AGNP AANP Boards 2026 | Adult-Gerontology
Nurse Practitioner Exam Review & Study Guide
A skin lesion that appears pearly, or waxlike (shiny) in appearance with telangiectasia is
the "classic" appearance for what skin condition? - ANS✔✔-Basal Cell Carcinoma
What is the name of a precancer of squamous cell carcinoma, that is usually located on
the scalp (males), face, and back of hands that appears crust/scaly and slowly enlarges
over time is called what? - ANS✔✔-Actinic Keratosis
What is the name for a type of cellulitis caused by strep that resembles a bright-red,
warm, raised-rash (plaque-like) with discrete borders usually located on the face or
shins? - ANS✔✔-Erysipelas
Rust colored sputum is associated with which infection? - ANS✔✔-Streptococcus
pneumoniae
you may see an elevated ESR/sed rate with which conditions (4)? - ANS✔✔-giant cell
arteritis, rheumatoid arthritis, lupus, inflammation
you may see an elevated CRP with which conditions (3)? - ANS✔✔-inflammation,
autoimmune disease, a RF for heart disease
what are the differential diagnoses for microcytic (MCV low <80) anemia? - ANS✔✔-iron
deficiency, alpha/beta thalassemia (consider ethnicity with these- East Asian aka
Filipino, or Mediterrean)
The ________ is a measure of the variability in size of red blood cells. When elevated it
is one of the earliest indicators for ______________. - ANS✔✔-RDW; Iron Deficiency
Anemia
In clinical practice, rule out IDA first before ordering... - ANS✔✔-hemoglobin
electrophoresis
When an oral drug reaches the stomach, it goes to the small intestines, then to the
portal circulation where it is metabolized by the liver. After the liver, it is released to
systemic circulation where it can reach the target organ. This concept is known as.... -
ANS✔✔-first pass metabolism (or first pass effect)
What are characteristics of a BV infection? - ANS✔✔-alkaline pH of urine, clue cells (
mature squamous epithelial cells w/ numerous bacteria of cell surface and borders),
milky/gray to off white discharge
what is first line treatment and duration for strep throat? alternatives? - ANS✔✔-PCN X
10 days; alternatives include macrolides and clindamycin
what is the first line treatment for CAP (pt has receive an abx in last 3 months)? naming
the drug class - ANS✔✔-Beta lactam
outpatient treatment of CAP in healthy patients (no comorbitdities) involes _______ or
_________. - ANS✔✔-amoxicillin; or doxycycline
disease causing the most deaths overall - ANS✔✔-heart disease
cancer with the highest mortality - ANS✔✔-lung cancer
cancer with the highest mortality in males and females - ANS✔✔-lung cancer
most common cause of death in adolescents - ANS✔✔-motor vehicle crashes
most common cancer in females - ANS✔✔-breast cancer
most common cancer in males - ANS✔✔-prostate cancer
most common type of cancer overall (males and females) - ANS✔✔-skin cancer
, AGNP AANP Boards 2026 | Adult-Gerontology
Nurse Practitioner Exam Review & Study Guide
most common type of skin cancer - ANS✔✔-basal cell cancer
skin cancer with highest mortality - ANS✔✔-melanoma
what are considered gynecologic cancers? and what is the most common? second most
common? - ANS✔✔-vulva, vagina, cervix, uterus, ovary; most common=
uterine/endometrial; second most common= ovarian
what is a torus palatinus? - ANS✔✔-a chronic bony growth located midline in the hard
palate of the mouth; it is benign and painless
oral hairy leukoplakia is commonly associated with which conditions? - ANS✔✔-
Epstein-Barr virus, HIV/AIDs infection
always rule out ________________ in a post-menopausal woman who has a palpable
ovary - ANS✔✔-ovarian cancer
what medication class is the preferred treatment for erosive esophagitis? - ANS✔✔-PPI
what is the first-line treatment for mild, uncomplicated GERD? - ANS✔✔-lifestyle
changes (e: avoid eating 3-4 hrs before bed, dietary changes, weight loss)
The patient with migraine headaches or who is taking an MAOI (Marplan, Nardil,
Parnate) should avoid which type of foods? why? - ANS✔✔-high-tyramine foods (aged
cheeses/meats, red wine, fava beans, draft beer, fermented foods); can lead to a
hypertensive crisis
patients with an atopic history (asthma, eczema, allergic rhinitis) with nasal polyps are
at a higher risk for ____________________. - ANS✔✔-Aspirin, and NSAID drug
allergies
what are the most common triggers for anaphylaxis in kids vs adults? - ANS✔✔-kids-
foods; adults- meds and insect stings
What is the next best step for a patient with an asthma exacerbation who PEG is <50%
of predicted value after being given nebulized albuterol/saline treatment in office? -
ANS✔✔-Call 911!
