1
AANP FNP ACTUAL EXAM
QUESTIONS 2025/2026 | PSI Practice
Questions with Evidence-Based
Rationales | Family NP Certification |
Pass Guarantee
1. A 24-year-old woman at 16 weeks gestation reports painless vaginal
spotting. FHR 150 bpm, cervix closed, no tissue. Next best step? A.
Expectant management
B. Misoprostol 400 µg vaginally
C. Transvaginal ultrasound
D. Immediate dilation & curettage
Answer: C. TVUS confirms viability, location, subchorionic bleed vs
placenta previa (ACOG 2025).
2. Which vaccine is live-attenuated and contraindicated in pregnancy? A. Tdap
B. Influenza (IIV)
C. MMR
D. Hepatitis B
Answer: C. MMR → theoretical fetal risk; give post-partum.
3. 68-year-old man with HFpEF develops new-onset atrial fibrillation.
CHA₂DS₂-VASc = 4. Anticoagulant of choice with CKD 3b? A.
Rivaroxaban 20 mg daily
B. Apixaban 5 mg BID
C. Warfarin (INR 2-3)
D. Dabigatran 150 mg BID
Answer: B. Apixaban safe eGFR 30-59; no dose adjustment until <15.
, 2
4. Gold-standard diagnostic test for pulmonary arterial hypertension? A. Chest
CT angiography
B. Right-heart catheterization
C. BNP level
D. Ventilation-perfusion scan
Answer: B. RHC documents mean PAP >20 mmHg (2025 ESC/ERS).
5. 55-year-old post-menopausal woman T-score –2.7. First-line pharmacologic
therapy? A. Teriparatide
B. Alendronate 70 mg weekly
C. Calcitonin nasal
D. Estrogen-progestin
Answer: B. Oral bisphosphonate reduces hip & vertebral fracture (USPSTF
2025).
6. 8-year-old with asthma uses ICS-LABA daily. School nurse notes peak flow
55 % personal best, accessory muscle use. First rescue? A. Nebulized
magnesium sulfate
B. Albuterol 2.5 mg nebulizer
C. PO prednisolone 2 mg/kg
D. Subcutaneous epinephrine
Answer: B. SABA first-line; add steroids if poor response.
7. Most specific physical finding for rotator-cuff tear? A. Painful arc 60-120°
B. Drop-arm test
C. Hawkins sign
D. Empty-can weakness
Answer: B. Drop-arm ≥90° highly specific for full-thickness tear.
8. 19-year-old college student with sore throat, no cough, tonsillar exudate,
temp 38.5 °C, anterior nodes. Centor score 4. Next step? A. Rapid strep +
culture if negative
B. Empiric amoxicillin 500 mg BID
C. Macrolide for coverage
, 3
D. Reassure viral; NSAIDs
Answer: B. Score ≥3 → treat without testing (IDSA 2025).
9. First-line agent for trigeminal neuralgia? A. Gabapentin
B. Carbamazepine
C. Baclofen
D. Oxcarbazepine
Answer: B. Carbamazepine FDA-indicated; Level A evidence.
10.72-year-old on warfarin (INR 3.8) needs urgent tooth extraction. INR goal?
A. Hold 2 doses; proceed if INR ≤1.5
B. Hold 5 days; bridge LMWH
C. Proceed if INR ≤3.0
D. Vitamin K 5 mg IV now
Answer: C. Dental extraction safe INR ≤3.0 (ACCP 2025).
11.35-year-old woman BMI 32, oligomenorrhea, acne, LH:FSH 2:1. First-line
infertility treatment? A. Letrozole 2.5 mg cycle days 3-7
B. Clomiphene 50 mg days 5-9
C. Metformin 1500 mg daily
D. IVF referral
Answer: A. Letrozole superior ovulation & live-birth vs clomiphene (NEJM
2024).
12.Classic ECG finding in acute pericarditis? A. Diffuse ST elevations + PR
depression
B. Q waves V1-V3
C. Peaked T waves
D. Brugada pattern
Answer: A.
