AANP FNP Exam 2025/2026 – 150
Verified Family Nurse Practitioner Board
Questions
Detailed Answers & Rationales | A+
Grade | Latest Update
Q1. All diastolic murmurs are pathological. A grade IV murmur is
characterized by:
A) Barely audible in quiet conditions
B) Audible but quiet
C) Clearly audible without a thrill
D) Audible with a palpable thrill
Correct Answer: D
Rationale: Heart murmurs are graded I-VI. Grade I is barely audible.
Grade II is quiet but audible. Grade III is moderately loud. Grade IV is
loud with a palpable thrill. Grade V is very loud, heard with stethoscope
partially off the chest. Grade VI is heard with stethoscope completely off
the chest. Diastolic murmurs are always pathological regardless of grade
.
Q2. Coarctation of the aorta presents with which of the following
physical exam findings?
A) Bounding femoral pulses and weak radial pulses
B) Equal pulses in all four extremities
C) Bounding radial pulses and weak femoral pulses
D) Absent pedal pulses with normal brachial pulses
,Correct Answer: C
Rationale: Coarctation of the aorta (COA) is a congenital narrowing of
the aorta. It causes hypertension and bounding pulses in the upper
extremities with diminished or absent pulses and hypotension in the
lower extremities. This pulse differential is a classic finding .
Q3. Jugular venous distention (JVD) can be caused by all of the
following EXCEPT:
A) Right-sided heart failure
B) Tension pneumothorax
C) Cardiac tamponade
D) Left-sided heart failure alone
Correct Answer: D
Rationale: JVD indicates elevated central venous pressure from right-
sided heart failure, not isolated left-sided failure. Other causes include
tension pneumothorax (impedes venous return), cardiac tamponade,
constrictive pericarditis, and superior vena cava syndrome .
Q4. A patient presents with AV nicking on fundoscopic examination.
This finding is most consistent with:
A) Diabetes mellitus
B) Hypertensive retinopathy
C) Glaucoma
D) Macular degeneration
Correct Answer: B
Rationale: AV nicking (arteriovenous nicking) occurs when arterioles
press on venules at crossing points. This is a classic sign of hypertensive
retinopathy caused by chronic hypertension .
,SECTION 2: PULMONARY SYSTEM
Q5. A 50-year-old man presents with excessive daytime sleepiness,
obesity (BMI 38 kg/m²), and hypertension. He reports falling asleep
at his desk at work despite getting 8 hours of sleep nightly. What is
the most likely diagnosis?
A) Narcolepsy
B) Restless legs syndrome
C) Obstructive sleep apnea
D) Insomnia
Correct Answer: C
Rationale: The triad of excessive daytime sleepiness, obesity, and
resistant hypertension in a patient who reports adequate sleep duration is
classic for obstructive sleep apnea (OSA). Nocturnal polysomnography
is indicated for diagnosis .
Q6. A patient with COPD has an oxygen saturation of 88% on room
air. Which oxygen delivery device is most appropriate?
A) Non-rebreather mask at 15 L/min
B) Nasal cannula at 2 L/min
C) Simple face mask at 10 L/min
D) Venturi mask at 40% FiO₂
Correct Answer: B
Rationale: Low-flow oxygen (nasal cannula 1-3 L/min) is preferred for
COPD patients to avoid suppressing the hypoxic drive. High-flow
oxygen can cause CO₂ retention and respiratory failure .
Q7. Koplik spots are pathognomonic for which infectious disease?
, A) Rubella
B) Measles (rubeola)
C) Roseola
D) Fifth disease
Correct Answer: B
Rationale: Koplik spots are small white spots with red halos on the
buccal mucosa. They appear 1-2 days before the measles rash and are
pathognomonic for measles (rubeola) .
Q8. A 55-year-old male with a 40-pack-year smoking history, quit 10
years ago, presents for a routine physical. According to USPSTF
guidelines, what lung cancer screening is recommended?
A) No screening as he quit >5 years ago
B) Annual screening with low-dose CT (LDCT) until age 80
C) Annual screening with chest x-ray
D) One-time screening with LDCT
Correct Answer: B
Rationale: USPSTF recommends annual LDCT screening for adults
aged 50-80 years with a 20 pack-year smoking history who currently
smoke or quit within the past 15 years. This patient qualifies .
Q9. A PPD (tuberculin skin test) is considered positive with
induration greater than 5 mm in which patient population?
