FAMILY NURSE PRACTITIONER
ANCC CERTIFICATION NEWEST
EXAM PREP TEST BANK WITH 250
MOST RECENT EXAM QUESTIONS
AND CORRECT VERIFIED
ANSWERS/ ANCC FNP EXAM PREP
LATEST
ANCC Family Nurse Practitioner (FNP-BC) Practice
Exam
Section 1: Assessment (19% of Scored Content)
1. A 72-year-old woman with a history of hypertension presents with progressive
shortness of breath over the last few weeks. She reports that her symptoms are
worse at night and she now needs to sleep on three pillows to breathe
comfortably. An echocardiogram demonstrates diffuse left ventricular
hypertrophy and an ejection fraction of 65%. In this patient population, which of
the following therapies has been proven to confer a mortality benefit?
A. Beta-blockers
B. Loop diuretics
C. Spironolactone
D. No agent has shown a definitive mortality benefit
Rationale: This presentation (exertional dyspnea, orthopnea, preserved ejection
fraction) is classic for heart failure with preserved ejection fraction (HFpEF). Large-scale
clinical trials have not consistently demonstrated a mortality benefit for beta-blockers,
,ACE inhibitors, ARBs, or spironolactone specifically in the HFpEF population. Current
management focuses on symptom control and aggressive treatment of comorbidities
like hypertension and atrial fibrillation.
2. A 52-year-old man presents for a routine visit. His office BP averages 134/84
mmHg across two visits. He has no ASCVD, diabetes, or CKD, and his 10-year
PREVENT risk is 5%. According to the 2025 AHA/ACC guideline, what is the MOST
appropriate next step?
A. Begin a thiazide diuretic today
B. Initiate lifestyle therapy and reassess in 3-6 months, starting medication if BP
remains ≥130/80
C. No intervention; this BP is normal
D. Begin a two-drug single-pill combination
Rationale: This is stage 1 hypertension (130-139/80-89). The 2025 guideline directs
pharmacotherapy for stage 1 when the patient has ASCVD, diabetes, CKD, or a 10-year
PREVENT risk ≥7.5%. With a PREVENT risk of 5% and no compelling indication, lifestyle
therapy for 3-6 months is first-line. Note the change from the 2017 guideline, which
used a 10% ASCVD threshold—PREVENT has replaced the Pooled Cohort Equations.
Option D is reserved for stage 2 disease.
3. Which finding on a diabetic foot examination is the STRONGEST predictor of
future ulceration and warrants the most urgent preventive intervention?
A. Onychomycosis of two toenails
B. Loss of protective sensation on 10-g monofilament testing
C. Dry, scaling skin over the heels
D. A bunion at the first metatarsophalangeal joint
Rationale: Loss of protective sensation is the single strongest predictor of ulceration
because the patient can no longer perceive the repetitive trauma that produces tissue
breakdown. The 10-g Semmes-Weinstein monofilament, ideally combined with one
other modality such as vibration or pinprick, is the standard screening test and should
be performed at least annually.
,4. A 3-week-old infant presents with a rectal temperature of 38.2°C (100.8°F). The
infant is feeding well and appears nontoxic. What is the MOST appropriate action?
A. Reassure the parents and follow up in 24 hours
B. Prescribe oral amoxicillin and arrange next-day follow-up
C. Refer immediately for emergency evaluation including full sepsis work-up
D. Obtain a urinalysis in the office and treat if positive
Rationale: Any fever of 38.0°C or higher in an infant under 28 days of age is a medical
emergency regardless of appearance, because neonates mount unreliable inflammatory
responses and can harbor invasive bacterial infection or HSV while looking well.
Management requires immediate referral for blood, urine, and CSF cultures with empiric
parenteral antibiotics. A well appearance is explicitly NOT reassuring at this age.
5. According to current USPSTF recommendations, at what age should average-
risk adults BEGIN screening for colorectal cancer?
