Adult Nurse Practitioner (ANP)
Certification Exam Verified Questions,
Correct Answers, and Detailed
Explanations for Science
Students||Already Graded A+
1. A 65-year-old patient presents with progressive shortness of
breath, orthopnea, and paroxysmal nocturnal dyspnea. On exam,
you hear an S3 heart sound. Which is the most likely diagnosis?
A. Myocardial infarction
B. Heart failure
C. Chronic obstructive pulmonary disease (COPD)
D. Pulmonary embolism
Rationale: The presence of orthopnea, paroxysmal nocturnal
dyspnea, and S3 is classic for heart failure.
2. Which of the following lab findings is most indicative of iron
deficiency anemia?
A. Macrocytosis
B. Low ferritin
C. Elevated vitamin B12
D. High reticulocyte count
Rationale: Ferritin reflects iron stores, and low ferritin is the most
specific marker of iron deficiency anemia.
3. A 45-year-old patient presents with polyuria, polydipsia, and
unexplained weight loss. Fasting blood glucose is 180 mg/dL. What is
the most likely diagnosis?
,A. Type 2 diabetes mellitus
B. Diabetes insipidus
C. Type 1 diabetes mellitus
D. Hyperthyroidism
Rationale: Classic hyperglycemia symptoms with fasting glucose >126
mg/dL suggest diabetes; abrupt onset with weight loss favors type 1
diabetes.
4. Which of the following medications is considered first-line therapy
for newly diagnosed hypertension in a patient without
comorbidities?
A. Beta-blocker
B. Thiazide diuretic
C. ACE inhibitor
D. Calcium channel blocker
Rationale: Current guidelines recommend thiazide diuretics as first-
line therapy for uncomplicated hypertension.
5. A patient presents with sudden-onset, severe right upper
quadrant pain, fever, and jaundice. What is the most likely diagnosis?
A. Hepatitis A
B. Acute cholangitis
C. Cholelithiasis
D. Pancreatitis
Rationale: The combination of RUQ pain, fever, and jaundice
constitutes Charcot's triad, indicative of acute cholangitis.
6. Which of the following vaccines is recommended annually for
adults, particularly those ≥65 years?
,A. Hepatitis B
B. Influenza
C. MMR
D. Varicella
Rationale: Influenza vaccination is recommended yearly for all adults,
especially older adults.
7. In chronic obstructive pulmonary disease (COPD), which
spirometry finding is most characteristic?
A. FEV1/FVC < 0.70
B. FEV1/FVC > 0.80
C. Increased DLCO
D. Normal FEV1
Rationale: COPD is characterized by airflow obstruction; an FEV1/FVC
ratio <0.70 confirms obstruction.
8. A patient presents with fatigue, weight gain, cold intolerance, and
constipation. Lab findings show elevated TSH and low free T4. What
is the most likely diagnosis?
A. Hyperthyroidism
B. Subclinical hypothyroidism
C. Primary hypothyroidism
D. Thyroiditis
Rationale: Elevated TSH with low free T4 indicates primary
hypothyroidism.
9. Which of the following is the most appropriate initial test for a
patient with suspected deep vein thrombosis (DVT)?
A. MRI
, B. Doppler ultrasound
C. CT angiography
D. Venography
Rationale: Duplex Doppler ultrasound is non-invasive and first-line for
diagnosing DVT.
10. Which of the following is the most common cause of community-
acquired pneumonia in adults?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Mycoplasma pneumoniae
Rationale: Streptococcus pneumoniae is the most common bacterial
cause of community-acquired pneumonia in adults.
11. A 70-year-old patient presents with resting tremor, bradykinesia,
and rigidity. What is the most likely diagnosis?
A. Huntington’s disease
B. Essential tremor
C. Parkinson’s disease
D. Alzheimer’s disease
Rationale: Parkinsonism presents with resting tremor, bradykinesia,
and rigidity.
12. A patient with a history of diabetes presents with sudden vision
loss in one eye. Fundoscopy reveals a pale retina with a cherry-red
spot. What is the most likely diagnosis?
