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AANP Family Nurse Practitioner (FNP) Certification Exam practice questions

210 free questions with answers and explanations.

Practice test
  1. 1.A 70-year-old female presents with a 3-day history of dysuria, urinary frequency, and suprapubic pain. She denies fever, flank pain, or vaginal discharge. Urinalysis shows positive leukocyte esterase, nitrites, and numerous bacteria. She has no known drug allergies. Which of the following is the most appropriate initial treatment?Evaluation
  2. 2.A 72-year-old male with hypertension and benign prostatic hyperplasia (BPH) is prescribed tamsulosin. He reports feeling dizzy upon standing, particularly in the mornings. His blood pressure is 118/72 mmHg sitting and 98/60 mmHg standing. Which of the following modifications to his treatment plan is most appropriate?Evaluation
  3. 3.A 65-year-old male with chronic heart failure (CHF) and ejection fraction of 30% is on furosemide 40 mg daily, lisinopril 10 mg daily, and metoprolol succinate 50 mg daily. He reports increasing shortness of breath, 2 lb weight gain over 2 days, and new ankle edema. His blood pressure is 110/70 mmHg, and heart rate is 68 bpm. What is the most appropriate modification to his treatment plan?Evaluation
  4. 4.A 35-year-old female with a history of anaphylaxis to peanuts is prescribed a new medication. The FNP is providing education on recognizing and responding to a severe allergic reaction. Which of the following is an early sign of anaphylaxis that requires immediate epinephrine administration?Evaluation
  5. 5.A 28-year-old female presents with a 3-day history of dysuria, frequency, and urgency. Urinalysis reveals positive leukocyte esterase, nitrites, and >100,000 CFU/mL E. coli. She has no fever or flank pain. She reports a penicillin allergy (rash). What is the most appropriate initial antibiotic for this uncomplicated urinary tract infection (UTI)?Evaluation
  6. 6.A 68-year-old male with a history of Type 2 Diabetes Mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD) is currently on metformin 1000 mg twice daily. His current A1c is 7.8%. He reports no issues with metformin. Which of the following is the most appropriate next step in managing his T2DM?Evaluation
  7. 7.A 50-year-old female with newly diagnosed fibromyalgia is started on duloxetine 30 mg daily. After 4 weeks, she reports a 20% improvement in pain but continues to have significant fatigue and widespread body aches. She tolerates the medication well. What is the most appropriate next step in her management?Evaluation
  8. 8.A 28-year-old female presents with recurrent urinary tract infections (UTIs), experiencing 3 episodes in the past 6 months. She is otherwise healthy. Which of the following is the most appropriate long-term management strategy for preventing future UTIs?Evaluation
  9. 9.A 60-year-old male with a history of chronic obstructive pulmonary disease (COPD) is prescribed a new long-acting beta-agonist (LABA) and inhaled corticosteroid (ICS) combination inhaler. He returns for follow-up and reports using his short-acting beta-agonist (SABA) rescue inhaler 4-5 times per week. Which of the following indicates a need for adjustment in his current COPD management?Evaluation
  10. 10.A 65-year-old male with chronic heart failure (CHF) and an ejection fraction of 30% is on furosemide 40 mg daily. He presents with increasing shortness of breath, bilateral pitting edema to his mid-shin, and a 5-pound weight gain over the past 3 days. His blood pressure is 130/80 mmHg. Which of the following is the most appropriate initial adjustment to his medication regimen?Evaluation
  11. 11.A 68-year-old male with a history of heart failure presents for a follow-up visit. He reports increased shortness of breath with exertion, 2+ pitting edema in his ankles, and a 5-pound weight gain over the past week. His current medication regimen includes furosemide 40 mg daily. Which of the following is the most appropriate initial modification to his treatment plan?Evaluation
  12. 12.A 50-year-old female with newly diagnosed fibromyalgia is started on duloxetine 30 mg daily. At her 4-week follow-up, she reports a 30% reduction in her pain scores but still experiences significant fatigue and widespread body aches. She tolerates the medication well with no side effects. Which of the following is the most appropriate next step in her treatment plan?Evaluation
