ADULT-GERONTOLOGY PRIMARY CARE
NURSE PRACTITIONER CERTIFICATION
EXAMINATION (AGPCNP-BC)
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
1. A 68-year-old patient with hypertension is started on lisinopril. Which lab
value should be monitored?
A. Hemoglobin A1c
B. Serum potassium
C. Serum calcium
D. Serum sodium
Rationale: ACE inhibitors can cause hyperkalemia by decreasing
aldosterone secretion, so potassium must be monitored closely.
2. A 72-year-old patient presents with sudden chest pain radiating to the back.
Which condition is most concerning?
A. GERD
B. Aortic dissection
C. Costochondritis
D. Peptic ulcer disease
Rationale: Sudden tearing chest pain radiating to the back is classic for
aortic dissection, a medical emergency.
3. First-line treatment for uncomplicated hypertension in older adults
includes:
A. Loop diuretics
, B. Thiazide diuretics
C. Beta blockers
D. Alpha blockers
Rationale: Thiazide diuretics are first-line therapy per guidelines for
uncomplicated hypertension.
4. A patient with COPD should receive which vaccine annually?
A. HPV vaccine
B. Influenza vaccine
C. Varicella vaccine
D. Yellow fever vaccine
Rationale: Annual influenza vaccination is essential for patients with
chronic lung disease.
5. Which symptom is most consistent with left-sided heart failure?
A. Peripheral edema
B. Dyspnea on exertion
C. Ascites
D. Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion causing
dyspnea.
6. A 70-year-old has sudden unilateral weakness and slurred speech. First
action?
A. Give aspirin immediately
B. Activate stroke protocol and obtain CT scan
C. Check blood glucose only
D. Give antihypertensive medication
Rationale: Rapid imaging is required to differentiate ischemic vs
hemorrhagic stroke.
7. Most common cause of community-acquired pneumonia in older adults:
A. Pseudomonas aeruginosa
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
, D. Mycobacterium tuberculosis
Rationale: Streptococcus pneumoniae remains the most common cause.
8. A patient on warfarin has INR of 6.0. Next step?
A. Increase dose
B. Hold warfarin
C. Give vitamin K immediately
D. Continue same dose
Rationale: INR is dangerously high; warfarin should be held first.
9. Classic sign of Parkinson’s disease:
A. Spastic paralysis
B. Resting tremor
C. Hyperreflexia
D. Ataxia
Rationale: Resting tremor is hallmark of Parkinson’s disease.
10.First-line treatment for type 2 diabetes:
A. Insulin
B. Metformin
C. Sulfonylureas
D. GLP-1 inhibitors
Rationale: Metformin is first-line unless contraindicated.
11.A patient with suspected DVT should undergo:
A. MRI brain
B. Doppler ultrasound
C. Chest X-ray
D. Echocardiogram
Rationale: Doppler ultrasound confirms venous thrombosis.
12.Most common cause of peptic ulcer disease:
A. NSAIDs only
B. Helicobacter pylori
C. Stress
NURSE PRACTITIONER CERTIFICATION
EXAMINATION (AGPCNP-BC)
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
1. A 68-year-old patient with hypertension is started on lisinopril. Which lab
value should be monitored?
A. Hemoglobin A1c
B. Serum potassium
C. Serum calcium
D. Serum sodium
Rationale: ACE inhibitors can cause hyperkalemia by decreasing
aldosterone secretion, so potassium must be monitored closely.
2. A 72-year-old patient presents with sudden chest pain radiating to the back.
Which condition is most concerning?
A. GERD
B. Aortic dissection
C. Costochondritis
D. Peptic ulcer disease
Rationale: Sudden tearing chest pain radiating to the back is classic for
aortic dissection, a medical emergency.
3. First-line treatment for uncomplicated hypertension in older adults
includes:
A. Loop diuretics
, B. Thiazide diuretics
C. Beta blockers
D. Alpha blockers
Rationale: Thiazide diuretics are first-line therapy per guidelines for
uncomplicated hypertension.
4. A patient with COPD should receive which vaccine annually?
A. HPV vaccine
B. Influenza vaccine
C. Varicella vaccine
D. Yellow fever vaccine
Rationale: Annual influenza vaccination is essential for patients with
chronic lung disease.
5. Which symptom is most consistent with left-sided heart failure?
A. Peripheral edema
B. Dyspnea on exertion
C. Ascites
D. Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion causing
dyspnea.
6. A 70-year-old has sudden unilateral weakness and slurred speech. First
action?
A. Give aspirin immediately
B. Activate stroke protocol and obtain CT scan
C. Check blood glucose only
D. Give antihypertensive medication
Rationale: Rapid imaging is required to differentiate ischemic vs
hemorrhagic stroke.
7. Most common cause of community-acquired pneumonia in older adults:
A. Pseudomonas aeruginosa
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
, D. Mycobacterium tuberculosis
Rationale: Streptococcus pneumoniae remains the most common cause.
8. A patient on warfarin has INR of 6.0. Next step?
A. Increase dose
B. Hold warfarin
C. Give vitamin K immediately
D. Continue same dose
Rationale: INR is dangerously high; warfarin should be held first.
9. Classic sign of Parkinson’s disease:
A. Spastic paralysis
B. Resting tremor
C. Hyperreflexia
D. Ataxia
Rationale: Resting tremor is hallmark of Parkinson’s disease.
10.First-line treatment for type 2 diabetes:
A. Insulin
B. Metformin
C. Sulfonylureas
D. GLP-1 inhibitors
Rationale: Metformin is first-line unless contraindicated.
11.A patient with suspected DVT should undergo:
A. MRI brain
B. Doppler ultrasound
C. Chest X-ray
D. Echocardiogram
Rationale: Doppler ultrasound confirms venous thrombosis.
12.Most common cause of peptic ulcer disease:
A. NSAIDs only
B. Helicobacter pylori
C. Stress
