He reports no
hypoglycemic episodes. What is the most appropriate next step in
management?
A. Add a sulfonylurea
B. Continue current therapy and reinforce lifestyle modifications
C. Initiate basal insulin
D. Add a DPP-4 inhibitor
B. Continue current therapy and reinforce lifestyle
modifications
RATIONALE: For most nonpregnant adults with type 2 diabetes,
an A1c goal of less than 7% is appropriate. However, a goal of less
than 8% may be acceptable for individuals with a history of severe
hypoglycemia, limited life expectancy, or advanced complications.
This patient’s A1c of 7.8% with no hypoglycemia suggests that
continuing metformin and reinforcing lifestyle changes is a
reasonable approach before intensifying pharmacotherapy.
Question 2
A 4-year-old child is brought to the clinic with a 2-day history of
fever, sore throat, and a sandpaper-like rash. On examination, the
,tonsils are erythematous and exudative, and the tongue has a
strawberry appearance. What is the most likely diagnosis?
A. Measles
B. Scarlet fever
C. Rubella
D. Kawasaki disease
B. Scarlet fever
RATIONALE: Scarlet fever is caused by group A beta-hemolytic
streptococcus and presents with fever, exudative pharyngitis, a
sandpaper-like rash, and a strawberry tongue. Measles typically
presents with Koplik spots and a maculopapular rash. Rubella has a
milder rash and postauricular lymphadenopathy. Kawasaki disease
features prolonged fever, conjunctivitis, and extremity changes.
Question 3
A 32-year-old female presents with a 3-day history of dysuria,
urinary frequency, and suprapubic discomfort. She is afebrile and
has no flank pain. A urine dipstick is positive for leukocyte esterase
and nitrites. What is the most appropriate treatment?
A. Nitrofurantoin monohydrate/macrocrystals for 5 days
B. Ciprofloxacin for 7 days
C. Amoxicillin for 10 days
D. Trimethoprim-sulfamethoxazole for 3 days
A. Nitrofurantoin monohydrate/macrocrystals for 5 days
RATIONALE: Uncomplicated cystitis in a healthy nonpregnant
female is typically treated with a short course of antibiotics.
, Nitrofurantoin for 5 days is a first-line option. Fluoroquinolones are
reserved for more complicated infections. Amoxicillin has high
resistance rates. Trimethoprim-sulfamethoxazole for 3 days is an
alternative but nitrofurantoin is preferred due to resistance
patterns.
Question 4
A 70-year-old male with hypertension and osteoarthritis presents
for a follow-up. He reports new-onset constipation and difficulty
urinating. He takes hydrochlorothiazide and ibuprofen. Which
medication is most likely contributing to his symptoms?
A. Hydrochlorothiazide
B. Ibuprofen
C. Both hydrochlorothiazide and ibuprofen
D. Neither medication
C. Both hydrochlorothiazide and ibuprofen
RATIONALE: Hydrochlorothiazide can cause constipation and
urinary retention. Ibuprofen, an NSAID, can also cause constipation
and urinary retention, particularly in older adults. The combination
of both medications increases the likelihood of these adverse
effects.
Question 5
A 25-year-old female presents with a 1-week history of bilateral hand
and wrist pain and morning stiffness lasting more than 1 hour. She
also reports fatigue. On examination, there is synovitis of the
metacarpophalangeal joints. What is the most likely diagnosis?
AANP QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
• Assessment and Health History
• Diagnosis and Differential Reasoning
• Pharmacotherapeutics and Prescriptive Authority
• Health Promotion and Disease Prevention
• Pathophysiology Across the Lifespan
• Legal, Regulatory, and Ethical Practice
• Patient Education and Counseling
• Interprofessional Collaboration and Care Coordination
Introduction
The Family Nurse Practitioner certification examination assesses the
entry-level competencies required for advanced nursing practice
across the lifespan. It evaluates clinical judgment, diagnostic
reasoning, and the safe application of evidence-informed care. The
test emphasizes real-world decision-making through multiple-choice
and scenario-based items that reflect primary care encounters.