  13. 13.A 50-year-old female with newly diagnosed hypothyroidism is started on levothyroxine 50 mcg daily. She returns for follow-up in 6 weeks. Her TSH is 8.2 mIU/L (reference range 0.4-4.0 mIU/L), and she reports persistent fatigue and weight gain. Which adjustment to her medication is most appropriate?Evaluation
  14. 14.A 55-year-old male with newly diagnosed hypertension is started on lisinopril 10 mg daily. After one month, his blood pressure remains 145/92 mmHg. He reports no side effects. What is the most appropriate adjustment to his treatment plan?Evaluation
  15. 15.A 75-year-old female with osteoarthritis is taking celecoxib 200 mg daily. She has a history of hypertension and well-controlled Type 2 Diabetes. During her annual physical, her FNP notes her blood pressure is 150/92 mmHg, and she has 1+ pedal edema. Her previous BP was 130/80 mmHg. What is the most likely cause of her elevated blood pressure and edema?Evaluation
  16. 16.A 70-year-old female with a history of recurrent Clostridium difficile infection (CDI) is discharged from the hospital after successful treatment. She is now at high risk for recurrence. What is the most appropriate preventative measure to include in her discharge plan?Evaluation
  17. 17.A 40-year-old pregnant patient (G1P0, 28 weeks gestation) presents with new onset gestational hypertension (BP 145/95 mmHg on two occasions, 4 hours apart, no proteinuria). She is otherwise healthy. Which of the following is the most appropriate initial management plan?Evaluation
  18. 18.A 58-year-old male with chronic stable angina reports an increase in chest pain frequency and severity over the past month, now occurring with minimal exertion. He is currently taking aspirin, atorvastatin, and metoprolol succinate 50 mg daily. His blood pressure is 130/80 mmHg, and heart rate is 62 bpm. Which of the following is the most appropriate initial modification to his treatment plan?Evaluation
  19. 19.An FNP is reviewing clinic data for patients with poorly controlled asthma. The data indicates that only 40% of patients with an Asthma Control Test (ACT) score <19 have a documented follow-up appointment within 4 weeks. Which quality improvement (QI) step does this finding represent?Evaluation
  20. 20.A 35-year-old female with newly diagnosed Type 2 Diabetes Mellitus is initiating metformin therapy. She expresses concern about potential side effects. Which of the following is the most important instruction to provide regarding metformin administration to minimize gastrointestinal upset?Evaluation
  21. 21.A 40-year-old male with new-onset seizure disorder is started on levetiracetam 500 mg twice daily. He presents for follow-up reporting increased irritability, anxiety, and occasional aggressive outbursts since starting the medication, which are uncharacteristic for him. His seizure control has been excellent. Which of the following is the most appropriate next step in his management?Evaluation
  22. 22.A 55-year-old female with chronic migraine is prescribed topiramate. At her three-month follow-up, she reports significant improvement in migraine frequency but also complains of memory difficulties and word-finding problems. Which action should the FNP consider first?Evaluation
  23. 23.A 58-year-old female with a history of hypertension and osteoarthritis is prescribed ibuprofen 600 mg three times daily for acute knee pain. She presents for follow-up reporting worsening edema in her ankles and her blood pressure is now consistently elevated at 150/90 mmHg. Which of the following is the most appropriate initial modification to her treatment plan?Evaluation
  24. 24.A 62-year-old male with chronic kidney disease (CKD) Stage 3 is prescribed lisinopril for hypertension. His baseline creatinine was 1.5 mg/dL with an eGFR of 45 mL/min/1.73m². One week after starting lisinopril, his creatinine is 1.8 mg/dL and eGFR is 38 mL/min/1.73m². He reports no new symptoms. What is the most appropriate action?Evaluation
  25. 25.A 75-year-old female with osteoarthritis is taking celecoxib 200 mg daily for chronic knee pain. She has a history of hypertension well-controlled with lisinopril. At her follow-up, her blood pressure is 150/95 mmHg, and she reports mild ankle swelling. What is the most likely cause of these new findings?Evaluation
  26. 26.A 32-year-old female presents for follow-up after being diagnosed with generalized anxiety disorder and initiated on escitalopram 10 mg daily four weeks ago. She reports feeling 'a little better' but still experiences significant anxiety symptoms, including restlessness and difficulty concentrating. Her PHQ-9 score has decreased from 18 to 12. What is the most appropriate next step in her treatment plan?Evaluation
