ANCC Adult-Gerontology Primary Care AGPCNP BC
Certification Exam New Latest Version with All 175
Multiple Choice Questions, 100% Correct Answers and
Rationale
AGPCNP-BC MOST TESTED & HARDEST QUESTIONS (1–25)
1. A 68-year-old patient presents with new-onset atrial fibrillation. Which risk score guides
anticoagulation decisions?
A. HAS-BLED
B. CHA₂DS₂-VASc
C. TIMI
D. Framingham
✅ Correct Answer: B
Explanation:
CHA₂DS₂-VASc estimates stroke risk and guides anticoagulation in AF.
HAS-BLED assesses bleeding risk after anticoagulation is considered.
2. Which blood pressure target is recommended for most adults ≥65 years according to current
guidelines?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
D. <120/70 mmHg
✅ Correct Answer: C
,3. A 72-year-old with diabetes has decreased vibration sense and numbness in feet. This finding
indicates:
A. Peripheral vascular disease
B. Diabetic neuropathy
C. Lumbar radiculopathy
D. Vitamin D deficiency
✅ Correct Answer: B
4. Which screening is MOST appropriate for a 66-year-old man who has ever smoked?
A. Colonoscopy
B. PSA testing
C. Low-dose CT scan of lungs
D. Chest X-ray annually
✅ Correct Answer: C
5. Which medication is FIRST-LINE for chronic stable angina in primary care?
A. ACE inhibitor
B. Beta-blocker
C. Calcium channel blocker
D. Nitrate
✅ Correct Answer: B
6. A patient presents with fatigue, cold intolerance, weight gain, and bradycardia. Which lab test
should be ordered FIRST?
A. Free T4
B. TSH
C. Cortisol
D. T3
✅ Correct Answer: B
7. Which immunization is recommended annually for adults ≥65 years?
A. Shingles
B. Pneumococcal
,C. Influenza
D. Tdap
✅ Correct Answer: C
8. A 70-year-old female presents with dysuria, urgency, and frequency. No fever or flank pain. First-
line treatment?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. TMP-SMX for 14 days
✅ Correct Answer: B
9. Which finding is MOST concerning in an older adult with acute confusion?
A. Polypharmacy
B. Recent hospitalization
C. Sudden onset of symptoms
D. History of dementia
✅ Correct Answer: C
Explanation:
Sudden confusion = delirium → medical emergency.
10. The MOST effective intervention to prevent osteoporosis in postmenopausal women is:
A. Estrogen therapy
B. Calcium only
C. Weight-bearing exercise
D. Vitamin C
✅ Correct Answer: C
11. A patient with COPD has PaO₂ 55 mm Hg. What is the appropriate oxygen goal?
A. 95–100%
B. 92–96%
C. 88–92%
D. 85–88%
✅ Correct Answer: C
, 12. Which symptom is MOST indicative of heart failure exacerbation?
A. Nocturia
B. Orthopnea
C. Weight loss
D. Bradycardia
✅ Correct Answer: B
13. Which screening is NOT recommended for asymptomatic adults?
A. Colorectal cancer screening
B. Lipid panel
C. Whole-body CT scan
D. Blood pressure screening
✅ Correct Answer: C
14. A patient on ACE inhibitors develops dry cough. Best alternative medication?
A. Thiazide diuretic
B. Beta-blocker
C. ARB
D. Calcium channel blocker
✅ Correct Answer: C
15. A 74-year-old patient reports unintentional weight loss. Your FIRST action is to:
A. Prescribe appetite stimulant
B. Order diagnostic workup
C. Reassure patient
D. Recommend supplements
✅ Correct Answer: B
16. Which condition is MOST associated with secondary hypertension?
A. Obesity
B. Diabetes
C. Renal artery stenosis
D. Aging
Certification Exam New Latest Version with All 175
Multiple Choice Questions, 100% Correct Answers and
Rationale
AGPCNP-BC MOST TESTED & HARDEST QUESTIONS (1–25)
1. A 68-year-old patient presents with new-onset atrial fibrillation. Which risk score guides
anticoagulation decisions?
A. HAS-BLED
B. CHA₂DS₂-VASc
C. TIMI
D. Framingham
✅ Correct Answer: B
Explanation:
CHA₂DS₂-VASc estimates stroke risk and guides anticoagulation in AF.
HAS-BLED assesses bleeding risk after anticoagulation is considered.
2. Which blood pressure target is recommended for most adults ≥65 years according to current
guidelines?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
D. <120/70 mmHg
✅ Correct Answer: C
,3. A 72-year-old with diabetes has decreased vibration sense and numbness in feet. This finding
indicates:
A. Peripheral vascular disease
B. Diabetic neuropathy
C. Lumbar radiculopathy
D. Vitamin D deficiency
✅ Correct Answer: B
4. Which screening is MOST appropriate for a 66-year-old man who has ever smoked?
A. Colonoscopy
B. PSA testing
C. Low-dose CT scan of lungs
D. Chest X-ray annually
✅ Correct Answer: C
5. Which medication is FIRST-LINE for chronic stable angina in primary care?
A. ACE inhibitor
B. Beta-blocker
C. Calcium channel blocker
D. Nitrate
✅ Correct Answer: B
6. A patient presents with fatigue, cold intolerance, weight gain, and bradycardia. Which lab test
should be ordered FIRST?
A. Free T4
B. TSH
C. Cortisol
D. T3
✅ Correct Answer: B
7. Which immunization is recommended annually for adults ≥65 years?
A. Shingles
B. Pneumococcal
,C. Influenza
D. Tdap
✅ Correct Answer: C
8. A 70-year-old female presents with dysuria, urgency, and frequency. No fever or flank pain. First-
line treatment?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. TMP-SMX for 14 days
✅ Correct Answer: B
9. Which finding is MOST concerning in an older adult with acute confusion?
A. Polypharmacy
B. Recent hospitalization
C. Sudden onset of symptoms
D. History of dementia
✅ Correct Answer: C
Explanation:
Sudden confusion = delirium → medical emergency.
10. The MOST effective intervention to prevent osteoporosis in postmenopausal women is:
A. Estrogen therapy
B. Calcium only
C. Weight-bearing exercise
D. Vitamin C
✅ Correct Answer: C
11. A patient with COPD has PaO₂ 55 mm Hg. What is the appropriate oxygen goal?
A. 95–100%
B. 92–96%
C. 88–92%
D. 85–88%
✅ Correct Answer: C
, 12. Which symptom is MOST indicative of heart failure exacerbation?
A. Nocturia
B. Orthopnea
C. Weight loss
D. Bradycardia
✅ Correct Answer: B
13. Which screening is NOT recommended for asymptomatic adults?
A. Colorectal cancer screening
B. Lipid panel
C. Whole-body CT scan
D. Blood pressure screening
✅ Correct Answer: C
14. A patient on ACE inhibitors develops dry cough. Best alternative medication?
A. Thiazide diuretic
B. Beta-blocker
C. ARB
D. Calcium channel blocker
✅ Correct Answer: C
15. A 74-year-old patient reports unintentional weight loss. Your FIRST action is to:
A. Prescribe appetite stimulant
B. Order diagnostic workup
C. Reassure patient
D. Recommend supplements
✅ Correct Answer: B
16. Which condition is MOST associated with secondary hypertension?
A. Obesity
B. Diabetes
C. Renal artery stenosis
D. Aging
