SARAH MICHELLE’S AANP BOARD EXAM REVIEW NEWEST
2025/ 2026 ACTUAL EXAM| COMPLETE REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST RECENT!!)
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
Advanced Health Assessment and Diagnostic Reasoning
Pharmacotherapeutics and Prescriptive Authority
Management of Acute and Chronic Illness Across the Lifespan
Health Promotion, Disease Prevention, and Epidemiology
Professional Role, Policy, and Regulatory Compliance
Ethical and Legal Principles in Advanced Practice Nursing
Evidence-Based Practice and Quality Improvement
Interprofessional Collaboration and Healthcare Systems
Introduction
This comprehensive assessment is designed to evaluate the
advanced clinical knowledge, diagnostic reasoning, and
professional judgment required for nurse practitioner certification.
It rigorously tests the competencies essential for autonomous
practice, including the formulation of differential diagnoses, the
initiation and management of complex pharmacologic regimens,
and the application of current evidence to patient care. The
examination employs a multiple-choice and scenario-based
structure, emphasizing real-world application and critical
decision-making. Candidates are challenged to demonstrate not
only factual recall but also the analytical skills necessary to
navigate regulatory requirements, ethical dilemmas, and the
dynamic challenges of modern healthcare delivery.
,SECTION ONE: QUESTIONS 1–150
1. A 68-year-old male with a history of heart failure with
reduced ejection fraction (HFrEF) is being evaluated for a
new prescription. His current medications include
carvedilol, lisinopril, and spironolactone. His most recent
echocardiogram showed an ejection fraction of 30%. The
NP considers adding sacubitril/valsartan. Which of the
following laboratory values is the most critical to evaluate
before initiating this therapy?
A. Serum creatinine and estimated glomerular filtration rate, to
assess renal function.
B. Serum potassium and renal function, to assess for
hyperkalemia and renal impairment.
C. Liver function tests, to assess for hepatic metabolism.
D. Complete blood count with differential, to assess for anemia.
B. Serum potassium and renal function, to assess for
hyperkalemia and renal impairment.
RATIONALE: The most critical labs to evaluate before initiating
sacubitril/valsartan are serum potassium and renal function. Both
sacubitril/valsartan and the already prescribed spironolactone and
lisinopril can increase potassium levels and affect renal function.
The risk of hyperkalemia and acute kidney injury is significant,
especially when these agents are used concurrently. A baseline
assessment is essential to establish safety and to monitor for
these potentially life-threatening adverse effects. While renal
function is part of the assessment, option B is more
comprehensive as it includes the critical electrolyte balance.
2. Which of the following is the most appropriate first-line
pharmacologic treatment for a 32-year-old female newly
diagnosed with uncomplicated major depressive disorder?
,A. Sertraline
B. Amitriptyline
C. Phenelzine
D. Alprazolam
A. Sertraline
RATIONALE: Sertraline, a selective serotonin reuptake
inhibitor (SSRI), is a first-line treatment for major depressive
disorder due to its favorable safety profile, efficacy, and
tolerability. Tricyclic antidepressants like amitriptyline are
generally reserved for more refractory cases due to their
significant anticholinergic and cardiac side effect profiles.
Monoamine oxidase inhibitors like phenelzine are typically used
for atypical depression or when other treatments fail, due to
severe dietary and drug interactions. Benzodiazepines like
alprazolam are not effective as monotherapy for depression.
3. A 23-year-old patient who is pregnant at 28 weeks
gestation presents to the clinic for a routine prenatal
checkup. Which fundal height measurement would warrant
a more conclusive assessment with an ultrasound?
A. 26 cm
B. 29 cm
C. 30 cm
D. 31 cm
D. 31 cm
RATIONALE: After 20 weeks gestation, the fundal height
should be measured with a measuring tape in centimeters and
should match the gestational age. It can be > or < 2 centimeters
and still be within normal limits. A fundal height of 26-30 cm is a
normal finding in a patient who is 28 weeks gestation. A result of
, 31 cm is larger than expected and should be further evaluated
with an ultrasound.
4. A parent brings in their 6-year-old son with concerns
about a pertussis exposure in the child's classroom. If the
patient is not up to date on vaccinations, which vaccine
should the nurse practitioner administer at today's visit?
A. DTaP
B. Td
C. Tdap
D. Vaccination is not necessary since he has already been
exposed
A. DTaP
RATIONALE: The patient should receive the DTaP vaccination
at today's visit. Five doses of pertussis-containing vaccine are
recommended before a child enters school. While the DTaP
vaccination is not guaranteed to prevent pertussis, it should help
lessen the severity of symptoms. Postexposure prophylaxis of
azithromycin is recommended in children who are in close contact
with an infected person or at high risk for severe pertussis.
5. A 6-year-old patient presents to the clinic accompanied
by his mother, who reports concerns regarding her child's
progressive urinary issues. The patient's mother states
that she and the child's father recently divorced, and the
child alternates weekly between her house and his father's
house. She reports he experiences episodes of urinary
incontinence and holds his stomach as if he is in pain. He
frequently asks to use the bathroom but is scared of
urination once he is there. Which of the following is the
most likely diagnosis?
