FNP Exam Review: Comprehensive NP Study Guide for AANP Boards (PASS YOUR FIRST TIME!)

FNP Exam Review: Comprehensive NP
Study Guide for AANP Boards (PASS YOUR
FIRST TIME!)

1. A 58-year-old male with a 30-pack-
nm nm nm nm nm nm




year smoking history presents with a new cough, hemoptysis, and unintentional weigh
nm nm nm nm nm nm nm nm nm nm nm




t loss. Chest X-ray shows a right hilar mass. What is the most appropriate next step?
nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm




A) CT scan of the chest
nm nm nm nm nm




B) Sputum cytology
nm nm




C) Bronchoscopy with biopsy
nm nm nm




D) PET scan
nm nm




Correct Answer: C – Bronchoscopy with biopsy
nm nm nm nm nm nm




Rationale: Tissue diagnosis is essential for a suspected lung malignancy. Bronchoscopy allows
nm nm nm nm nm nm nm nm nm nm nm n




direct visualization and biopsy of the hilar mass. Sputum cytology has low sensitivity; CT/PET
m nm nm nm nm nm nm nm nm nm nm nm nm nm n




are staging tools after diagnosis.
m nm nm nm nm




2. A 72-year-old female with hypertension and osteoporosis presents with acute-
nm nm nm nm nm nm nm nm nm nm




onset right flank pain, nausea, and hematuria. Urinalysis shows many red blood cells.
nm nm nm nm nm nm nm nm nm nm nm nm nm




Which test is most appropriate to confirm the diagnosis?
nm nm nm nm nm nm nm nm




A) Renal ultrasound
nm nm




B) Non-contrast CT abdomen/pelvis
nm nm nm




C) IV pyelogram
nm nm




D) KUB X-ray
nm nm




Correct Answer: B – Non-contrast CT abdomen/pelvis
nm nm nm nm nm nm




Rationale: Non- nm




contrast CT is the gold standard for diagnosing nephrolithiasis, with high sensitivity for stone
nm nm nm nm nm nm nm nm nm nm nm nm nm




s regardless of composition. Ultrasound is an option for pregnancy or radiation avoidance bu
nm nm nm nm nm nm nm nm nm nm nm nm nm




t is less sensitive.
nm nm nm




3. Which of the following clinical findings is most consistent with carpal tunnel syndro
nm nm nm nm nm nm nm nm nm nm nm nm nm




me?

A) Worsening symptoms with wrist flexion
nm nm nm nm nm




B) Positive Froment’s sign
nm nm nm

,C) Numbness in the hypothenar eminence
nm nm nm nm nm




D) Loss of two-point discrimination in the index finger only
nm nm nm nm nm nm nm nm nm




Correct Answer: A – Worsening symptoms with wrist flexion
nm nm nm nm nm nm nm nm




Rationale: Phalen’s maneuver (wrist flexion) reproduces median nerve paresthesias. Froment’s
nm nm nm nm nm nm nm nm nm nm




sign indicates ulnar nerve palsy. Hypothenar numbness is ulnar distribution. Two-
nm nm nm nm nm nm nm nm nm nm




point discrimination loss is a late finding.
nm nm nm nm nm nm




4. A 45-year-
nm nm




old obese female presents with right upper quadrant pain after fatty meals, nausea, an
nm nm nm nm nm nm nm nm nm nm nm nm nm




d bloating. Murphy’s sign is positive. What is the most appropriate initial imaging stu
nm nm nm nm nm nm nm nm nm nm nm nm nm




dy?

