AGPCNP-BC QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES |
LATEST VERSION PDF QUESTIONS WITH
DETAILED RATIONALES
Question 1
A 72-year-old patient with a history of hypertension presents with a sudden onset
of "thunderclap" headache. Which of the following is the most appropriate initial
diagnostic action?
A. Perform a lumbar puncture
B. Order an emergent non-contrast CT scan of the head
C. Initiate statin therapy
D. Schedule an MRI for the following week
Correct answer: B
Rationale: A sudden, severe "thunderclap" headache is a classic presentation for a
subarachnoid hemorrhage, which requires immediate neuroimaging to rule out
intracranial bleeding. A non-contrast CT scan of the head is the most sensitive
initial imaging study for acute subarachnoid hemorrhage, with sensitivity
approaching 95-100% within the first 24 hours of symptom onset. Lumbar
puncture is indicated if CT is negative but clinical suspicion remains high.
Question 2
Which screening tool is validated for assessing depression in older adults?
A. PHQ-9
B. Mini-Mental State Examination (MMSE)
C. CAGE questionnaire
D. Morse Fall Scale
Correct answer: A
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a standardized,
validated tool specifically used to screen for and monitor the severity of depression
in primary care settings. The MMSE assesses cognitive function, the CAGE
,questionnaire screens for alcohol use disorder, and the Morse Fall Scale assesses
fall risk. The PHQ-9 is widely used in geriatric populations and has been validated
for use in older adults.
Question 3
A 65-year-old patient presents for a routine health maintenance visit. Which
screening test is recommended annually for this patient based on USPSTF
guidelines?
A. Colonoscopy
B. Mammogram
C. Lipid panel
D. PSA testing
Correct answer: C
Rationale: The USPSTF recommends screening for lipid disorders (lipid panel) in
adults aged 40-75 years. Colonoscopy is recommended every 10 years,
mammography every 1-2 years based on individual risk, and PSA testing is not
recommended routinely. Annual lipid screening is important for cardiovascular
disease prevention in this age group.
Question 4
A 68-year-old patient with a 30-pack-year smoking history is being counseled on
lung cancer screening. Which of the following is the recommended screening
modality?
A. Chest X-ray
B. Low-dose computed tomography (CT) scan
C. Sputum cytology
D. Positron emission tomography (PET) scan
Correct answer: B
Rationale: Low-dose CT (LDCT) scan is the recommended screening modality for
lung cancer in high-risk patients (age 50-80 years, ≥20 pack-year history, current
smoker or quit within 15 years). Chest X-ray and sputum cytology are not
,recommended for screening due to lack of evidence for mortality benefit. LDCT
has been shown to reduce lung cancer mortality in high-risk populations.
Question 5
Which of the following immunizations is recommended annually for all adults
aged 65 years and older?
A. Pneumococcal conjugate vaccine (PCV13)
B. Influenza vaccine
C. Tdap vaccine
D. Zoster vaccine
Correct answer: B
Rationale: Influenza vaccine is recommended annually for all adults aged 65 years
and older. Pneumococcal vaccines (PCV13 and PPSV23) are recommended but not
annually; Tdap is given once then Td every 10 years; zoster vaccine (Shingrix) is
recommended for adults aged 50 years and older but is a two-dose series, not
annual.
Question 6
A 75-year-old patient asks about colorectal cancer screening. According to
USPSTF guidelines, what is the recommended screening interval for colonoscopy
in average-risk patients?
A. Every 5 years
B. Every 10 years
C. Every 15 years
D. Once in a lifetime
Correct answer: B
Rationale: The USPSTF recommends colonoscopy every 10 years for average-risk
adults aged 45-75 years. Screening may be individualized for adults aged 76-85
years based on overall health and prior screening history. Flexible sigmoidoscopy
is recommended every 5 years, and FIT testing annually.
, Question 7
A 70-year-old female patient with no history of osteoporosis presents for
evaluation. Which of the following is a risk factor for osteoporosis that should
prompt bone density screening?
A. Body mass index (BMI) of 28 kg/m²
B. History of early menopause
C. History of osteoarthritis
D. Daily calcium intake of 1,200 mg
Correct answer: B
Rationale: Early menopause (before age 45) is a significant risk factor for
osteoporosis due to premature estrogen deficiency. Other risk factors include low
BMI (<20 kg/m²), smoking, excessive alcohol consumption, and family history of
osteoporosis. Osteoarthritis is not a risk factor for osteoporosis; in fact, it is
associated with higher bone density.
Question 8
A 66-year-old male patient asks about screening for abdominal aortic aneurysm
(AAA). What is the USPSTF recommendation for AAA screening?
A. One-time ultrasound screening for men aged 65-75 who have ever smoked
B. Annual ultrasound screening for all adults aged 65-75
C. One-time ultrasound screening for women aged 65-75
D. No screening recommended
Correct answer: A
Rationale: The USPSTF recommends one-time ultrasound screening for
abdominal aortic aneurysm in men aged 65-75 years who have a history of
smoking. Screening is not recommended for women due to lower prevalence and
lack of evidence for benefit. The recommendation is based on evidence that
screening reduces AAA-related mortality.
Question 9
A 73-year-old patient with diabetes is being evaluated for foot care. Which of the
following is the most important component of diabetic foot care?
