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AANP Family Nurse Practitioner (FNP) Certification Exam practice questions

210 free questions with answers and explanations.

Practice test
  1. 51.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
  2. 52.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
  3. 53.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
  4. 54.A 52-year-old male presents to the clinic with a chief complaint of sudden onset of severe, crushing chest pain radiating to his left arm and jaw. He reports associated diaphoresis, shortness of breath, and nausea. His past medical history includes hypertension and hyperlipidemia. On examination, his blood pressure is 150/90 mmHg, heart rate 105 bpm, and respiratory rate 22 bpm. ECG shows ST-segment elevations in leads II, III, and aVF. Which of the following is the most appropriate initial diagnosis?Diagnosis
  5. 55.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
  6. 56.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
  7. 57.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
  8. 58.A 3-year-old child presents with a 2-day history of high fever (up to 103°F/39.4°C), bilateral non-purulent conjunctivitis, polymorphic rash on the trunk, and cervical lymphadenopathy. The child's lips are red and cracked, and the tongue has a 'strawberry' appearance. The mother denies any recent illnesses in other family members. What is the most likely diagnosis?Diagnosis
  9. 59.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
  10. 60.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
  11. 61.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
  12. 62.A 45-year-old female presents with a 6-month history of progressive fatigue, generalized weakness, and ptosis that worsens throughout the day and improves with rest. She also reports occasional difficulty swallowing and chewing. Neurological examination reveals fluctuating muscle weakness. Which of the following diagnostic tests should the FNP order first to confirm the suspected diagnosis?Assessment
  13. 63.A 55-year-old male presents with a 2-month history of progressive difficulty swallowing solids, which has now progressed to liquids. He also reports unintentional weight loss of 15 lbs, occasional regurgitation of undigested food, and a persistent sensation of food sticking in his throat. He has a history of gastroesophageal reflux disease (GERD). Which of the following diagnostic tests should the FNP prioritize?Assessment
  14. 64.A 60-year-old male presents with a 6-month history of progressive difficulty swallowing solids and liquids. He reports frequent regurgitation of undigested food, occasional nocturnal cough, and significant weight loss. He denies heartburn or abdominal pain. Barium swallow shows a 'bird's beak' appearance of the distal esophagus, and manometry reveals aperistalsis of the esophageal body and incomplete relaxation of the lower esophageal sphincter (LES). What is the most likely diagnosis?Diagnosis
  15. 65.A 4-year-old child is brought to the clinic by her mother, who reports a 3-day history of fever (up to 102°F), poor appetite, and irritability. On examination, the nurse practitioner observes multiple small, painful vesicles and ulcers on the buccal mucosa and tongue, along with a maculopapular rash on the palms and soles. The child's immunizations are up-to-date. What is the most appropriate management plan?Assessment
  16. 66.A 68-year-old male with a history of hypertension and smoking presents for a routine physical examination. He denies any current symptoms. As part of his health promotion and risk assessment, the FNP considers screening for an abdominal aortic aneurysm (AAA). According to current guidelines, which of the following is the most appropriate screening recommendation for this patient?Assessment
  17. 67.A 68-year-old male presents with a gradual onset of difficulty hearing in both ears over the past several years. He reports particular trouble understanding conversations in noisy environments and often asks people to repeat themselves. Otoscopic examination reveals clear ear canals and tympanic membranes. Weber test lateralizes to the better-hearing ear, and Rinne test shows air conduction greater than bone conduction bilaterally. What is the most likely diagnosis?Diagnosis
  18. 68.A 38-year-old female presents to the clinic with a 3-month history of intermittent abdominal pain, bloating, and alternating constipation and diarrhea. She denies fever, weight loss, or nocturnal symptoms. A physical examination is unremarkable. Which of the following diagnostic criteria is most consistent with Irritable Bowel Syndrome (IBS)?Assessment
  19. 69.A 48-year-old male presents with acute onset of severe pain, swelling, and redness in his right great toe, which started overnight. He denies any recent trauma. He has a history of hypertension and occasionally drinks alcohol. On examination, the affected joint is exquisitely tender to touch, warm, and erythematous. What is the most appropriate initial diagnostic test?Assessment
  20. 70.A 5-year-old child presents with a 3-day history of fever, malaise, and a 'slapped-cheek' rash on the face, followed by a lacy, reticular rash on the trunk and extremities. The child is otherwise active and well-appearing. Which of the following is the most likely causative agent?Assessment
  21. 71.A 38-year-old female presents with a 3-month history of intermittent abdominal pain, bloating, and alternating constipation and diarrhea. The pain is often relieved by defecation. She denies weight loss, fever, or nocturnal symptoms. Physical examination is unremarkable. Which of the following diagnostic criteria is most appropriate to confirm the diagnosis?Assessment
