100 Barkley-Style Practice Questions with Answers and
Evidence-Based Rationales for the AANP Family Nurse
Practitioner (FNP) Certification Examination
DOMAIN 1: HEALTH PROMOTION & DISEASE PREVENTION
(Questions 1-20)
Question 1
A 55-year-old woman of average risk asks when she can stop screening mammography.
According to the USPSTF, the recommendation is to:
A) Stop at age 65
B) Stop at age 70
C) Continue biennial screening through age 74, with insufficient evidence for women
≥75
D) Continue annual screening for life
Answer: C
Rationale: The USPSTF recommends biennial screening mammography for women
aged 50-74. For women ≥75, evidence is insufficient to assess the balance of benefits
and harms. Screening decisions should be individualized for women 75 and older based
on health status and life expectancy .
Question 2
A 50-year-old man at average risk asks about colorectal cancer screening. According to
the USPSTF, which of the following is a recommended option?
A) Fecal immunochemical test (FIT) annually
B) Colonoscopy every 10 years
,C) CT colonography every 5 years
D) All of the above
Answer: D
Rationale: The USPSTF recommends screening for adults aged 45-75 using several
strategies, including FIT annually, colonoscopy every 10 years, FIT-DNA every 3 years, CT
colonography every 5 years, or flexible sigmoidoscopy every 5 years (with FIT annually).
All options listed are acceptable .
Question 3
An 11-year-old girl presents for a well visit. She has not yet received the HPV vaccine.
The FNP should recommend:
A) One dose of HPV vaccine
B) Two doses of HPV vaccine (0 and 6-12 months)
C) Three doses of HPV vaccine
D) No vaccine because she is too young
Answer: B
Rationale: The CDC recommends a 2-dose schedule for HPV vaccination if initiated
before age 15. If started at age 15 or older, a 3-dose schedule is used .
Question 4
A healthy 65-year-old man asks which vaccines he needs. According to the CDC, he
should receive all of the following EXCEPT:
,A) Influenza (inactivated) annually
B) Tdap (once, then Td booster every 10 years)
C) Shingrix (recombinant zoster vaccine)
D) MMR (live attenuated)
Answer: D
Rationale: Adults born before 1957 are generally considered immune to measles,
mumps, and rubella. MMR is not routinely given to this age group unless there is a
specific indication (e.g., lack of immunity). The other vaccines are recommended for
adults 65 and older .
Question 5
A 30-year-old woman with no chronic conditions presents for a well-woman exam. Her
blood pressure is 118/76 mmHg, BMI 22, and she exercises regularly. What is the
appropriate interval for lipid screening?
A) Every 5 years
B) Every 2 years
C) Only if she develops risk factors
D) Not recommended for women <45 without risk factors
Answer: D
Rationale: The USPSTF does not recommend routine lipid screening in young adults
without risk factors. Screening is recommended in women 45 and older (or younger if at
increased risk). This patient is low risk and does not require routine lipid screening .
, Question 6
A mother brings her healthy 4-month-old infant for a check-up. Which vaccine is NOT
routinely given at this age?
A) DTaP
B) MMR
C) Inactivated polio (IPV)
D) Haemophilus influenzae type b (Hib)
Answer: B
Rationale: MMR is given at 12-15 months. At 4 months, the routine vaccines include
DTaP, IPV, Hib, PCV13, and rotavirus .
Question 7
A healthy 12-year-old girl presents for a well-child visit. According to the CDC
immunization schedule, which vaccines are recommended at this age?
A) Tdap, HPV, MCV4 (first dose)
B) MMR, varicella, hepatitis B
C) Influenza only
D) HPV, hepatitis A, MCV4
Answer: A
Rationale: At age 11-12, the CDC recommends Tdap booster, HPV vaccine (first dose;
two-dose series if started before age 15), and meningococcal conjugate vaccine
(MenACWY) with a booster at age 16 .
Evidence-Based Rationales for the AANP Family Nurse
Practitioner (FNP) Certification Examination
DOMAIN 1: HEALTH PROMOTION & DISEASE PREVENTION
(Questions 1-20)
Question 1
A 55-year-old woman of average risk asks when she can stop screening mammography.
According to the USPSTF, the recommendation is to:
A) Stop at age 65
B) Stop at age 70
C) Continue biennial screening through age 74, with insufficient evidence for women
≥75
D) Continue annual screening for life
Answer: C
Rationale: The USPSTF recommends biennial screening mammography for women
aged 50-74. For women ≥75, evidence is insufficient to assess the balance of benefits
and harms. Screening decisions should be individualized for women 75 and older based
on health status and life expectancy .
Question 2
A 50-year-old man at average risk asks about colorectal cancer screening. According to
the USPSTF, which of the following is a recommended option?
A) Fecal immunochemical test (FIT) annually
B) Colonoscopy every 10 years
,C) CT colonography every 5 years
D) All of the above
Answer: D
Rationale: The USPSTF recommends screening for adults aged 45-75 using several
strategies, including FIT annually, colonoscopy every 10 years, FIT-DNA every 3 years, CT
colonography every 5 years, or flexible sigmoidoscopy every 5 years (with FIT annually).
All options listed are acceptable .
Question 3
An 11-year-old girl presents for a well visit. She has not yet received the HPV vaccine.
The FNP should recommend:
A) One dose of HPV vaccine
B) Two doses of HPV vaccine (0 and 6-12 months)
C) Three doses of HPV vaccine
D) No vaccine because she is too young
Answer: B
Rationale: The CDC recommends a 2-dose schedule for HPV vaccination if initiated
before age 15. If started at age 15 or older, a 3-dose schedule is used .
Question 4
A healthy 65-year-old man asks which vaccines he needs. According to the CDC, he
should receive all of the following EXCEPT:
,A) Influenza (inactivated) annually
B) Tdap (once, then Td booster every 10 years)
C) Shingrix (recombinant zoster vaccine)
D) MMR (live attenuated)
Answer: D
Rationale: Adults born before 1957 are generally considered immune to measles,
mumps, and rubella. MMR is not routinely given to this age group unless there is a
specific indication (e.g., lack of immunity). The other vaccines are recommended for
adults 65 and older .
Question 5
A 30-year-old woman with no chronic conditions presents for a well-woman exam. Her
blood pressure is 118/76 mmHg, BMI 22, and she exercises regularly. What is the
appropriate interval for lipid screening?
A) Every 5 years
B) Every 2 years
C) Only if she develops risk factors
D) Not recommended for women <45 without risk factors
Answer: D
Rationale: The USPSTF does not recommend routine lipid screening in young adults
without risk factors. Screening is recommended in women 45 and older (or younger if at
increased risk). This patient is low risk and does not require routine lipid screening .
, Question 6
A mother brings her healthy 4-month-old infant for a check-up. Which vaccine is NOT
routinely given at this age?
A) DTaP
B) MMR
C) Inactivated polio (IPV)
D) Haemophilus influenzae type b (Hib)
Answer: B
Rationale: MMR is given at 12-15 months. At 4 months, the routine vaccines include
DTaP, IPV, Hib, PCV13, and rotavirus .
Question 7
A healthy 12-year-old girl presents for a well-child visit. According to the CDC
immunization schedule, which vaccines are recommended at this age?
A) Tdap, HPV, MCV4 (first dose)
B) MMR, varicella, hepatitis B
C) Influenza only
D) HPV, hepatitis A, MCV4
Answer: A
Rationale: At age 11-12, the CDC recommends Tdap booster, HPV vaccine (first dose;
two-dose series if started before age 15), and meningococcal conjugate vaccine
(MenACWY) with a booster at age 16 .