ANSWERS WITH DETAILED RATIONALES |
LATEST VERSION PDF QUESTIONS WITH
DETAILED RATIONALES
Question 1
A 72-year-old patient with a history of hypertension presents with a sudden onset
of "thunderclap" headache. Which of the following is the most appropriate initial
diagnostic action?
A. Perform a lumbar puncture
B. Order an emergent non-contrast CT scan of the head
C. Initiate statin therapy
D. Schedule an MRI for the following week
Correct answer: B
Rationale: A sudden, severe "thunderclap" headache is a classic presentation for a
subarachnoid hemorrhage, which requires immediate neuroimaging to rule out
intracranial bleeding. A non-contrast CT scan of the head is the most sensitive
initial imaging study for acute subarachnoid hemorrhage, with sensitivity
approaching 95-100% within the first 24 hours of symptom onset. Lumbar
puncture is indicated if CT is negative but clinical suspicion remains high.
Question 2
Which screening tool is validated for assessing depression in older adults?
A. PHQ-9
B. Mini-Mental State Examination (MMSE)
C. CAGE questionnaire
D. Morse Fall Scale
Correct answer: A
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a standardized,
validated tool specifically used to screen for and monitor the severity of depression
in primary care settings. The MMSE assesses cognitive function, the CAGE
,questionnaire screens for alcohol use disorder, and the Morse Fall Scale assesses
fall risk. The PHQ-9 is widely used in geriatric populations and has been validated
for use in older adults.
Question 3
A 65-year-old patient presents for a routine health maintenance visit. Which
screening test is recommended annually for this patient based on USPSTF
guidelines?
A. Colonoscopy
B. Mammogram
C. Lipid panel
D. PSA testing
Correct answer: C
Rationale: The USPSTF recommends screening for lipid disorders (lipid panel) in
adults aged 40-75 years. Colonoscopy is recommended every 10 years,
mammography every 1-2 years based on individual risk, and PSA testing is not
recommended routinely. Annual lipid screening is important for cardiovascular
disease prevention in this age group.
Question 4
A 68-year-old patient with a 30-pack-year smoking history is being counseled on
lung cancer screening. Which of the following is the recommended screening
modality?
A. Chest X-ray
B. Low-dose computed tomography (CT) scan
C. Sputum cytology
D. Positron emission tomography (PET) scan
Correct answer: B
Rationale: Low-dose CT (LDCT) scan is the recommended screening modality for
lung cancer in high-risk patients (age 50-80 years, ≥20 pack-year history, current
smoker or quit within 15 years). Chest X-ray and sputum cytology are not
,recommended for screening due to lack of evidence for mortality benefit. LDCT
has been shown to reduce lung cancer mortality in high-risk populations.
Question 5
Which of the following immunizations is recommended annually for all adults
aged 65 years and older?
A. Pneumococcal conjugate vaccine (PCV13)
B. Influenza vaccine
C. Tdap vaccine
D. Zoster vaccine
Correct answer: B
Rationale: Influenza vaccine is recommended annually for all adults aged 65 years
and older. Pneumococcal vaccines (PCV13 and PPSV23) are recommended but not
annually; Tdap is given once then Td every 10 years; zoster vaccine (Shingrix) is
recommended for adults aged 50 years and older but is a two-dose series, not
annual.
Question 6
A 75-year-old patient asks about colorectal cancer screening. According to
USPSTF guidelines, what is the recommended screening interval for colonoscopy
in average-risk patients?
A. Every 5 years
B. Every 10 years
C. Every 15 years
D. Once in a lifetime
Correct answer: B
Rationale: The USPSTF recommends colonoscopy every 10 years for average-risk
adults aged 45-75 years. Screening may be individualized for adults aged 76-85
years based on overall health and prior screening history. Flexible sigmoidoscopy
is recommended every 5 years, and FIT testing annually.
, Question 7
A 70-year-old female patient with no history of osteoporosis presents for
evaluation. Which of the following is a risk factor for osteoporosis that should
prompt bone density screening?
A. Body mass index (BMI) of 28 kg/m²
B. History of early menopause
C. History of osteoarthritis
D. Daily calcium intake of 1,200 mg
Correct answer: B
Rationale: Early menopause (before age 45) is a significant risk factor for
osteoporosis due to premature estrogen deficiency. Other risk factors include low
BMI (<20 kg/m²), smoking, excessive alcohol consumption, and family history of
osteoporosis. Osteoarthritis is not a risk factor for osteoporosis; in fact, it is
associated with higher bone density.
Question 8
A 66-year-old male patient asks about screening for abdominal aortic aneurysm
(AAA). What is the USPSTF recommendation for AAA screening?
A. One-time ultrasound screening for men aged 65-75 who have ever smoked
B. Annual ultrasound screening for all adults aged 65-75
C. One-time ultrasound screening for women aged 65-75
D. No screening recommended
Correct answer: A
Rationale: The USPSTF recommends one-time ultrasound screening for
abdominal aortic aneurysm in men aged 65-75 years who have a history of
smoking. Screening is not recommended for women due to lower prevalence and
lack of evidence for benefit. The recommendation is based on evidence that
screening reduces AAA-related mortality.
Question 9
A 73-year-old patient with diabetes is being evaluated for foot care. Which of the
following is the most important component of diabetic foot care?