  27. 27.A 30-year-old female presents with symptoms of generalized anxiety disorder (GAD). She has been taking sertraline 50 mg daily for 6 weeks and reports some improvement, but still experiences significant anxiety and interferes with her daily life. She denies side effects. What is the most appropriate next step in her treatment plan?Evaluation
  28. 28.A 48-year-old female with Type 2 Diabetes Mellitus presents for a follow-up. Her current A1C is 8.2%. She is on metformin 1000 mg BID. She reports consistent medication adherence and dietary modifications. Her renal function is stable. What is the most appropriate next step in her treatment plan?Evaluation
  29. 29.A 40-year-old female with a history of generalized anxiety disorder (GAD) has been taking sertraline 50 mg daily for 6 weeks. She reports some improvement in her anxiety but still experiences significant worry and muscle tension. Which of the following is the most appropriate next step in her treatment plan?Evaluation
  30. 30.A 45-year-old male with Type 2 Diabetes is monitoring his blood glucose levels. His fasting blood glucose readings have consistently been between 130-150 mg/dL over the past two weeks, despite adherence to his current diet and metformin 1000 mg twice daily. His last HbA1c was 7.8% three months ago. Which of the following modifications is most appropriate at this time?Evaluation
  31. 31.A 60-year-old male with Type 2 Diabetes Mellitus and obesity (BMI 32 kg/m²) is on metformin 1000 mg BID. His A1C is 7.8%, and he has established atherosclerotic cardiovascular disease (ASCVD). What is the most appropriate addition to his current regimen to improve glycemic control and reduce cardiovascular risk?Evaluation
  32. 32.An FNP is reviewing quality improvement data for their clinic related to hypertension management. They notice that only 60% of patients with hypertension have achieved their target blood pressure of <140/90 mmHg. Which of the following is the most appropriate initial step in a quality improvement (QI) initiative to address this outcome?Evaluation
  33. 33.A 35-year-old female with a history of anaphylaxis to peanuts is prescribed a new medication for her asthma. After the first dose, she develops generalized urticaria, angioedema, and wheezing. Her blood pressure is 80/40 mmHg. Which of the following is the most immediate and critical intervention?Evaluation
  34. 34.A 40-year-old male with new-onset seizure disorder is started on levetiracetam. He is concerned about potential side effects. The FNP should advise him to report which of the following symptoms immediately, as it may indicate a serious adverse reaction?Evaluation
  35. 35.A 40-year-old male presents with acute onset of excruciating pain and swelling in his left great toe. He denies trauma. On examination, the joint is red, hot, and exquisitely tender to touch. He reports a history of occasional similar episodes in the past, often after consuming alcohol or red meat. His serum uric acid level is 8.5 mg/dL (normal range 3.5-7.2 mg/dL). What is the most likely diagnosis?Diagnosis
  36. 36.A 7-year-old child presents with a 2-week history of worsening right hip pain, limping, and limited range of motion, particularly internal rotation and abduction. He denies recent trauma or fever. On examination, the child is afebrile, and his right leg appears slightly shorter than the left. Which of the following conditions should be prioritized in the differential diagnosis?Diagnosis
  37. 37.A 72-year-old female presents with a 2-month history of unilateral headache, jaw claudication, and scalp tenderness. She reports recent onset of blurred vision in her right eye. On examination, the right temporal artery is palpable, nodular, and tender with diminished pulsation. Her erythrocyte sedimentation rate (ESR) is 100 mm/hr (normal <20 mm/hr). What is the most critical immediate diagnosis to consider?Diagnosis
  38. 38.A 22-year-old female presents with a 3-week history of fatigue, generalized weakness, and a sore throat. On examination, she has bilateral posterior cervical lymphadenopathy, pharyngeal erythema with exudates, and mild splenomegaly. Rapid strep test is negative. Her CBC shows lymphocytosis with atypical lymphocytes. What is the most likely diagnosis?Diagnosis
  39. 39.A 62-year-old female presents with a 4-month history of progressive difficulty swallowing solids, initially, and now liquids. She reports regurgitation of undigested food and occasional nocturnal cough. She denies heartburn or significant weight loss. Barium swallow shows a 'bird's beak' appearance at the gastroesophageal junction. What is the most likely diagnosis?Diagnosis
