FNP Exam Question Types & Strategies

FNP Exam Question Types & Strategies

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The AANP and ANCC FNP certification exams are standardized tests, meaning that each will be predictable in terms of format and content. As with any standardized exam, you can increase your odds of being successful by not only reviewing the tested content but also by knowing about the construction of the test and the types of questions you will face. Keep reading to learn more about the different types of questions on the FNP exams and review our expert FNP exam question strategies. Then, test your knowledge with our FNP practice questions and review the answer explanations.

[ READ NEXT: AANP vs. ANCC: What’s Tested on the FNP Exams? ]

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TABLE OF CONTENTS:

FNP Exam Question Types

Both the AANP and ANCC FNP exams have multiple-choice questions. The ANCC includes alternate-type questions, including multiple response, drag and drop, and hot spot, but most of the test questions are multiple choice. Regardless of question type, identifying the structure of the question can assist you in determining the best approach to the question and answer choices.

FNP Exam Multiple-Choice Questions

Multiple-choice questions are made up of a stem (scenario and question) and answer choices. Typical answer choices include one correct answer, one incorrect answer, and two partially correct answers or plausible incorrect answers. You will learn to distinguish partially correct responses (sometimes correct or with an exception) from the best answer choice, given the context. There may be more than one question related to a given scenario. Negatively phrased questions (“all of the following except”) questions are rare.

While some test items evaluate factual knowledge (e.g., selecting a common sign or symptom of a given condition), the majority of questions measure higher-level thinking and reasoning and will ask you to apply your clinical expertise with assessment or intervention to a clinical situation. The information you need to answer a multiple-choice question is included in the question and answer choices, but you need to know the content to understand the question and the nuances of each of the answer choices. The test is not testing content per se, but rather your ability to use it in a new situation to make a safe and effective decision.

With every multiple-choice question, the answer is provided. You simply have to identify the correct answer by eliminating the incorrect ones. Remember: your job is to determine the correct answer (the safest, most effective answer).

FNP Exam Question Keywords

Keywords can help you determine the type of question. For example, priority questions on the FNP exams include words like: first, next, best, most important, etc. You are asked for the best answer; think: “If I can do one thing.” The best answer may not be exactly what you are looking for; it may not be perfect, but it will be better than the rest. Evaluation questions include words such as “indicate an understanding” or “further teaching is needed.” You are asked to find the correct (true) or incorrect (false) answer in relation to the topic.

Expert FNP Tip

Read every answer choice carefully. Look for clue words and numbers. These modifiers can assist in selecting or eliminating answer choices.

FNP Exam Multiple Response Questions

Multiple-response (select all that apply) questions on the ANCC FNP exam have more than four possible answer choices. For the question to be scored as correct, you must select all of the answer choices that apply, not just the best response. No partial credit is given. When more than one correct answer is required, the number of correct answers to be selected is stated in the question. Read the stem thoroughly to determine what the question is asking. Look at each item one at a time, independent of the other answer choices. Don’t group answer choices; read each as if it is the only piece of information being evaluated. It does not work to compare and contrast the answer choices, as you would when answering a multiple-choice question. Change each answer choice into a statement, and then determine if the statement is correct or incorrect in relation to the topic. A statement may be a correct (true) statement, but it needs to be viewed within the context of the question asked.

FNP Exam Ordered Response Questions

Drag and drop – or ordered-response questions – on the ANCC FNP exam, ask you to place answers in a specific order. The strategy to use when answering this kind of question is to picture yourself performing the procedure. Or, find the first step, then the last, and then fill in the center steps last. All the steps of the task may not be included in the answer options. In these cases, you need to correctly order the steps that are listed. No partial credit is given for this type of question.

FNP Exam Hot Spot Questions

Hot spot questions on the ANCC FNP exam ask you to identify a location on a graphic (image) or table. This is not a test of your fine motor skills; this question type is designed to evaluate your knowledge of nursing content, anatomy and physiology, and pathophysiology. Select the area on the image that best describes the answer to the question asked.

Expert FNP Tip

Answer every question on the FNP exam. Questions left blank are marked with a zero. You can and should guess—with a random guess, you have a 25% chance of getting the question correct; with educated guessing, that jumps to 50–75%.

FNP Exam Question Strategies

Below, we list some of our best strategies for tackling questions on the FNP exams.

  • Be mindful of the nursing process as you answer each question.

    Make sure your assessment is complete before you diagnose, plan, or intervene. Determine the purpose of the question. Is it to test your ability to gather subjective and objective information, develop a diagnosis, implement a plan of care, or evaluate care given? Read each answer choice only after you understand the context of the question.

