Skip to main content
Sign inStart free
Start free

Free AANP Practice Exam: 16 Sourced FNP Study Questions and How the Real Exam Works

By , MD, FRCPC · Published · 17 min read

How we write and check articles: Editorial Policy.

A single stylised nurse practitioner student seen from behind at a desk, working through a stack of printed question sheets

Disclosure: Alma publishes this article and makes one of the study tools it discusses.

Looking for a free AANP practice exam? Below are 16 original, single-best-answer questions written for family nurse practitioner (FNP) candidates. Every question is keyed to a guideline page that was opened for this article, and every answer names its source so you can check it yourself. This is a short set, not a full mock: the real AANPCB exam has 150 questions[1], and no free set of 16 questions can tell you whether you will pass.

Exam study material, not clinical guidance. These questions test whether you know what a named guideline says. Guidelines change and patients differ, so check the current version before you apply anything to a real patient. The questions are original; they are not AANPCB exam content, and AANPCB's handbook forbids sharing real exam content[1].

How the real AANPCB FNP exam is built

Facts from the FNP Candidate Handbook updated 06/2026[1]:

Item What the handbook says
Format Computer-based, 150 multiple-choice questions
Scored vs pretest 135 scored, 15 unscored pretest questions
Time 3 hours
Scoring A passing score set by a standard-setting method; scores are not reported as a percent of questions correct
Domains (scored items) Assess 43 (32%), Diagnose 36 (27%), Plan 36 (27%), Evaluate 20 (15%)
Patient age (scored items) Newborn 2%, infant 3%, toddler 4%, child 4%, adolescent 9%, young adult 22%, middle adult 26%, older adult 30%

AANPCB's FNP exam page prints the Diagnose and Plan weights as 26.5% each[20]; 36 of 135 items is 26.7%, so the handbook rounds that to 27%. At the exam's average pace (3 hours for 150 questions, 1.2 minutes each), 16 questions take about 19 minutes. That is a pacing guide, not a rule.

Take the 16-question set

  • Single best answer, four options. (AANPCB's pages say "multiple choice"; they do not state the number of options, so this format is ours.)
  • Set a timer for 19 minutes if you want exam pace, or take it untimed to study.
  • Do not look at the answers until you finish. Write down your choice and how sure you were (guess, unsure, sure).

Questions

1. A healthy, asymptomatic 46-year-old man at average risk has never been screened for colorectal cancer. Which statement is consistent with the USPSTF recommendation?

A. Defer screening until age 50, because screening is not recommended earlier. B. Screen only if a first-degree relative has had colorectal cancer. C. Recommend screening now; annual FIT and colonoscopy every 10 years are among the listed strategies. D. Offer screening selectively, because the evidence is graded C at his age.

2. A 62-year-old woman who currently smokes has a 25 pack-year history and no symptoms. Which screening plan matches the USPSTF recommendation?

A. Annual chest radiograph. B. Annual low-dose CT of the chest. C. A single low-dose CT, repeated only if a nodule is found. D. No screening until age 65.

3. A 41-year-old woman at average risk asks when to begin mammography. According to the USPSTF recommendation, what is the best answer?

A. Begin at age 50. B. Begin annual mammography now and continue yearly. C. Begin only if she has a first-degree relative with breast cancer. D. Begin biennial screening now (every two years).

4. A 58-year-old man with hypertension and an LDL cholesterol of 130 mg/dL has no history of cardiovascular disease and takes no statin. His estimated 10-year cardiovascular risk is 12%. Which USPSTF recommendation applies?

A. Prescribe a statin (grade B). B. Selectively offer a statin because the benefit is small (grade C). C. The evidence is insufficient to recommend for or against a statin. D. Recommend lifestyle change only; a statin is not recommended below 20% risk.

5. A 28-year-old woman with chronic hypertension is 14 weeks pregnant. She has had no problems with aspirin in the past. Which action matches the USPSTF recommendation on preeclampsia prevention?

