2023 AANP AGPCNP PSI TeST 1 & 2:
HIGH-GrAde PrACTICe exAm 200
QueSTIoNS wITH ComPleTe SoluTIoNS
ANd deTAIled rATIoNAleS AlreAdY
GrAded A+ lATTeST VerSIoN
EXAM INSTRUCTIONS
This comprehensive practice examination is compiled from TOPSCORE materials for the 2023
AANP Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) certification exam. It
contains 200 actual exam-style questions with verified answers and rationales, organized to
reflect the PSI Test 1 and Test 2 formats.
Exam Domains:
• Assessment (History, Physical Exam, Diagnostic Tests)
• Diagnosis (Differential and Primary Diagnosis)
• Plan of Care (Treatment, Management, Education)
• Professional Practice
TEST 1: QUESTIONS 1-100
Question 1
An 88-year-old presents with right-side weakness after being unable to rise unassisted following
a fall to the bathroom floor. History includes aphasia and noncompliance with hypertension
medication regimen. What is the most likely diagnosis?
A) Right-sided CVA
B) Left-sided CVA
,C) Transient ischemic attack
D) Subdural hematoma
Correct Answer: B) LEFT-SIDED CVA
Rationale: A left-sided cerebrovascular accident (CVA) typically presents with right-sided
weakness and aphasia. The left hemisphere controls language function and right-sided motor
function. The patient's noncompliance with hypertension medication is a significant risk factor
for stroke. Left-sided CVA often results in expressive aphasia (Broca's area) or receptive aphasia
(Wernicke's area) depending on the specific location within the left hemisphere.
Question 2
Which of the following signs/symptoms are often associated with headaches due to intracranial
tumor?
A) Acute onset: hours to days
B) Hyperflexia, personality change
C) Pain worse laying down, focal neurological signs
D) Pupillary constriction; stupor
Correct Answer: C) Pain worse laying down, focal neurological signs
Rationale: Intracranial tumors typically cause headaches that are worse when lying down due to
increased intracranial pressure. Focal neurological signs reflect the specific location of the
tumor. These headaches are often worse in the morning, may awaken the patient from sleep,
and can be associated with nausea, vomiting, and visual changes. Personality changes may
occur but are not the primary distinguishing feature.
Question 3
Which of the following pharmacotherapeutics would be most important to administer to a
patient who has a corneal abrasion?
A) Timolol
B) Gentamicin ophthalmic (Genoptic)
C) Cromolyn ophthalmic
D) Olopatadine
Correct Answer: B) Gentamicin ophthalmic (Genoptic)
,Rationale: Topical antibiotics such as gentamicin (or erythromycin, moxifloxacin) are used
prophylactically to prevent infection in corneal abrasions. Fluorescein staining is used for
diagnosis. Patching is controversial, and cycloplegics may be used for pain control. Gentamicin
provides broad-spectrum coverage against common ocular pathogens.
Question 4
A 25-year-old presents with the chief complaint of decreased mobility and pain of the right
shoulder exacerbated by movement. The patient reports that he participated in extensive house
painting 24 hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No
redness or ecchymosis is present. What is the next step to be taken in order to make a
diagnosis?
A) X-ray of shoulder
B) Palpate structures around the shoulder
C) MRI of shoulder
D) EMG
Correct Answer: B) Palpate structures around the shoulder
Rationale: Bicipital tendonitis (from overhead activity like painting) is suspected. Palpation of the
bicipital groove would reproduce pain. Passive ROM remains intact, distinguishing this from
adhesive capsulitis. Diagnosis is clinical, and imaging is typically not required unless symptoms
persist or other pathology is suspected.
Question 5
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle
spotting. She has not missed any doses and uses no other medication. Which of the following is
appropriate?
A) Changing to Ortho-Novum 1/35
B) Discontinue use
C) Providing reassurance
D) Double dose for two days
Correct Answer: C) Providing reassurance
Rationale: Breakthrough bleeding is common during the first 1-3 months of oral contraceptive
use and typically resolves spontaneously. Reassurance is appropriate. If bleeding persists beyond
, 3 months, evaluation for other causes may be indicated. This is a normal physiologic adaptation
to hormonal contraception.
Question 6
According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT
a current recommendation guideline for preventive care in elderly female patients?
A) Mammogram and clinical breast exams
B) Fecal Occult blood test and/or sigmoidoscopy
C) Rubella serology or vaccination history
D) Pneumo and influenza vaccines
Correct Answer: C) Rubella serology or vaccination history
Rationale: Rubella screening is typically recommended for women of childbearing age, not
specifically for elderly female patients. USPSTF recommends mammography (biennially for
women 50-74), colorectal cancer screening (fecal occult blood test, sigmoidoscopy, or
colonoscopy), and immunizations (pneumococcal and influenza vaccines) for older adults.
Question 7
An 87-year-old nursing home patient is drowsy and barely responsive. Temp 95°F, BP: 110/70,
Pulse 60, R 10. The best action is to:
A) Initiate passive warming
B) Apply a rebreather mask
C) Perform fluid replacement
D) Initiate active warming
Correct Answer: A) Initiate passive warming
Rationale: For mild to moderate hypothermia (95°F), passive external rewarming is appropriate.
Active rewarming carries risks for frail elderly patients, including rewarming shock and
arrhythmias. Remove wet clothing, cover with warm blankets, and provide warm fluids. The
patient's core temperature should be monitored closely.