  40. 40.A 24-year-old female presents with recurrent episodes of abdominal pain, bloating, and alternating constipation and diarrhea for the past 8 months. She reports that her symptoms are often worse after eating and improve after a bowel movement. She has undergone a colonoscopy, which was normal. Her blood tests (CBC, ESR, CRP, celiac serology) are all unremarkable. What is the most likely diagnosis?Diagnosis
  41. 41.A 48-year-old male presents with a 2-week history of nocturnal polyuria, polydipsia, and fatigue. He denies weight loss but reports increased appetite. On examination, his BMI is 32 kg/m², and blood pressure is 140/85 mmHg. Random plasma glucose is 280 mg/dL (15.5 mmol/L). Which of the following is the most appropriate initial diagnosis?Diagnosis
  42. 42.A 35-year-old female presents with a 3-month history of non-bloody diarrhea, abdominal pain, and unintentional weight loss of 10 pounds. She reports occasional oral aphthous ulcers and perianal skin tags. Her ESR and CRP are elevated, and a colonoscopy reveals patchy inflammation with skip lesions and cobblestoning in the terminal ileum and ascending colon. Which of the following is the most appropriate diagnosis?Diagnosis
  43. 43.A 55-year-old male presents with a 3-month history of progressive muscle weakness, particularly in his upper extremities, difficulty swallowing (dysphagia), and fasciculations observed on his tongue and shoulders. He denies sensory changes, pain, or bladder/bowel dysfunction. Neurological examination reveals diffuse muscle atrophy, hyperreflexia, and a positive Babinski sign. What is the most likely diagnosis?Diagnosis
  44. 44.A 45-year-old female presents with fatigue, constipation, cold intolerance, and weight gain despite no changes in diet. On examination, her skin is dry, and she has bradycardia. Her thyroid-stimulating hormone (TSH) level is 12.5 mIU/L (normal range 0.4-4.0 mIU/L), and free T4 is low. What is the most likely diagnosis?Diagnosis
  45. 45.A 68-year-old female presents with a 3-month history of progressive difficulty remembering recent events, frequently misplacing items, and occasionally getting lost in familiar surroundings. Her family reports she has become more withdrawn and struggles with complex tasks like managing finances. Neurological examination is unremarkable. Mini-Mental State Examination (MMSE) score is 20/30. What is the most likely diagnosis?Diagnosis
  46. 46.A 65-year-old male presents with sudden onset of unilateral facial drooping, slurred speech, and weakness in his right arm. He denies headache or dizziness. His blood pressure is 160/90 mmHg. He has a history of hypertension and hyperlipidemia. What is the most critical immediate diagnostic consideration?Diagnosis
  47. 47.A 5-year-old child is brought to the clinic by his mother due to a 3-day history of high fever (up to 104°F), irritability, and a confluent, blanching erythematous rash that started on his trunk and spread to his extremities. He also has bilateral non-exudative conjunctivitis, 'strawberry tongue,' and cervical lymphadenopathy. His hands and feet are swollen. Which of the following conditions is the most urgent diagnostic concern?Diagnosis
  48. 48.A 30-year-old female presents with recurrent episodes of sudden, intense anxiety, accompanied by palpitations, sweating, trembling, shortness of breath, and a fear of losing control or dying. These episodes peak within minutes and last for about 15-30 minutes. She has started avoiding crowded places and public transportation due to fear of having another attack. Her physical exam and lab work are normal. What is the most likely diagnosis?Diagnosis
  49. 49.A 32-year-old male presents with recurrent episodes of severe, unilateral, throbbing headache, associated with nausea, photophobia, and phonophobia. These episodes typically last for 4-72 hours and are preceded by visual aura (scintillating scotoma). He reports relief with sumatriptan. What is the most appropriate diagnosis?Diagnosis
  50. 50.A 55-year-old female presents with a 6-month history of widespread musculoskeletal pain, fatigue, and difficulty sleeping. She reports tenderness in multiple specific areas upon palpation, along with subjective memory problems and anxiety. Laboratory tests including CBC, ESR, CRP, and thyroid function are all within normal limits. Based on these findings, which of the following is the most likely diagnosis?Diagnosis