1
ANCC AGPCNP-BC Practice Exam – 260 Questions
with Rationales | Adult-Gerontology Primary Care
Nurse Practitioner Certification | Updated 2026
TABLE OF CONTENTS
Domain 1: Patient Assessment Process Questions 1 to 65
Domain 2: Plan of Care Questions 66 to 130
Domain 3: Professional Practice Questions 131 to 195
Domain 4: Mixed Review and High-Yield Scenarios Questions 196 to 260
DOMAIN 1: PATIENT ASSESSMENT PROCESS QUESTIONS 1 TO 65
Question 1
A 68-year-old female patient presents with complaints of fatigue, weight
gain, and cold intolerance. On physical exam, you note bradycardia and dry,
coarse skin. Which of the following is the most appropriate initial diagnostic
test?
A. Thyroid-stimulating hormone level
B. Complete blood count
C. Serum cortisol level
D. Fasting blood glucose
, 2
Correct Answer: A
Rationale: The patient's symptoms of fatigue, weight gain, cold intolerance,
bradycardia, and dry skin are classic for hypothyroidism. Thyroid-
stimulating hormone is the most sensitive initial screening test for thyroid
dysfunction. A complete blood count may show anemia but is not diagnostic
for hypothyroidism. Serum cortisol would be indicated for adrenal
insufficiency. Fasting blood glucose would be indicated for diabetes
mellitus.
Question 2
A 72-year-old male patient reports a history of falling twice in the past
month. Which of the following is the most important component of the
assessment for falls in the older adult?
A. Orthostatic blood pressure measurement
B. Vision screening
C. Medication review
D. All of the above
Correct Answer: D
Rationale: A comprehensive fall risk assessment in the older adult includes
orthostatic blood pressure measurement to evaluate for postural
hypotension, vision screening to identify visual impairment, and medication
review to identify drugs that increase fall risk such as sedatives and
, 3
antihypertensives. All components are essential for identifying modifiable
risk factors.
Question 3
A 65-year-old male patient presents with a complaint of difficulty starting
urination and a weak urinary stream. His digital rectal exam reveals an
enlarged, smooth prostate. Which of the following is the most likely
diagnosis?
A. Benign prostatic hyperplasia
B. Prostate cancer
C. Prostatitis
D. Urethral stricture
Correct Answer: A
Rationale: Benign prostatic hyperplasia presents with obstructive urinary
symptoms including hesitancy, weak stream, and nocturia. The prostate is
typically enlarged and smooth on digital rectal exam. Prostate cancer may
present with similar symptoms but the prostate is often hard and nodular.
Prostatitis presents with perineal pain and a tender prostate. Urethral
stricture presents with a weak stream but the prostate is normal.
Question 4
A 58-year-old female patient reports a dry cough that has persisted for eight
weeks following a viral respiratory infection. She is a non-smoker and has
, 4
no other symptoms. Which of the following is the most appropriate initial
management?
A. Observation and reassurance
B. Chest x-ray
C. Antibiotics
D. Antihistamines
Correct Answer: B
Rationale: A cough persisting for more than three weeks warrants further
evaluation with a chest x-ray, especially in a patient over 50 years of age.
Observation and reassurance would be appropriate for a cough lasting less
than three weeks. Antibiotics are not indicated without evidence of
infection. Antihistamines may help if post-nasal drip is suspected but are not
the initial management.
Question 5
A 62-year-old female patient reports difficulty with memory and
concentration. She also reports depressed mood and sleep disturbance.
Which of the following is the most appropriate initial assessment?
A. Cognitive screening with MoCA or Mini-Cog
B. Depression screening with PHQ-9
C. Medication review
D. All of the above
ANCC AGPCNP-BC Practice Exam – 260 Questions
with Rationales | Adult-Gerontology Primary Care
Nurse Practitioner Certification | Updated 2026
TABLE OF CONTENTS
Domain 1: Patient Assessment Process Questions 1 to 65
Domain 2: Plan of Care Questions 66 to 130
Domain 3: Professional Practice Questions 131 to 195
Domain 4: Mixed Review and High-Yield Scenarios Questions 196 to 260
DOMAIN 1: PATIENT ASSESSMENT PROCESS QUESTIONS 1 TO 65
Question 1
A 68-year-old female patient presents with complaints of fatigue, weight
gain, and cold intolerance. On physical exam, you note bradycardia and dry,
coarse skin. Which of the following is the most appropriate initial diagnostic
test?
A. Thyroid-stimulating hormone level
B. Complete blood count
C. Serum cortisol level
D. Fasting blood glucose
, 2
Correct Answer: A
Rationale: The patient's symptoms of fatigue, weight gain, cold intolerance,
bradycardia, and dry skin are classic for hypothyroidism. Thyroid-
stimulating hormone is the most sensitive initial screening test for thyroid
dysfunction. A complete blood count may show anemia but is not diagnostic
for hypothyroidism. Serum cortisol would be indicated for adrenal
insufficiency. Fasting blood glucose would be indicated for diabetes
mellitus.
Question 2
A 72-year-old male patient reports a history of falling twice in the past
month. Which of the following is the most important component of the
assessment for falls in the older adult?
A. Orthostatic blood pressure measurement
B. Vision screening
C. Medication review
D. All of the above
Correct Answer: D
Rationale: A comprehensive fall risk assessment in the older adult includes
orthostatic blood pressure measurement to evaluate for postural
hypotension, vision screening to identify visual impairment, and medication
review to identify drugs that increase fall risk such as sedatives and
, 3
antihypertensives. All components are essential for identifying modifiable
risk factors.
Question 3
A 65-year-old male patient presents with a complaint of difficulty starting
urination and a weak urinary stream. His digital rectal exam reveals an
enlarged, smooth prostate. Which of the following is the most likely
diagnosis?
A. Benign prostatic hyperplasia
B. Prostate cancer
C. Prostatitis
D. Urethral stricture
Correct Answer: A
Rationale: Benign prostatic hyperplasia presents with obstructive urinary
symptoms including hesitancy, weak stream, and nocturia. The prostate is
typically enlarged and smooth on digital rectal exam. Prostate cancer may
present with similar symptoms but the prostate is often hard and nodular.
Prostatitis presents with perineal pain and a tender prostate. Urethral
stricture presents with a weak stream but the prostate is normal.
Question 4
A 58-year-old female patient reports a dry cough that has persisted for eight
weeks following a viral respiratory infection. She is a non-smoker and has
, 4
no other symptoms. Which of the following is the most appropriate initial
management?
A. Observation and reassurance
B. Chest x-ray
C. Antibiotics
D. Antihistamines
Correct Answer: B
Rationale: A cough persisting for more than three weeks warrants further
evaluation with a chest x-ray, especially in a patient over 50 years of age.
Observation and reassurance would be appropriate for a cough lasting less
than three weeks. Antibiotics are not indicated without evidence of
infection. Antihistamines may help if post-nasal drip is suspected but are not
the initial management.
Question 5
A 62-year-old female patient reports difficulty with memory and
concentration. She also reports depressed mood and sleep disturbance.
Which of the following is the most appropriate initial assessment?
A. Cognitive screening with MoCA or Mini-Cog
B. Depression screening with PHQ-9
C. Medication review
D. All of the above