Question 8
HIGH-GrAde PrACTICe exAm 200
QueSTIoNS wITH ComPleTe SoluTIoNS
ANd deTAIled rATIoNAleS AlreAdY
GrAded A+ lATTeST VerSIoN
EXAM INSTRUCTIONS
This comprehensive practice examination is compiled from TOPSCORE materials for the 2023
AANP Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) certification exam. It
contains 200 actual exam-style questions with verified answers and rationales, organized to
reflect the PSI Test 1 and Test 2 formats.
Exam Domains:
• Assessment (History, Physical Exam, Diagnostic Tests)
• Diagnosis (Differential and Primary Diagnosis)
• Plan of Care (Treatment, Management, Education)
• Professional Practice
TEST 1: QUESTIONS 1-100
Question 1
An 88-year-old presents with right-side weakness after being unable to rise unassisted following
a fall to the bathroom floor. History includes aphasia and noncompliance with hypertension
medication regimen. What is the most likely diagnosis?
A) Right-sided CVA
B) Left-sided CVA
,C) Transient ischemic attack
D) Subdural hematoma
Correct Answer: B) LEFT-SIDED CVA
Rationale: A left-sided cerebrovascular accident (CVA) typically presents with right-sided
weakness and aphasia. The left hemisphere controls language function and right-sided motor
function. The patient's noncompliance with hypertension medication is a significant risk factor
for stroke. Left-sided CVA often results in expressive aphasia (Broca's area) or receptive aphasia
(Wernicke's area) depending on the specific location within the left hemisphere.
Question 2
Which of the following signs/symptoms are often associated with headaches due to intracranial
tumor?
A) Acute onset: hours to days
B) Hyperflexia, personality change
C) Pain worse laying down, focal neurological signs
D) Pupillary constriction; stupor
Correct Answer: C) Pain worse laying down, focal neurological signs
Rationale: Intracranial tumors typically cause headaches that are worse when lying down due to
increased intracranial pressure. Focal neurological signs reflect the specific location of the
tumor. These headaches are often worse in the morning, may awaken the patient from sleep,
and can be associated with nausea, vomiting, and visual changes. Personality changes may
occur but are not the primary distinguishing feature.
Question 3
Which of the following pharmacotherapeutics would be most important to administer to a
patient who has a corneal abrasion?
A) Timolol
B) Gentamicin ophthalmic (Genoptic)
C) Cromolyn ophthalmic
D) Olopatadine
Correct Answer: B) Gentamicin ophthalmic (Genoptic)
,Rationale: Topical antibiotics such as gentamicin (or erythromycin, moxifloxacin) are used
prophylactically to prevent infection in corneal abrasions. Fluorescein staining is used for
diagnosis. Patching is controversial, and cycloplegics may be used for pain control. Gentamicin
provides broad-spectrum coverage against common ocular pathogens.
Question 4
A 25-year-old presents with the chief complaint of decreased mobility and pain of the right
shoulder exacerbated by movement. The patient reports that he participated in extensive house
painting 24 hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No
redness or ecchymosis is present. What is the next step to be taken in order to make a
diagnosis?
A) X-ray of shoulder
B) Palpate structures around the shoulder
C) MRI of shoulder
D) EMG
Correct Answer: B) Palpate structures around the shoulder
Rationale: Bicipital tendonitis (from overhead activity like painting) is suspected. Palpation of the
bicipital groove would reproduce pain. Passive ROM remains intact, distinguishing this from
adhesive capsulitis. Diagnosis is clinical, and imaging is typically not required unless symptoms
persist or other pathology is suspected.
Question 5
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle
spotting. She has not missed any doses and uses no other medication. Which of the following is
appropriate?
A) Changing to Ortho-Novum 1/35
B) Discontinue use
C) Providing reassurance
D) Double dose for two days
Correct Answer: C) Providing reassurance
Rationale: Breakthrough bleeding is common during the first 1-3 months of oral contraceptive
use and typically resolves spontaneously. Reassurance is appropriate. If bleeding persists beyond
, 3 months, evaluation for other causes may be indicated. This is a normal physiologic adaptation
to hormonal contraception.
Question 6
According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT
a current recommendation guideline for preventive care in elderly female patients?
A) Mammogram and clinical breast exams
B) Fecal Occult blood test and/or sigmoidoscopy
C) Rubella serology or vaccination history
D) Pneumo and influenza vaccines
Correct Answer: C) Rubella serology or vaccination history
Rationale: Rubella screening is typically recommended for women of childbearing age, not
specifically for elderly female patients. USPSTF recommends mammography (biennially for
women 50-74), colorectal cancer screening (fecal occult blood test, sigmoidoscopy, or
colonoscopy), and immunizations (pneumococcal and influenza vaccines) for older adults.
Question 7
An 87-year-old nursing home patient is drowsy and barely responsive. Temp 95°F, BP: 110/70,
Pulse 60, R 10. The best action is to:
A) Initiate passive warming
B) Apply a rebreather mask
C) Perform fluid replacement
D) Initiate active warming
Correct Answer: A) Initiate passive warming
Rationale: For mild to moderate hypothermia (95°F), passive external rewarming is appropriate.
Active rewarming carries risks for frail elderly patients, including rewarming shock and
arrhythmias. Remove wet clothing, cover with warm blankets, and provide warm fluids. The
patient's core temperature should be monitored closely.
Question 8
