ANCC Board Certification Exam Practice Questions and
Answers 2025
For: FNP, AGPCNP, PMHNP, and Adult/Gero Clinical Nurse Specialists
Format: Multiple Choice Questions
Includes: Bolded Correct Answers + Rationales
These questions are designed to help nurse practitioner candidates review key topics for the
American Nurses Credentialing Center (ANCC) board exams, including diagnosis,
pharmacology, scope of practice, ethics, pathophysiology, and clinical management. The
content aligns with the 2025 ANCC test outlines and covers both primary care and
psychiatric/mental health domains.
1. A 68-year-old patient presents with new-onset confusion, fever, and
productive cough. Which of the following is the most likely cause?
A. Alzheimer’s disease
B. Delirium secondary to pneumonia
C. Vascular dementia
D. Generalized anxiety disorder
Rationale:
Delirium is a sudden change in mental status caused by an underlying medical
condition. Pneumonia is a common cause of delirium in older adults due to
systemic infection.
2. Which of the following best describes the concept of autonomy in nursing
ethics?
,A. Doing no harm to the patient
B. Providing equal treatment to all
C. Respecting the patient's right to make decisions
D. Acting in the patient's best interest
Rationale:
Autonomy refers to the patient’s right to self-determination, including making
informed choices about their own care.
3. A 25-year-old woman with generalized anxiety disorder has been prescribed
buspirone. What should the nurse practitioner emphasize during patient
education?
A. “Take this medication only as needed for acute anxiety.”
B. “It may take 2–4 weeks to notice the full effect.”
C. “This drug has a high potential for addiction.”
D. “You can safely drink alcohol with this medication.”
Rationale:
Buspirone is not effective for acute anxiety; it requires consistent use over time. It
is non-addictive but does not mix well with alcohol.
4. Which lab value is most important to monitor in a patient taking lithium?
A. Liver enzymes
B. Hemoglobin A1c
C. Serum creatinine and sodium
D. White blood cell count
, Rationale:
Lithium is excreted by the kidneys, so renal function (creatinine) and sodium
levels must be monitored closely to avoid toxicity.
5. A nurse practitioner is evaluating a research article. Which component
determines the study’s internal validity?
A. Generalizability of results
B. Control of confounding variables
C. Application of findings to clinical practice
D. Statistical significance
Rationale:
Internal validity refers to the degree to which the study controls for confounding
variables and measures what it intends to.
6. A patient with heart failure is taking lisinopril. What side effect requires
immediate attention?
A. Fatigue
B. Swelling of the lips and tongue
C. Cough
D. Headache
Rationale:
Swelling of the lips/tongue suggests angioedema, a life-threatening adverse
reaction to ACE inhibitors.
Answers 2025
For: FNP, AGPCNP, PMHNP, and Adult/Gero Clinical Nurse Specialists
Format: Multiple Choice Questions
Includes: Bolded Correct Answers + Rationales
These questions are designed to help nurse practitioner candidates review key topics for the
American Nurses Credentialing Center (ANCC) board exams, including diagnosis,
pharmacology, scope of practice, ethics, pathophysiology, and clinical management. The
content aligns with the 2025 ANCC test outlines and covers both primary care and
psychiatric/mental health domains.
1. A 68-year-old patient presents with new-onset confusion, fever, and
productive cough. Which of the following is the most likely cause?
A. Alzheimer’s disease
B. Delirium secondary to pneumonia
C. Vascular dementia
D. Generalized anxiety disorder
Rationale:
Delirium is a sudden change in mental status caused by an underlying medical
condition. Pneumonia is a common cause of delirium in older adults due to
systemic infection.
2. Which of the following best describes the concept of autonomy in nursing
ethics?
,A. Doing no harm to the patient
B. Providing equal treatment to all
C. Respecting the patient's right to make decisions
D. Acting in the patient's best interest
Rationale:
Autonomy refers to the patient’s right to self-determination, including making
informed choices about their own care.
3. A 25-year-old woman with generalized anxiety disorder has been prescribed
buspirone. What should the nurse practitioner emphasize during patient
education?
A. “Take this medication only as needed for acute anxiety.”
B. “It may take 2–4 weeks to notice the full effect.”
C. “This drug has a high potential for addiction.”
D. “You can safely drink alcohol with this medication.”
Rationale:
Buspirone is not effective for acute anxiety; it requires consistent use over time. It
is non-addictive but does not mix well with alcohol.
4. Which lab value is most important to monitor in a patient taking lithium?
A. Liver enzymes
B. Hemoglobin A1c
C. Serum creatinine and sodium
D. White blood cell count
, Rationale:
Lithium is excreted by the kidneys, so renal function (creatinine) and sodium
levels must be monitored closely to avoid toxicity.
5. A nurse practitioner is evaluating a research article. Which component
determines the study’s internal validity?
A. Generalizability of results
B. Control of confounding variables
C. Application of findings to clinical practice
D. Statistical significance
Rationale:
Internal validity refers to the degree to which the study controls for confounding
variables and measures what it intends to.
6. A patient with heart failure is taking lisinopril. What side effect requires
immediate attention?
A. Fatigue
B. Swelling of the lips and tongue
C. Cough
D. Headache
Rationale:
Swelling of the lips/tongue suggests angioedema, a life-threatening adverse
reaction to ACE inhibitors.