A. Start aspirin 325 mg daily at 36 weeks. B. Start aspirin 81 mg daily only if she has had preeclampsia before. C. Start aspirin 81 mg daily now, because she is after 12 weeks of gestation and at high risk. D. Do not give aspirin in pregnancy.

6. A 52-year-old woman has an average office blood pressure of 152/96 mm Hg confirmed over repeated visits. She has no other conditions and takes no medication. Which initial approach matches the 2025 AHA/ACC high blood pressure guideline?

A. Lifestyle changes alone for six months before any medication. B. Medications from two different first-line classes, ideally in a single-pill combination. C. A single first-line agent, adding a second only after three months. D. A beta-blocker plus an alpha-blocker.

7. A 64-year-old man with type 2 diabetes has heart failure with reduced ejection fraction. His A1C is 6.9% on metformin. What do the 2026 ADA Standards of Care recommend adding?

A. A sulfonylurea, to lower A1C further. B. Basal insulin. C. Nothing, because his A1C is at goal. D. An SGLT2 inhibitor, irrespective of A1C.

8. Which drug class do the 2026 ADA Standards of Care name as preferred for glycemic management in adults with type 2 diabetes and advanced CKD (eGFR below 30 mL/min/1.73 m²), because of a lower risk of hypoglycemia?

A. GLP-1 receptor agonist. B. Sulfonylurea. C. NPH insulin. D. Meglitinide.

9. A 26-year-old woman has mild asthma, uses albuterol alone, and has been using it twice a week. According to the 2026 GINA report, which is the preferred approach for adults and adolescents?

A. Albuterol alone as needed. B. Daily montelukast. C. As-needed low-dose ICS-formoterol (GINA Track 1). D. Daily low-dose ICS plus as-needed albuterol (Track 2) as the first choice.

10. A 68-year-old man with COPD has had one moderate exacerbation in the past year and is on no maintenance inhaler. His blood eosinophil count is 150 cells/µL. Under the 2026 GOLD report (group E), which initial pharmacologic treatment is preferred?

A. LABA plus ICS. B. LABA plus LAMA. C. LABA plus LAMA plus ICS. D. A short-acting bronchodilator alone.

11. A healthy 30-year-old with no comorbidities, no recent antibiotics and no risk factors for resistant organisms has community-acquired pneumonia and is well enough for outpatient care. According to the 2019 ATS/IDSA guideline, which is a recommended empiric option?

A. Azithromycin alone, in an area where more than 25% of pneumococci are macrolide-resistant. B. Amoxicillin-clavulanate plus doxycycline. C. Ceftriaxone intramuscularly for 7 days. D. Amoxicillin 1 g three times daily.

12. A 24-year-old woman at 26 weeks of pregnancy has a positive chlamydia NAAT. According to the CDC 2021 STI guidelines, which regimen is recommended?

A. Azithromycin 1 g orally, single dose. B. Doxycycline 100 mg orally twice daily for 7 days. C. Ceftriaxone 500 mg intramuscularly, single dose. D. No treatment until delivery; retest then.

13. A man who weighs 160 kg has uncomplicated urethral gonorrhea, and chlamydial infection has not been excluded. According to the CDC 2021 STI guidelines, which treatment is recommended?

A. Ceftriaxone 500 mg intramuscularly alone. B. Ceftriaxone 1 g intramuscularly alone. C. Ceftriaxone 1 g intramuscularly plus doxycycline 100 mg orally twice daily for 7 days. D. Ceftriaxone 500 mg intramuscularly plus azithromycin 1 g orally.

14. A 3-year-old who weighs 15 kg has acute otitis media. The clinician decides to treat with an antibiotic. The child has no penicillin allergy, no purulent conjunctivitis and has not had amoxicillin in the past 30 days. Using the top of the AAP-recommended high-dose range, which prescription is correct?

A. Amoxicillin 300 mg twice daily. B. Amoxicillin 675 mg twice daily. C. Amoxicillin 450 mg twice daily. D. Amoxicillin 1,350 mg twice daily.