assume that a patient has ______________ if excoriated pruritic rashes are located in
the finger webs and penis until proven otherwise - ANS✔✔-scabies
signs and symptoms of scarlet fever (4)- commonly follows strep throat infection
(Streptococcus A) - ANS✔✔-1. scarlatina rash (sandpaper like texture)- not pruritic
2. sore throat
3. strawberry tongue
4. skin desquamation (peeling) of palms and soles
describe the appearance of an impetigo rash - ANS✔✔-initially appears as papules that
develop into bullae. they ruptures and weep honey colored exudate that crust over. they
are pruritic located on face, arms and legs. insect bites/acne lesions/varicella can
become secondarily infected resulting in impetigo
what is the preferred first line antibiotic for acute otitis media and acute sinusitis in
children (for pts with no risk factors for resistant organisms)? what if they were
previously on an abx in the last 3 months? if PCN allergic? - ANS✔✔-first line-
amoxicillin
if previously on abx- Augmentin or Cefdinir (Omnicef)
PCN allergy- Zpak or clarithyromycin
, AGNP AANP Boards 2026 | Adult-Gerontology
Nurse Practitioner Exam Review & Study Guide
which is the best location to auscultate for the S3 heart sounds? - ANS✔✔-mitral
auscultation area (aka the cardiac apex) best heard at L 5th ICS, along midclavicular
line; left lateral recumbent position makes this easier to hear
You should not give a suicidal patient a prescription for which drug class and why? -
ANS✔✔-TCAs (amitriptyline, nortriptyline, doxepin, desipramine); there is a high risk of
hoarding the drug and OD (fatal- CNS and cardiac toxicity)
what are typical clinical findings with otitis externa? - ANS✔✔-more common in
warm/humid conditions (history of swimming); bright green pus may be present bc
usually most common bacterial pathogen is pseudomonas; you will see reddened and
swollen ear canal, pulling on tragus is painful; there is will be a regular tympanic
membrane
what is the preferred treatment agent for Rocky Mountain Spotted Fever? - ANS✔✔-
Doxycycline
what is the second most common cause of mortality among adolescents? third? -
ANS✔✔-second- suicide
third- homicide
cavitations (round, black areas on CXR) on the upper lobes of the lung are of of the
classic signs for.... - ANS✔✔-active or passive TB
if a patient has both mono and strep throat, avoid using __________ or _________.
