AANP FNP CERTIFICATION EXAM BANK 2026 |
ACCURATE REAL EXAM Questions And Correct Answers
(Verified Answers) Plus Rationales 2026 Q&A.
1. Question:
A 45-year-old woman presents with a complaint of persistent cough for 2 weeks.
She reports no fever or shortness of breath. On examination, her lung sounds are
clear, and there is no wheezing. She has a history of seasonal allergies. Which of
the following is the most likely diagnosis?
A) Acute bronchitis
B) Asthma exacerbation
C) Viral upper respiratory infection
D) Allergic rhinitis
Answer: A) Acute bronchitis
Rationale:
Acute bronchitis typically presents with a persistent cough lasting for more than
five days and up to 3 weeks, often following a viral upper respiratory infection.
This patient does not exhibit symptoms like fever, shortness of breath, or wheezing
that would suggest asthma or a viral upper respiratory infection. The absence of
fever and wheezing, along with the persistent cough, aligns with acute bronchitis.
2. Question:
A 60-year-old male with a history of hypertension presents for a routine check-up.
His blood pressure is 145/90 mmHg. Which of the following is the most
appropriate management?
A) Initiate a low-sodium diet
B) Begin treatment with a thiazide diuretic
C) Encourage weight loss and exercise only
D) Refer for evaluation of secondary hypertension
,Answer: B) Begin treatment with a thiazide diuretic
Rationale:
The patient has Stage 1 hypertension (BP ≥ 130/80 mmHg). The first-line
treatment for hypertension in most cases is a thiazide diuretic. Although lifestyle
modifications (such as a low-sodium diet, exercise, and weight loss) are important,
pharmacologic treatment is warranted when blood pressure is above the target
range (≥130/80 mmHg).
3. Question:
A 22-year-old female presents with a sore throat, fever, and a rash that began 2
days ago. On physical examination, she has erythematous tonsils with white
exudates, a temperature of 101°F, and a fine maculopapular rash. What is the most
likely diagnosis?
A) Streptococcal pharyngitis
B) Infectious mononucleosis
C) Scarlet fever
D) Viral pharyngitis
Answer: B) Infectious mononucleosis
Rationale:
Infectious mononucleosis, caused by the Epstein-Barr virus, presents with fever,
sore throat, and lymphadenopathy. The presence of a maculopapular rash, along
with the exudative tonsils and fever, points to mononucleosis rather than
streptococcal pharyngitis. The rash often develops after amoxicillin use in
mononucleosis, a classic clue.
4. Question:
A 35-year-old woman with no significant medical history presents with a
complaint of intermittent headaches for the past 6 months. The headaches are
described as pressure-like and are often worse in the afternoon. There is no
associated nausea or visual disturbances. What is the most appropriate next step in
management?
,A) MRI of the brain
B) Referral to a neurologist
C) Trial of NSAIDs for 2 weeks
D) Prescribe a triptan medication
Answer: C) Trial of NSAIDs for 2 weeks
Rationale:
This patient presents with a tension-type headache, which is the most common type
of headache. Treatment for tension headaches includes NSAIDs or other pain
relievers. MRI or referral to a neurologist is unnecessary unless the headaches
change in pattern, are severe, or are associated with neurological findings.
5. Question:
A 24-year-old woman presents with complaints of excessive thirst, frequent
urination, and weight loss. Her blood glucose is 300 mg/dL. What is the most
likely diagnosis?
A) Type 1 diabetes
B) Type 2 diabetes
C) Hyperthyroidism
D) Adrenal insufficiency
Answer: A) Type 1 diabetes
Rationale:
The patient's symptoms of excessive thirst, frequent urination, weight loss, and
elevated blood glucose are classic signs of Type 1 diabetes. Type 1 diabetes is
more common in younger individuals and often presents acutely with symptoms
like these due to an absolute insulin deficiency.
6. Question:
A 70-year-old man with a history of smoking presents with weight loss,
hemoptysis, and cough. He is found to have a mass in the upper lobe of the right
lung. What is the most likely diagnosis?
, A) Bronchitis
B) Pulmonary embolism
C) Lung cancer
D) Tuberculosis
Answer: C) Lung cancer
Rationale:
Given the patient's history of smoking and presenting with weight loss,
hemoptysis, and cough, lung cancer is the most likely diagnosis. The presence of a
mass in the upper lobe of the lung is highly suggestive of a malignancy. Smoking
is a significant risk factor for lung cancer.
7. Question:
A 50-year-old male with a history of chronic alcohol use presents with confusion,
ataxia, and nystagmus. What is the most likely diagnosis?
A) Wernicke’s encephalopathy
B) Hepatic encephalopathy
C) Alcoholic neuropathy
D) Alcoholic cardiomyopathy
Answer: A) Wernicke’s encephalopathy
Rationale:
Wernicke’s encephalopathy is a neurological disorder often seen in individuals
with chronic alcohol use, characterized by confusion, ataxia, and nystagmus due to
thiamine deficiency. Immediate thiamine replacement is essential to prevent
permanent neurological damage.
8. Question:
A 65-year-old female presents with a complaint of gradual, bilateral hip pain that
worsens with activity and improves with rest. Physical examination reveals
decreased internal rotation and hip flexion. What is the most likely diagnosis?