15. A 78-year-old woman with allergic rhinitis and a past episode of delirium asks about an over-the-counter nighttime allergy product. Which ingredient does the 2023 AGS Beers Criteria list as one to avoid in older adults?

A. Loratadine. B. Intranasal saline. C. Intranasal fluticasone. D. Diphenhydramine.

16. A 67-year-old postmenopausal woman has never had a fracture and has no known osteoporosis. Which statement matches the USPSTF recommendation?

A. Screen for osteoporosis, because she is a woman aged 65 or older. B. Wait until age 70 to screen. C. Screen only after a first fragility fracture. D. Screening is not recommended without a family history.

Answers

Answers and rationales. Each names the source (numbers match the Sources list). Check your score after you read why you missed an item, not before.

  1. C. The USPSTF recommends screening ages 45 to 49 (grade B) and 50 to 75 (grade A). The listed strategies for average-risk adults include annual high-sensitivity gFOBT or FIT and colonoscopy every 10 years. Option D describes ages 76 to 85, the grade C group[3].
  2. B. Annual low-dose CT is recommended for adults 50 to 80 with a 20 pack-year history who currently smoke or quit within the past 15 years (grade B)[4].
  3. D. The USPSTF recommends biennial screening mammography for women 40 to 74 (grade B, April 2024). Other organizations make different recommendations; this item asks only about the USPSTF[5].
  4. A. For adults 40 to 75 with at least one risk factor (dyslipidemia, diabetes, hypertension or smoking) and a 10-year risk of 10% or more, the USPSTF recommends prescribing a statin (grade B). Selective offering (grade C) is for 7.5% to under 10%[6].
  5. C. The USPSTF recommends 81 mg daily after 12 weeks of gestation for people at high risk. Chronic hypertension is on its list of high-risk factors, as is prior preeclampsia, so option B is too narrow[7].
  6. B. The guideline defines stage 2 as 140/90 mm Hg or higher and recommends starting medications from two different classes, ideally in a single pill (class of recommendation 1). First-line classes it lists are thiazide-type diuretics, long-acting dihydropyridine calcium channel blockers, ACE inhibitors and ARBs[8]. (Source note: the recommendation wording was checked in the case-based companion article to the guideline, published in Hypertension; see Sources.)
  7. D. Recommendation 9.8: in adults with type 2 diabetes and heart failure (reduced or preserved ejection fraction), an SGLT2 inhibitor is recommended for glycemic management and to prevent HF hospitalizations, irrespective of A1C[9].
  8. A. Recommendation 9.11: in type 2 diabetes with advanced CKD (eGFR below 30), a GLP-1 RA is preferred for glycemic management because of lower hypoglycemia risk and for cardiovascular event reduction[9].
  9. C. GINA calls Track 1, where the reliever is low-dose ICS-formoterol, its preferred approach, because it reduces severe exacerbation risk compared with a SABA reliever. Track 2 is an alternative if Track 1 is not possible[10].
  10. B. The 2026 GOLD report modified group E to include people with one moderate exacerbation in the previous year, and calls LABA plus LAMA the preferred initial therapy for group E. It suggests considering LABA plus LAMA plus ICS if eosinophils are 300 cells/µL or higher, and says LABA plus ICS is not encouraged[11].
  11. D. For healthy outpatient adults without comorbidities, the guideline recommends amoxicillin 1 g three times daily (strong), doxycycline 100 mg twice daily (conditional), or a macrolide only where pneumococcal macrolide resistance is below 25% (conditional). The combination in option B is the regimen for outpatients with comorbidities[12].
  12. A. In pregnancy the CDC lists azithromycin 1 g orally as a single dose. Doxycycline is contraindicated in the second and third trimesters because of risk of tooth discoloration. The CDC page recommends retesting about 4 weeks after treatment in pregnancy. Ceftriaxone 500 mg is the gonorrhea regimen[13].
  13. C. For uncomplicated gonorrhea of the urethra, cervix or rectum, ceftriaxone is 500 mg IM for people under 150 kg and 1 g IM for people 150 kg or more. When chlamydia has not been excluded, add doxycycline 100 mg orally twice daily for 7 days[14].
  14. B. The AAP's first-line dose for a child with AOM is amoxicillin 80 to 90 mg/kg per day in 2 divided doses. At 90 mg/kg/day: 15 kg × 90 = 1,350 mg per day, divided in 2 = 675 mg per dose. (At 80 mg/kg/day it would be 600 mg per dose.) Option A is the 40 mg/kg/day standard dose (15 × 40 / 2 = 300 mg); option D forgets to divide; option C is 60 mg/kg/day[15].
  15. D. The 2023 Beers Criteria list first-generation antihistamines, including oral diphenhydramine, as drugs to avoid in older adults because they are highly anticholinergic (strong recommendation). Loratadine and the nasal products are not on that antihistamine row[16].
  16. A. The USPSTF recommends osteoporosis screening in women 65 or older (grade B, January 2025). It also recommends screening in postmenopausal women younger than 65 who are at increased risk by clinical risk assessment[17].

