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FNP AANP Practice EXAM 2025 | ALL
CURRENT EXAM VERSIONS 2025 |
ACCURATE REAL EXAM QUESTIONS AND
ANSWERS | ACCURATE AND VERIFIED
FOR GUARANTEED PASS | GRADED A
- A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting. What is the most appropriate response? A. Change to a different contraceptive B. Add a second method of contraception C. Provide reassurance D. Discontinue the medication ✅ Correct Answer: C. Provide reassurance Rationale: Midcycle spotting is a common side effect in the first few months of starting oral contraceptives and typically resolves with time.
- Development of fever in a child with a seizure disorder may: A. Increase seizure resistance B. Have no effect C. Lower the seizure threshold D. Cure the disorder ✅ Correct Answer: C. Lower the seizure threshold Rationale: Fever can reduce the seizure threshold and trigger seizures in susceptible children.
- When prescribing medications to the elderly, a common rule is to: A. Start with the adult dose B. Use pediatric doses C. Start low and go slow D. Avoid all medications ✅ Correct Answer: C. Start low and go slow Rationale: Elderly patients are more susceptible to side effects; starting with a lower dose minimizes risk.
- Which antihypertensive class is contraindicated in bilateral renal artery stenosis? A. Beta-blockers B. Calcium channel blockers C. ACE inhibitors
D. Thiazide diuretics ✅ Correct Answer: C. ACE inhibitors Rationale: ACE inhibitors can significantly reduce glomerular filtration in patients with bilateral renal artery stenosis, leading to acute renal failure.
- After a camping trip, an 11-year-old presents with a target lesion and systemic symptoms. What is the treatment? A. Amoxicillin B. Doxycycline C. Acyclovir D. Metronidazole ✅ Correct Answer: B. Doxycycline Rationale: This presentation is consistent with Lyme disease, and doxycycline is the first-line treatment.
- After treating an 18-month-old with otitis media, the best follow-up action is to: A. Refer to ENT B. Repeat antibiotics immediately C. Reevaluate in 10 days D. Schedule hearing test ✅ Correct Answer: C. Reevaluate in 10 days Rationale: Post-treatment reevaluation ensures resolution and rules out complications or persistent infection.
- To improve longevity in COPD patients, the most effective intervention is: A. Corticosteroids B. Bronchodilators C. Oxygen therapy D. Antibiotics ✅ Correct Answer: C. Oxygen therapy Rationale: Long-term oxygen therapy improves survival in patients with chronic hypoxemia.
- First-line treatment for polymyalgia rheumatica: A. NSAIDs B. Methotrexate C. Prednisone D. Hydroxychloroquine ✅ Correct Answer: C. Prednisone Rationale: Low-dose corticosteroids like prednisone are effective in relieving symptoms quickly.
- Rectal pain, itching, and a bluish mass in a 40-year-old man indicates: A. Colon cancer B. Ulcerative colitis
B. Iron panel C. Hemoglobin electrophoresis D. Peripheral smear ✅ Correct Answer: C. Hemoglobin electrophoresis Rationale: This test confirms the diagnosis and differentiates types of thalassemia.
- In an elderly diabetic patient on digoxin and hydrochlorothiazide, a key concern is: A. Increased hypoglycemia B. Risk of digoxin toxicity C. Decreased statin efficacy D. Lower insulin needs ✅ Correct Answer: B. Risk of digoxin toxicity Rationale: HCTZ can cause hypokalemia, which increases sensitivity to digoxin and risk of toxicity.
- A 14-year-old returns with fever, pleuritic pain, and green sputum after bronchitis. What finding is expected? A. Decreased breath sounds bilaterally B. Egophony over upper lobes C. Right lower lobe crackles D. Wheezing throughout ✅ Correct Answer: C. Right lower lobe crackles Rationale: These findings are consistent with lower lobe pneumonia.
- Pulmonary rehabilitation in COPD includes all EXCEPT: A. Improved exercise tolerance B. Education and breathing strategies C. Increased lung capacity D. Decreased hospitalization rates ✅ Correct Answer: C. Increased lung capacity Rationale: Lung capacity is not significantly improved, but function and quality of life are.
