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FNP AANP CERTIFICATION QUESTIONS |
ACCURATE QUESTIONS AND DETAILED
ANSWERS | GUARANTEED PASS | GRADED
A | LATEST UPDATE 2024-2025 WITH 200+
QUESTIONS
1. Match the correct car safety device for each child: Which car safety device is appropriate for the following children? A. Rear-facing car seat B. Forward-facing seat with harness C. Belt-positioning booster seat D. Seat belt 1. An 18-month-old born at 38 weeks' gestation 2. A 9-year-old who is 4 feet 10 inches tall 3. A 1-year-old who is at 50th percentile in height and weight 4. A 7-year-old who is at 75th percentile in height and weight A. 1 - B 2-D 3-A 4-C B. 1 - A 2-D 3-A 4-C ✅ C. 1 - C 2-B 3-D 4-A D. 1 - A 2-C 3-C 4-B ✅ Correct Answer: B Rationale: - Children under 2 years or until they outgrow the rear-facing height/weight limit should remain rear-facing. - A 9-year-old over 4'9" can transition to a seat belt. - A 1-year-old still requires rear-facing for optimal protection. - A 7-year-old likely still fits a booster seat for proper belt fit.
2. Vaccine most likely to cause mild fever post-injection in 6-month-old: What vaccine is most likely to cause a mild 1– 2 - day fever after administration in a 6-month-old? A. Inactivated polio virus (IPV) B. Haemophilus influenzae type B (Hib) C. Pneumococcal conjugate 13-valent vaccine (PCV13) ✅ D. Injectable influenza vaccine ✅ Correct Answer: C Rationale: PCV13 is associated with local site reactions and low-grade fever, especially in infants. These mild symptoms are common and self-limiting. 3. Immunization to omit for a 13-year-old with no vaccination record: Which vaccine should be omitted when updating immunizations for a 13-year-old with no documented vaccines? A. Hepatitis B B. Haemophilus influenzae type B (Hib) ✅ C. Tetanus, diphtheria, acellular pertussis (Tdap) D. Measles, mumps, rubella (MMR) ✅ Correct Answer: B Rationale: Hib vaccine is not routinely given after age 5 as the risk for invasive disease decreases, and the vaccine is not effective in older children. 4. Most common ACS symptom in elderly diabetic woman: What symptom is most likely in a 78-year-old diabetic woman with suspected ACS? A. Retrosternal chest pain radiating to left arm B. Syncope C. Unusual fatigue ✅ D. Nausea and vomiting ✅ Correct Answer: C
C. Systolic heart disease D. Calcific aortic stenosis ✅ ✅ Correct Answer: D Rationale: Classic findings of calcific aortic stenosis include systolic murmur at upper sternal border with radiation to neck, delayed carotid upstroke, and exertional symptoms.
8. Likely cause of systolic murmur in a healthy 18-year-old athlete: A harsh systolic murmur radiating to the neck in an asymptomatic 18-year-old most likely indicates: A. Aortic stenosis ✅ B. Aortic regurgitation C. Mitral valve prolapse D. Physiologic murmur ✅ Correct Answer: A Rationale: Even in asymptomatic athletes, a harsh systolic murmur radiating to the neck is concerning for aortic stenosis and needs further evaluation. 9. Murmur characteristics pointing to mitral regurgitation: A 62-year-old man has a holosystolic murmur radiating to the axilla that increases on left lateral decubitus. What is the most likely diagnosis? A. Mitral valve prolapse B. Aortic stenosis C. Pulmonic stenosis D. Mitral regurgitation ✅ ✅ Correct Answer: D Rationale: Classic signs of mitral regurgitation include holosystolic murmur, best heard at the apex and radiating to the axilla, often louder in the left lateral position.
10. Classic gouty arthritis presentation: What is the most common presentation of acute gouty arthritis? A. Swelling at the 3rd distal interphalangeal joint B. Redness at the first metatarsophalangeal joint ✅ C. White nodular lesion on the ear D. Effusion in the right knee ✅ Correct Answer: B Rationale: The first metatarsophalangeal joint (big toe) is the most commonly affected site in acute gout, often red, swollen, and painful. 11. Ineffective gout treatment during acute attack: Which medication is NOT effective for treating an acute gouty arthritis episode? A. Intraarticular corticosteroid B. Naproxen C. Febuxostat ✅ D. Colchicine ✅ Correct Answer: C Rationale: Febuxostat lowers uric acid but is not used in acute gout attacks as it doesn't relieve current inflammation. 12. Not a trigger for gout flare: Which is not a known trigger of acute gouty arthritis? A. Thiazide diuretics B. Organ meat consumption C. Alcohol use D. Increased intake of acidic foods ✅ ✅ Correct Answer: D
A. Azithromycin B. Amoxicillin-clavulanate ✅ C. Ciprofloxacin D. Doxycycline ✅ Correct Answer: B Rationale: Amoxicillin-clavulanate is the recommended first-line treatment due to rising resistance of S. pneumoniae and H. influenzae to macrolides.