A. 40 years
B. 45 years
C. 50 years
D. 55 years
Rationale: The USPSTF lowered the starting age for average-risk colorectal cancer
screening from 50 to 45 years (grade B for ages 45-49, grade A for 50-75), reflecting
rising incidence in younger adults. Acceptable strategies include colonoscopy every 10
years, annual FIT, FIT-DNA every 1-3 years, or CT colonography every 5 years.
6. A 40-year-old woman with no personal or family history of breast cancer asks
when she should begin mammography. Based on the 2024 USPSTF
recommendation, the FNP should advise:
A. Annual mammography beginning now
B. Biennial mammography beginning now, continuing through age 74
, C. Biennial mammography beginning at age 50
D. No screening until age 45
Rationale: In 2024 the USPSTF lowered the starting age for biennial screening
mammography from 50 to 40 years (grade B), continuing through age 74. Evidence for
screening at 75 and older is insufficient. Note that this differs from the American Cancer
Society, which offers annual screening from 45; when guidelines diverge, shared
decision-making that accounts for patient values is the appropriate approach.
7. Which patient meets USPSTF criteria for annual low-dose CT lung cancer
screening?
A. A 45-year-old with a 30 pack-year history who currently smokes
B. A 62-year-old with a 25 pack-year history who quit 8 years ago
C. A 55-year-old with a 15 pack-year history who currently smokes
D. A 70-year-old with a 40 pack-year history who quit 20 years ago
Rationale: All three criteria must be met: age 50-80, at least a 20 pack-year history, and
current smoking or cessation within the past 15 years. Option B satisfies each. Option A
fails on age, option C on pack-years, and option D on the cessation interval, since risk
declines substantially beyond 15 years of abstinence.
8. A patient with diabetes reports numb feet. Which focused assessment is most
appropriate?
A. Foot inspection, skin integrity, pulses, sensation, footwear, and injury history
B. Only blood pressure
C. Only visual acuity
D. Only abdominal examination
Rationale: Diabetes-related foot risk requires vascular, neurologic, skin, footwear, and
injury assessment. A comprehensive foot examination is essential to identify risk factors
for ulceration and amputation.
ANCC CERTIFICATION NEWEST
EXAM PREP TEST BANK WITH 250
MOST RECENT EXAM QUESTIONS
AND CORRECT VERIFIED
ANSWERS/ ANCC FNP EXAM PREP
LATEST
ANCC Family Nurse Practitioner (FNP-BC) Practice
Exam
Section 1: Assessment (19% of Scored Content)
1. A 72-year-old woman with a history of hypertension presents with progressive
shortness of breath over the last few weeks. She reports that her symptoms are
worse at night and she now needs to sleep on three pillows to breathe
comfortably. An echocardiogram demonstrates diffuse left ventricular
hypertrophy and an ejection fraction of 65%. In this patient population, which of
the following therapies has been proven to confer a mortality benefit?
A. Beta-blockers
B. Loop diuretics
C. Spironolactone
D. No agent has shown a definitive mortality benefit
Rationale: This presentation (exertional dyspnea, orthopnea, preserved ejection
fraction) is classic for heart failure with preserved ejection fraction (HFpEF). Large-scale
clinical trials have not consistently demonstrated a mortality benefit for beta-blockers,
,ACE inhibitors, ARBs, or spironolactone specifically in the HFpEF population. Current
management focuses on symptom control and aggressive treatment of comorbidities
like hypertension and atrial fibrillation.
2. A 52-year-old man presents for a routine visit. His office BP averages 134/84
mmHg across two visits. He has no ASCVD, diabetes, or CKD, and his 10-year
PREVENT risk is 5%. According to the 2025 AHA/ACC guideline, what is the MOST
appropriate next step?
A. Begin a thiazide diuretic today
B. Initiate lifestyle therapy and reassess in 3-6 months, starting medication if BP
remains ≥130/80
C. No intervention; this BP is normal
D. Begin a two-drug single-pill combination
Rationale: This is stage 1 hypertension (130-139/80-89). The 2025 guideline directs
pharmacotherapy for stage 1 when the patient has ASCVD, diabetes, CKD, or a 10-year
PREVENT risk ≥7.5%. With a PREVENT risk of 5% and no compelling indication, lifestyle
therapy for 3-6 months is first-line. Note the change from the 2017 guideline, which
used a 10% ASCVD threshold—PREVENT has replaced the Pooled Cohort Equations.
