1
ANCC Nursing Certification Exam
2025/2026 – Actual Verified Questions
and Correct Answers with Rationales
Question 1
Which research design provides the strongest evidence for determining the effectiveness of a
nursing intervention?
A. Case-control study
B. Clinical trial
C. Cohort study
D. Cross-sectional study
B. Clinical trial
Rationale: Clinical trials, particularly randomized controlled trials, provide the highest level
of evidence for intervention effectiveness due to their controlled, experimental design, which
minimizes bias and establishes causality.
Question 2
A 55-year-old patient with paroxysmal atrial fibrillation and no history of diabetes, heart disease,
or hypertension requires antithrombotic therapy. What is the recommended treatment based on
stroke prevention guidelines?
A. Aspirin
B. Aspirin with dipyridamole
C. Clopidogrel
D. Warfarin
A. Aspirin
Rationale: For patients with paroxysmal atrial fibrillation and low stroke risk (no additional
risk factors), aspirin is recommended as a first-line antithrombotic therapy per national
guidelines, balancing efficacy and bleeding risk.
Question 3
A nurse practitioner is offered an honorarium by a pharmaceutical company to present on a lipid -
lowering drug but is asked to focus solely on their product. This situation represents:
, 2
A. Breach of contract
B. Conflict of interest
C. Personal choice
D. Reasonable request
B. Conflict of interest
Rationale: Accepting payment to promote a specific drug while limiting discussion to that
product compromises objectivity, creating a conflict of interest that undermines professional
integrity.
Question 4
A 32-year-old patient post-splenectomy for a ruptured spleen is preparing for discharge. Which
instruction should the nurse practitioner emphasize?
A. Continue antibiotics for 14 days
B. Follow up for vaccinations
C. Avoid international travel for five years
D. No weight-lifting restrictions
B. Follow up for vaccinations
Rationale: Post-splenectomy patients are at high risk for infections due to impaired immune
function. Vaccinations (e.g., pneumococcal, meningococcal) are critical to prevent serious
infections.
Question 5
When is it permissible to breach patient confidentiality?
A. When a family member gives consent
B. When a family member pays for treatment
C. When the patient is unresponsive
D. When the patient plans to harm someone
D. When the patient plans to harm someone
Rationale: Confidentiality can be breached under the duty to warn (Tarasoff rule) if a patient
poses a credible threat to harm others, prioritizing public safety.
Question 6
, 3
When reviewing a systematic review, what is the most critical element a nurse practitioner
should ensure is included?
A. Description of the intended audience
B. Study inclusion criteria
C. Peer-reviewed journal publication
D. Expert authorship
B. Study inclusion criteria
Rationale: The inclusion criteria define the scope and quality of studies in a systematic
review, ensuring relevance and validity of the findings.
Question 7
What is the primary goal of evidence-based practice in nursing?
A. Reducing healthcare costs
B. Improving patient outcomes through research integration
C. Increasing nurse workload
D. Avoiding clinical guidelines
B. Improving patient outcomes through research integration
Rationale: Evidence-based practice integrates the best available research evidence with
clinical expertise and patient values to optimize patient outcomes.
Question 8
Which action best demonstrates leadership in a nursing team?
A. Assigning tasks without input
B. Encouraging collaboration and professional development
C. Ignoring team feedback
D. Delegating all decisions to subordinates
B. Encouraging collaboration and professional development
Rationale: Effective nursing leadership fosters teamwork, encourages input, and supports
professional growth to enhance team performance and patient care.
Question 9
What is the first step in the nursing process?
A. Planning
ANCC Nursing Certification Exam
2025/2026 – Actual Verified Questions
and Correct Answers with Rationales
Question 1
Which research design provides the strongest evidence for determining the effectiveness of a
nursing intervention?
A. Case-control study
B. Clinical trial
C. Cohort study
D. Cross-sectional study
B. Clinical trial
Rationale: Clinical trials, particularly randomized controlled trials, provide the highest level
of evidence for intervention effectiveness due to their controlled, experimental design, which
minimizes bias and establishes causality.
Question 2
A 55-year-old patient with paroxysmal atrial fibrillation and no history of diabetes, heart disease,
or hypertension requires antithrombotic therapy. What is the recommended treatment based on
stroke prevention guidelines?
A. Aspirin
B. Aspirin with dipyridamole
C. Clopidogrel
D. Warfarin
A. Aspirin
Rationale: For patients with paroxysmal atrial fibrillation and low stroke risk (no additional
risk factors), aspirin is recommended as a first-line antithrombotic therapy per national
guidelines, balancing efficacy and bleeding risk.
Question 3
A nurse practitioner is offered an honorarium by a pharmaceutical company to present on a lipid -
lowering drug but is asked to focus solely on their product. This situation represents:
, 2
A. Breach of contract
B. Conflict of interest
C. Personal choice
D. Reasonable request
B. Conflict of interest
Rationale: Accepting payment to promote a specific drug while limiting discussion to that
product compromises objectivity, creating a conflict of interest that undermines professional
integrity.
Question 4
A 32-year-old patient post-splenectomy for a ruptured spleen is preparing for discharge. Which
instruction should the nurse practitioner emphasize?
A. Continue antibiotics for 14 days
B. Follow up for vaccinations
C. Avoid international travel for five years
D. No weight-lifting restrictions
B. Follow up for vaccinations
Rationale: Post-splenectomy patients are at high risk for infections due to impaired immune
function. Vaccinations (e.g., pneumococcal, meningococcal) are critical to prevent serious
infections.
Question 5
When is it permissible to breach patient confidentiality?
A. When a family member gives consent
B. When a family member pays for treatment
C. When the patient is unresponsive
D. When the patient plans to harm someone
D. When the patient plans to harm someone
Rationale: Confidentiality can be breached under the duty to warn (Tarasoff rule) if a patient
poses a credible threat to harm others, prioritizing public safety.
Question 6
, 3
When reviewing a systematic review, what is the most critical element a nurse practitioner
should ensure is included?
A. Description of the intended audience
B. Study inclusion criteria
C. Peer-reviewed journal publication
D. Expert authorship
B. Study inclusion criteria
Rationale: The inclusion criteria define the scope and quality of studies in a systematic
review, ensuring relevance and validity of the findings.
Question 7
What is the primary goal of evidence-based practice in nursing?
A. Reducing healthcare costs
B. Improving patient outcomes through research integration
C. Increasing nurse workload
D. Avoiding clinical guidelines
B. Improving patient outcomes through research integration
Rationale: Evidence-based practice integrates the best available research evidence with
clinical expertise and patient values to optimize patient outcomes.
Question 8
Which action best demonstrates leadership in a nursing team?
A. Assigning tasks without input
B. Encouraging collaboration and professional development
C. Ignoring team feedback
D. Delegating all decisions to subordinates
B. Encouraging collaboration and professional development
Rationale: Effective nursing leadership fosters teamwork, encourages input, and supports
professional growth to enhance team performance and patient care.
Question 9
What is the first step in the nursing process?
A. Planning
