FAMILY NURSE PRACTITIONER (FNP)
CERTIFICATION EXAMINATION
PRACTICE QUESTIONS AND ANSWERS
(2026/2027)
1. A 65-year-old male presents for a routine checkup. On auscultation, you hear a harsh
systolic crescendo-decrescendo murmur at the second intercostal space at the right sternal
border that radiates to the carotid arteries. Which of the following is the most likely
diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: B
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur heard best
at the right second intercostal space (base) that radiates to the neck (carotids).
,2. A 45-year-old patient with no significant history presents with a blood pressure of 148/94
mmHg. According to JNC 8 and ACC/AHA guidelines, what is the most appropriate next step if
a second reading is similar?
A. Diagnose Stage 2 Hypertension and recommend lifestyle modifications plus medication
B. Start lisinopril 10mg daily immediately
C. Wait 6 months and re-check
D. Refer to a cardiologist for emergency management
Answer: A
Conceptual Explanation: A BP of 140/90 or higher is classified as Stage 2 Hypertension
under current guidelines, requiring both lifestyle changes and pharmacological
intervention.
3. Which of the following physical exam findings is most suggestive of a ruptured Achilles
tendon?
A. Positive Lachman test
B. Positive McMurray test
C. Positive Phalen test
D. Positive Thompson test
Answer: D
, Conceptual Explanation: The Thompson test (squeezing the calf muscle) is used to assess
for Achilles tendon rupture; if the foot does not plantarflex, the test is positive.
4. A 32-year-old female presents with fatigue, cold intolerance, and weight gain. Her TSH is
8.5 mU/L (Ref: 0.5-4.5) and her Free T4 is normal. This condition is classified as:
A. Subclinical Hypothyroidism
B. Graves’ Disease
C. Primary Hyperthyroidism
D. Secondary Hypothyroidism
Answer: A
Conceptual Explanation: Subclinical hypothyroidism is defined as an elevated TSH with a
normal Free T4 level.
5. A patient with Type 2 Diabetes reports high fasting blood glucose levels in the morning.
You advise the patient to check their blood sugar at 3:00 AM. The 3:00 AM reading is 60
mg/dL. This phenomenon is known as:
A. Dawn Phenomenon
B. Insulin Resistance
C. Somogyi Effect
D. Metabolic Syndrome
Answer: C
CERTIFICATION EXAMINATION
PRACTICE QUESTIONS AND ANSWERS
(2026/2027)
1. A 65-year-old male presents for a routine checkup. On auscultation, you hear a harsh
systolic crescendo-decrescendo murmur at the second intercostal space at the right sternal
border that radiates to the carotid arteries. Which of the following is the most likely
diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: B
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur heard best
at the right second intercostal space (base) that radiates to the neck (carotids).
,2. A 45-year-old patient with no significant history presents with a blood pressure of 148/94
mmHg. According to JNC 8 and ACC/AHA guidelines, what is the most appropriate next step if
a second reading is similar?
A. Diagnose Stage 2 Hypertension and recommend lifestyle modifications plus medication
B. Start lisinopril 10mg daily immediately
C. Wait 6 months and re-check
D. Refer to a cardiologist for emergency management
Answer: A
Conceptual Explanation: A BP of 140/90 or higher is classified as Stage 2 Hypertension
under current guidelines, requiring both lifestyle changes and pharmacological
intervention.
3. Which of the following physical exam findings is most suggestive of a ruptured Achilles
tendon?
A. Positive Lachman test
B. Positive McMurray test
C. Positive Phalen test
D. Positive Thompson test
Answer: D
, Conceptual Explanation: The Thompson test (squeezing the calf muscle) is used to assess
for Achilles tendon rupture; if the foot does not plantarflex, the test is positive.
4. A 32-year-old female presents with fatigue, cold intolerance, and weight gain. Her TSH is
8.5 mU/L (Ref: 0.5-4.5) and her Free T4 is normal. This condition is classified as:
A. Subclinical Hypothyroidism
B. Graves’ Disease
C. Primary Hyperthyroidism
D. Secondary Hypothyroidism
Answer: A
Conceptual Explanation: Subclinical hypothyroidism is defined as an elevated TSH with a
normal Free T4 level.
5. A patient with Type 2 Diabetes reports high fasting blood glucose levels in the morning.
You advise the patient to check their blood sugar at 3:00 AM. The 3:00 AM reading is 60
mg/dL. This phenomenon is known as:
A. Dawn Phenomenon
B. Insulin Resistance
C. Somogyi Effect
D. Metabolic Syndrome
Answer: C
