ANCC FNP 2024/2025 ACTUAL EXAM VERSION 1 WITH 200 REAL EXAM
QUESTIONS AND CORRECT ANSWERS WITH A STUDY GUIDE(100% CORRECT
ANSWERS PLUS RATIONALES GRADED A+) ANCC FAMILY NURSE PRACTITIONER
ACTUAL EXAM 2024/2025 (NEW!!)
Question 1
A patient presents with itchy, watery, and red eyes. The FNP diagnoses mild allergic
conjunctivitis. What is the most appropriate first-line treatment?
A) Topical corticosteroids
B) Oral antihistamines
C) Topical antihistamine/mast cell stabilizer drops
D) Systemic corticosteroids
Correct Answer: C) Topical antihistamine/mast cell stabilizer drops
Rationale: Topical antihistamines/mast cell stabilizers (e.g., olopatadine, ketotifen) are first-
line treatment for allergic conjunctivitis as they provide rapid relief and address the
underlying allergic mechanism. Oral antihistamines can cause dry eyes, and corticosteroids
are reserved for severe cases due to side effect risks.
Question 2
A 45-year-old male who is HIV positive presents with painless, white, corrugated lesions on the
lateral aspects of his tongue that cannot be scraped off. What is the most likely diagnosis?
A) Oral candidiasis (thrush)
B) Geographic tongue
C) Oral hairy leukoplakia
D) Squamous cell carcinoma
Correct Answer: C) Oral hairy leukoplakia
Rationale: Oral hairy leukoplakia presents as elongated papillae on the lateral aspects of the
tongue. It is caused by the Epstein-Barr virus (EBV) and is most commonly seen in
immunocompromised individuals.
Question 3
A mother brings in her 4-year-old child with a high fever and a new rash. During the oral exam,
the FNP notes clusters of small red papules with white centers on the buccal mucosa. What are
,these spots called?
A) Forchheimer spots
B) Koplik's spots
C) Strawberry spots
D) Petechiae
Correct Answer: B) Koplik's spots
Rationale: Koplik's spots are pathognomonic for measles (rubeola). They are small white spots
(like grains of salt) on a red base found on the buccal mucosa and appear 2-3 days before the
measles rash.
Question 4
A patient complains that their tongue looks like a map, with multiple fissures and irregular
smoother areas on the surface. This benign, inflammatory condition is known as:
A) Oral hairy leukoplakia
B) Atrophic glossitis
C) Fissured tongue
D) Geographic tongue
Correct Answer: D) Geographic tongue
Rationale: Geographic tongue is an inflammatory disorder characterized by migratory,
irregular patches on the tongue's surface, giving it a map-like appearance. It is typically
painless and benign.
Question 5
An elderly patient with ill-fitting dentures presents with painful inflammation and cracking at
the corners of their mouth. What is the clinical term for this condition?
A) Cheilosis
B) Aphthous stomatitis
C) Herpes labialis
D) Leukoplakia
Correct Answer: A) Cheilosis
Rationale: Cheilosis, or angular cheilitis, is an inflammatory condition affecting the corners of
,the mouth. It can be caused by nutritional deficiencies (iron, B vitamins), ill-fitting dentures,
or fungal/bacterial infections.
Question 6
A 22-year-old presents with a severe sore throat, difficulty swallowing, muffled "hot potato"
voice, and trismus (difficulty opening the jaw). On examination, the uvula is deviated to the left.
What is the most likely diagnosis?
A) Acute pharyngitis
B) Mononucleosis
C) Peritonsillar abscess
D) Epiglottitis
Correct Answer: C) Peritonsillar abscess
Rationale: A peritonsillar abscess is a collection of pus behind the tonsil. The combination of
severe unilateral sore throat, muffled voice, trismus, and contralateral uvular deviation is
classic for this condition, which is a medical emergency.
Question 7
A 60-year-old landscaper presents with a yellow, triangular thickening of the conjunctiva that
has grown from the nasal side across a portion of the cornea. What is this condition called?
A) Pinguecula
B) Chalazion
C) Pterygium
D) Xanthelasma
Correct Answer: C) Pterygium
Rationale: A pterygium is a growth of fleshy, conjunctival tissue that extends over the cornea.
It is often caused by chronic sun (UV) exposure and is also known as "surfer's eye."
Question 8
A patient points to a yellowish, slightly raised growth on the white part of their eye, located
next to the cornea but not crossing onto it. What is the most likely diagnosis?
A) Pterygium
, B) Pinguecula
C) Hordeolum
D) Chalazion
Correct Answer: B) Pinguecula
Rationale: A pinguecula is a common degenerative condition of the conjunctiva. Unlike a
pterygium, it does not grow onto the cornea.
Question 9
A patient presents with a hard, non-tender nodule on the middle of their upper eyelid that has
been present for several weeks. This is characteristic of a:
A) Hordeolum (stye)
B) Blepharitis
C) Chalazion
D) Xanthelasma
Correct Answer: C) Chalazion
Rationale: A chalazion is a chronic, granulomatous inflammation of a meibomian gland. It
presents as a painless, rubbery nodule, distinguishing it from an acute, painful hordeolum.
Question 10
A patient has a tender, red, pimple-like bump on the edge of their eyelid. This acute infection of
a hair follicle and sebaceous gland is called a:
A) Chalazion
B) Blepharitis
C) Dacryocystitis
D) Hordeolum (stye)
Correct Answer: D) Hordeolum (stye)
Rationale: A hordeolum, or stye, is an acute abscess of an eyelid gland. It is typically painful,
red, and tender.
