AANP FNP CERTIFICATION EXAM 2025/2026
Actual Questions and Answers
Expert-Verified Explanation
This Exam contains:
✪ 30 Questions and Answers
✪ Multiple-choice and True/False Format
✪ Expert-Verified Explanations
✪ Verified with Trusted Textbooks
1. All diastolic murmurs are pathological. Which murmur grade first presents with a palpable thrill?
A. Grade I
B. Grade II
C. Grade III
D. Grade IV
Answer: D
EXPLANATION: Grade IV murmurs are the first to have a palpable thrill. Grade I is barely audible, Grade
II is faint but heard, and Grade III is clearly audible without thrill.
2. Where is the fundus palpable at 12 weeks gestation?
A. At the level of the umbilicus
B. At the xiphoid process
C. At the symphysis pubis
D. Above the symphysis pubis
Answer: D
EXPLANATION: At 12 weeks, the uterine fundus is just above the symphysis pubis.
3. A 3-month-old infant with Down syndrome shows pale conjunctiva and low HCT after being fed goat's
milk. What test should be ordered?
A. Bilirubin
B. Stool occult blood
C. Iron and TIBC
D. BUN and Creatinine
Answer: C
EXPLANATION: Goat's milk is deficient in folate and iron, increasing risk for anemia. Iron studies (Iron
and TIBC) are needed.
4. A patient has been on Synthroid for 3 months. TSH is elevated, T4 is normal. What should you do?
A. Stop Synthroid
B. Continue current dose
,C. Lower Synthroid dose
D. Increase Synthroid dose
Answer: D
EXPLANATION: Elevated TSH with normal T4 suggests inadequate thyroid hormone replacement; the
dose should be increased.
5. Which test assesses cognitive function in patients with memory loss?
A. GAD-7
B. PHQ-9
C. MMSE
D. CAGE
Answer: C
EXPLANATION: The Mini-Mental State Examination (MMSE) is a common screening tool for cognitive
function.
6. A 4-month-old has intermittent strabismus. What should the nurse practitioner tell the parent?
A. Immediate referral to ophthalmologist
B. This is a sign of permanent vision damage
C. It is normal in infants
D. Eye surgery may be necessary
Answer: C
EXPLANATION: Intermittent strabismus is normal up to 6 months of age.
7. A 4-month-old is vomiting everything. What is the priority assessment?
A. Skin turgor
B. Temperature
C. Growth chart
D. Abdominal ultrasound
Answer: C
EXPLANATION: Growth chart data helps determine if vomiting is impacting weight and development.
8. A 6-month-old has a closed anterior fontanel. What is the next step?
A. MRI
B. Observation only
C. Referral to endocrinology
D. Skull X-ray
Answer: D
EXPLANATION: Early fontanel closure requires imaging (skull X-ray) to assess for craniosynostosis.
,9. A woman’s PAP shows abnormal cells. What is the next step?
A. Repeat in 1 year
B. Start antibiotics
C. Colposcopy referral
D. Cryotherapy
Answer: C
EXPLANATION: Abnormal PAP requires colposcopic evaluation for further investigation.
10. What does the “C” in the CAGE acronym stand for?
A. Craving
B. Cut down
C. Collapse
D. Control
Answer: B
EXPLANATION: CAGE is a screening tool for alcohol abuse. C = Cut down on drinking.
11. Which is not a cause of tachycardia?
A. Fever
B. Anemia
C. Hypotension
D. Hypercalcemia
Answer: D
EXPLANATION: Fever, anemia, and hypotension can cause tachycardia; hypercalcemia generally does
not.
12. Which cranial nerves are involved in extraocular eye movement?
A. CN II, III, IV
B. CN III, IV, VI
C. CN I, II, VI
D. CN V, VI, VII
Answer: B
EXPLANATION: CN III (oculomotor), IV (trochlear), and VI (abducens) control eye movement.
13. What defines metabolic syndrome?
A. Elevated TSH
B. Cluster of cardiovascular risk factors
C. Presence of depression and fatigue
D. Elevated ESR
Answer: B
EXPLANATION: Metabolic syndrome is defined by a cluster of conditions increasing cardiovascular risk.
, 14. How is trichomoniasis definitively diagnosed?
A. Blood test
B. Wet prep
C. Culture
D. PCR
Answer: B
EXPLANATION: Wet mount microscopy confirms diagnosis by visualizing motile protozoa.
15. Elderly with atrophic vaginitis and a palpable 4x5 cm ovary. Next step?
A. Monitor only
B. Pap smear
C. Pelvic ultrasound
D. Estrogen cream
Answer: C
EXPLANATION: Ovaries should be non-palpable in postmenopausal women; US is needed to rule out
pathology.
16. Where does epistaxis most commonly occur?
A. Posterior nasal wall
B. Inferior turbinate
C. Anterior septum (Kiesselbach’s triangle)
D. Middle concha
Answer: C
EXPLANATION: Most nosebleeds originate from Kiesselbach’s triangle in the anterior nasal septum.
17. What confirms acute bacterial prostatitis?
A. PSA level
B. DRE
C. Urinalysis and culture
D. CT scan
Answer: C
EXPLANATION: Diagnosis requires UA and urine culture showing infection.
