LATTEST AANP FNP CErTiFiCATioN ExAm
2024: Two ComPrEhENSivE PrACTiCE
vErSioNS 350+ QuESTioNS wiTh vEriFiEd
ANSwErS & rATioNALES ALrEAdY
GrAdEd A+
VERSION 1: EXAM A (175 Questions)
INSTRUCTIONS
This practice examination is designed to reflect the 2024 AANP FNP-C exam blueprint. The exam
contains 150 questions (135 scored, 15 pretest) with a 3-hour time limit. This version includes
175 questions for comprehensive practice across all four domains: Assess (32%), Diagnose
(26.5%), Plan (26.5%), and Evaluate (15%) .
DOMAIN 1: ASSESS (Questions 1-55)
Section A: History & Physical Examination
1. Assessment of the optic disc is a component of the evaluation of which cranial nerve?
A) Cranial Nerve I
B) Cranial Nerve II
C) Cranial Nerve III
D) Cranial Nerve IV
Correct Answer: B) Cranial Nerve II
Rationale: Cranial Nerve II (Optic) is assessed by evaluating visual acuity, visual fields, and
fundoscopic examination of the optic disc. CN I is olfactory, CN III is oculomotor, and CN IV is
trochlear .
,2. A 62-year-old woman with a 20-year history of hypertension reports intermittent use of
medications, stating, "I feel better without them." On examination, the PMI has a downward
and lateral shift with a Grade II/VI holosystolic murmur radiating to the axilla. This health
history is most likely to include which symptom?
A) Syncopal episodes
B) Episodes of chest pain at rest
C) Dyspnea with exertion
D) Vertigo
Correct Answer: C) Dyspnea with exertion
Rationale: A displaced PMI and holosystolic murmur radiating to the axilla suggest mitral
regurgitation. This can be caused by chronic hypertension leading to left ventricular dilation, and
the patient would most likely report dyspnea on exertion .
3. A 4-month-old infant with strabismus is brought in by a worried mother. What is the most
appropriate response?
A) Refer immediately to ophthalmology
B) Tell her it is normal at this age
C) Order an MRI
D) Prescribe patching therapy
Correct Answer: B) Tell her it is normal at this age
Rationale: Strabismus is common in infants up to 4-6 months of age as ocular muscles are still
developing. If it persists beyond 6 months, referral is indicated .
4. Which cranial nerves are responsible for extraocular eye movements?
A) CN I, II, III
B) CN III, IV, VI
C) CN II, III, IV
D) CN III, V, VII
Correct Answer: B) CN III, IV, VI
Rationale: Cranial nerves III (oculomotor), IV (trochlear), and VI (abducens) control extraocular
eye movements. CN III innervates all extraocular muscles except superior oblique (CN IV) and
lateral rectus (CN VI) .
,5. You are setting up a healthcare clinic for migrant farm workers. Which site is most
desirable?
A) Community hall of a local church
B) Local hospital ambulatory care center
C) Mobile van
D) Space in a shopping center
Correct Answer: C) Mobile van
Rationale: A mobile van is the most desirable option for reaching migrant farm workers because
it can travel to where the workers are located, overcoming transportation barriers .
6. The NP demonstrates fulfillment of the advanced practice nursing leadership role by
participating in which activity?
A) Teaching a 56-year-old man with newly-diagnosed type 2 diabetes about self-glucose
monitoring
B) Volunteering to teach a class on contraceptive methods to teen mothers
C) Discussing barriers to blood pressure control with a hypertensive patient
D) Collaborating with the regional public health department on an initiative to combat obesity
through a community-based exercise program
Correct Answer: D) Collaborating with the regional public health department on an initiative
to combat obesity
Rationale: Leadership in advanced practice nursing extends beyond direct patient care to include
community-level interventions, collaboration with public health departments, and population
health initiatives .
7. A 58-year-old woman presents for an initial examination. She is a nonsmoker, drinks 1-2
glasses of wine per week, and works as an administrative assistant. BMI = 34 kg/m² and BP =
144/98 mmHg bilaterally. What is the most appropriate next step?
A) Prescribe a low-dose thiazide diuretic
B) Arrange for additional blood pressure measurements within the next four weeks
C) Order serum creatinine, BUN, and urinalysis
D) Advise sodium restriction and limiting alcohol to no more than 1 glass of wine per week
, Correct Answer: B) Arrange for additional blood pressure measurements within the next four
weeks
Rationale: Hypertension diagnosis requires confirmation on at least two subsequent visits.
Lifestyle modifications should be initiated, but pharmacologic therapy is not indicated based on
a single elevated reading without further assessment .
8. When obtaining a patient history, which of the following is a component of subjective
information?
A) Blood pressure measurement
B) Laboratory results
C) Chief complaint and history of present illness
D) Physical examination findings
Correct Answer: C) Chief complaint and history of present illness
Rationale: Subjective information includes what the patient reports, such as chief complaint,
history of present illness, past medical history, and review of systems. Objective information
includes physical exam findings and lab results .
9. A patient presents with "bag of worms" on scrotal examination. This indicates:
A) Hydrocele
B) Varicocele
C) Spermatocele
D) Testicular torsion
Correct Answer: B) Varicocele
Rationale: A varicocele is described as a "bag of worms" on palpation due to dilated, tortuous
veins in the pampiniform plexus. It is more common on the left side .