- Early morning hyperglycemia that worsens after increasing PM insulin indicates: A. Dawn phenomenon B. Diabetic ketoacidosis C. The Somogyi effect D. Hypoglycemia ✅ Correct Answer: C. The Somogyi effect Rationale: This occurs due to rebound hyperglycemia from nocturnal hypoglycemia; increasing insulin worsens it.
- A 15-year-old treated for trichomonas now reports dysuria without leukorrhea. What test is most appropriate? A. Repeat vaginal wet mount B. Gonorrhea test C. Microscopic urinalysis D. Pelvic ultrasound ✅ Correct Answer: C. Microscopic urinalysis Rationale: Dysuria without discharge suggests UTI; urinalysis confirms diagnosis.
- A patient taking atenolol, paroxetine, loratadine-D, and HCTZ complains of delayed ejaculation. The likely cause is: A. Atenolol B. Paroxetine (Paxil) C. HCTZ D. Loratadine ✅ Correct Answer: B. Paroxetine (Paxil) Rationale: SSRIs like paroxetine are known to cause sexual side effects, including delayed ejaculation.
- When managing hypothyroidism in an 84-year-old patient, what condition may worsen? A. Hyperlipidemia B. Osteoporosis C. Hypertension D. Depression ✅ Correct Answer: B. Osteoporosis Rationale: Thyroid hormone therapy can accelerate bone loss, increasing osteoporosis risk in the elderly.
- A 4-year-old girl reports inappropriate contact by a sibling during a UTI follow-up. What should the NP do next? A. Schedule counseling B. Report to child protective services C. Confront the sibling D. Refer to pediatrician ✅ Correct Answer: B. Report to child protective services Rationale: Any suspicion of sexual abuse must be reported to appropriate authorities immediately.
- After treatment of radial head subluxation, what indicates success? A. Pain on movement B. X-ray shows normal alignment C. Child uses the arm normally D. Elbow swelling resolves
B. ELISA and Western Blot C. CD4 count and viral load D. HIV antibody titer ✅ Correct Answer: C. CD4 count and viral load Rationale: CD4 and viral load are the gold standard for staging and monitoring treatment response in HIV.
- A 28-week pregnant woman reports one episode of painless vaginal bleeding. What test is appropriate? A. Pelvic exam B. Wet mount C. Ultrasound D. Amniocentesis ✅ Correct Answer: C. Ultrasound Rationale: Ultrasound helps rule out placenta previa or abruption, both potential causes of bleeding.
- A 3-year-old from a crowded home presents with cough and fever. Best diagnostic test? A. Skin test B. Sputum culture C. Chest x-ray D. Rapid influenza test ✅ Correct Answer: B. Sputum culture Rationale: In high-risk settings (e.g., close contacts), TB or bacterial infections should be ruled out via culture.
- How do psoriatic lesions typically appear in elderly patients? A. Pink plaques with pus B. Red plaques with silver scales C. Purple lesions with ulceration D. Raised yellow papules ✅ Correct Answer: B. Red plaques with silver scales Rationale: Psoriasis presents as sharply defined red plaques with silvery scales, common even in older adults.
- A diabetic patient on insulin and beta-blockers should be taught that the most reliable sign of hypoglycemia is: A. Tremors B. Palpitations C. Sweating D. Anxiety ✅ Correct Answer: C. Sweating Rationale: Beta-blockers can mask many adrenergic symptoms of hypoglycemia except for sweating.
- Which test best evaluates memory loss in an 88-year-old male? A. Clock drawing test
B. Beck Depression Inventory C. Folstein Mini-Mental State Exam D. Neuroimaging ✅ Correct Answer: C. Folstein Mini-Mental State Exam Rationale: The MMSE is a validated tool for screening cognitive impairment and memory issues.
- What is the leading cause of cancer-related deaths in women? A. Breast cancer B. Lung cancer C. Ovarian cancer D. Colorectal cancer ✅ Correct Answer: B. Lung cancer Rationale: Lung cancer remains the top cause of cancer death among women, often due to late diagnosis.
