AGACNP-BC® Adult-Gerontology Acute Care Nurse
Practitioner Certification – Verified Questions & Correct
Answers | instant pdf download
Intro
This exam is designed to help prepare for the AGACNP-BC® certification by providing verified
multiple-choice questions with correct answers and detailed explanations. It mirrors the
content and format of the actual exam to maximize readiness.
Coverage:
Cardiovascular & Pulmonary Systems – Heart failure, acute coronary syndromes,
arrhythmias, and respiratory emergencies
Neurology & Neurosurgery – Stroke, seizures, traumatic brain injuries, and
neurocritical care
Gastrointestinal & Hepatic Disorders – Liver failure, GI bleeding, pancreatitis, and
acute interventions
Renal & Electrolyte Disorders – AKI, electrolyte imbalances, and fluid management
Endocrine & Metabolic Disorders – Diabetes emergencies, thyroid crises, and critical
metabolic disturbances
Infectious Diseases & Sepsis – Recognition, management, and antimicrobial therapy
Critical Care Procedures & Pharmacology – Central line care, ventilation, and high-
acuity medication management
Ethical, Legal, & Professional Practice – Scope of practice, patient safety, and
evidence-based care
1. A 68-year-old patient presents with acute shortness of breath, pulmonary edema, and
elevated BNP. What is the most likely diagnosis?
A) Pneumonia
B) Acute decompensated heart failure
C) COPD exacerbation
D) Pulmonary embolism
Answer: B) Acute decompensated heart failure
Explanation: Pulmonary edema and elevated BNP in an older adult suggest acute
decompensation of heart failure.
2. Which ECG finding is most consistent with atrial fibrillation?
A) Regular P waves with normal QRS
,B) Irregularly irregular rhythm with absent P waves
C) ST-segment elevation in leads II, III, aVF
D) Wide QRS with monomorphic pattern
Answer: B) Irregularly irregular rhythm with absent P waves
Explanation: Atrial fibrillation shows irregularly irregular rhythm without identifiable P
waves.
3. A patient with severe sepsis has a MAP of 58 mmHg despite fluid resuscitation. What is the
next step in management?
A) Administer vasopressors
B) Give oral antibiotics
C) Place on low-flow oxygen
D) Monitor only
Answer: A) Administer vasopressors
Explanation: MAP <65 mmHg after fluids requires vasopressors to maintain organ
perfusion
4. Which antimicrobial therapy is recommended as empiric treatment for community-
acquired pneumonia in adults without comorbidities?
A) Vancomycin
B) Amoxicillin or doxycycline
C) Ciprofloxacin alone
D) Metronidazole
Answer: B) Amoxicillin or doxycycline
Explanation: First-line empiric therapy for healthy adults with CAP includes amoxicillin
or doxycycline.
5. In a patient with acute ischemic stroke, what is the maximum window for intravenous
thrombolysis (tPA)?
A) 24 hours
B) 12 hours
C) 4.5 hours
D) 1 hour
Answer: C) 4.5 hours
Explanation: IV tPA is indicated within 4.5 hours of symptom onset for eligible patients.
,6. Which lab value is most indicative of acute kidney injury?
A) Elevated BUN and creatinine
B) Low hemoglobin
C) High sodium only
D) Low potassium
Answer: A) Elevated BUN and creatinine
Explanation: Rising BUN and creatinine indicate decreased renal function consistent
with AKI
7. A patient with diabetic ketoacidosis presents with K+ of 3.0 mEq/L. Which intervention is
most urgent?
A) Start IV insulin immediately
B) Give IV potassium before insulin
C) Administer IV glucose
D) Start antibiotics
Answer: B) Give IV potassium before insulin
Explanation: Insulin drives potassium into cells; low K+ must be corrected first to
prevent arrhythmias.
8. Which arterial blood gas result is consistent with metabolic acidosis?
A) pH 7.25, HCO3- 18 mEq/L
B) pH 7.50, HCO3- 30 mEq/L
C) pH 7.40, HCO3- 24 mEq/L
D) pH 7.60, HCO3- 22 mEq/L
Answer: A) pH 7.25, HCO3- 18 mEq/L
Explanation: Low pH and low bicarbonate indicate metabolic acidosis.
9. Which ventilator setting is most important to monitor in a patient with ARDS?
A) Tidal volume
B) Inspiratory oxygen only
C) Flow rate
D) PEEP
Answer: D) PEEP
Explanation: Positive end-expiratory pressure prevents alveolar collapse and improves
oxygenation in ARDS.
, 10. A patient with acute coronary syndrome has ST elevation in leads II, III, aVF. Which artery
is likely involved?
A) Left anterior descending
B) Right coronary artery
C) Left circumflex
D) Posterior descending
Answer: B) Right coronary artery
Explanation: Inferior STEMI (leads II, III, aVF) commonly involves the RCA.
11. Which sedative is preferred for rapid sequence intubation in hemodynamically unstable
patients?
A) Etomidate
B) Propofol
C) Midazolam
D) Diazepam
Answer: A) Etomidate
Explanation: Etomidate maintains hemodynamic stability compared to other agents.
12. A patient develops sudden hypotension, tachycardia, and rash after penicillin. What is
the immediate treatment?
A) IV fluids and epinephrine
B) Oral antihistamines
C) Beta-blockers
D) Monitor only
Answer: A) IV fluids and epinephrine
Explanation: Anaphylaxis requires immediate epinephrine and supportive fluids.
13. Which hemodynamic parameter best reflects left ventricular preload?
A) Pulmonary capillary wedge pressure
B) Central venous pressure
C) MAP
D) Heart rate
Answer: A) Pulmonary capillary wedge pressure
Explanation: PCWP estimates left atrial pressure and left ventricular preload.
