Step2Study

AANP Family Nurse Practitioner (FNP) Certification Exam practice questions

210 free questions with answers and explanations.

Practice test
  1. 101.A 45-year-old female presents with a 3-month history of fatigue, weight gain, cold intolerance, and constipation. Her TSH is 8.2 mIU/L (normal range 0.4-4.0 mIU/L) and free T4 is 0.7 ng/dL (normal range 0.8-1.8 ng/dL). What is the most likely diagnosis?Assessment
  2. 102.A 45-year-old male presents with a 3-month history of a persistent, productive cough with thick, purulent sputum, often worse in the mornings. He reports recurrent respiratory infections since childhood. Physical examination reveals crackles and wheezes, and clubbing of the digits. Which of the following diagnostic studies is most likely to confirm the suspected diagnosis?Assessment
  3. 103.A 32-year-old female presents with recurrent episodes of palpitations, sweating, tremors, and a feeling of impending doom over the past 3 months. These episodes are sudden, peak within 10 minutes, and resolve spontaneously. She reports avoiding situations where these attacks have occurred, such as crowded places and driving on highways. Physical exam and routine lab work (CBC, TSH, electrolytes) are unremarkable. What is the most likely diagnosis?Assessment
  4. 104.A 5-year-old male presents with a sudden onset of high fever (103°F), severe sore throat, difficulty swallowing, and drooling. His mother reports he has been refusing to eat or drink. On examination, the child appears anxious and is leaning forward in the 'tripod position.' The nurse practitioner notes stridor and muffled voice, but is unable to visualize the posterior pharynx due to poor cooperation. What is the most appropriate initial action?Assessment
  5. 105.A 5-year-old child is brought to the clinic with a 2-day history of sudden onset of high fever (103°F), difficulty swallowing, drooling, and muffled voice. The child is sitting in a 'tripod position' and appears anxious. The mother reports the child has not been immunized according to the recommended schedule. Which of the following actions should the FNP prioritize?Assessment
  6. 106.A 48-year-old male presents with a 2-week history of nocturnal polyuria (waking up multiple times to urinate), polydipsia (excessive thirst), and fatigue. He reports a 10-pound unintentional weight loss over the same period. His body mass index (BMI) is 32 kg/m². Random blood glucose is 280 mg/dL (normal < 200 mg/dL). What is the most likely diagnosis?Diagnosis
  7. 107.A 16-year-old female presents with a 2-day history of sudden onset of right-sided facial weakness. She reports difficulty closing her right eye, drooping of her right mouth, and impaired taste on the right anterior tongue. She denies any other neurological symptoms, fever, or rash. Physical examination confirms complete paralysis of the muscles of facial expression on the right side. Which of the following is the most likely diagnosis?Assessment
  8. 108.A 16-year-old female presents with a 2-day history of sudden onset of right-sided facial weakness. She reports difficulty closing her right eye, an inability to wrinkle her forehead on the right, and a drooping right corner of her mouth. She denies headache, fever, or trauma. On physical examination, the FNP notes complete paralysis of the muscles of facial expression on the right side. Which of the following is the most likely diagnosis?Assessment
  9. 109.A 45-year-old female presents with a 6-month history of diffuse, dull, aching pain in her muscles and joints, accompanied by profound fatigue, non-restorative sleep, and cognitive difficulties (''fibro fog''). She reports tenderness in multiple specific areas upon palpation. Laboratory tests, including CBC, thyroid function, and inflammatory markers (ESR, CRP), are all within normal limits. What is the most likely diagnosis?Diagnosis
  10. 110.A 3-year-old child presents with a 2-day history of high fever (up to 103°F/39.4°C), bilateral conjunctival injection without exudate, a diffuse erythematous rash on the trunk, and swollen, erythematous hands and feet. The mother also notes cracked lips and a 'strawberry tongue.' What is the most likely diagnosis?Diagnosis
  11. 111.A 35-year-old female presents with a 2-week history of a 'red, itchy rash' that started on her trunk and has spread to her extremities. She denies new medications, travel, or sick contacts. On examination, the nurse practitioner notes multiple oval-shaped, erythematous, slightly raised lesions with fine scaling, arranged in a 'Christmas tree' pattern on her back. A larger, solitary 'herald patch' is identified on her abdomen. What is the most likely diagnosis?Assessment
  12. 112.A 4-year-old child is brought to the clinic by their parent due to a 2-day history of fever, irritability, and refusal to eat or drink. On examination, the FNP notes vesicles and ulcers on the posterior pharynx, tonsils, and soft palate. There are no skin lesions. Which of the following is the most likely diagnosis?Assessment