Reading your result

Count your correct answers, then sort every miss into one of three buckets: did not know the guideline, knew it but misread the stem, or guessed. Fix the first two differently. For a gap in knowledge, write the rule as a flashcard. For a misread stem, slow down on the last sentence of the question.

This page gives no "passing percentage", because there is none to give. AANPCB does not report certification scores as a percent correct[1], and its own practice-exam page states that practice performance is not a predictor of passing or failing[2].

How AANPCB's own practice exams work

Per NPCB's practice exam page, read on November 7, 2026[2]:

  • Each practice exam has 50 multiple-choice questions and a 60-minute limit.
  • The page listed Family NP (7 exams), Adult-Gerontology NP (3), Emergency NP (3) and Psychiatric Mental Health NP (2), at $50 per exam, one attempt per purchase. Check the page for the current price.
  • Results are reported as percentages, not on the certification exam's scale, and are confidential and not used for certification.
  • The handbook says practice exams follow the same blueprint as the certification exam but are not meant to assess readiness or predict performance[1].

Use an official practice exam to learn the interface and the question style, and use sets like this one to practice with the guidelines behind them.

Turn the misses into a study loop

Two randomized studies in physicians in training support the loop below, with limits. In a randomized study of 41 medical students, repeated testing (written tests or standardized-patient testing) generally produced better retention six months later than studying a review sheet[18]. A randomized trial of 537 urology residents found that spaced online questions improved retention of clinical knowledge compared with a single bolus of the same questions, though the gains did not generalize to higher in-service examination scores[19]. Neither study enrolled NP students.

  1. Re-do every missed question after a day, then after a few days, then after a week.
  2. Write each rule you missed as one flashcard, with the guideline name and year on the back.
  3. Take another timed set, from this article or an official practice exam, in a week.

If you want software for that loop, Alma's Flashcards schedule cards with FSRS. You can also upload your own program notes or slides to the Learning Hub and take clinical-vignette quizzes from them; Alma does not contain a bank of AANP exam questions. Alma's Study Schedule lets you add your exam date as an "other" exam, type the topics you want covered, and build a plan from today to that date. The Practice exams button there keeps a log of the scores you type in, so you can see the trend. See also our free FNP practice questions and how to pick between the AANPCB and ANCC FNP exams. More NP guides are on the NP blog hub.

Frequently asked questions

Is there a free AANP practice exam?

AANPCB sells its official practice exams (the page listed $50 per exam when read on November 7, 2026)[2]. This article gives a free, short, original set of 16 questions with sourced answers. It is a study aid, not a substitute for the full 150-question format.

How many questions are on the AANP FNP exam?

150 multiple-choice questions, of which 135 are scored and 15 are unscored pretest questions. You have 3 hours[1].

What is a good score on an AANP practice test?

There is no official good score. AANPCB reports practice results as percentages and says they do not predict whether you will pass[1][2]. Use the score to find weak topics, not to forecast your result.