  • Remember: Nursing is seldom black and white.

    As such, a correct answer will usually contain relative qualifiers that allow for exception (e.g., may be, may, few, rarely). The correct answer rarely includes absolute qualifiers (e.g., always, never, must), as they do not allow for exceptions.

  • The response with the most common presentation is likely correct.

    For example, a person with alcohol withdrawal can present with fine motor tremors and motor seizures. Because fine motor tremors are seen in most adults with alcohol withdrawal and motor seizures are far less common, fine motor tremors is a better choice.

  • Avoid selecting an answer because it contains familiar words from a lecture or reading.

    Avoid selecting an answer because it is a true statement. Just because an answer choice is true does not mean it is the correct answer to a given question. The correct answer relates back to the topic/context.

  • Don’t agonize over any one question; it can upset your pacing and confidence.

    If you read a question and don’t know the answer, just take a deep breath and start eliminating options.

FNP Exam Practice Questions

The following are two practice questions similar to those you would find on the FNP exams. The first is an example of a priority question and the second is an evaluation question.

FNP Exam Practice Question #1

A family nurse practitioner examines a 24-year-old female patient, 12 weeks pregnant, who is experiencing dysuria and urinary urgency and frequency. The patient reports that her roommate gave her some doxycycline 100 mg tablets, and she has taken three pills over the last three days, with little relief of her symptoms. What is the nurse practitioner’s best response?

A. Inform the patient to avoid taking prescription drugs prescribed for another person

B. Prescribe trimethoprim-sulfamethoxazole 800–160 mg orally every 12 hours for 10 days

C. Continue with doxycycline 100 mg orally for 7 days

D. Request a urine sample from the patient for a culture and sensitivity

This is an action-oriented question. You are asked to consider the patient’s symptoms and care and determine the best answer. From this scenario, you can make some assumptions. 

You are told the patient is pregnant, but no other chronic illnesses are mentioned. You can assume that this pregnant young woman is in otherwise good health. Dysuria and urinary frequency are common symptoms of a urinary tract infection (UTI), and UTIs are common in pregnancy. Usual bacteria include Escherichia coli, Klebsiella, Proteus mirabilis, and Staphylococcus saprophyticus. UTIs are commonly diagnosed and treated after a culture and sensitivity. Common antibiotics include trimethoprim-sulfamethoxazole, fosfomycin, nitrofurantoin, ciprofloxacin, levofloxacin, cephalexin, azithromycin, and doxycycline.

Which answer choice is the best course of action for this patient?

Let’s look at choice A—Inform the patient to avoid taking prescription drugs prescribed for another person. While this is a true statement, the outcome does nothing for the patient’s current symptoms. This meets a psychosocial need of the patient (teaching information). The underlying cause of a UTI is physical; you want a physical answer.

Now let’s look at choice B—Prescribe trimethoprim-sulfamethoxazole 800–160 mg orally every 12 hours for 10 days. Trimethoprim-sulfamethoxazole is frequently used to treat UTIs, yet this is not the best answer. First, the patient is pregnant, and trimethoprim must be used cautiously during the first trimester of pregnancy. Second, this selection represents treatment, and evidence-based practice dictates a culture and sensitivity to diagnose and appropriately treat. It is not known if the bacteria are susceptible to trimethoprim-sulfamethoxazole.

Choice C is next—Continue with doxycycline 100 mg orally for 7 days. Doxycycline is commonly used to treat UTIs, but this is not the best answer. First, it is prescribed every 12 hours, not daily. Second, as stated above, evidence-based practice dictates a culture and sensitivity to diagnose and appropriately treat. It is not known if the bacteria are susceptible to doxycycline.

Finally, choice D—Request a urine sample from the patient for a culture and sensitivity. This is an assessment answer. Diagnosis and treatment of a UTI are based on culture and sensitivity. This is the safest answer for this patient.


FNP Exam Practice Question #2

A 25-year-old patient presents to the clinic with what his friends suspect to be alcohol withdrawal. Which of the following would be the most likely finding?

A. Visual hallucinations

B. Fine motor tremors

C. Nausea and vomiting

D. Motor seizures

This is an evaluation question. You are asked to consider the patient’s symptoms and determine which represents the most likely finding. It is a true/false (correct/incorrect) question. Consider the answers.

Answer choices (A), (B), and (D) may be seen in alcohol withdrawal. However, fine motor tremors (B) are by far the most common. Choice (C), nausea and vomiting, is more commonly found in alcohol intoxication.


FNP Exam Pop Quizzes

Keep practicing for the FNP exams with our free pop quizzes.

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