ACCURATE REAL EXAM Questions And Correct Answers
(Verified Answers) Plus Rationales 2026 Q&A.
1. Question:
A 45-year-old woman presents with a complaint of persistent cough for 2 weeks.
She reports no fever or shortness of breath. On examination, her lung sounds are
clear, and there is no wheezing. She has a history of seasonal allergies. Which of
the following is the most likely diagnosis?
A) Acute bronchitis
B) Asthma exacerbation
C) Viral upper respiratory infection
D) Allergic rhinitis
Answer: A) Acute bronchitis
Rationale:
Acute bronchitis typically presents with a persistent cough lasting for more than
five days and up to 3 weeks, often following a viral upper respiratory infection.
This patient does not exhibit symptoms like fever, shortness of breath, or wheezing
that would suggest asthma or a viral upper respiratory infection. The absence of
fever and wheezing, along with the persistent cough, aligns with acute bronchitis.
2. Question:
A 60-year-old male with a history of hypertension presents for a routine check-up.
His blood pressure is 145/90 mmHg. Which of the following is the most
appropriate management?
A) Initiate a low-sodium diet
B) Begin treatment with a thiazide diuretic
C) Encourage weight loss and exercise only
D) Refer for evaluation of secondary hypertension
,Answer: B) Begin treatment with a thiazide diuretic
Rationale:
The patient has Stage 1 hypertension (BP ≥ 130/80 mmHg). The first-line
treatment for hypertension in most cases is a thiazide diuretic. Although lifestyle
modifications (such as a low-sodium diet, exercise, and weight loss) are important,
pharmacologic treatment is warranted when blood pressure is above the target
range (≥130/80 mmHg).
3. Question:
A 22-year-old female presents with a sore throat, fever, and a rash that began 2
days ago. On physical examination, she has erythematous tonsils with white
exudates, a temperature of 101°F, and a fine maculopapular rash. What is the most
likely diagnosis?
A) Streptococcal pharyngitis
B) Infectious mononucleosis
C) Scarlet fever
D) Viral pharyngitis
Answer: B) Infectious mononucleosis
Rationale:
Infectious mononucleosis, caused by the Epstein-Barr virus, presents with fever,
sore throat, and lymphadenopathy. The presence of a maculopapular rash, along
with the exudative tonsils and fever, points to mononucleosis rather than
streptococcal pharyngitis. The rash often develops after amoxicillin use in
mononucleosis, a classic clue.
4. Question:
A 35-year-old woman with no significant medical history presents with a
complaint of intermittent headaches for the past 6 months. The headaches are
described as pressure-like and are often worse in the afternoon. There is no
associated nausea or visual disturbances. What is the most appropriate next step in
management?
,A) MRI of the brain
B) Referral to a neurologist
C) Trial of NSAIDs for 2 weeks
D) Prescribe a triptan medication
Answer: C) Trial of NSAIDs for 2 weeks
Rationale:
This patient presents with a tension-type headache, which is the most common type
of headache. Treatment for tension headaches includes NSAIDs or other pain
relievers. MRI or referral to a neurologist is unnecessary unless the headaches
change in pattern, are severe, or are associated with neurological findings.
5. Question:
A 24-year-old woman presents with complaints of excessive thirst, frequent
urination, and weight loss. Her blood glucose is 300 mg/dL. What is the most
likely diagnosis?
A) Type 1 diabetes
B) Type 2 diabetes
C) Hyperthyroidism
D) Adrenal insufficiency
Answer: A) Type 1 diabetes
Rationale:
The patient's symptoms of excessive thirst, frequent urination, weight loss, and
elevated blood glucose are classic signs of Type 1 diabetes. Type 1 diabetes is
more common in younger individuals and often presents acutely with symptoms
like these due to an absolute insulin deficiency.
6. Question:
A 70-year-old man with a history of smoking presents with weight loss,
hemoptysis, and cough. He is found to have a mass in the upper lobe of the right
lung. What is the most likely diagnosis?
, A) Bronchitis
B) Pulmonary embolism
C) Lung cancer
D) Tuberculosis
Answer: C) Lung cancer
Rationale:
Given the patient's history of smoking and presenting with weight loss,
hemoptysis, and cough, lung cancer is the most likely diagnosis. The presence of a
mass in the upper lobe of the lung is highly suggestive of a malignancy. Smoking
is a significant risk factor for lung cancer.
7. Question:
A 50-year-old male with a history of chronic alcohol use presents with confusion,
ataxia, and nystagmus. What is the most likely diagnosis?
A) Wernicke’s encephalopathy
B) Hepatic encephalopathy
C) Alcoholic neuropathy
D) Alcoholic cardiomyopathy
Answer: A) Wernicke’s encephalopathy
Rationale:
Wernicke’s encephalopathy is a neurological disorder often seen in individuals
with chronic alcohol use, characterized by confusion, ataxia, and nystagmus due to
thiamine deficiency. Immediate thiamine replacement is essential to prevent
permanent neurological damage.
8. Question:
A 65-year-old female presents with a complaint of gradual, bilateral hip pain that
worsens with activity and improves with rest. Physical examination reveals
decreased internal rotation and hip flexion. What is the most likely diagnosis?