- What is a classic sign of acute appendicitis? A. Lower left quadrant pain B. Rebound tenderness at McBurney’s point C. Diffuse abdominal distension D. Hypoactive bowel sounds ✅ Correct Answer: B. Rebound tenderness at McBurney’s point Rationale: Localized pain and rebound tenderness in the RLQ are hallmark signs of appendicitis.
- Macular degeneration most affects which part of vision? A. Peripheral field B. Entire visual field C. Central vision D. Night vision ✅ Correct Answer: C. Central vision Rationale: Macular degeneration causes central vision loss, often affecting reading and facial recognition.
- To assess abstract thinking in a patient, the NP should ask: A. Date of birth B. Meaning of a common proverb C. To count backward from 100 D. Their home address ✅ Correct Answer: B. Meaning of a common proverb Rationale: Interpreting proverbs is a traditional method to evaluate abstract thought processes.
- During an employment exam, what should NOT be part of the history for unexplained breast bruising? A. History of falls
B. No symptoms C. Hematuria D. Painful urination with fever ✅ Correct Answer: B. No symptoms Rationale: Many Chlamydia cases, especially in men, are asymptomatic and found during screening.
- To assess the S1 spinal nerve, which reflex should be tested? A. Patellar B. Biceps C. Achilles D. Triceps ✅ Correct Answer: C. Achilles Rationale: The Achilles tendon reflex evaluates the integrity of the S1 spinal segment.
- A student takes an herb for migraines and cramps. Which is most likely? A. Ginkgo biloba B. Echinacea C. Feverfew D. St. John’s Wort ✅ Correct Answer: C. Feverfew Rationale: Feverfew is commonly used for migraine prevention and menstrual symptom relief. A 47- year-old patient presents with complaints of upper abdominal discomfort with nausea and burning after eating. The patient does not currently take any medications. The most likely differential diagnoses would include:
- Ans - gastritis and peptic ulcer disease. A patient with a diagnosis of diverticulosis presents with localized left lower quadrant discomfort, a palpable mass, mild leukocytosis, and T = 100°F (37.8°C). The patient does not appear toxic and can tolerate fluids. An appropriate plan should include:
- Ans - clear liquids and oral antibiotics. Which of the following pharmacotherapeutics would be most important to administer to a patient who has a corneal abrasion?
- Ans - Gentamicin ophthalmic (Genoptic) The most common bacteria responsible for pneumonia in older adults residing in the community is: - Ans - Streptococcus pneumoniae.
An 88-year-old patient has had a gradual onset of hearing loss in the left ear. Examination shows a large accumulation of cerumen in the external auditory canal. Assuming there is no neural loss, the nurse practitioner would expect the Weber test to: - Ans - lateralize to the left. Which of the following wet-mount results confirms a preliminary diagnosis of bacterial vaginosis? - Ans
- Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, and many white blood cells Which of the following would be most appropriate to perform in the initial evaluation of a patient with symptoms of acute prostatitis? - Ans - Urinalysis and urine culture A 25-year-old presents with the chief complaint of decreased mobility and pain of the right shoulder exacerbated by movement. The patient reports that he participated in extensive house painting 24 hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No redness or ecchymosis is present. What is the next step that should be taken in order to make a diagnosis? - Ans - Palpate structures around the shoulder. Assessment findings that would support a diagnosis of mitral regurgitation include: - Ans - Loud, highpitched pansystolic murmur. Which of the following gastrointestinal changes is associated with normal aging? - Ans - Decreased production of gastric acid Which of the following signs/symptoms are often associated with headaches due to an intracranial tumor? - Ans - Pain worse in supine position; focal neurological signs Which of the following is NOT an indication of preeclampsia? - Ans - Glucosuria Which of the following laboratory tests should a nurse practitioner order when the suspected diagnosis is temporal arteritis? - Ans - Erythrocyte sedimentation rate (ESR) According to the American Diabetes Association, the newest standard for determining the presence of diabetes mellitus based on fasting plasma sugar level is a value equal to or greater than: - Ans - 126 mg/dL.
