1
AANP Family Nurse Practitioner (FNP)
Certification Exam 2025/2026 – Practice
Questions with Answers and Rationales
Question 1
A 65-year-old woman presents with a fasting lipid profile showing cholesterol 240 mg/dL, HDL
30 mg/dL, and LDL 200 mg/dL. She is a smoker, and her hypertension is controlled with
medication. Her mother died at age 40 from a heart attack. In addition to therapeutic lifestyle
changes, what is the most appropriate initial pharmacological treatment?
A. Bile acid sequestrant
B. Cholesterol absorption inhibitor
C. Low-dose aspirin
D. Statin drug
Correct Answer: D. Statin drug
Rationale: Statins are first-line therapy for hyperlipidemia with elevated LDL, especially in
patients with cardiovascular risk factors like smoking and family history of premature heart
disease. They reduce LDL levels and cardiovascular risk effectively.
Question 2
A 3-year-old with an upper respiratory infection (URI) presents with a fever of 100.4°F and nasal
congestion. What is the most appropriate treatment?
A. Amoxicillin 80 mg/kg/day
B. Azithromycin 10 mg/kg/day
C. Supportive care with fluids and rest
D. Oseltamivir 3 mg/kg twice daily
Correct Answer: C. Supportive care with fluids and rest
Rationale: Most URIs in children are viral. Supportive care, including hydration and rest, is
the standard treatment unless bacterial infection is suspected. Antibiotics or antivirals are not
indicated without specific evidence.
Question 3
, 2
What is the most common sign of cervical cancer in a 45-year-old woman?
A. Strong odor from vaginal discharge
B. Postcoital bleeding
C. Itching in the vaginal area
D. Molluscum contagiosum
Correct Answer: B. Postcoital bleeding
Rationale: Postcoital bleeding is the most common presenting symptom of cervical cancer,
often due to friable cervical tissue. Other symptoms like odor or itching are less specific.
Question 4
A patient with type 2 diabetes reports neuropathic pain. Which medication is most appropriate to
initiate?
A. Azathioprine
B. Ibuprofen
C. Amitriptyline
D. Cyclophosphamide
Correct Answer: C. Amitriptyline
Rationale: Amitriptyline, a tricyclic antidepressant, is first-line for neuropathic pain due to
its effect on nerve pain modulation. Ibuprofen is less effective, and azathioprine and
cyclophosphamide are not indicated.
Question 5
A 28-year-old woman started St. John’s wort for mood support. Which medication, if taken
concurrently, requires immediate discontinuation to avoid serotonin syndrome?
A. Benadryl
B. Famotidine
C. Metformin
D. Sumatriptan
Correct Answer: D. Sumatriptan
Rationale: St. John’s wort increases serotonin levels and, when combined with sumatriptan
(a serotonin agonist), can cause serotonin syndrome. The other medications do not pose this risk.
Question 6
, 3
A 3-month-old infant with Down syndrome is switched to goat’s milk due to cow’s milk
intolerance. The infant now has pale conjunctiva but is otherwise healthy. Labs show low
hematocrit. What additional test should be ordered?
A. Serum ferritin
B. Thyroid panel
C. Blood glucose
D. Liver function tests
Correct Answer: A. Serum ferritin
Rationale: Pale conjunctiva and low hematocrit suggest anemia, likely iron deficiency due
to goat’s milk, which lacks adequate iron and folate. Serum ferritin assesses iron stores.
Question 7
Which symptom is specific to post-traumatic stress disorder (PTSD) but not major depressive
disorder (MDD)?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritability
Correct Answer: B. Hypervigilance
Rationale: Hypervigilance is a hallmark of PTSD, reflecting heightened alertness to threats,
but is not a feature of MDD. The other symptoms overlap between both disorders.
Question 8
A 50-year-old man presents with chest pain radiating to the left arm, diaphoresis, and nausea.
What is the most appropriate initial action?
A. Administer sublingual nitroglycerin
B. Order a chest X-ray
C. Perform a 12-lead ECG
D. Prescribe ibuprofen
Correct Answer: C. Perform a 12-lead ECG
Rationale: Chest pain with radiation, diaphoresis, and nausea suggests acute coronary
syndrome. A 12-lead ECG is the first step to evaluate for myocardial infarction.