Candidates must demonstrate proficiency in assessment, diagnosis,
,planning, and evaluation while integrating legal, ethical, and patient-
centered principles into practice.
Section One: Questions 1–100
Question 1
A 58-year-old male with a history of type 2 diabetes presents for a
routine visit. His most recent hemoglobin A1c is 7.8%. He is
currently taking metformin 1000 mg twice daily. He reports no
hypoglycemic episodes. What is the most appropriate next step in
management?
A. Add a sulfonylurea
B. Continue current therapy and reinforce lifestyle modifications
C. Initiate basal insulin
D. Add a DPP-4 inhibitor
B. Continue current therapy and reinforce lifestyle
modifications
RATIONALE: For most nonpregnant adults with type 2 diabetes,
an A1c goal of less than 7% is appropriate. However, a goal of less
than 8% may be acceptable for individuals with a history of severe
hypoglycemia, limited life expectancy, or advanced complications.
This patient’s A1c of 7.8% with no hypoglycemia suggests that
continuing metformin and reinforcing lifestyle changes is a
reasonable approach before intensifying pharmacotherapy.
Question 2
A 4-year-old child is brought to the clinic with a 2-day history of
fever, sore throat, and a sandpaper-like rash. On examination, the
,tonsils are erythematous and exudative, and the tongue has a
strawberry appearance. What is the most likely diagnosis?
A. Measles
B. Scarlet fever
C. Rubella
D. Kawasaki disease
B. Scarlet fever
RATIONALE: Scarlet fever is caused by group A beta-hemolytic
streptococcus and presents with fever, exudative pharyngitis, a
sandpaper-like rash, and a strawberry tongue. Measles typically
presents with Koplik spots and a maculopapular rash. Rubella has a
milder rash and postauricular lymphadenopathy. Kawasaki disease
features prolonged fever, conjunctivitis, and extremity changes.
Question 3
A 32-year-old female presents with a 3-day history of dysuria,
urinary frequency, and suprapubic discomfort. She is afebrile and
has no flank pain. A urine dipstick is positive for leukocyte esterase
and nitrites. What is the most appropriate treatment?
A. Nitrofurantoin monohydrate/macrocrystals for 5 days
B. Ciprofloxacin for 7 days
C. Amoxicillin for 10 days
D. Trimethoprim-sulfamethoxazole for 3 days
A. Nitrofurantoin monohydrate/macrocrystals for 5 days
RATIONALE: Uncomplicated cystitis in a healthy nonpregnant
female is typically treated with a short course of antibiotics.
, Nitrofurantoin for 5 days is a first-line option. Fluoroquinolones are
reserved for more complicated infections. Amoxicillin has high
resistance rates. Trimethoprim-sulfamethoxazole for 3 days is an
alternative but nitrofurantoin is preferred due to resistance
patterns.
Question 4
A 70-year-old male with hypertension and osteoarthritis presents
for a follow-up. He reports new-onset constipation and difficulty
urinating. He takes hydrochlorothiazide and ibuprofen. Which
medication is most likely contributing to his symptoms?
A. Hydrochlorothiazide
B. Ibuprofen
C. Both hydrochlorothiazide and ibuprofen
D. Neither medication
C. Both hydrochlorothiazide and ibuprofen
RATIONALE: Hydrochlorothiazide can cause constipation and
urinary retention. Ibuprofen, an NSAID, can also cause constipation
and urinary retention, particularly in older adults. The combination
of both medications increases the likelihood of these adverse
effects.
Question 5
A 25-year-old female presents with a 1-week history of bilateral hand
and wrist pain and morning stiffness lasting more than 1 hour. She
also reports fatigue. On examination, there is synovitis of the
metacarpophalangeal joints. What is the most likely diagnosis?