A. Retinal detachment
B. Central retinal artery occlusion
Certification Exam Verified Questions,
Correct Answers, and Detailed
Explanations for Science
Students||Already Graded A+
1. A 65-year-old patient presents with progressive shortness of
breath, orthopnea, and paroxysmal nocturnal dyspnea. On exam,
you hear an S3 heart sound. Which is the most likely diagnosis?
A. Myocardial infarction
B. Heart failure
C. Chronic obstructive pulmonary disease (COPD)
D. Pulmonary embolism
Rationale: The presence of orthopnea, paroxysmal nocturnal
dyspnea, and S3 is classic for heart failure.
2. Which of the following lab findings is most indicative of iron
deficiency anemia?
A. Macrocytosis
B. Low ferritin
C. Elevated vitamin B12
D. High reticulocyte count
Rationale: Ferritin reflects iron stores, and low ferritin is the most
specific marker of iron deficiency anemia.
3. A 45-year-old patient presents with polyuria, polydipsia, and
unexplained weight loss. Fasting blood glucose is 180 mg/dL. What is
the most likely diagnosis?
,A. Type 2 diabetes mellitus
B. Diabetes insipidus
C. Type 1 diabetes mellitus
D. Hyperthyroidism
Rationale: Classic hyperglycemia symptoms with fasting glucose >126
mg/dL suggest diabetes; abrupt onset with weight loss favors type 1
diabetes.
4. Which of the following medications is considered first-line therapy
for newly diagnosed hypertension in a patient without
comorbidities?
A. Beta-blocker
B. Thiazide diuretic
C. ACE inhibitor
D. Calcium channel blocker
Rationale: Current guidelines recommend thiazide diuretics as first-
line therapy for uncomplicated hypertension.
5. A patient presents with sudden-onset, severe right upper
quadrant pain, fever, and jaundice. What is the most likely diagnosis?
A. Hepatitis A
B. Acute cholangitis
C. Cholelithiasis
D. Pancreatitis
Rationale: The combination of RUQ pain, fever, and jaundice
constitutes Charcot's triad, indicative of acute cholangitis.
6. Which of the following vaccines is recommended annually for
adults, particularly those ≥65 years?
,A. Hepatitis B
B. Influenza
C. MMR
D. Varicella
Rationale: Influenza vaccination is recommended yearly for all adults,
especially older adults.
7. In chronic obstructive pulmonary disease (COPD), which
spirometry finding is most characteristic?
A. FEV1/FVC < 0.70
B. FEV1/FVC > 0.80
C. Increased DLCO
D. Normal FEV1
Rationale: COPD is characterized by airflow obstruction; an FEV1/FVC
ratio <0.70 confirms obstruction.
8. A patient presents with fatigue, weight gain, cold intolerance, and
constipation. Lab findings show elevated TSH and low free T4. What
is the most likely diagnosis?
A. Hyperthyroidism
B. Subclinical hypothyroidism
C. Primary hypothyroidism
D. Thyroiditis
Rationale: Elevated TSH with low free T4 indicates primary
hypothyroidism.
9. Which of the following is the most appropriate initial test for a
patient with suspected deep vein thrombosis (DVT)?
A. MRI
, B. Doppler ultrasound
C. CT angiography
D. Venography
Rationale: Duplex Doppler ultrasound is non-invasive and first-line for
diagnosing DVT.
10. Which of the following is the most common cause of community-
acquired pneumonia in adults?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Mycoplasma pneumoniae
Rationale: Streptococcus pneumoniae is the most common bacterial
cause of community-acquired pneumonia in adults.
11. A 70-year-old patient presents with resting tremor, bradykinesia,
and rigidity. What is the most likely diagnosis?
A. Huntington’s disease
B. Essential tremor
C. Parkinson’s disease
D. Alzheimer’s disease
Rationale: Parkinsonism presents with resting tremor, bradykinesia,
and rigidity.
12. A patient with a history of diabetes presents with sudden vision
loss in one eye. Fundoscopy reveals a pale retina with a cherry-red
spot. What is the most likely diagnosis?
A. Retinal detachment
B. Central retinal artery occlusion