  13. 113.A 22-year-old female presents with a 3-week history of profound fatigue, generalized weakness, sore throat, and low-grade fever. She reports recently attending several social gatherings. Physical examination reveals bilateral posterior cervical lymphadenopathy, tonsillar exudates, and mild hepatosplenomegaly. Rapid strep test is negative. What is the most likely diagnosis?Diagnosis
  14. 114.A 55-year-old male presents with sudden onset of excruciating, unilateral retro-orbital pain, accompanied by ipsilateral lacrimation, conjunctival injection, nasal congestion, and ptosis. The attacks occur several times a day in clusters and last about 45 minutes. He denies aura or visual changes. Which of the following is the most likely diagnosis?Assessment
  15. 115.A 15-year-old male presents for a sports physical. He denies any medical problems or symptoms. His maternal uncle died suddenly at age 30 due to a cardiac event. On physical examination, a harsh systolic murmur is heard best at the left sternal border and increases with a Valsalva maneuver. Which of the following diagnostic tests should be ordered first?Assessment
  16. 116.A 45-year-old female presents with a 6-month history of progressive fatigue, generalized weakness, and occasional double vision, especially at the end of the day. She also reports difficulty chewing and swallowing after prolonged meals. On physical examination, ptosis is noted, which worsens with sustained upward gaze. Which diagnostic test is most appropriate for initial evaluation?Assessment
  17. 117.A 72-year-old female presents with a 6-month history of progressive memory loss, difficulty with daily tasks, and mood changes. Her family reports she often gets lost on familiar routes and has trouble managing her finances. On mental status examination, she scores 18/30 on the Mini-Mental State Examination (MMSE). All routine blood work (CBC, CMP, TSH, B12) is within normal limits. What is the most appropriate next step in her diagnostic workup?Assessment
  18. 118.A 45-year-old male presents with a 3-month history of a persistent, productive cough with thick, purulent sputum, recurrent respiratory infections, and occasional hemoptysis. He has a history of childhood recurrent pneumonia. On examination, he has crackles and rhonchi bilaterally. A high-resolution computed tomography (HRCT) scan of the chest is ordered. Which of the following findings on HRCT would be most characteristic of bronchiectasis?Assessment
  19. 119.A 15-year-old male presents for a sports physical. He reports no current symptoms but his maternal uncle died suddenly at age 30 during exercise. On cardiac auscultation, a harsh systolic murmur is heard best at the left sternal border, which increases in intensity with standing and decreases with squatting. What is the most appropriate initial diagnostic test to evaluate this finding?Assessment
  20. 120.A 48-year-old male presents with acute onset of severe pain, swelling, and redness in his right great toe. He denies any trauma. He reports a history of occasional alcohol consumption and recently started a new medication for hypertension. On physical examination, the right great toe is exquisitely tender, warm, and erythematous. Which of the following diagnostic tests is most definitive for confirming the suspected diagnosis?Assessment
  21. 121.A 35-year-old female presents with a 3-month history of non-bloody diarrhea, crampy abdominal pain, and unintentional weight loss of 8 pounds. She also reports occasional oral aphthous ulcers and perianal skin tags. Endoscopy reveals patchy inflammation with skip lesions and deep ulcerations in the terminal ileum. What is the most likely diagnosis?Diagnosis
  22. 122.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 7 weeks ago. She reports a positive home pregnancy test. On examination, she has mild suprapubic tenderness and a closed cervical os. What is the most crucial diagnostic test to perform next?Assessment
  23. 123.A 55-year-old male presents with a 3-month history of progressive muscle weakness, particularly in his hands and feet, accompanied by fasciculations. He reports difficulty with fine motor tasks and occasional muscle cramps. His neurological examination reveals atrophy and hyperreflexia in the affected limbs, with no sensory deficits. What is the most likely diagnosis?Diagnosis
  24. 124.A 68-year-old male presents for a routine physical examination. He denies any current symptoms. His past medical history includes hypertension and hyperlipidemia, both well-controlled with medication. He has a 40-pack-year smoking history but quit 5 years ago. On abdominal palpation, the FNP notes a pulsatile mass superior to the umbilicus. Which of the following diagnostic tests is most appropriate for initial evaluation?Assessment