16. Screening recommendation for colorectal cancer: At what age should routine colorectal cancer screening begin in an average-risk adult? A. 40 years B. 45 years ✅ C. 50 years D. 55 years ✅ Correct Answer: B Rationale: The USPSTF now recommends beginning screening at age 45 for average-risk adults due to rising incidence in younger populations. 17. Diagnostic hallmark of temporal arteritis: Which of the following is most characteristic of temporal arteritis (giant cell arteritis)? A. Hypertension B. Jaw claudication ✅ C. Facial numbness D. Periorbital edema ✅ Correct Answer: B Rationale: Jaw claudication is a hallmark symptom. Temporal arteritis can cause blindness if not treated promptly with corticosteroids.
18. First-line treatment for iron deficiency anemia: What is the preferred first-line therapy for iron deficiency anemia? A. IV iron sucrose B. Ferrous sulfate 325 mg orally TID ✅ C. Blood transfusion D. Vitamin B12 injections ✅ Correct Answer: B Rationale: Oral ferrous sulfate is the first-line treatment unless there is severe anemia or intolerance, in which case IV iron may be used. 19. Condition with bilateral lower extremity edema and jugular vein distension: Which diagnosis is most consistent with bilateral leg edema, JVD, and hepatomegaly? A. Chronic venous insufficiency B. Deep vein thrombosis C. Right-sided heart failure ✅ D. Cellulitis ✅ Correct Answer: C Rationale: Right heart failure causes systemic congestion—leg edema, JVD, and liver enlargement—due to backup into the venous system. 20. Best first-line therapy for newly diagnosed hypertension in a 56-year-old Black patient: A 56-year-old Black man is newly diagnosed with essential hypertension. Which is the most appropriate initial antihypertensive agent? A. Beta-blocker B. ACE inhibitor C. Thiazide diuretic ✅ D. Alpha-blocker ✅ Correct Answer: C
A-50% B-70% C-40% D-20%
A-70% B-40% C-50% D-20%
A-40% B-50% C-20% D-70%
A-70% B-50% C-40% D-20%
- Ans - Ans: A-70% B-50% C-40% D-20% Match each test or sign with the relevant condition below: A. Drop arm test B. Finkelstein test C. McMurray test D. Lachman test E. Spurling test F. Straight-leg raising test G. Talar tilt H. Tinel's Sign Conditions:
- Meniscal tear __
- Ankle instability __
- Carpal tunnel syndrome __
- Anterior cruciate ligament tear __
- Lumbar nerve root compression __
- Cervical nerve root compression __
- Rotator cuff evaluation __
- De Quervain's tenosynovitis __
- Ans - Ans: 1-C (McMurray Test- Meniscal tear of the knee) 2 - G (Talar Tilt test for ankle instability) 3 - H (Tinel's sign for Carpal tunnel syndrome - two hand place against with hyperflexion of the wrists, if numbness or tingling sensation is elicited test is +) 4 - D (Lachman Test for ACL injury of the knee where tendon is twisted causing injury; patient cannot squat, very painful) 5 - F (straigth leg raising test_ leg is raised 45 degrees, ask pt to hyperextend against the examiner's hand if pt is experienced pain, test is +) 6 - E (Spruling test - test for range of motion (flexion.. of neck) 7 - A (Drop-arm test for rotator cuff evaluation) 8 - B (Finkelstein test) Ms. Hannigan is a 70-year-old woman with well-controlled hypertension, dyslipidemia, and hypothyroidism. Her current medications include a statin, ACE inhibitor, a thiazide diuretic, and levothyroxine replacement. She presents today with a chief complaint of a 2-month history of fatigue and aching sensation accompanied by morning stiffness in her hips and shoulders. During this time, she has lost 8 lb (3.6 kg) "without even trying" and reports struggling to get dressed, especially when putting on a shirt or pants. Physical exam reveals full limb strength, decreased active range of motion in the hips and shoulders, cool, smooth joints, and no excessive muscle tenderness. Laboratory test results include: Hb=10.8 g/dL (108 g/L) Hct=32% (0.32 proportion) MCV=86 fL RDW=12.2% (0.122 proportion) ESR=112 mm/h (ULN=20 mm/h) The result of her hemogram reveals: Iron deficiency anemia.