  22. 72.A 38-year-old female presents to the clinic with a 3-month history of intermittent abdominal pain, bloating, and alternating constipation and diarrhea. The pain is often relieved by defecation. She denies fever, weight loss, or blood in her stool. Physical examination is normal. Based on the Rome IV criteria, which of the following is essential for the diagnosis of Irritable Bowel Syndrome (IBS)?Assessment
  23. 73.A 72-year-old female presents with a 2-month history of a new-onset, unilateral headache localized to her right temple, accompanied by jaw claudication, scalp tenderness, and visual disturbances. Her erythrocyte sedimentation rate (ESR) is significantly elevated at 90 mm/hr. What is the most critical immediate diagnostic step?Diagnosis
  24. 74.A 48-year-old male presents with acute onset of right great toe pain, swelling, and redness. He reports the pain is excruciating and started suddenly last night. He denies trauma. His medical history includes hypertension, for which he takes hydrochlorothiazide. On examination, the right great toe is exquisitely tender, warm, and erythematous with overlying shiny skin. What is the most appropriate initial diagnostic test?Assessment
  25. 75.A 62-year-old male with a history of hypertension and hyperlipidemia presents with sudden onset of severe, tearing chest pain radiating to his back. He reports associated shortness of breath and diaphoresis. On examination, his blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. A faint diastolic murmur is appreciated. What is the most critical diagnostic test to perform immediately?Assessment
  26. 76.A 32-year-old female presents with a 4-week history of worsening fatigue, generalized itching, dark urine, and pale stools. She denies alcohol use or recent travel. On examination, she has scleral icterus and mild right upper quadrant tenderness. Laboratory tests reveal elevated bilirubin (predominantly direct), elevated alkaline phosphatase, and mildly elevated AST/ALT. Which of the following is the most likely cause of her symptoms?Assessment
  27. 77.A 32-year-old female presents with a 2-month history of intermittent, severe, unilateral, throbbing headaches that last 4-72 hours. She reports nausea, photophobia, and phonophobia during these episodes. Before some headaches, she experiences visual disturbances, including shimmering lights and zigzag lines, lasting about 20-30 minutes. What is the most likely diagnosis?Diagnosis
  28. 78.A 45-year-old male presents with a 2-month history of intermittent abdominal pain, bloating, and alternating episodes of diarrhea and constipation. He reports that the pain is often relieved by defecation. He denies any weight loss, nocturnal symptoms, or blood in his stool. His physical exam is unremarkable. Based on the Rome IV criteria, which of the following is most consistent with Irritable Bowel Syndrome (IBS)?Assessment
  29. 79.A 48-year-old male presents with a 2-week history of nocturnal polyuria (waking up multiple times to urinate), polydipsia, and fatigue. He also reports recent unintentional weight loss despite increased appetite. His past medical history is unremarkable. A random plasma glucose is 280 mg/dL. Which additional diagnostic test is most essential to confirm the diagnosis and guide initial management?Diagnosis
  30. 80.A 58-year-old male presents with sudden onset of excruciating, tearing chest pain radiating to his back. He reports a history of uncontrolled hypertension. On examination, his blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. His pulses are palpable but diminished in the left arm compared to the right. Which of the following diagnostic tests is the most appropriate initial imaging study?Assessment
  31. 81.A 55-year-old male presents with a 2-month history of progressive difficulty swallowing, initially with solids and now also with liquids. He reports associated unintentional weight loss of 10 pounds and occasional regurgitation of undigested food. He has a history of gastroesophageal reflux disease (GERD) for many years. Which of the following is the most appropriate initial diagnostic study?Assessment
  32. 82.A 58-year-old male with a history of hypertension and hyperlipidemia presents with sudden onset of excruciating, tearing chest pain radiating to his back. He appears pale and diaphoretic. His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. Which of the following is the most concerning finding on physical examination?Assessment
  33. 83.A 28-year-old female presents for a well-woman exam. She reports no significant medical history, takes no medications, and has no allergies. Her last menstrual period was 3 weeks ago. She is sexually active with one male partner and uses condoms inconsistently. Her mother had breast cancer at age 55. Which of the following is the most important health promotion recommendation for this patient at this visit?Assessment
  34. 84.A 72-year-old female is brought to the clinic by her daughter due to concerns about her mother's memory. The daughter reports a 9-month history of increasing forgetfulness, difficulty managing finances, getting lost in familiar places, and occasional personality changes. The patient is able to perform basic activities of daily living (ADLs) but struggles with instrumental ADLs (IADLs). Her neurological exam is unremarkable. Which of the following is the most appropriate initial diagnostic approach?Assessment
  35. 85.A 32-year-old female presents with a 2-day history of unilateral lower abdominal pain, vaginal spotting, and mild dizziness. Her last menstrual period was 6 weeks ago. A urine pregnancy test is positive. On examination, she has mild right adnexal tenderness. What is the most critical initial diagnostic step?Assessment