Trigeminal neuralgia manifests itself primarily with: - Ans - electric-shock-like unilateral facial pain. A 65-year-old male presents to a clinic complaining of increasing fatigue, dyspnea on exertion, and ankle edema during the day. He has a history of mild hypertension, for which he saw his physician years ago. The physician advised the patient to decrease his salt intake. On physical examination, the patient is tachycardic, positive for jugular venous distention, and positive for S3, with a systolic murmur. Chest X-ray reveals cardiomegaly with vascular redistribution. The nurse practitioner's diagnosis should be: - Ans - heart failure. Which of the following criteria differentiates a TIA from a stroke? - Ans - Absence of residual symptoms A 66-year-old patient presents with bilateral otitis media with effusion and white patches in the mouth that do not rub off when wiped with a 4 × 4. The patient should be evaluated for: - Ans - HIV infection. A 14-year-old patient who fell on an outstretched hand complains of proximal forearm pain. X-ray reveals a positive fat pad sign, and the patient is unable to fully extend the elbow. No definitive bony changes are seen on X-ray. The most likely working diagnosis is: - Ans - radial head fracture. A 2-month-old infant is presented for examination and immunizations. History includes an uncomplicated full-term delivery and hepatitis B virus immunization shortly after birth. Examination is unremarkable except for a diffusely erythematous (non-beet-red) macular rash in the diaper area, sparing the inguinal folds. No satellite lesions are noted. The infant's diaper rash is most likely caused by: - Ans - contact dermatitis. A 17-year-old female has never had her menses. She is at Tanner stage III of sexual development. Her physical examination is completely normal, and her weight is appropriate for her age and height. What is the most likely diagnosis? - Ans - Primary amenorrhea A 70-year-old male presents with paresthesia of the lower extremities. On examination, the patient appears pale and shows a decreased vibratory sense. Laboratory tests reveal elevated indirect bilirubin; Hct = 30%; mean corpuscular volume (MCV) = 120 μm3 [normal = 87-103 μm3]. The most likely diagnosis is: - Ans - pernicious anemia. Hegar's sign - Ans - Softening of lower uterine segment Chadwick's sign - Ans - Bluish color of cervix and vagina at 6-8 weeks
Goodell's sign - Ans - Softening of cervix at 4+ weeks Lipids in chronic inactivity - Ans - Low HDL Lipids in under- or untreated hypothyroidism - Ans - Elevated total cholesterol, TG, and LDL Lipids in chronic renal insufficiency - Ans - Elevated total cholesterol and TG Lipids in alcohol abuse - Ans - Elevated TG, HDL, and LDL Vaccines with live attenuated viruses - Ans - MMR, varicella, flu-mist(intranasal), Zostavax Drugs of choice for abdominal infection - Ans - Beta lactams + metronidazole (most common); fluoroquinolones Drugs of choice for urinary tract infection - Ans - Fluoroquinolones (except moxi), TMP-SMX, fluconazole, b-lactams, nitrofurantoin, fosfomycin if pt has many allergies Drugs of choice for pulmonary infections - Ans - Macrolides, resp fluoroquinolones, b-lactams, doxycycline (MRSA, atypical coverage) Drugs of choice for skin and soft tissue infections - Ans - MRSA: TMP-SMZ, doxycycline, clindamycin; blactams Drugs of choice for MRSA - Ans - Vancomycin, daptomycin , linezolid, TMP-SMZ, doxycycline, ceftaroline Macrolide drugs - Ans - Erythromycin, clarithromycin, azithromycin Macrolide AEs - Ans - GI, QT prolongation