How many times can I take the FNP exam?

The handbook says FNP candidates may test up to three times per calendar year[1]. NPCB's FAQ has two versions of this answer, and the newer one also mentions a minimum of 15 continuing education hours for retakes; confirm the current rules with NPCB before you apply.

Are these questions on the real exam?

No. They are original items written from public guidelines. Real exam content is confidential, and sharing it can invalidate results[1].

Sources

Opened on November 7, 2026. Guidelines are revised, so check each page for a newer version.

  1. AANPCB (NPCB) Family Nurse Practitioner Candidate Handbook, updated 06/2026: https://www.aanpcert.org/wp-content/uploads/FNP-Candidate-Handbook-06-04-2026.pdf
  2. NPCB practice exams: https://www.aanpcert.org/certify/practice-exam
  3. USPSTF, Colorectal Cancer: Screening, final recommendation, May 18, 2021: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
  4. USPSTF, Lung Cancer: Screening, final recommendation, March 9, 2021: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
  5. USPSTF, Breast Cancer: Screening, final recommendation, April 30, 2024: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening
  6. USPSTF, Statin Use for the Primary Prevention of Cardiovascular Disease in Adults, August 23, 2022: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medication
  7. USPSTF, Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality, September 28, 2021: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication
  8. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. Hypertension 2025;82:e212-e316: https://www.ahajournals.org/doi/10.1161/HYP.0000000000000249 (recommendation wording read in the companion article: Case-Based Applications of the 2025 AHA/ACC/Multi-specialty High Blood Pressure Guideline, Hypertension, 2025: https://pmc.ncbi.nlm.nih.gov/articles/PMC12617343/)
  9. American Diabetes Association Professional Practice Committee. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2026. Diabetes Care 2026;49(Suppl 1):S183-S215: https://pmc.ncbi.nlm.nih.gov/articles/PMC12690185/
  10. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2026 update: https://ginasthma.org/wp-content/uploads/2026/05/GINA-2026-Strategy-Report-WMS.pdf
  11. Global Initiative for Chronic Obstructive Lung Disease. 2026 GOLD Report: https://goldcopd.org/2026-gold-report-and-pocket-guide/
  12. Metlay JP, Waterer GW, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019;200(7):e45-e67: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812437/
  13. CDC, Sexually Transmitted Infections Treatment Guidelines, 2021: Chlamydial Infections: https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm
  14. CDC, Sexually Transmitted Infections Treatment Guidelines, 2021: Gonococcal Infections Among Adolescents and Adults: https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm
  15. Lieberthal AS, Carroll AE, Chonmaitree T, et al. The Diagnosis and Management of Acute Otitis Media. Pediatrics 2013;131(3):e964-e999: https://www.aepap.org/sites/default/files/oma_aap_2013.pdf (copy of the AAP guideline, DOI 10.1542/peds.2012-3488)
  16. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2023;71(7):2052-2081: https://doi.org/10.1111/jgs.18372 (PDF copy read: https://health.hawaii.gov/docd/files/2024/08/AGS-Beers-Criteria-2023.pdf)
  17. USPSTF, Osteoporosis to Prevent Fractures: Screening, January 14, 2025: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening
  18. Larsen DP, Butler AC, Lawson AL, Roediger HL. The importance of seeing the patient: test-enhanced learning with standardized patients and written tests improves clinical application of knowledge. Adv Health Sci Educ Theory Pract. 2012;18(3):409-25. PMID 22618856. https://doi.org/10.1007/s10459-012-9379-7
  19. Kerfoot BP, Baker HE, Koch MO, Connelly D, Joseph DB, Ritchey ML. Randomized, controlled trial of spaced education to urology residents in the United States and Canada. J Urol. 2007;177(4):1481-7. PMID 17382760. https://doi.org/10.1016/j.juro.2006.11.074
  20. NPCB FNP exam page: https://aanpcert.org/certify/fnp-exam/