(ANCC Exam 2026 Questions – Verified Answers & Rationales A+: 2026).
ANCC Exam
2026 Questions
– Verified
Answers &
Rationales
Page 1 of 140 3/23/2026, 4:16:49 PM
, (ANCC Exam 2026 Questions – Verified Answers & Rationales A+: 2026).
1. Type 2 Diabetes – Stimulating Insulin Release
Scenario: 50-year-old woman, T2DM, max metformin, HbA1c 8.6%, refuses insulin.
Question: Which medication stimulates insulin release from pancreatic beta cells?
Answer: D. Glipizide (Glucotrol)
Rationale: Glipizide is a sulfonylurea that directly stimulates insulin secretion.
● Incorrect options:
○ Acarbose: delays carbohydrate absorption.
○ Dulaglutide: GLP-1 receptor agonist, enhances glucose-dependent insulin
release.
○ Empagliflozin: SGLT2 inhibitor, increases urinary glucose excretion.
2. Otitis Media Diagnosis
Scenario: 18-year-old, unilateral ear pain, tympanic membrane bulging, obscured
landmarks, distorted light reflex.
Answer: C. Otitis media
Rationale: Bulging, inflamed TM with distorted light reflex indicates middle ear infection.
● Incorrect options:
○ Mastoiditis: infection spreads to mastoid bone, usually post-otitis media.
○ Otitis externa: external ear canal inflammation.
○ Presbycusis: age-related hearing loss.
3. Oral Allergy Syndrome
Scenario: 7-year-old boy, itchy throat/eye swelling 2 hrs post-lunch, airway patent.
Answer: C. Peaches
Rationale: Certain fresh fruits (peaches, apples, cherries) can trigger cross-reactive allergic
reactions in patients with pollen allergies.
● Incorrect options: milk, eggs, salmon—less likely to cause oral allergy syndrome.
4. Erythema Infectiosum (Fifth Disease)
Scenario: 8-year-old boy, lacy maculopapular rash on trunk/arms, red cheeks, post-fever.
Answer: A. Erythema infectiosum
Rationale: “Slapped cheek” appearance and lacy rash on body is classic.
Page 2 of 140 3/23/2026, 4:16:49 PM
, (ANCC Exam 2026 Questions – Verified Answers & Rationales A+: 2026).
● Incorrect options:
○ Hand-foot-mouth: vesicular lesions.
○ Roseola: high fever followed by rose-colored rash.
○ Rubella: generalized rash, milder, post-natal exposure.
5. Hypertension Management
Scenario: 85-year-old man, BP 168/74 → 128/78 after 2 weeks lisinopril 10 mg daily.
Answer: B. Continue lisinopril at current dose
Rationale: Target BP achieved; no need to adjust. Monitor for adverse effects.
● Incorrect: Increasing dose or adding meds unnecessarily risks hypotension.
6. Parkinson’s Disease – Next Step
Scenario: 66-year-old man, resting tremor L side, lead-pipe rigidity, bradykinesia.
Answer: D. Referral to a neurologist
Rationale: Specialist evaluation is needed for diagnosis and initiation of management;
levodopa challenge not first-line without neurologist oversight.
7. Obesity – Lifestyle Management
Scenario: 45-year-old man, BMI 32, minimal weight loss after 1 month of diet/exercise.
Answer: C. Recommend stress management
Rationale: Stress can impact adherence and weight loss. Behavioral interventions are
first-line before medications or surgery.
● Incorrect: Phentermine, bariatric surgery, or abrupt increase in exercise may be
premature.
8. Sleep-Related Movement Disorder
Scenario: Older adult, history of poor sleep, uncontrollable urge to move extremities.
Answer: D. Restless leg syndrome
Rationale: Classic movement disorder causing sleep disturbance; differs from tremor or
PAD.
9. STI Treatment – Noncompliant Patient
Page 3 of 140 3/23/2026, 4:16:49 PM
, (ANCC Exam 2026 Questions – Verified Answers & Rationales A+: 2026).
Scenario: 27-year-old woman, mucopurulent cervical discharge, history of STIs.
Answer: B. Ceftriaxone 500 mg IM + Azithromycin 1 g orally single dose
Rationale: Single-dose therapy improves adherence; treats gonorrhea + chlamydia
coverage.
● Incorrect: Acyclovir: antiviral, for herpes simplex, not bacterial STIs.