Instead use, ___________ to treat to avoid non allergic drug rash. - ANS✔✔-amoxicillin,
or ampicillin; instead PCN or macrolide to treat
A patient with symptoms of gout and a history of hypertension should avoid which HTN
treatment med? - ANS✔✔-Thiazide Diuretics (worsen gout)
Prior to initiating an ACE or ARB, the NP should monitor which laboratory value (s)? -
ANS✔✔-potassium and creatinine
What is the goal INR for a patient with afib? patient with prosthetic heart valve? -
ANS✔✔-afib- 2-3
prosthetic heart valve- 2.5-3.5
The FDA recommends genotyping all Asians for HLA-B*1502 allele prior to starting
__________________. Because of the increased risk for ____________________. -
ANS✔✔-Carbamazepine; increased risk for fatal carbamazepine induced Stevens-
Johnson syndrome and toxic epidermal necrolysis-- common among chinese
All oral drugs (except sublingual) must go through _____________ before they can be
released and used by the body. - ANS✔✔-first pass metabolism
What is the main organ involved in drug metabolism, and what is the main system in
this organ called that is responsible for 90% of drug metabolism? - ANS✔✔-liver;
CYP450 enzyme system (also located in intestines and kidneys)
What is the principle organ for drug excretion? - ANS✔✔-kidneys
when should warfarin be discontinued before surgery? - ANS✔✔-7 days
a patient taking pioglitazone (Actos) suddenly develops dyspnea, weight gain, and
cough...the NP knows she must - ANS✔✔-discontinue the medication (signs of CHF--
Actos and cause of exacerbate CHF)
, AGNP AANP Boards 2026 | Adult-Gerontology
Nurse Practitioner Exam Review & Study Guide
When prescribed atypical antipsychotics such as risperidone (Risperdal), Olanzapine
(Zyprexa), and Quetiapine (Seroquel) the NP must monitor.... - ANS✔✔-weight every 3
months; TSH, lipids, blood glucose/A1C (high risk of weight gain, metabolic syndrome,
type II diabetes)
The patient with osteoporosis taking oral bisphosphonates suddenly develops chest
pain with eating, odynophagia, dysphagia, heartburn..the NP knows that this condition is
know as ________________ and that she should _________________. If the patient
develops jaw pain you should also suspect ______________. - ANS✔✔-Erosive
esophagitis; stop immediately; osteonecrosis of jaw
what are the main adverse effects of phenytoin? - ANS✔✔-toxicity (early signs-
horizontal nystagmus, unsteady gait; severe- slurred speech, lethargy, confusion,
coma); gingival hyperplasia
Tramadol should be avoided in the elderly according to the BEERs criteria due to which
side effect... - ANS✔✔-hyponatremia from SIADH
according to the BEERs criteria, ______________ and _____________ carry a higher
bleeding risk than warfarin and other DOACs - ANS✔✔-Rivaroxaban (Xarelto) and
Dabigatran (Pradaxa)
For patients with valvular disease or prosthetic heart valves, the only appropriate
anticoagulation is... - ANS✔✔-warfarin (Coumadin)
If a patient has a stable INR and has a single out-of-range value (<0.5 below or above
therapeutic of 2-3), the NP should... - ANS✔✔-continue current warfarin dose; retest
INR within 1-2 weeks
what class of anti-hypertensive meds should be avoided with aortic stenosis? - ANS✔✔-
ACEis
It can take up to ________ days for platelet function to return to normal after a patient
stops taking clopidogrel (Plavix) - ANS✔✔-10
mayonnaise, canola oil and soybean oil all have high levels of _____________. -
ANS✔✔-Vitamin K (caution when on warfarin)
Which ethnicity of patients may require lower starting and maintenance doses of
warfarin? - ANS✔✔-
which herbal supplements can increase your bleeding risk if taken in high doses? -
ANS✔✔-ginkgo biloba, garlic, ginseng, fish oil, feverfew, Dong quai
What is recommended as first line therapy in Black patients with HTN? - ANS✔✔-
Thiazide Diuretics
thiazide and loop diuretics are contraindicated with which allergy? - ANS✔✔-sulfa
thiazide diuretics should not be combined with which medication due to the increased
for toxicity? - ANS✔✔-lithium
patients with both hypertension and osteoporosis receive an extra benefit from taking a
thiazide diuretic...why? - ANS✔✔-thiazides reduce calcium excretion by the kidneys and
stimulate osteoblasts which helps build bone
Caution when combining the use of loop diuretics and aminoglycosides due to the risk
of - ANS✔✔-ototoxicity
Nurse Practitioner Exam Review & Study Guide
A skin lesion that appears pearly, or waxlike (shiny) in appearance with telangiectasia is