2025/ 2026 ACTUAL EXAM| COMPLETE REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST RECENT!!)
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
Advanced Health Assessment and Diagnostic Reasoning
Pharmacotherapeutics and Prescriptive Authority
Management of Acute and Chronic Illness Across the Lifespan
Health Promotion, Disease Prevention, and Epidemiology
Professional Role, Policy, and Regulatory Compliance
Ethical and Legal Principles in Advanced Practice Nursing
Evidence-Based Practice and Quality Improvement
Interprofessional Collaboration and Healthcare Systems
Introduction
This comprehensive assessment is designed to evaluate the
advanced clinical knowledge, diagnostic reasoning, and
professional judgment required for nurse practitioner certification.
It rigorously tests the competencies essential for autonomous
practice, including the formulation of differential diagnoses, the
initiation and management of complex pharmacologic regimens,
and the application of current evidence to patient care. The
examination employs a multiple-choice and scenario-based
structure, emphasizing real-world application and critical
decision-making. Candidates are challenged to demonstrate not
only factual recall but also the analytical skills necessary to
navigate regulatory requirements, ethical dilemmas, and the
dynamic challenges of modern healthcare delivery.
,SECTION ONE: QUESTIONS 1–150
1. A 68-year-old male with a history of heart failure with
reduced ejection fraction (HFrEF) is being evaluated for a
new prescription. His current medications include
carvedilol, lisinopril, and spironolactone. His most recent
echocardiogram showed an ejection fraction of 30%. The
NP considers adding sacubitril/valsartan. Which of the
following laboratory values is the most critical to evaluate
before initiating this therapy?
A. Serum creatinine and estimated glomerular filtration rate, to
assess renal function.
B. Serum potassium and renal function, to assess for
hyperkalemia and renal impairment.
C. Liver function tests, to assess for hepatic metabolism.
D. Complete blood count with differential, to assess for anemia.
B. Serum potassium and renal function, to assess for
hyperkalemia and renal impairment.
RATIONALE: The most critical labs to evaluate before initiating
sacubitril/valsartan are serum potassium and renal function. Both
sacubitril/valsartan and the already prescribed spironolactone and
lisinopril can increase potassium levels and affect renal function.
The risk of hyperkalemia and acute kidney injury is significant,
especially when these agents are used concurrently. A baseline
assessment is essential to establish safety and to monitor for
these potentially life-threatening adverse effects. While renal
function is part of the assessment, option B is more
comprehensive as it includes the critical electrolyte balance.
2. Which of the following is the most appropriate first-line
pharmacologic treatment for a 32-year-old female newly
diagnosed with uncomplicated major depressive disorder?
,A. Sertraline
B. Amitriptyline
C. Phenelzine
D. Alprazolam
A. Sertraline
RATIONALE: Sertraline, a selective serotonin reuptake
inhibitor (SSRI), is a first-line treatment for major depressive
disorder due to its favorable safety profile, efficacy, and
tolerability. Tricyclic antidepressants like amitriptyline are
generally reserved for more refractory cases due to their
significant anticholinergic and cardiac side effect profiles.
Monoamine oxidase inhibitors like phenelzine are typically used
for atypical depression or when other treatments fail, due to
severe dietary and drug interactions. Benzodiazepines like
alprazolam are not effective as monotherapy for depression.
3. A 23-year-old patient who is pregnant at 28 weeks
gestation presents to the clinic for a routine prenatal
checkup. Which fundal height measurement would warrant
a more conclusive assessment with an ultrasound?
A. 26 cm
B. 29 cm
C. 30 cm
D. 31 cm
D. 31 cm
RATIONALE: After 20 weeks gestation, the fundal height
should be measured with a measuring tape in centimeters and
should match the gestational age. It can be > or < 2 centimeters
and still be within normal limits. A fundal height of 26-30 cm is a
normal finding in a patient who is 28 weeks gestation. A result of
, 31 cm is larger than expected and should be further evaluated
with an ultrasound.
4. A parent brings in their 6-year-old son with concerns
about a pertussis exposure in the child's classroom. If the
patient is not up to date on vaccinations, which vaccine
should the nurse practitioner administer at today's visit?
A. DTaP
B. Td
C. Tdap
D. Vaccination is not necessary since he has already been
exposed
A. DTaP
RATIONALE: The patient should receive the DTaP vaccination
at today's visit. Five doses of pertussis-containing vaccine are
recommended before a child enters school. While the DTaP
vaccination is not guaranteed to prevent pertussis, it should help
lessen the severity of symptoms. Postexposure prophylaxis of
azithromycin is recommended in children who are in close contact
with an infected person or at high risk for severe pertussis.
5. A 6-year-old patient presents to the clinic accompanied
by his mother, who reports concerns regarding her child's
progressive urinary issues. The patient's mother states
that she and the child's father recently divorced, and the
child alternates weekly between her house and his father's
house. She reports he experiences episodes of urinary
incontinence and holds his stomach as if he is in pain. He
frequently asks to use the bathroom but is scared of
urination once he is there. Which of the following is the
most likely diagnosis?
