ANCC Certification Comprehensive Exam 2025
Questions and Answers with Rationales
1. A 62-year-old patient with hypertension and diabetes presents for a routine
visit. According to the USPSTF, which of the following screenings is most
appropriate?
A. Prostate cancer screening
B. Abdominal aortic aneurysm (AAA) screening
C. Hepatitis A screening
D. Colonoscopy every 2 years
Rationale: The USPSTF recommends a one-time AAA screening by
ultrasonography for men aged 65-75 who have ever smoked. However, in
diabetic and hypertensive men ≥60, screening may also be considered.
2. A patient presents with symptoms of major depressive disorder. Which
antidepressant is most appropriate for a patient who is also experiencing
neuropathic pain?
A. Fluoxetine
B. Sertraline
C. Duloxetine
D. Bupropion
,Rationale: Duloxetine, an SNRI, treats both depression and neuropathic pain,
making it a good choice in patients with comorbid conditions.
3. A 45-year-old man is diagnosed with metabolic syndrome. Which of the
following is NOT a component of metabolic syndrome?
A. Elevated fasting glucose
B. Elevated triglycerides
C. Low LDL cholesterol
D. Low HDL cholesterol
Rationale: Low LDL is not a component of metabolic syndrome. Metabolic
syndrome includes abdominal obesity, elevated fasting glucose, high
triglycerides, low HDL, and hypertension.
4. A patient presents with unilateral facial paralysis, inability to wrinkle the
forehead, and drooping of the mouth. What is the most likely diagnosis?
A. Stroke
B. Bell’s palsy
C. Myasthenia gravis
D. Trigeminal neuralgia
Rationale: Bell’s palsy affects the facial nerve (CN VII) and causes ipsilateral
facial paralysis including the forehead, which helps distinguish it from a stroke.
, 5. A 28-year-old woman presents with a painless breast mass. Which initial
diagnostic test is most appropriate?
A. Mammogram
B. CT scan
C. Breast ultrasound
D. MRI
Rationale: Ultrasound is the preferred initial imaging in women <30 years with a
breast mass due to the density of breast tissue.
6. The most appropriate way to assess for diabetic neuropathy in the lower
extremities is:
A. Checking dorsalis pedis pulse
B. Measuring fasting glucose
C. Monofilament testing
D. Ankle-brachial index
Rationale: Monofilament testing detects loss of protective sensation, a key sign
of diabetic peripheral neuropathy.
7. Which of the following lab abnormalities is most consistent with Addison’s
disease?
A. Hypernatremia
B. Hyponatremia
Questions and Answers with Rationales
1. A 62-year-old patient with hypertension and diabetes presents for a routine
visit. According to the USPSTF, which of the following screenings is most
appropriate?
A. Prostate cancer screening
B. Abdominal aortic aneurysm (AAA) screening
C. Hepatitis A screening
D. Colonoscopy every 2 years
Rationale: The USPSTF recommends a one-time AAA screening by
ultrasonography for men aged 65-75 who have ever smoked. However, in
diabetic and hypertensive men ≥60, screening may also be considered.
2. A patient presents with symptoms of major depressive disorder. Which
antidepressant is most appropriate for a patient who is also experiencing
neuropathic pain?
A. Fluoxetine
B. Sertraline
C. Duloxetine
D. Bupropion
,Rationale: Duloxetine, an SNRI, treats both depression and neuropathic pain,
making it a good choice in patients with comorbid conditions.
3. A 45-year-old man is diagnosed with metabolic syndrome. Which of the
following is NOT a component of metabolic syndrome?
A. Elevated fasting glucose
B. Elevated triglycerides
C. Low LDL cholesterol
D. Low HDL cholesterol
Rationale: Low LDL is not a component of metabolic syndrome. Metabolic
syndrome includes abdominal obesity, elevated fasting glucose, high
triglycerides, low HDL, and hypertension.
4. A patient presents with unilateral facial paralysis, inability to wrinkle the
forehead, and drooping of the mouth. What is the most likely diagnosis?
A. Stroke
B. Bell’s palsy
C. Myasthenia gravis
D. Trigeminal neuralgia
Rationale: Bell’s palsy affects the facial nerve (CN VII) and causes ipsilateral
facial paralysis including the forehead, which helps distinguish it from a stroke.
, 5. A 28-year-old woman presents with a painless breast mass. Which initial
diagnostic test is most appropriate?
A. Mammogram
B. CT scan
C. Breast ultrasound
D. MRI
Rationale: Ultrasound is the preferred initial imaging in women <30 years with a
breast mass due to the density of breast tissue.
6. The most appropriate way to assess for diabetic neuropathy in the lower
extremities is:
A. Checking dorsalis pedis pulse
B. Measuring fasting glucose
C. Monofilament testing
D. Ankle-brachial index
Rationale: Monofilament testing detects loss of protective sensation, a key sign
of diabetic peripheral neuropathy.
7. Which of the following lab abnormalities is most consistent with Addison’s
disease?
A. Hypernatremia
B. Hyponatremia