the "classic" appearance for what skin condition? - ANS✔✔-Basal Cell Carcinoma
What is the name of a precancer of squamous cell carcinoma, that is usually located on
the scalp (males), face, and back of hands that appears crust/scaly and slowly enlarges
over time is called what? - ANS✔✔-Actinic Keratosis
What is the name for a type of cellulitis caused by strep that resembles a bright-red,
warm, raised-rash (plaque-like) with discrete borders usually located on the face or
shins? - ANS✔✔-Erysipelas
Rust colored sputum is associated with which infection? - ANS✔✔-Streptococcus
pneumoniae
you may see an elevated ESR/sed rate with which conditions (4)? - ANS✔✔-giant cell
arteritis, rheumatoid arthritis, lupus, inflammation
you may see an elevated CRP with which conditions (3)? - ANS✔✔-inflammation,
autoimmune disease, a RF for heart disease
what are the differential diagnoses for microcytic (MCV low <80) anemia? - ANS✔✔-iron
deficiency, alpha/beta thalassemia (consider ethnicity with these- East Asian aka
Filipino, or Mediterrean)
The ________ is a measure of the variability in size of red blood cells. When elevated it
is one of the earliest indicators for ______________. - ANS✔✔-RDW; Iron Deficiency
Anemia
In clinical practice, rule out IDA first before ordering... - ANS✔✔-hemoglobin
electrophoresis
When an oral drug reaches the stomach, it goes to the small intestines, then to the
portal circulation where it is metabolized by the liver. After the liver, it is released to
systemic circulation where it can reach the target organ. This concept is known as.... -
ANS✔✔-first pass metabolism (or first pass effect)
What are characteristics of a BV infection? - ANS✔✔-alkaline pH of urine, clue cells (
mature squamous epithelial cells w/ numerous bacteria of cell surface and borders),
milky/gray to off white discharge
what is first line treatment and duration for strep throat? alternatives? - ANS✔✔-PCN X
10 days; alternatives include macrolides and clindamycin
what is the first line treatment for CAP (pt has receive an abx in last 3 months)? naming
the drug class - ANS✔✔-Beta lactam
outpatient treatment of CAP in healthy patients (no comorbitdities) involes _______ or
_________. - ANS✔✔-amoxicillin; or doxycycline
disease causing the most deaths overall - ANS✔✔-heart disease
cancer with the highest mortality - ANS✔✔-lung cancer
cancer with the highest mortality in males and females - ANS✔✔-lung cancer
most common cause of death in adolescents - ANS✔✔-motor vehicle crashes
most common cancer in females - ANS✔✔-breast cancer
most common cancer in males - ANS✔✔-prostate cancer
most common type of cancer overall (males and females) - ANS✔✔-skin cancer
, AGNP AANP Boards 2026 | Adult-Gerontology
Nurse Practitioner Exam Review & Study Guide
most common type of skin cancer - ANS✔✔-basal cell cancer
skin cancer with highest mortality - ANS✔✔-melanoma
what are considered gynecologic cancers? and what is the most common? second most
common? - ANS✔✔-vulva, vagina, cervix, uterus, ovary; most common=
uterine/endometrial; second most common= ovarian
what is a torus palatinus? - ANS✔✔-a chronic bony growth located midline in the hard
palate of the mouth; it is benign and painless
oral hairy leukoplakia is commonly associated with which conditions? - ANS✔✔-
Epstein-Barr virus, HIV/AIDs infection
always rule out ________________ in a post-menopausal woman who has a palpable
ovary - ANS✔✔-ovarian cancer
what medication class is the preferred treatment for erosive esophagitis? - ANS✔✔-PPI
what is the first-line treatment for mild, uncomplicated GERD? - ANS✔✔-lifestyle
changes (e: avoid eating 3-4 hrs before bed, dietary changes, weight loss)
The patient with migraine headaches or who is taking an MAOI (Marplan, Nardil,
Parnate) should avoid which type of foods? why? - ANS✔✔-high-tyramine foods (aged
cheeses/meats, red wine, fava beans, draft beer, fermented foods); can lead to a
hypertensive crisis
patients with an atopic history (asthma, eczema, allergic rhinitis) with nasal polyps are
at a higher risk for ____________________. - ANS✔✔-Aspirin, and NSAID drug
allergies
what are the most common triggers for anaphylaxis in kids vs adults? - ANS✔✔-kids-
foods; adults- meds and insect stings
What is the next best step for a patient with an asthma exacerbation who PEG is <50%
of predicted value after being given nebulized albuterol/saline treatment in office? -
ANS✔✔-Call 911!