10. What is the most common area for epistaxis?
A) Posterior nasal cavity
B) Kiesselbach's triangle (anterior septum)
C) Nasopharynx
D) Ethmoid sinus
2024: Two ComPrEhENSivE PrACTiCE
vErSioNS 350+ QuESTioNS wiTh vEriFiEd
ANSwErS & rATioNALES ALrEAdY
GrAdEd A+
VERSION 1: EXAM A (175 Questions)
INSTRUCTIONS
This practice examination is designed to reflect the 2024 AANP FNP-C exam blueprint. The exam
contains 150 questions (135 scored, 15 pretest) with a 3-hour time limit. This version includes
175 questions for comprehensive practice across all four domains: Assess (32%), Diagnose
(26.5%), Plan (26.5%), and Evaluate (15%) .
DOMAIN 1: ASSESS (Questions 1-55)
Section A: History & Physical Examination
1. Assessment of the optic disc is a component of the evaluation of which cranial nerve?
A) Cranial Nerve I
B) Cranial Nerve II
C) Cranial Nerve III
D) Cranial Nerve IV
Correct Answer: B) Cranial Nerve II
Rationale: Cranial Nerve II (Optic) is assessed by evaluating visual acuity, visual fields, and
fundoscopic examination of the optic disc. CN I is olfactory, CN III is oculomotor, and CN IV is
trochlear .
,2. A 62-year-old woman with a 20-year history of hypertension reports intermittent use of
medications, stating, "I feel better without them." On examination, the PMI has a downward
and lateral shift with a Grade II/VI holosystolic murmur radiating to the axilla. This health
history is most likely to include which symptom?
A) Syncopal episodes
B) Episodes of chest pain at rest
C) Dyspnea with exertion
D) Vertigo
Correct Answer: C) Dyspnea with exertion
Rationale: A displaced PMI and holosystolic murmur radiating to the axilla suggest mitral
regurgitation. This can be caused by chronic hypertension leading to left ventricular dilation, and
the patient would most likely report dyspnea on exertion .
3. A 4-month-old infant with strabismus is brought in by a worried mother. What is the most
appropriate response?
A) Refer immediately to ophthalmology
B) Tell her it is normal at this age
C) Order an MRI
D) Prescribe patching therapy
Correct Answer: B) Tell her it is normal at this age
Rationale: Strabismus is common in infants up to 4-6 months of age as ocular muscles are still
developing. If it persists beyond 6 months, referral is indicated .
4. Which cranial nerves are responsible for extraocular eye movements?
A) CN I, II, III
B) CN III, IV, VI
C) CN II, III, IV
D) CN III, V, VII
Correct Answer: B) CN III, IV, VI
Rationale: Cranial nerves III (oculomotor), IV (trochlear), and VI (abducens) control extraocular
eye movements. CN III innervates all extraocular muscles except superior oblique (CN IV) and
lateral rectus (CN VI) .
,5. You are setting up a healthcare clinic for migrant farm workers. Which site is most
desirable?
A) Community hall of a local church
B) Local hospital ambulatory care center
C) Mobile van
D) Space in a shopping center
Correct Answer: C) Mobile van
Rationale: A mobile van is the most desirable option for reaching migrant farm workers because
it can travel to where the workers are located, overcoming transportation barriers .
6. The NP demonstrates fulfillment of the advanced practice nursing leadership role by
participating in which activity?
A) Teaching a 56-year-old man with newly-diagnosed type 2 diabetes about self-glucose
monitoring
B) Volunteering to teach a class on contraceptive methods to teen mothers
C) Discussing barriers to blood pressure control with a hypertensive patient
D) Collaborating with the regional public health department on an initiative to combat obesity
through a community-based exercise program
Correct Answer: D) Collaborating with the regional public health department on an initiative
to combat obesity
Rationale: Leadership in advanced practice nursing extends beyond direct patient care to include
community-level interventions, collaboration with public health departments, and population
health initiatives .
7. A 58-year-old woman presents for an initial examination. She is a nonsmoker, drinks 1-2
glasses of wine per week, and works as an administrative assistant. BMI = 34 kg/m² and BP =
144/98 mmHg bilaterally. What is the most appropriate next step?
A) Prescribe a low-dose thiazide diuretic
B) Arrange for additional blood pressure measurements within the next four weeks
C) Order serum creatinine, BUN, and urinalysis
D) Advise sodium restriction and limiting alcohol to no more than 1 glass of wine per week
, Correct Answer: B) Arrange for additional blood pressure measurements within the next four
weeks
Rationale: Hypertension diagnosis requires confirmation on at least two subsequent visits.
Lifestyle modifications should be initiated, but pharmacologic therapy is not indicated based on
a single elevated reading without further assessment .
8. When obtaining a patient history, which of the following is a component of subjective
information?
A) Blood pressure measurement
B) Laboratory results
C) Chief complaint and history of present illness
D) Physical examination findings
Correct Answer: C) Chief complaint and history of present illness
Rationale: Subjective information includes what the patient reports, such as chief complaint,
history of present illness, past medical history, and review of systems. Objective information
includes physical exam findings and lab results .
9. A patient presents with "bag of worms" on scrotal examination. This indicates:
A) Hydrocele
B) Varicocele
C) Spermatocele
D) Testicular torsion
Correct Answer: B) Varicocele
Rationale: A varicocele is described as a "bag of worms" on palpation due to dilated, tortuous
veins in the pampiniform plexus. It is more common on the left side .
10. What is the most common area for epistaxis?
A) Posterior nasal cavity
B) Kiesselbach's triangle (anterior septum)
C) Nasopharynx
D) Ethmoid sinus