Question 9
AANP Family Nurse Practitioner (FNP)
Certification Exam 2025/2026 – Practice
Questions with Answers and Rationales
Question 1
A 65-year-old woman presents with a fasting lipid profile showing cholesterol 240 mg/dL, HDL
30 mg/dL, and LDL 200 mg/dL. She is a smoker, and her hypertension is controlled with
medication. Her mother died at age 40 from a heart attack. In addition to therapeutic lifestyle
changes, what is the most appropriate initial pharmacological treatment?
A. Bile acid sequestrant
B. Cholesterol absorption inhibitor
C. Low-dose aspirin
D. Statin drug
Correct Answer: D. Statin drug
Rationale: Statins are first-line therapy for hyperlipidemia with elevated LDL, especially in
patients with cardiovascular risk factors like smoking and family history of premature heart
disease. They reduce LDL levels and cardiovascular risk effectively.
Question 2
A 3-year-old with an upper respiratory infection (URI) presents with a fever of 100.4°F and nasal
congestion. What is the most appropriate treatment?
A. Amoxicillin 80 mg/kg/day
B. Azithromycin 10 mg/kg/day
C. Supportive care with fluids and rest
D. Oseltamivir 3 mg/kg twice daily
Correct Answer: C. Supportive care with fluids and rest
Rationale: Most URIs in children are viral. Supportive care, including hydration and rest, is
the standard treatment unless bacterial infection is suspected. Antibiotics or antivirals are not
indicated without specific evidence.
Question 3
, 2
What is the most common sign of cervical cancer in a 45-year-old woman?
A. Strong odor from vaginal discharge
B. Postcoital bleeding
C. Itching in the vaginal area
D. Molluscum contagiosum
Correct Answer: B. Postcoital bleeding
Rationale: Postcoital bleeding is the most common presenting symptom of cervical cancer,
often due to friable cervical tissue. Other symptoms like odor or itching are less specific.
Question 4
A patient with type 2 diabetes reports neuropathic pain. Which medication is most appropriate to
initiate?
A. Azathioprine
B. Ibuprofen
C. Amitriptyline
D. Cyclophosphamide
Correct Answer: C. Amitriptyline
Rationale: Amitriptyline, a tricyclic antidepressant, is first-line for neuropathic pain due to
its effect on nerve pain modulation. Ibuprofen is less effective, and azathioprine and
cyclophosphamide are not indicated.
Question 5
A 28-year-old woman started St. John’s wort for mood support. Which medication, if taken
concurrently, requires immediate discontinuation to avoid serotonin syndrome?
A. Benadryl
B. Famotidine
C. Metformin
D. Sumatriptan
Correct Answer: D. Sumatriptan
Rationale: St. John’s wort increases serotonin levels and, when combined with sumatriptan
(a serotonin agonist), can cause serotonin syndrome. The other medications do not pose this risk.
Question 6
, 3
A 3-month-old infant with Down syndrome is switched to goat’s milk due to cow’s milk
intolerance. The infant now has pale conjunctiva but is otherwise healthy. Labs show low
hematocrit. What additional test should be ordered?
A. Serum ferritin
B. Thyroid panel
C. Blood glucose
D. Liver function tests
Correct Answer: A. Serum ferritin
Rationale: Pale conjunctiva and low hematocrit suggest anemia, likely iron deficiency due
to goat’s milk, which lacks adequate iron and folate. Serum ferritin assesses iron stores.
Question 7
Which symptom is specific to post-traumatic stress disorder (PTSD) but not major depressive
disorder (MDD)?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritability
Correct Answer: B. Hypervigilance
Rationale: Hypervigilance is a hallmark of PTSD, reflecting heightened alertness to threats,
but is not a feature of MDD. The other symptoms overlap between both disorders.
Question 8
A 50-year-old man presents with chest pain radiating to the left arm, diaphoresis, and nausea.
What is the most appropriate initial action?
A. Administer sublingual nitroglycerin
B. Order a chest X-ray
C. Perform a 12-lead ECG
D. Prescribe ibuprofen
Correct Answer: C. Perform a 12-lead ECG
Rationale: Chest pain with radiation, diaphoresis, and nausea suggests acute coronary
syndrome. A 12-lead ECG is the first step to evaluate for myocardial infarction.
Question 9