Practitioner Certification – Verified Questions & Correct
Answers | instant pdf download
Intro
This exam is designed to help prepare for the AGACNP-BC® certification by providing verified
multiple-choice questions with correct answers and detailed explanations. It mirrors the
content and format of the actual exam to maximize readiness.
Coverage:
Cardiovascular & Pulmonary Systems – Heart failure, acute coronary syndromes,
arrhythmias, and respiratory emergencies
Neurology & Neurosurgery – Stroke, seizures, traumatic brain injuries, and
neurocritical care
Gastrointestinal & Hepatic Disorders – Liver failure, GI bleeding, pancreatitis, and
acute interventions
Renal & Electrolyte Disorders – AKI, electrolyte imbalances, and fluid management
Endocrine & Metabolic Disorders – Diabetes emergencies, thyroid crises, and critical
metabolic disturbances
Infectious Diseases & Sepsis – Recognition, management, and antimicrobial therapy
Critical Care Procedures & Pharmacology – Central line care, ventilation, and high-
acuity medication management
Ethical, Legal, & Professional Practice – Scope of practice, patient safety, and
evidence-based care
1. A 68-year-old patient presents with acute shortness of breath, pulmonary edema, and
elevated BNP. What is the most likely diagnosis?
A) Pneumonia
B) Acute decompensated heart failure
C) COPD exacerbation
D) Pulmonary embolism
Answer: B) Acute decompensated heart failure
Explanation: Pulmonary edema and elevated BNP in an older adult suggest acute
decompensation of heart failure.
2. Which ECG finding is most consistent with atrial fibrillation?
A) Regular P waves with normal QRS
,B) Irregularly irregular rhythm with absent P waves
C) ST-segment elevation in leads II, III, aVF
D) Wide QRS with monomorphic pattern
Answer: B) Irregularly irregular rhythm with absent P waves
Explanation: Atrial fibrillation shows irregularly irregular rhythm without identifiable P
waves.
3. A patient with severe sepsis has a MAP of 58 mmHg despite fluid resuscitation. What is the
next step in management?
A) Administer vasopressors
B) Give oral antibiotics
C) Place on low-flow oxygen
D) Monitor only
Answer: A) Administer vasopressors
Explanation: MAP <65 mmHg after fluids requires vasopressors to maintain organ
perfusion
4. Which antimicrobial therapy is recommended as empiric treatment for community-
acquired pneumonia in adults without comorbidities?
A) Vancomycin
B) Amoxicillin or doxycycline
C) Ciprofloxacin alone
D) Metronidazole
Answer: B) Amoxicillin or doxycycline
Explanation: First-line empiric therapy for healthy adults with CAP includes amoxicillin
or doxycycline.
5. In a patient with acute ischemic stroke, what is the maximum window for intravenous
thrombolysis (tPA)?
A) 24 hours
B) 12 hours
C) 4.5 hours
D) 1 hour
Answer: C) 4.5 hours
Explanation: IV tPA is indicated within 4.5 hours of symptom onset for eligible patients.
,6. Which lab value is most indicative of acute kidney injury?
A) Elevated BUN and creatinine
B) Low hemoglobin
C) High sodium only
D) Low potassium
Answer: A) Elevated BUN and creatinine
Explanation: Rising BUN and creatinine indicate decreased renal function consistent
with AKI
7. A patient with diabetic ketoacidosis presents with K+ of 3.0 mEq/L. Which intervention is
most urgent?
A) Start IV insulin immediately
B) Give IV potassium before insulin
C) Administer IV glucose
D) Start antibiotics
Answer: B) Give IV potassium before insulin
Explanation: Insulin drives potassium into cells; low K+ must be corrected first to
prevent arrhythmias.
8. Which arterial blood gas result is consistent with metabolic acidosis?
A) pH 7.25, HCO3- 18 mEq/L
B) pH 7.50, HCO3- 30 mEq/L
C) pH 7.40, HCO3- 24 mEq/L
D) pH 7.60, HCO3- 22 mEq/L
Answer: A) pH 7.25, HCO3- 18 mEq/L
Explanation: Low pH and low bicarbonate indicate metabolic acidosis.
9. Which ventilator setting is most important to monitor in a patient with ARDS?
A) Tidal volume
B) Inspiratory oxygen only
C) Flow rate
D) PEEP
Answer: D) PEEP
Explanation: Positive end-expiratory pressure prevents alveolar collapse and improves
oxygenation in ARDS.
, 10. A patient with acute coronary syndrome has ST elevation in leads II, III, aVF. Which artery
is likely involved?
A) Left anterior descending
B) Right coronary artery
C) Left circumflex
D) Posterior descending
Answer: B) Right coronary artery
Explanation: Inferior STEMI (leads II, III, aVF) commonly involves the RCA.
11. Which sedative is preferred for rapid sequence intubation in hemodynamically unstable
patients?
A) Etomidate
B) Propofol
C) Midazolam
D) Diazepam
Answer: A) Etomidate
Explanation: Etomidate maintains hemodynamic stability compared to other agents.
12. A patient develops sudden hypotension, tachycardia, and rash after penicillin. What is
the immediate treatment?
A) IV fluids and epinephrine
B) Oral antihistamines
C) Beta-blockers
D) Monitor only
Answer: A) IV fluids and epinephrine
Explanation: Anaphylaxis requires immediate epinephrine and supportive fluids.
13. Which hemodynamic parameter best reflects left ventricular preload?
A) Pulmonary capillary wedge pressure
B) Central venous pressure
C) MAP
D) Heart rate
Answer: A) Pulmonary capillary wedge pressure
Explanation: PCWP estimates left atrial pressure and left ventricular preload.
