ADULT-GERONTOLOGY PRIMARY CARE NURSE
PRACTITIONER (AGPCNP-BC) BOARD CERTIFICATION – ANCC
COMPREHENSIVE EXAM - LATEST PRACTICE QUESTIONS
AND 100% VERIFIED CORRECT ANSWERS | COMPLETE EXAM
PREP TESTBANK | GUARANTEED PASS | INSTANT DOWNLOAD
PDF
Exam Overview
This comprehensive 150-question practice examination mirrors the structure, content distribution, and
clinical reasoning level of the ANCC AGPCNP-BC certification exam administered by the American
Nurses Credentialing Center.
This assessment covers:
Health promotion & disease prevention (across young adult, middle adult, older adult)
Advanced pathophysiology and clinical management (all body systems)
Differential diagnosis and clinical decision-making
Pharmacology and therapeutics
Diagnostic interpretation (labs, imaging, screening tools)
Geriatric syndromes and complex chronic disease management
Professional role, scope of practice, and interprofessional collaboration
Ethical principles and legal/regulatory standards
Evidence-based practice and quality improvement
Cultural competence and population health
Question Distribution:
Section 1 (1–50): Health promotion, foundational science, assessment, and system-based primary
care
Section 2 (51–100): Complex clinical management, geriatrics, pharmacology, diagnostics
Section 3 (101–150): Professional practice, ethics, policy, leadership, research, and high-level
clinical integration
1. A 52-year-old male with hypertension presents for routine follow-up. His BP
today is 148/92 mmHg despite lifestyle modification. According to current
hypertension guidelines, what is the most appropriate next step?
A. Reassess in 6 months
B. Begin ACE inhibitor monotherapy
C. Initiate pharmacologic therapy with first-line antihypertensive
, medication
D. Order renal ultrasound
Persistent BP ≥140/90 mmHg after lifestyle modification requires pharmacologic
therapy initiation.
2. A 68-year-old female reports gradual onset fatigue and pallor. Labs show
Hgb 9.8 g/dL, MCV 72 fL. Most likely diagnosis?
A. Anemia of chronic disease
B. Iron deficiency anemia
C. Vitamin B12 deficiency
D. Aplastic anemia
Microcytic anemia (MCV <80) is most commonly iron deficiency in older adults
unless proven otherwise.
3. A 45-year-old woman asks about colorectal cancer screening. She has
average risk. When should screening begin?
A. 40
B. 45
C. 50
D. 55
Current USPSTF guidelines recommend screening starting at age 45.
, 4. An 80-year-old with new confusion and fluctuating consciousness most
likely has:
A. Dementia
B. Depression
C. Delirium
D. Psychosis
Acute onset and fluctuating course indicate delirium.
5. A patient with type 2 diabetes has A1C 9.2% on metformin. Next best step?
A. Continue current therapy
B. Stop metformin
C. Add second antihyperglycemic agent
D. Initiate insulin immediately
When A1C >9%, dual therapy is indicated unless symptomatic hyperglycemia.
6. Which vaccine is recommended once at age 65 if not previously given?
A. Tdap
B. Zoster live
C. Pneumococcal conjugate vaccine (PCV)
D. MMR
Adults ≥65 should receive pneumococcal vaccination per updated guidelines.
, 7. A 60-year-old smoker presents with chronic productive cough for 3 years.
Most likely diagnosis?
A. Asthma
B. Chronic bronchitis
C. Bronchiectasis
D. Lung cancer
Chronic productive cough ≥3 months/year for 2 years defines chronic bronchitis.
8. Orthostatic hypotension is confirmed by:
A. 10 mmHg systolic drop
B. ≥20 mmHg systolic drop within 3 minutes of standing
C. Pulse increase only
D. Diastolic increase
Diagnostic criteria: ≥20 systolic or ≥10 diastolic drop within 3 minutes.
9. An older adult with gradual memory decline but intact daily function most
likely has:
A. Delirium
B. Mild cognitive impairment
C. Alzheimer’s dementia
D. Vascular dementia
Preserved function distinguishes MCI from dementia.