A) A patient born in a country with high TB prevalence
B) A healthcare worker
C) An immunocompromised patient or close contact of an active TB
case
D) A patient with diabetes
Correct Answer: C
Verified Family Nurse Practitioner Board
Questions
Detailed Answers & Rationales | A+
Grade | Latest Update
Q1. All diastolic murmurs are pathological. A grade IV murmur is
characterized by:
A) Barely audible in quiet conditions
B) Audible but quiet
C) Clearly audible without a thrill
D) Audible with a palpable thrill
Correct Answer: D
Rationale: Heart murmurs are graded I-VI. Grade I is barely audible.
Grade II is quiet but audible. Grade III is moderately loud. Grade IV is
loud with a palpable thrill. Grade V is very loud, heard with stethoscope
partially off the chest. Grade VI is heard with stethoscope completely off
the chest. Diastolic murmurs are always pathological regardless of grade
.
Q2. Coarctation of the aorta presents with which of the following
physical exam findings?
A) Bounding femoral pulses and weak radial pulses
B) Equal pulses in all four extremities
C) Bounding radial pulses and weak femoral pulses
D) Absent pedal pulses with normal brachial pulses
,Correct Answer: C
Rationale: Coarctation of the aorta (COA) is a congenital narrowing of
the aorta. It causes hypertension and bounding pulses in the upper
extremities with diminished or absent pulses and hypotension in the
lower extremities. This pulse differential is a classic finding .
Q3. Jugular venous distention (JVD) can be caused by all of the
following EXCEPT:
A) Right-sided heart failure
B) Tension pneumothorax
C) Cardiac tamponade
D) Left-sided heart failure alone
Correct Answer: D
Rationale: JVD indicates elevated central venous pressure from right-
sided heart failure, not isolated left-sided failure. Other causes include
tension pneumothorax (impedes venous return), cardiac tamponade,
constrictive pericarditis, and superior vena cava syndrome .
Q4. A patient presents with AV nicking on fundoscopic examination.
This finding is most consistent with:
A) Diabetes mellitus
B) Hypertensive retinopathy
C) Glaucoma
D) Macular degeneration
Correct Answer: B
Rationale: AV nicking (arteriovenous nicking) occurs when arterioles
press on venules at crossing points. This is a classic sign of hypertensive
retinopathy caused by chronic hypertension .
,SECTION 2: PULMONARY SYSTEM
Q5. A 50-year-old man presents with excessive daytime sleepiness,
obesity (BMI 38 kg/m²), and hypertension. He reports falling asleep
at his desk at work despite getting 8 hours of sleep nightly. What is
the most likely diagnosis?
A) Narcolepsy
B) Restless legs syndrome
C) Obstructive sleep apnea
D) Insomnia
Correct Answer: C
Rationale: The triad of excessive daytime sleepiness, obesity, and
resistant hypertension in a patient who reports adequate sleep duration is
classic for obstructive sleep apnea (OSA). Nocturnal polysomnography
is indicated for diagnosis .
Q6. A patient with COPD has an oxygen saturation of 88% on room
air. Which oxygen delivery device is most appropriate?
A) Non-rebreather mask at 15 L/min
B) Nasal cannula at 2 L/min
C) Simple face mask at 10 L/min
D) Venturi mask at 40% FiO₂
Correct Answer: B
Rationale: Low-flow oxygen (nasal cannula 1-3 L/min) is preferred for
COPD patients to avoid suppressing the hypoxic drive. High-flow
oxygen can cause CO₂ retention and respiratory failure .
Q7. Koplik spots are pathognomonic for which infectious disease?
, A) Rubella
B) Measles (rubeola)
C) Roseola
D) Fifth disease
Correct Answer: B
Rationale: Koplik spots are small white spots with red halos on the
buccal mucosa. They appear 1-2 days before the measles rash and are
pathognomonic for measles (rubeola) .
Q8. A 55-year-old male with a 40-pack-year smoking history, quit 10
years ago, presents for a routine physical. According to USPSTF
guidelines, what lung cancer screening is recommended?
A) No screening as he quit >5 years ago
B) Annual screening with low-dose CT (LDCT) until age 80
C) Annual screening with chest x-ray
D) One-time screening with LDCT
Correct Answer: B
Rationale: USPSTF recommends annual LDCT screening for adults
aged 50-80 years with a 20 pack-year smoking history who currently
smoke or quit within the past 15 years. This patient qualifies .
Q9. A PPD (tuberculin skin test) is considered positive with
induration greater than 5 mm in which patient population?
A) A patient born in a country with high TB prevalence
B) A healthcare worker
C) An immunocompromised patient or close contact of an active TB
case
D) A patient with diabetes
Correct Answer: C