decreased active range of motion in the hips and shoulders, cool, smooth joints, and no excessive muscle tenderness. Laboratory test results include: Hb=10.8 g/dL (108 g/L) Hct=32% (0.32 proportion) MCV=86 fL RDW=12.2% (0.122 proportion) ESR=112 mm/h (ULN=20 mm/h) Referra - Ans - Ans: Initiating a course of systemic corticosteroids Which of the following is unlikely to be noted in Tom, a 62-year-old man with lumbar spinal stenosis? Report of back pain worsening with standing Bilateral leg numbness Pain improvement with flexed forward position Absent pedal pulses - Ans - Ans: Absent pedal pulses Richard is a 28-year-old man who presents with a chief complaint of left knee pain and swelling for the past month, as well as redness and tearing in the left eye for the past week. He also has had intermittent dysuria and 2-3 loose stools per day for the past 2 weeks. He denies weight loss, skin rash, or fever. Physical exam reveals a smooth, swollen, red, warm left knee with decreased range of motion, pupils equal and reactive to light with marked unilateral conjunctival redness. The urinary meatus is reddened. Richard's clinical presentation is most consistent with:
Systemic lupus erythematosus. Polymyalgia rheumatica. Reactive arthritis (Reiter's syndrome). Psoriatic arthritis. - Ans - ans: Reactive arthritis (Reiter's syndrome). n evaluating Richard, the next most appropriate test to obtain is: Based on the below scenario: Richard is a 28-year-old man who presents with a chief complaint of left knee pain and swelling for the past month, as well as redness and tearing in the left eye for the past week. He also has had intermittent dysuria and 2-3 loose stools per day for the past 2 weeks. He denies weight loss, skin rash, or fever. Physical exam reveals a smooth, swollen, red, warm left knee with decreased range of motion, pupils equal and reactive to light with marked unilateral conjunctival redness. The urinary meatus is reddened. Serum antinuclear antibodies. Serum rheumatoid factor. Urinary PCR testing for N. gonorrhoeae and C. trachomatis. Stool for ova and parasites. - Ans - ans: Urinary PCR testing for N. gonorrhoeae and C. trachomatis. Josh is a 14-year-old basketball player who presents with anterior knee pain that has occurred intermittently over the past 3 months. The pain worsens with squatting and walking up or down stairs, and is better with rest. He denies fever, weight loss, joint redness, or skin rash. Physical examination reveals a Tanner 3 male in no acute distress with a tender, swollen tibial tuberosity
Which of the following is an acceptable team sport for a college-age young adult with a bleeding disorder to participate in? Lacrosse Soccer Swimming No team sport is acceptable. - Ans - Ans: Swimming You are evaluating Karen, a 48-year-old African American woman who is a nonsmoker and drinks 2 glasses of wine per week. She has a longstanding intermittent lumbosacral strain that she attributes in part to her work, which requires her to be physically active. Today she presents with a 2-week history of shooting pain down the right leg and occasional "dragging" of the right foot with walking. Karen denies any recent trauma or precipitating event. Examination reveals abnormal straight-leg raising, diminished right patellar reflex, and difficulty performing heel walking. She relates, "I am really uncomfortable. This is different than my usual back pain." Her presentation is most consistent with: Lumbar radiculopathy. Exacerbation of chronic lumbar-sacral strain. Vertebral compression fracture. Spondyloarthropathy. - Ans - Ans: Lumbar radiculopathy. Which of the following represents the most appropriate next step in Karen's plan of care? Based on the below scenario:
You are evaluating Karen, a 48-year-old African American woman who is a nonsmoker and drinks 2 glasses of wine per week. She has a longstanding intermittent lumbosacral strain that she attributes in part to her work, which requires her to be physically active. Today she presents with a 2-week history of shooting pain down the right leg and occasional "dragging" of the right foot with walking. Karen denies any recent trauma or precipitating event. Examination reveals abnormal straight-leg raising, diminished right patellar reflex, and difficulty performing heel walking. She relates, "I am really uncomfortable. This is different than my usual back pain." Advise a 3-day course of bedrest Refer to physical therapy Order a lumbosacral MRI Obtain a standing lumbosacral x-ray - Ans - Ans: Refer to physical therapy You are counseling a 56-year-old woman who asks about increasing her dietary calcium intake with nondairy foods. You counsel about adding all of the following foods that are calcium-rich except for: Spinach. Tofu. Almonds. Red grapes. - Ans - ans: Red grapes. Match each of the following findings with the associated disease state. An item can be used more than once. A. Rheumatoid arthritis
Mrs. Garcia's most likely diagnosis is: Systemic lupus erythematosus. Rheumatoid arthritis. Osteoarthritis. Reactive arthritis. - Ans - Ans: Osteoarthritis. Jane is a 56-year-old woman who undergoes DXA testing of the spine and reveals a T-score of ‒ 2.9. Based on recommendations by the American College of Physicians, the NP suggests: No treatment needed at this time. Initiating treatment with risedronate. Initiating treatment with estrogen therapy. Initiating treatment with raloxifene. - Ans - Ans: Initiating treatment with risedronate. For a woman initiating bisphosphonate therapy for osteoporosis, treatment should continue: Until BMD improves by 25%. For 2 years.
For 5 years. Indefinitely. - Ans - ans: for 5 years When initiating pharmacologic treatment for osteoporosis in women, the American College of Physicians recommends bone mineral density monitoring: Annually. At 6 months following initiation of treatment, then annually thereafter. Every 2 years. At the completion of therapy. - Ans - Ans: At the completion of therapy All of the following are characteristics of knee osteoarthritis except: Limited range of motion. Morning stiffness. Erythema surrounding the joint. Crepitus. - Ans - Ans: Erythema surrounding the joint. The preferred technique for initial diagnosis of osteoarthritis of the knee is: X-ray.