  36. 86.A 22-year-old female presents with a 3-week history of worsening productive cough with thick, purulent sputum, occasional hemoptysis, and recurrent fevers. She reports a history of recurrent respiratory infections since childhood. On examination, crackles and rhonchi are heard bilaterally. Clubbing of the digits is noted. Her chest X-ray shows dilated and thickened bronchi with 'tram track' opacities. What is the most appropriate next diagnostic step?Assessment
  37. 87.A 55-year-old male presents with a 2-month history of progressive difficulty swallowing, initially for solids and now for liquids. He reports unintentional weight loss of 10 lbs and occasional regurgitation of undigested food. He has a history of gastroesophageal reflux disease (GERD) for 15 years, poorly controlled. On physical examination, he appears cachectic. Which diagnostic test should the FNP prioritize to evaluate this patient's symptoms?Assessment
  38. 88.A 28-year-old female presents with a 2-day history of unilateral lower abdominal pain, vaginal spotting, and mild nausea. Her last menstrual period was 6 weeks ago. She reports a history of pelvic inflammatory disease (PID) 2 years prior. On examination, she has mild guarding and tenderness in the right lower quadrant, and cervical motion tenderness. A urine pregnancy test is positive. What is the most critical immediate diagnostic step for this patient?Assessment
  39. 89.A 28-year-old female presents with a 2-day history of unilateral lower abdominal pain, vaginal spotting, and mild dizziness. Her last menstrual period was 7 weeks ago. She reports a history of pelvic inflammatory disease (PID). On physical exam, she has mild tenderness in the right adnexa. Which of the following diagnostic tests is most crucial to perform immediately?Assessment
  40. 90.A 35-year-old female presents with a 3-month history of non-bloody diarrhea, crampy abdominal pain, and significant weight loss. She also reports intermittent fever and joint pain. Physical examination reveals diffuse abdominal tenderness and perianal skin tags. Which diagnostic finding would most strongly support a diagnosis of Crohn's Disease?Diagnosis
  41. 91.A 22-year-old female presents with a 3-month history of a persistent, productive cough with thick, purulent sputum, recurrent respiratory infections, and occasional hemoptysis. She reports a history of frequent childhood pneumonias. On physical examination, crackles and wheezes are heard in the lower lung fields. Which of the following is the most appropriate diagnostic test to confirm the suspected diagnosis?Assessment
  42. 92.A 3-year-old child presents with a sudden onset of high fever (103.5°F), sore throat, dysphagia, and inspiratory stridor. The child is drooling, appears anxious, and is sitting in a 'tripod' position. The parents report the child's immunizations are not up to date. Which of the following actions should the FNP prioritize?Assessment
  43. 93.A 72-year-old female is brought to the clinic by her daughter due to concerns about her mother's progressive memory loss, difficulty with executive functions (e.g., managing finances), and occasional disorientation over the past year. The patient has a history of hypertension and well-controlled type 2 diabetes. She denies depression or recent head trauma. Which of the following is the most appropriate initial diagnostic step in her workup for dementia?Assessment
  44. 94.A 24-year-old male presents to the clinic with a 3-day history of low-grade fever, malaise, and a 'maculopapular rash' that started on his trunk and spread to his extremities, including his palms and soles. He denies any recent travel but reports unprotected sexual contact with a new partner 2 months ago. On physical examination, diffuse lymphadenopathy is noted. Which of the following diagnostic tests is most appropriate at this time?Assessment
  45. 95.A 4-year-old child presents with a 2-day history of fever (101°F), poor oral intake, and multiple small, painful vesicles and ulcers on the posterior oropharynx (tonsillar pillars, soft palate, uvula). The child does not have a rash on the hands or feet. What is the most likely diagnosis?Assessment
  46. 96.A 4-year-old child presents with a 2-day history of fever (101°F), poor oral intake, and multiple small, painful vesicles on the posterior oropharynx, tonsillar pillars, and soft palate. The child's hands and feet are clear. The mother reports no other family members are ill. Which of the following is the most likely diagnosis?Assessment
  47. 97.A 5-year-old child presents with a 3-day history of fever, malaise, and a 'slapped-cheek' rash on her face. The rash then spread to her trunk and extremities, appearing as a lacy, reticulated (net-like) pattern. She has no other significant symptoms. Her immunizations are up to date. Which of the following is the most likely diagnosis?Assessment
  48. 98.A 42-year-old female presents with a 6-month history of fatigue, generalized muscle weakness that worsens with activity and improves with rest, and fluctuating ptosis and diplopia, particularly in the evenings. On examination, she has symmetric proximal muscle weakness. Which of the following is the most appropriate initial diagnostic test?Assessment
  49. 99.A 24-year-old female presents with recurrent episodes of abdominal pain, bloating, and alternating constipation and diarrhea for the past 8 months. The pain is often relieved by defecation. She denies weight loss, fever, or blood in her stool. Her physical exam is unremarkable, and recent stool studies, CBC, and thyroid panel are all normal. What is the most likely diagnosis?Diagnosis
  50. 100.A 40-year-old male presents with acute onset of excruciating pain, swelling, redness, and tenderness in his left great toe. He denies any recent trauma. He reports consuming a large amount of seafood and alcohol at a party the previous night. Physical examination reveals an exquisitely tender, warm, and erythematous metatarsophalangeal joint of the left great toe. What is the most likely diagnosis?Diagnosis