A) CT scan of the abdomen
nm nm nm nm nm




B) HIDA scan
nm nm




C) Right upper quadrant ultrasound
nm nm nm nm




D) MRI cholangiopancreatography
nm nm




Correct Answer: C – Right upper quadrant ultrasound
nm nm nm nm nm nm nm




Rationale: Ultrasound is the initial test of choice for suspected cholelithiasis or cholecystitis; it
nm nm nm nm nm nm nm nm nm nm nm nm nm




is highly sensitive for gallstones and can assess for wall thickening or pericholecystic fluid.
nm nm nm nm nm nm nm nm nm nm nm nm nm nm




5. Which medication is first-
nm nm nm nm




line therapy for stable angina in a patient with no contraindications?
nm nm nm nm nm nm nm nm nm nm




A) Amlodipine
nm




B) Isosorbide mononitrate
nm nm




C) Metoprolol
nm




D) Aspirinnm




Correct Answer: C – Metoprolol nm nm nm nm




Rationale: Beta-blockers (e.g., metoprolol) are first-
nm nm nm nm nm




line for stable angina because they reduce myocardial oxygen demand by lowering heart rat
nm nm nm nm nm nm nm nm nm nm nm nm nm




e and contractility. Aspirin is for secondary prevention but not anti-anginal therapy.
nm nm nm nm nm nm nm nm nm nm nm




6. A 6-year-
nm nm




old presents with sudden onset of stridor, drooling, and tripod positioning. He is febril
nm nm nm nm nm nm nm nm nm nm nm nm nm




e and appears toxic. What is the most appropriate next step?
nm nm nm nm nm nm nm nm nm nm




A) Immediate oral exam with tongue depressor
nm nm nm nm nm nm




B) Lateral neck X-ray
nm nm nm

, C) Nebulized epinephrine
nm nm




D) Prepare for emergent airway management
nm nm nm nm nm




Correct Answer: D – Prepare for emergent airway management
nm nm nm nm nm nm nm nm




Rationale: This presentation is concerning for epiglottitis (now rare due to Hib vaccine but sti
nm nm nm nm nm nm nm nm nm nm nm nm nm nm




ll possible). Any manipulation (e.g., oral exam, X-
nm nm nm nm nm nm nm




ray) can precipitate complete airway obstruction. Secure the airway immediately.
nm nm nm nm nm nm nm nm nm




7. A 28-year-
nm nm




old G1P0 at 34 weeks gestation presents with painless, bright red vaginal bleeding. Fet
nm nm nm nm nm nm nm nm nm nm nm nm nm




al heart rate is reassuring. What is the most likely diagnosis?
nm nm nm nm nm nm nm nm nm nm




A) Placental abruption
nm nm




B) Placenta previa
nm nm




C) Vasa previa
nm nm




D) Labor nm




Correct Answer: B – Placenta previa
nm nm nm nm nm




Rationale: Painless third- nm nm




trimester bleeding is classic for placenta previa. Digital exam is contraindicated. Abruptio plac
nm nm nm nm nm nm nm nm nm nm nm nm




entae typically presents with painful bleeding. Vasa previa is rare and associated with fetal br
nm nm nm nm nm nm nm nm nm nm nm nm nm nm




adycardia.



8. A 55-year-old diabetic male presents with a 3-
nm nm nm nm nm nm nm nm




day history of unilateral facial droop, inability to close his right eye, and forehead inv
nm nm nm nm nm nm nm nm nm nm nm nm nm nm




olvement. No extremity weakness or dysarthria. What is the most appropriate treatme
nm nm nm nm nm nm nm nm nm nm nm




nt?

A) Alteplase (tPA)
nm nm




B) Aspirin 325 mg daily
nm nm nm nm




C) Prednisone and valacyclovir
nm nm nm




D) Observation only
nm nm




Correct Answer: C – Prednisone and valacyclovir
nm nm nm nm nm nm




Rationale: This is Bell’s palsy (peripheral CN VII palsy). Evidence supports early corticosteroids;
nm nm nm nm nm nm nm nm nm nm nm nm




antivirals (valacyclovir) are added if severe. tPA is for stroke –
nm nm nm nm nm nm nm nm nm nm nm




lack of cortical signs (forehead spared in central causes) rules out stroke.
nm nm nm nm nm nm nm nm nm nm nm nm




9. Which lab finding is most consistent with syndrome of inappropriate antidiuretic ho
nm nm nm nm nm nm nm nm nm nm nm nm




rmone (SIADH)? nm