  25. 125.A 52-year-old female presents with a 3-month history of progressive fatigue, generalized weakness, and muscle cramps. She also reports constipation and occasional heart palpitations. On physical examination, her deep tendon reflexes are diminished, and she has periorbital edema. Her current medications include a multivitamin and omeprazole for GERD. Which of the following diagnostic tests is most appropriate to order initially?Assessment
  26. 126.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 new medications. On physical examination, she has scleral icterus and excoriations on her skin. Liver function tests show elevated alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT), with mildly elevated bilirubin. Which of the following is the most likely diagnosis?Assessment
  27. 127.A 15-year-old male presents for a sports physical. He is asymptomatic, denies any medical problems, and takes no medications. His family history is notable for his paternal uncle who died suddenly at age 30 due to a 'heart problem.' On physical examination, the nurse practitioner notes a loud S4 gallop and a harsh, crescendo-decrescendo systolic murmur heard best at the left sternal border, which increases with standing. What is the most important diagnostic test to order?Assessment
  28. 128.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 daily tasks, and occasional disorientation over the past year. The daughter reports no sudden onset of symptoms or focal neurological deficits. Which of the following is the most appropriate initial diagnostic workup for this patient?Assessment
  29. 129.A 4-year-old child presents with a 2-day history of fever, poor oral intake, and multiple painful vesicles and ulcers on the posterior pharynx, tonsillar pillars, and uvula. The child denies skin rash or lesions on hands and feet. Which of the following is the most likely diagnosis?Assessment
  30. 130.A 6-year-old child presents with a 2-week history of worsening right hip pain, especially with activity, and a noticeable limp. The pain sometimes radiates to the knee. On examination, there is decreased range of motion, particularly internal rotation and abduction of the right hip. There is no history of trauma or fever. What is the most appropriate initial diagnostic study?Diagnosis
  31. 131.A 5-year-old child is brought to the clinic with a 2-day history of sudden onset of high fever (103°F), severe sore throat, dysphagia, and drooling. The child appears anxious and is sitting in a 'tripod' position. What is the immediate priority for the Family Nurse Practitioner?Assessment
  32. 132.A 6-year-old child presents after a fall from a bicycle, complaining of right ankle pain and inability to bear weight. On examination, there is tenderness over the posterior edge of the lateral malleolus and the base of the fifth metatarsal. According to the Ottawa Ankle Rules, which of the following is the most appropriate next step?Assessment
  33. 133.A 32-year-old female presents with a 2-day history of unilateral lower abdominal pain, vaginal spotting, and a positive home pregnancy test. Her last menstrual period was 7 weeks ago. On physical examination, she has mild tenderness in the right adnexa. Which of the following diagnostic tests is most crucial for immediate evaluation?Assessment
  34. 134.A 72-year-old female presents with a 2-month history of a new-onset, unilateral headache, primarily in the temporal region, accompanied by jaw claudication when chewing. She also reports scalp tenderness and malaise. Her erythrocyte sedimentation rate (ESR) is significantly elevated at 85 mm/hr (normal < 20 mm/hr). What is the most appropriate initial diagnosis to consider and manage urgently?Diagnosis
  35. 135.A 6-year-old child presents after a fall from a bicycle, complaining of right ankle pain and inability to bear weight. On examination, there is swelling and tenderness over the distal fibula. The FNP performs the Ottawa ankle rules to determine the need for radiography. Which of the following findings would necessitate an ankle X-ray?Assessment
  36. 136.A 6-year-old child presents with a 2-week history of worsening right hip pain, especially after activity, and an antalgic gait. Physical examination reveals limited internal rotation and abduction of the right hip, with some muscle atrophy in the right thigh. X-rays show flattening and fragmentation of the right femoral head. What is the most likely diagnosis?Diagnosis
  37. 137.A 16-year-old female presents with a 2-day history of sudden onset of right-sided facial weakness, making it difficult to close her eye, smile, or wrinkle her forehead. She denies headache, fever, or trauma. She reports a recent viral illness. On examination, the FNP notes complete paralysis of the right side of her face, including the forehead. All other neurological findings are normal. What is the most likely diagnosis?Assessment