assume that a patient has ______________ if excoriated pruritic rashes are located in
the finger webs and penis until proven otherwise - ANS✔✔-scabies
signs and symptoms of scarlet fever (4)- commonly follows strep throat infection
(Streptococcus A) - ANS✔✔-1. scarlatina rash (sandpaper like texture)- not pruritic
2. sore throat
3. strawberry tongue
4. skin desquamation (peeling) of palms and soles
describe the appearance of an impetigo rash - ANS✔✔-initially appears as papules that
develop into bullae. they ruptures and weep honey colored exudate that crust over. they
are pruritic located on face, arms and legs. insect bites/acne lesions/varicella can
become secondarily infected resulting in impetigo
what is the preferred first line antibiotic for acute otitis media and acute sinusitis in
children (for pts with no risk factors for resistant organisms)? what if they were
previously on an abx in the last 3 months? if PCN allergic? - ANS✔✔-first line-
amoxicillin
if previously on abx- Augmentin or Cefdinir (Omnicef)
PCN allergy- Zpak or clarithyromycin
, AGNP AANP Boards 2026 | Adult-Gerontology
Nurse Practitioner Exam Review & Study Guide
which is the best location to auscultate for the S3 heart sounds? - ANS✔✔-mitral
auscultation area (aka the cardiac apex) best heard at L 5th ICS, along midclavicular
line; left lateral recumbent position makes this easier to hear
You should not give a suicidal patient a prescription for which drug class and why? -
ANS✔✔-TCAs (amitriptyline, nortriptyline, doxepin, desipramine); there is a high risk of
hoarding the drug and OD (fatal- CNS and cardiac toxicity)
what are typical clinical findings with otitis externa? - ANS✔✔-more common in
warm/humid conditions (history of swimming); bright green pus may be present bc
usually most common bacterial pathogen is pseudomonas; you will see reddened and
swollen ear canal, pulling on tragus is painful; there is will be a regular tympanic
membrane
what is the preferred treatment agent for Rocky Mountain Spotted Fever? - ANS✔✔-
Doxycycline
what is the second most common cause of mortality among adolescents? third? -
ANS✔✔-second- suicide
third- homicide
cavitations (round, black areas on CXR) on the upper lobes of the lung are of of the
classic signs for.... - ANS✔✔-active or passive TB
if a patient has both mono and strep throat, avoid using __________ or _________.