Option D is reserved for stage 2 disease.
3. Which finding on a diabetic foot examination is the STRONGEST predictor of
future ulceration and warrants the most urgent preventive intervention?
A. Onychomycosis of two toenails
B. Loss of protective sensation on 10-g monofilament testing
C. Dry, scaling skin over the heels
D. A bunion at the first metatarsophalangeal joint
Rationale: Loss of protective sensation is the single strongest predictor of ulceration
because the patient can no longer perceive the repetitive trauma that produces tissue
breakdown. The 10-g Semmes-Weinstein monofilament, ideally combined with one
other modality such as vibration or pinprick, is the standard screening test and should
be performed at least annually.
,4. A 3-week-old infant presents with a rectal temperature of 38.2°C (100.8°F). The
infant is feeding well and appears nontoxic. What is the MOST appropriate action?
A. Reassure the parents and follow up in 24 hours
B. Prescribe oral amoxicillin and arrange next-day follow-up
C. Refer immediately for emergency evaluation including full sepsis work-up
D. Obtain a urinalysis in the office and treat if positive
Rationale: Any fever of 38.0°C or higher in an infant under 28 days of age is a medical
emergency regardless of appearance, because neonates mount unreliable inflammatory
responses and can harbor invasive bacterial infection or HSV while looking well.
Management requires immediate referral for blood, urine, and CSF cultures with empiric
parenteral antibiotics. A well appearance is explicitly NOT reassuring at this age.
5. According to current USPSTF recommendations, at what age should average-
risk adults BEGIN screening for colorectal cancer?
A. 40 years
B. 45 years
C. 50 years
D. 55 years
Rationale: The USPSTF lowered the starting age for average-risk colorectal cancer
screening from 50 to 45 years (grade B for ages 45-49, grade A for 50-75), reflecting
rising incidence in younger adults. Acceptable strategies include colonoscopy every 10
years, annual FIT, FIT-DNA every 1-3 years, or CT colonography every 5 years.
6. A 40-year-old woman with no personal or family history of breast cancer asks
when she should begin mammography. Based on the 2024 USPSTF
recommendation, the FNP should advise:
A. Annual mammography beginning now
B. Biennial mammography beginning now, continuing through age 74
, C. Biennial mammography beginning at age 50
D. No screening until age 45
Rationale: In 2024 the USPSTF lowered the starting age for biennial screening
mammography from 50 to 40 years (grade B), continuing through age 74. Evidence for
screening at 75 and older is insufficient. Note that this differs from the American Cancer
Society, which offers annual screening from 45; when guidelines diverge, shared
decision-making that accounts for patient values is the appropriate approach.
7. Which patient meets USPSTF criteria for annual low-dose CT lung cancer
screening?
A. A 45-year-old with a 30 pack-year history who currently smokes
B. A 62-year-old with a 25 pack-year history who quit 8 years ago
C. A 55-year-old with a 15 pack-year history who currently smokes
D. A 70-year-old with a 40 pack-year history who quit 20 years ago
Rationale: All three criteria must be met: age 50-80, at least a 20 pack-year history, and
current smoking or cessation within the past 15 years. Option B satisfies each. Option A
fails on age, option C on pack-years, and option D on the cessation interval, since risk
declines substantially beyond 15 years of abstinence.
8. A patient with diabetes reports numb feet. Which focused assessment is most
appropriate?
A. Foot inspection, skin integrity, pulses, sensation, footwear, and injury history
B. Only blood pressure
C. Only visual acuity
D. Only abdominal examination
Rationale: Diabetes-related foot risk requires vascular, neurologic, skin, footwear, and
injury assessment. A comprehensive foot examination is essential to identify risk factors
for ulceration and amputation.