Itraconazole interactions - Ans - Acid suppressive therapies Fluconazole dose adjust - Ans - Renal Antifungal AEs - Ans - GI, QTc prolongation (fluconazole) Antifungal drug interactions - Ans - QT prolongation meds, warfarin Anti-infectives not for pregnant - Ans - Tetracyclines, TMP-SMZ TMP-SMZ coverage - Ans - G+, G-, MRSA, Protozoa (toxoplasma gondii), fungus (pneumocystis jirovecii), poor anaerobic activity TMP-SMZ AEs - Ans - Sulfa allergy, photosensitivity, hematologic (anemia, leukopenia, thrombocytopenia) TMP-SMZ on renal function - Ans - Dose adjust in renal impairment, false elevation in serum Cr TMP-SMZ drug interactions - Ans - Warfarin Gram + only coverage - Ans - Clindamycin, linezolid, vancomycin, daptomycin Gram - only - Ans - Monobactams (aztreonam), penicillin VK Gram +/- - Ans - PCN (aminopcn, ext. spectrum), carbapenams, aminoglycosides, TMP-SMZ, fluoroquinolones, fosfomycin Head growth in first year of life - Ans - Total 12cm Head growth 0-3mo - Ans - 6cm
Head growth 4-6mo - Ans - 3cm Head growth 6-12mo - Ans - 3cm Head growth 2-7yo - Ans - 0.5cm/yr Head growth 8-12yo - Ans - 0.3cm/yr Tumor grading: T0 - Ans - No evidence of primary tumor Tumor grading: T1 - Ans - 2 cm or less in greatest dimension Tumor grading: T2 - Ans - >2-5cm Tumor grading: T3 - Ans - >5cm Chvostek sign - Ans - Hypocalcemia, spasm when tap facial nerve Trousseau sign - Ans - Hypocalcemia, spasm when compress brachial artery w/ BP cuff Myocardial ischemia EKG changes - Ans - Inverted T wave, T wave depression Myocardial injury EKG changes, - Ans - ST segment elevation, tall peaked t wave Myocardial infarction EKG changes - Ans - Q wave 1st gen antihistamines - Ans - Diphenhydramine, chlorpheniramine 2nd gen antihistamines - Ans - Loratadine, desloratadine, cetirizine, fexofenadine, levocetirazine
Lyme stage 2 (early disseminated) - Ans - Months after initial infx, classic rash may reappear w/ multiple lesions. Arthralgias, myalgia, HA, fatigue. Less common: heart block, neuro findings (Bell's palsy) Lyme stage 3 (late persistent) - Ans - 1 year after initial infection, msk s/s persist w/ joint pain, frank arthritis, joint damage. Neuropsychiatric findings - memory problems, depression, neuropathy. Lyme organism - Ans - B. burgdorferri (tick-transmitted spirochete) Lyme testing - Ans - ELISA confirmed with western blot Lyme tx - Ans - Doxycycline (children >8yo), amoxicillin, cefuroxime - adults and children Chancroid tx - Ans - Azithromycin or ceftriaxone, alt. ciprofloxacin or erythromycin Genital herpes (HSV 2) tx - Ans - Acyclovir Lymphogranuloma vereneum (c. trachomatis) tx - Ans - Doxycycline, or erythromycin Nongonococcal urethritis/cervicitis (c. Trachomatis) tx - Ans - Azithromycin or doxycycline Gonococcal urethritis/cervicitis tx - Ans - Cefixime or ceftriaxone, add azithromycin or doxy if chlamydia not ruled out Bacterial vaginosis tx - Ans - Metronidazole Pelvic inflammatory disease tx - Ans - Ceftriaxone+doxycycline +/- metronidazole Trichomoniasis tx - Ans – Metronidazole Cranial nerves responsible for extraoculomotor movements? - Ans - a. 2, 3, 6? b.
Patient with hx of hypertension and stroke, now having memory loss and confusion - indicates what? - Ans - a. Alzheimer's b. Vascular Dementia? CAGE acronym - Ans -? Treatment for chronic alcoholism? - Ans -? Frail elderly mammogram breast tissue? - Ans -? Patient has Barrett's esophagus, insurance no longer covers gastroenterologist who was treating condition, patient at the FNP office, wanting a prescription for medication... What should the FNP do?
- Ans - a. Refer to oncologist? b. Refill prescription? GERD treatment? - Ans - a. PPI? Per American College of Gastroenterology, treatment should begin with a PPI. b. H2? An H2 is inferior to PPI's. 3 months on Symmetrel, TSH increased, T4 normal, what do you do? - Ans - a. Increase medication? b. Decrease medication? Lipid level of 1500, increased risk for? - Ans - a. pancreatitis? Frail elder, increased creatinine, indication? - Ans -? Fingernail hematoma treatment? - Ans - a. drill hole and drain blood? Abnormal cells on PAP, what do you do next? - Ans - a. Refer for colposcopy? Red beefy tongue? - Ans - a. Pernicious Anemia?