Question 11
According to the HEARS mnemonic for identifying high-risk factors for hearing loss in premature
QUESTIONS AND CORRECT ANSWERS WITH A STUDY GUIDE(100% CORRECT
ANSWERS PLUS RATIONALES GRADED A+) ANCC FAMILY NURSE PRACTITIONER
ACTUAL EXAM 2024/2025 (NEW!!)
Question 1
A patient presents with itchy, watery, and red eyes. The FNP diagnoses mild allergic
conjunctivitis. What is the most appropriate first-line treatment?
A) Topical corticosteroids
B) Oral antihistamines
C) Topical antihistamine/mast cell stabilizer drops
D) Systemic corticosteroids
Correct Answer: C) Topical antihistamine/mast cell stabilizer drops
Rationale: Topical antihistamines/mast cell stabilizers (e.g., olopatadine, ketotifen) are first-
line treatment for allergic conjunctivitis as they provide rapid relief and address the
underlying allergic mechanism. Oral antihistamines can cause dry eyes, and corticosteroids
are reserved for severe cases due to side effect risks.
Question 2
A 45-year-old male who is HIV positive presents with painless, white, corrugated lesions on the
lateral aspects of his tongue that cannot be scraped off. What is the most likely diagnosis?
A) Oral candidiasis (thrush)
B) Geographic tongue
C) Oral hairy leukoplakia
D) Squamous cell carcinoma
Correct Answer: C) Oral hairy leukoplakia
Rationale: Oral hairy leukoplakia presents as elongated papillae on the lateral aspects of the
tongue. It is caused by the Epstein-Barr virus (EBV) and is most commonly seen in
immunocompromised individuals.
Question 3
A mother brings in her 4-year-old child with a high fever and a new rash. During the oral exam,
the FNP notes clusters of small red papules with white centers on the buccal mucosa. What are
,these spots called?
A) Forchheimer spots
B) Koplik's spots
C) Strawberry spots
D) Petechiae
Correct Answer: B) Koplik's spots
Rationale: Koplik's spots are pathognomonic for measles (rubeola). They are small white spots
(like grains of salt) on a red base found on the buccal mucosa and appear 2-3 days before the
measles rash.
Question 4
A patient complains that their tongue looks like a map, with multiple fissures and irregular
smoother areas on the surface. This benign, inflammatory condition is known as:
A) Oral hairy leukoplakia
B) Atrophic glossitis
C) Fissured tongue
D) Geographic tongue
Correct Answer: D) Geographic tongue
Rationale: Geographic tongue is an inflammatory disorder characterized by migratory,
irregular patches on the tongue's surface, giving it a map-like appearance. It is typically
painless and benign.
Question 5
An elderly patient with ill-fitting dentures presents with painful inflammation and cracking at
the corners of their mouth. What is the clinical term for this condition?
A) Cheilosis
B) Aphthous stomatitis
C) Herpes labialis
D) Leukoplakia
Correct Answer: A) Cheilosis
Rationale: Cheilosis, or angular cheilitis, is an inflammatory condition affecting the corners of
,the mouth. It can be caused by nutritional deficiencies (iron, B vitamins), ill-fitting dentures,
or fungal/bacterial infections.
Question 6
A 22-year-old presents with a severe sore throat, difficulty swallowing, muffled "hot potato"
voice, and trismus (difficulty opening the jaw). On examination, the uvula is deviated to the left.
What is the most likely diagnosis?
A) Acute pharyngitis
B) Mononucleosis
C) Peritonsillar abscess
D) Epiglottitis
Correct Answer: C) Peritonsillar abscess
Rationale: A peritonsillar abscess is a collection of pus behind the tonsil. The combination of
severe unilateral sore throat, muffled voice, trismus, and contralateral uvular deviation is
classic for this condition, which is a medical emergency.
Question 7
A 60-year-old landscaper presents with a yellow, triangular thickening of the conjunctiva that
has grown from the nasal side across a portion of the cornea. What is this condition called?
A) Pinguecula
B) Chalazion
C) Pterygium
D) Xanthelasma
Correct Answer: C) Pterygium
Rationale: A pterygium is a growth of fleshy, conjunctival tissue that extends over the cornea.
It is often caused by chronic sun (UV) exposure and is also known as "surfer's eye."
Question 8
A patient points to a yellowish, slightly raised growth on the white part of their eye, located
next to the cornea but not crossing onto it. What is the most likely diagnosis?
A) Pterygium
, B) Pinguecula
C) Hordeolum
D) Chalazion
Correct Answer: B) Pinguecula
Rationale: A pinguecula is a common degenerative condition of the conjunctiva. Unlike a
pterygium, it does not grow onto the cornea.
Question 9
A patient presents with a hard, non-tender nodule on the middle of their upper eyelid that has
been present for several weeks. This is characteristic of a:
A) Hordeolum (stye)
B) Blepharitis
C) Chalazion
D) Xanthelasma
Correct Answer: C) Chalazion
Rationale: A chalazion is a chronic, granulomatous inflammation of a meibomian gland. It
presents as a painless, rubbery nodule, distinguishing it from an acute, painful hordeolum.
Question 10
A patient has a tender, red, pimple-like bump on the edge of their eyelid. This acute infection of
a hair follicle and sebaceous gland is called a:
A) Chalazion
B) Blepharitis
C) Dacryocystitis
D) Hordeolum (stye)
Correct Answer: D) Hordeolum (stye)
Rationale: A hordeolum, or stye, is an acute abscess of an eyelid gland. It is typically painful,
red, and tender.
Question 11
According to the HEARS mnemonic for identifying high-risk factors for hearing loss in premature