Instead use, ___________ to treat to avoid non allergic drug rash. - ANS✔✔-amoxicillin,
or ampicillin; instead PCN or macrolide to treat
A patient with symptoms of gout and a history of hypertension should avoid which HTN
treatment med? - ANS✔✔-Thiazide Diuretics (worsen gout)
Prior to initiating an ACE or ARB, the NP should monitor which laboratory value (s)? -
ANS✔✔-potassium and creatinine
What is the goal INR for a patient with afib? patient with prosthetic heart valve? -
ANS✔✔-afib- 2-3
prosthetic heart valve- 2.5-3.5
The FDA recommends genotyping all Asians for HLA-B*1502 allele prior to starting
__________________. Because of the increased risk for ____________________. -
ANS✔✔-Carbamazepine; increased risk for fatal carbamazepine induced Stevens-
Johnson syndrome and toxic epidermal necrolysis-- common among chinese
All oral drugs (except sublingual) must go through _____________ before they can be
released and used by the body. - ANS✔✔-first pass metabolism
What is the main organ involved in drug metabolism, and what is the main system in
this organ called that is responsible for 90% of drug metabolism? - ANS✔✔-liver;
CYP450 enzyme system (also located in intestines and kidneys)
What is the principle organ for drug excretion? - ANS✔✔-kidneys
when should warfarin be discontinued before surgery? - ANS✔✔-7 days
a patient taking pioglitazone (Actos) suddenly develops dyspnea, weight gain, and
cough...the NP knows she must - ANS✔✔-discontinue the medication (signs of CHF--
Actos and cause of exacerbate CHF)
, AGNP AANP Boards 2026 | Adult-Gerontology
Nurse Practitioner Exam Review & Study Guide
When prescribed atypical antipsychotics such as risperidone (Risperdal), Olanzapine
(Zyprexa), and Quetiapine (Seroquel) the NP must monitor.... - ANS✔✔-weight every 3
months; TSH, lipids, blood glucose/A1C (high risk of weight gain, metabolic syndrome,
type II diabetes)
The patient with osteoporosis taking oral bisphosphonates suddenly develops chest
pain with eating, odynophagia, dysphagia, heartburn..the NP knows that this condition is
know as ________________ and that she should _________________. If the patient
develops jaw pain you should also suspect ______________. - ANS✔✔-Erosive
esophagitis; stop immediately; osteonecrosis of jaw
what are the main adverse effects of phenytoin? - ANS✔✔-toxicity (early signs-
horizontal nystagmus, unsteady gait; severe- slurred speech, lethargy, confusion,
coma); gingival hyperplasia
Tramadol should be avoided in the elderly according to the BEERs criteria due to which
side effect... - ANS✔✔-hyponatremia from SIADH
according to the BEERs criteria, ______________ and _____________ carry a higher
bleeding risk than warfarin and other DOACs - ANS✔✔-Rivaroxaban (Xarelto) and
Dabigatran (Pradaxa)
For patients with valvular disease or prosthetic heart valves, the only appropriate
anticoagulation is... - ANS✔✔-warfarin (Coumadin)
If a patient has a stable INR and has a single out-of-range value (<0.5 below or above
therapeutic of 2-3), the NP should... - ANS✔✔-continue current warfarin dose; retest
INR within 1-2 weeks
what class of anti-hypertensive meds should be avoided with aortic stenosis? - ANS✔✔-
ACEis
It can take up to ________ days for platelet function to return to normal after a patient
stops taking clopidogrel (Plavix) - ANS✔✔-10
mayonnaise, canola oil and soybean oil all have high levels of _____________. -
ANS✔✔-Vitamin K (caution when on warfarin)
Which ethnicity of patients may require lower starting and maintenance doses of
warfarin? - ANS✔✔-
which herbal supplements can increase your bleeding risk if taken in high doses? -
ANS✔✔-ginkgo biloba, garlic, ginseng, fish oil, feverfew, Dong quai
What is recommended as first line therapy in Black patients with HTN? - ANS✔✔-
Thiazide Diuretics
thiazide and loop diuretics are contraindicated with which allergy? - ANS✔✔-sulfa
thiazide diuretics should not be combined with which medication due to the increased
for toxicity? - ANS✔✔-lithium
patients with both hypertension and osteoporosis receive an extra benefit from taking a
thiazide diuretic...why? - ANS✔✔-thiazides reduce calcium excretion by the kidneys and
stimulate osteoblasts which helps build bone
Caution when combining the use of loop diuretics and aminoglycosides due to the risk
of - ANS✔✔-ototoxicity