Page 4 of 140 3/23/2026, 4:16:49 PM
ANCC Exam
2026 Questions
– Verified
Answers &
Rationales
Page 1 of 140 3/23/2026, 4:16:49 PM
, (ANCC Exam 2026 Questions – Verified Answers & Rationales A+: 2026).
1. Type 2 Diabetes – Stimulating Insulin Release
Scenario: 50-year-old woman, T2DM, max metformin, HbA1c 8.6%, refuses insulin.
Question: Which medication stimulates insulin release from pancreatic beta cells?
Answer: D. Glipizide (Glucotrol)
Rationale: Glipizide is a sulfonylurea that directly stimulates insulin secretion.
● Incorrect options:
○ Acarbose: delays carbohydrate absorption.
○ Dulaglutide: GLP-1 receptor agonist, enhances glucose-dependent insulin
release.
○ Empagliflozin: SGLT2 inhibitor, increases urinary glucose excretion.
2. Otitis Media Diagnosis
Scenario: 18-year-old, unilateral ear pain, tympanic membrane bulging, obscured
landmarks, distorted light reflex.
Answer: C. Otitis media
Rationale: Bulging, inflamed TM with distorted light reflex indicates middle ear infection.
● Incorrect options:
○ Mastoiditis: infection spreads to mastoid bone, usually post-otitis media.
○ Otitis externa: external ear canal inflammation.
○ Presbycusis: age-related hearing loss.
3. Oral Allergy Syndrome
Scenario: 7-year-old boy, itchy throat/eye swelling 2 hrs post-lunch, airway patent.
Answer: C. Peaches
Rationale: Certain fresh fruits (peaches, apples, cherries) can trigger cross-reactive allergic
reactions in patients with pollen allergies.
● Incorrect options: milk, eggs, salmon—less likely to cause oral allergy syndrome.
4. Erythema Infectiosum (Fifth Disease)
Scenario: 8-year-old boy, lacy maculopapular rash on trunk/arms, red cheeks, post-fever.
Answer: A. Erythema infectiosum
Rationale: “Slapped cheek” appearance and lacy rash on body is classic.
Page 2 of 140 3/23/2026, 4:16:49 PM
, (ANCC Exam 2026 Questions – Verified Answers & Rationales A+: 2026).
● Incorrect options:
○ Hand-foot-mouth: vesicular lesions.
○ Roseola: high fever followed by rose-colored rash.
○ Rubella: generalized rash, milder, post-natal exposure.
5. Hypertension Management
Scenario: 85-year-old man, BP 168/74 → 128/78 after 2 weeks lisinopril 10 mg daily.
Answer: B. Continue lisinopril at current dose
Rationale: Target BP achieved; no need to adjust. Monitor for adverse effects.
● Incorrect: Increasing dose or adding meds unnecessarily risks hypotension.
6. Parkinson’s Disease – Next Step
Scenario: 66-year-old man, resting tremor L side, lead-pipe rigidity, bradykinesia.
Answer: D. Referral to a neurologist
Rationale: Specialist evaluation is needed for diagnosis and initiation of management;
levodopa challenge not first-line without neurologist oversight.
7. Obesity – Lifestyle Management
Scenario: 45-year-old man, BMI 32, minimal weight loss after 1 month of diet/exercise.
Answer: C. Recommend stress management
Rationale: Stress can impact adherence and weight loss. Behavioral interventions are
first-line before medications or surgery.
● Incorrect: Phentermine, bariatric surgery, or abrupt increase in exercise may be
premature.
8. Sleep-Related Movement Disorder
Scenario: Older adult, history of poor sleep, uncontrollable urge to move extremities.
Answer: D. Restless leg syndrome
Rationale: Classic movement disorder causing sleep disturbance; differs from tremor or
PAD.
9. STI Treatment – Noncompliant Patient
Page 3 of 140 3/23/2026, 4:16:49 PM
, (ANCC Exam 2026 Questions – Verified Answers & Rationales A+: 2026).
Scenario: 27-year-old woman, mucopurulent cervical discharge, history of STIs.
Answer: B. Ceftriaxone 500 mg IM + Azithromycin 1 g orally single dose
Rationale: Single-dose therapy improves adherence; treats gonorrhea + chlamydia
coverage.
● Incorrect: Acyclovir: antiviral, for herpes simplex, not bacterial STIs.
Page 4 of 140 3/23/2026, 4:16:49 PM