13.Drug of choice for acute mania in 26-year-old with bipolar I & normal renal
function? A. Lithium carbonate
B. Risperidone
C. Lamotrigine
AANP FNP ACTUAL EXAM
QUESTIONS 2025/2026 | PSI Practice
Questions with Evidence-Based
Rationales | Family NP Certification |
Pass Guarantee
1. A 24-year-old woman at 16 weeks gestation reports painless vaginal
spotting. FHR 150 bpm, cervix closed, no tissue. Next best step? A.
Expectant management
B. Misoprostol 400 µg vaginally
C. Transvaginal ultrasound
D. Immediate dilation & curettage
Answer: C. TVUS confirms viability, location, subchorionic bleed vs
placenta previa (ACOG 2025).
2. Which vaccine is live-attenuated and contraindicated in pregnancy? A. Tdap
B. Influenza (IIV)
C. MMR
D. Hepatitis B
Answer: C. MMR → theoretical fetal risk; give post-partum.
3. 68-year-old man with HFpEF develops new-onset atrial fibrillation.
CHA₂DS₂-VASc = 4. Anticoagulant of choice with CKD 3b? A.
Rivaroxaban 20 mg daily
B. Apixaban 5 mg BID
C. Warfarin (INR 2-3)
D. Dabigatran 150 mg BID
Answer: B. Apixaban safe eGFR 30-59; no dose adjustment until <15.
, 2
4. Gold-standard diagnostic test for pulmonary arterial hypertension? A. Chest
CT angiography
B. Right-heart catheterization
C. BNP level
D. Ventilation-perfusion scan
Answer: B. RHC documents mean PAP >20 mmHg (2025 ESC/ERS).
5. 55-year-old post-menopausal woman T-score –2.7. First-line pharmacologic
therapy? A. Teriparatide
B. Alendronate 70 mg weekly
C. Calcitonin nasal
D. Estrogen-progestin
Answer: B. Oral bisphosphonate reduces hip & vertebral fracture (USPSTF
2025).
6. 8-year-old with asthma uses ICS-LABA daily. School nurse notes peak flow
55 % personal best, accessory muscle use. First rescue? A. Nebulized
magnesium sulfate
B. Albuterol 2.5 mg nebulizer
C. PO prednisolone 2 mg/kg
D. Subcutaneous epinephrine
Answer: B. SABA first-line; add steroids if poor response.
7. Most specific physical finding for rotator-cuff tear? A. Painful arc 60-120°
B. Drop-arm test
C. Hawkins sign
D. Empty-can weakness
Answer: B. Drop-arm ≥90° highly specific for full-thickness tear.
8. 19-year-old college student with sore throat, no cough, tonsillar exudate,
temp 38.5 °C, anterior nodes. Centor score 4. Next step? A. Rapid strep +
culture if negative
B. Empiric amoxicillin 500 mg BID
C. Macrolide for coverage
, 3
D. Reassure viral; NSAIDs
Answer: B. Score ≥3 → treat without testing (IDSA 2025).
9. First-line agent for trigeminal neuralgia? A. Gabapentin
B. Carbamazepine
C. Baclofen
D. Oxcarbazepine
Answer: B. Carbamazepine FDA-indicated; Level A evidence.
10.72-year-old on warfarin (INR 3.8) needs urgent tooth extraction. INR goal?
A. Hold 2 doses; proceed if INR ≤1.5
B. Hold 5 days; bridge LMWH
C. Proceed if INR ≤3.0
D. Vitamin K 5 mg IV now
Answer: C. Dental extraction safe INR ≤3.0 (ACCP 2025).
11.35-year-old woman BMI 32, oligomenorrhea, acne, LH:FSH 2:1. First-line
infertility treatment? A. Letrozole 2.5 mg cycle days 3-7
B. Clomiphene 50 mg days 5-9
C. Metformin 1500 mg daily
D. IVF referral
Answer: A. Letrozole superior ovulation & live-birth vs clomiphene (NEJM
2024).
12.Classic ECG finding in acute pericarditis? A. Diffuse ST elevations + PR
depression
B. Q waves V1-V3
C. Peaked T waves
D. Brugada pattern
Answer: A.
13.Drug of choice for acute mania in 26-year-old with bipolar I & normal renal
function? A. Lithium carbonate
B. Risperidone
C. Lamotrigine