PRACTITIONER (AGPCNP-BC) BOARD CERTIFICATION – ANCC
COMPREHENSIVE EXAM - LATEST PRACTICE QUESTIONS
AND 100% VERIFIED CORRECT ANSWERS | COMPLETE EXAM
PREP TESTBANK | GUARANTEED PASS | INSTANT DOWNLOAD
Exam Overview
This comprehensive 150-question practice examination mirrors the structure, content distribution, and
clinical reasoning level of the ANCC AGPCNP-BC certification exam administered by the American
Nurses Credentialing Center.
This assessment covers:
Health promotion & disease prevention (across young adult, middle adult, older adult)
Advanced pathophysiology and clinical management (all body systems)
Differential diagnosis and clinical decision-making
Pharmacology and therapeutics
Diagnostic interpretation (labs, imaging, screening tools)
Geriatric syndromes and complex chronic disease management
Professional role, scope of practice, and interprofessional collaboration
Ethical principles and legal/regulatory standards
Evidence-based practice and quality improvement
Cultural competence and population health
Question Distribution:
Section 1 (1–50): Health promotion, foundational science, assessment, and system-based primary
care
Section 2 (51–100): Complex clinical management, geriatrics, pharmacology, diagnostics
Section 3 (101–150): Professional practice, ethics, policy, leadership, research, and high-level
clinical integration
1. A 52-year-old male with hypertension presents for routine follow-up. His BP
today is 148/92 mmHg despite lifestyle modification. According to current
hypertension guidelines, what is the most appropriate next step?
A. Reassess in 6 months
B. Begin ACE inhibitor monotherapy
C. Initiate pharmacologic therapy with first-line antihypertensive
, medication
D. Order renal ultrasound
Persistent BP ≥140/90 mmHg after lifestyle modification requires pharmacologic
therapy initiation.
2. A 68-year-old female reports gradual onset fatigue and pallor. Labs show
Hgb 9.8 g/dL, MCV 72 fL. Most likely diagnosis?
A. Anemia of chronic disease
B. Iron deficiency anemia
C. Vitamin B12 deficiency
D. Aplastic anemia
Microcytic anemia (MCV <80) is most commonly iron deficiency in older adults
unless proven otherwise.
3. A 45-year-old woman asks about colorectal cancer screening. She has
average risk. When should screening begin?
A. 40
B. 45
C. 50
D. 55
Current USPSTF guidelines recommend screening starting at age 45.
, 4. An 80-year-old with new confusion and fluctuating consciousness most
likely has:
A. Dementia
B. Depression
C. Delirium
D. Psychosis
Acute onset and fluctuating course indicate delirium.
5. A patient with type 2 diabetes has A1C 9.2% on metformin. Next best step?
A. Continue current therapy
B. Stop metformin
C. Add second antihyperglycemic agent
D. Initiate insulin immediately
When A1C >9%, dual therapy is indicated unless symptomatic hyperglycemia.
6. Which vaccine is recommended once at age 65 if not previously given?
A. Tdap
B. Zoster live
C. Pneumococcal conjugate vaccine (PCV)
D. MMR
Adults ≥65 should receive pneumococcal vaccination per updated guidelines.
, 7. A 60-year-old smoker presents with chronic productive cough for 3 years.
Most likely diagnosis?
A. Asthma
B. Chronic bronchitis
C. Bronchiectasis
D. Lung cancer
Chronic productive cough ≥3 months/year for 2 years defines chronic bronchitis.
8. Orthostatic hypotension is confirmed by:
A. 10 mmHg systolic drop
B. ≥20 mmHg systolic drop within 3 minutes of standing
C. Pulse increase only
D. Diastolic increase
Diagnostic criteria: ≥20 systolic or ≥10 diastolic drop within 3 minutes.
9. An older adult with gradual memory decline but intact daily function most
likely has:
A. Delirium
B. Mild cognitive impairment
C. Alzheimer’s dementia
D. Vascular dementia
Preserved function distinguishes MCI from dementia.