  38. 138.A 24-year-old male presents with a 3-day history of low-grade fever, malaise, and a widespread, non-pruritic maculopapular rash involving his palms and soles. He also reports generalized lymphadenopathy. What is the most likely diagnosis?Assessment
  39. 139.A 68-year-old male presents to the clinic with a chief complaint of a new onset, painless, swollen testicle. On physical examination, the nurse practitioner notes a firm, non-transilluminating mass that is irreducible. The patient denies any trauma or fever. What is the most appropriate initial diagnostic test?Assessment
  40. 140.A 6-month-old infant is brought to the clinic by their parents due to a 2-day history of fussiness, poor feeding, and a temperature of 101.5°F (38.6°C). On examination, the infant appears irritable, and the anterior fontanelle is bulging. Which of the following diagnostic tests is most immediately indicated?Assessment
  41. 141.A 58-year-old male presents to the emergency department with sudden onset of severe, tearing chest pain radiating to his back. He reports the pain started abruptly and is the worst pain he has ever experienced. His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. Peripheral pulses are diminished in the left arm. Electrocardiogram shows no ischemic changes. What is the most critical diagnosis to consider?Diagnosis
  42. 142.A 68-year-old male presents for a routine physical examination. He has a history of hypertension and hyperlipidemia. He is a former smoker with a 30-pack-year history, quit 10 years ago. He reports no current symptoms. According to current guidelines, which of the following screening tests is most appropriate for this patient?Assessment
  43. 143.A 42-year-old female presents with a 6-month history of fatigue, generalized muscle weakness, and difficulty climbing stairs. She also reports intermittent double vision and drooping eyelids, which worsen with activity and improve with rest. Physical examination reveals bilateral ptosis and mild proximal muscle weakness. Which of the following diagnostic tests is most likely to confirm the suspected diagnosis?Assessment
  44. 144.A 70-year-old female with a history of atrial fibrillation on warfarin presents for her annual flu shot. She expresses concern about bleeding risk with the injection due to her anticoagulant therapy. Which of the following is the most appropriate action by the FNP?Plan
  45. 145.A 28-year-old female presents for a pre-conception counseling visit. She has a history of well-controlled generalized anxiety disorder (GAD) and is currently taking paroxetine 20 mg daily. She plans to conceive within the next 3-6 months. What is the most appropriate recommendation regarding her medication?Plan
  46. 146.A 62-year-old male with newly diagnosed localized prostate cancer is discussing treatment options with his FNP. He is concerned about the potential impact of treatment on his quality of life, including sexual function and urinary control. He expresses a desire for a less aggressive approach if possible. Which of the following concepts is most crucial for the FNP to discuss with the patient at this stage?Plan
  47. 147.A 35-year-old female presents for a follow-up after being diagnosed with newly onset type 2 diabetes. She has a BMI of 32 kg/m², and her A1C is 7.5%. She is initiated on metformin. She asks about other ways to manage her condition. Which of the following referrals is most appropriate to optimize her long-term diabetes management?Plan
  48. 148.A 28-year-old female presents with persistent, severe lower back pain radiating down her left leg, consistent with sciatica. She has tried NSAIDs and physical therapy without significant relief. A recent MRI shows a herniated disc at L5-S1. She is concerned about long-term opioid use and asks about other options. Which of the following non-pharmacological interventions would be most appropriate to discuss as a next step?Plan
  49. 149.A 45-year-old female presents with a 3-month history of generalized anxiety disorder. She reports difficulty sleeping, restlessness, and persistent worry. She has tried relaxation techniques and exercise with minimal improvement. She has no significant medical history or contraindications. Which of the following pharmacological agents is the most appropriate initial treatment?Plan
  50. 150.A 72-year-old male with a history of hypertension, hyperlipidemia, and stable angina presents for routine follow-up. He reports occasional mild chest pain with exertion, relieved by rest. He is currently on aspirin, atorvastatin, and metoprolol. His blood pressure is 130/80 mmHg, and heart rate is 62 bpm. Which of the following is the most appropriate pharmacological management adjustment to optimize his angina control?Plan