18. First-line treatment for GERD?
A. PPI twice daily
B. Antacids
C. H2 blockers at bedtime
D. Surgery
Actual Questions and Answers
Expert-Verified Explanation
This Exam contains:
✪ 30 Questions and Answers
✪ Multiple-choice and True/False Format
✪ Expert-Verified Explanations
✪ Verified with Trusted Textbooks
1. All diastolic murmurs are pathological. Which murmur grade first presents with a palpable thrill?
A. Grade I
B. Grade II
C. Grade III
D. Grade IV
Answer: D
EXPLANATION: Grade IV murmurs are the first to have a palpable thrill. Grade I is barely audible, Grade
II is faint but heard, and Grade III is clearly audible without thrill.
2. Where is the fundus palpable at 12 weeks gestation?
A. At the level of the umbilicus
B. At the xiphoid process
C. At the symphysis pubis
D. Above the symphysis pubis
Answer: D
EXPLANATION: At 12 weeks, the uterine fundus is just above the symphysis pubis.
3. A 3-month-old infant with Down syndrome shows pale conjunctiva and low HCT after being fed goat's
milk. What test should be ordered?
A. Bilirubin
B. Stool occult blood
C. Iron and TIBC
D. BUN and Creatinine
Answer: C
EXPLANATION: Goat's milk is deficient in folate and iron, increasing risk for anemia. Iron studies (Iron
and TIBC) are needed.
4. A patient has been on Synthroid for 3 months. TSH is elevated, T4 is normal. What should you do?
A. Stop Synthroid
B. Continue current dose
,C. Lower Synthroid dose
D. Increase Synthroid dose
Answer: D
EXPLANATION: Elevated TSH with normal T4 suggests inadequate thyroid hormone replacement; the
dose should be increased.
5. Which test assesses cognitive function in patients with memory loss?
A. GAD-7
B. PHQ-9
C. MMSE
D. CAGE
Answer: C
EXPLANATION: The Mini-Mental State Examination (MMSE) is a common screening tool for cognitive
function.
6. A 4-month-old has intermittent strabismus. What should the nurse practitioner tell the parent?
A. Immediate referral to ophthalmologist
B. This is a sign of permanent vision damage
C. It is normal in infants
D. Eye surgery may be necessary
Answer: C
EXPLANATION: Intermittent strabismus is normal up to 6 months of age.
7. A 4-month-old is vomiting everything. What is the priority assessment?
A. Skin turgor
B. Temperature
C. Growth chart
D. Abdominal ultrasound
Answer: C
EXPLANATION: Growth chart data helps determine if vomiting is impacting weight and development.
8. A 6-month-old has a closed anterior fontanel. What is the next step?
A. MRI
B. Observation only
C. Referral to endocrinology
D. Skull X-ray
Answer: D
EXPLANATION: Early fontanel closure requires imaging (skull X-ray) to assess for craniosynostosis.
,9. A woman’s PAP shows abnormal cells. What is the next step?
A. Repeat in 1 year
B. Start antibiotics
C. Colposcopy referral
D. Cryotherapy
Answer: C
EXPLANATION: Abnormal PAP requires colposcopic evaluation for further investigation.
10. What does the “C” in the CAGE acronym stand for?
A. Craving
B. Cut down
C. Collapse
D. Control
Answer: B
EXPLANATION: CAGE is a screening tool for alcohol abuse. C = Cut down on drinking.
11. Which is not a cause of tachycardia?
A. Fever
B. Anemia
C. Hypotension
D. Hypercalcemia
Answer: D
EXPLANATION: Fever, anemia, and hypotension can cause tachycardia; hypercalcemia generally does
not.
12. Which cranial nerves are involved in extraocular eye movement?
A. CN II, III, IV
B. CN III, IV, VI
C. CN I, II, VI
D. CN V, VI, VII
Answer: B
EXPLANATION: CN III (oculomotor), IV (trochlear), and VI (abducens) control eye movement.
13. What defines metabolic syndrome?
A. Elevated TSH
B. Cluster of cardiovascular risk factors
C. Presence of depression and fatigue
D. Elevated ESR
Answer: B
EXPLANATION: Metabolic syndrome is defined by a cluster of conditions increasing cardiovascular risk.
, 14. How is trichomoniasis definitively diagnosed?
A. Blood test
B. Wet prep
C. Culture
D. PCR
Answer: B
EXPLANATION: Wet mount microscopy confirms diagnosis by visualizing motile protozoa.
15. Elderly with atrophic vaginitis and a palpable 4x5 cm ovary. Next step?
A. Monitor only
B. Pap smear
C. Pelvic ultrasound
D. Estrogen cream
Answer: C
EXPLANATION: Ovaries should be non-palpable in postmenopausal women; US is needed to rule out
pathology.
16. Where does epistaxis most commonly occur?
A. Posterior nasal wall
B. Inferior turbinate
C. Anterior septum (Kiesselbach’s triangle)
D. Middle concha
Answer: C
EXPLANATION: Most nosebleeds originate from Kiesselbach’s triangle in the anterior nasal septum.
17. What confirms acute bacterial prostatitis?
A. PSA level
B. DRE
C. Urinalysis and culture
D. CT scan
Answer: C
EXPLANATION: Diagnosis requires UA and urine culture showing infection.
18. First-line treatment for GERD?
A. PPI twice daily
B. Antacids
C. H2 blockers at bedtime
D. Surgery
