AANP AGPCNP PSI TEST 1 & 2 FINAL EXAM NEWEST 2026/2027
ACTUAL EXAM COMPLETE 300 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH RATIONALES|ALREADY
GRADED A+||BRAND NEW VERSION!!
Key Content Areas Covered:
• Health Promotion & Disease Prevention
• Cardiovascular Disorders
• Respiratory Disorders
• Endocrine Disorders
• Neurological Disorders
• Musculoskeletal Disorders
• Gastrointestinal Disorders
• Genitourinary & Renal Disorders
• Reproductive Health
• Dermatological Conditions
• Ophthalmologic & ENT Conditions
• Hematologic & Oncologic Disorders
• Infectious Diseases
• Mental Health & Psychiatric Conditions
• Pharmacology
• Geriatric Syndromes & Special Considerations
• Evidence-Based Practice & Clinical Guidelines
PSI TEST 1 – QUESTIONS 1-150
SECTION 1 – CARDIOVASCULAR DISORDERS (Questions 1–30)
Question 1
A 68-year-old patient presents with shortness of breath, lower extremity edema,
and fatigue. On auscultation, the nurse practitioner notes an S3 gallop and
crackles in the lung bases. Which condition is most likely?
A) Left-sided heart failure
B) Right-sided heart failure
C) Pericarditis
D) Aortic stenosis
,Answer: A
Rationale: Left-sided heart failure is characterized by pulmonary congestion
(crackles, dyspnea) and an S3 gallop (ventricular gallop). Right-sided heart
failure presents with peripheral edema, JVD, and hepatomegaly. Pericarditis
typically presents with chest pain that worsens with inspiration and improves
leaning forward. Aortic stenosis presents with a systolic ejection murmur and
syncope.
Question 2
A 72-year-old patient with a history of hypertension is newly diagnosed with
atrial fibrillation. Which medication should the nurse practitioner prescribe
to reduce the risk of thromboembolic events?
A) Aspirin
B) Clopidogrel
C) Warfarin
D) Heparin
Answer: C
Rationale: Warfarin is the standard anticoagulant for stroke prevention in
patients with atrial fibrillation and a CHA₂DS₂-VASc score ≥ 2. Aspirin is less
effective for stroke prevention in afib. Clopidogrel is used in combination
with aspirin for patients who cannot take warfarin but is not first-line.
Heparin is used for acute management, not long-term prophylaxis.
Question 3
A 65-year-old patient reports substernal chest pain that occurs with exertion
and is relieved by rest. The pain radiates to the left arm. What is the most
likely diagnosis?
A) Unstable angina
B) Stable angina
C) Myocardial infarction
D) Pericarditis
,Answer: B
Rationale: Stable angina is characterized by predictable chest pain that occurs
with exertion and is relieved by rest or nitroglycerin. Unstable angina occurs
at rest or with minimal exertion and is not relieved by rest. Myocardial
infarction presents with persistent pain not relieved by rest or nitroglycerin,
often with EKG changes and elevated cardiac enzymes. Pericarditis pain worsens
with inspiration and improves leaning forward.
Question 4
A 75-year-old patient with hypertension is started on lisinopril. Which
laboratory value should the nurse practitioner monitor within 1-2 weeks of
initiating therapy?
A) Serum potassium and creatinine
B) Serum sodium and calcium
C) Hemoglobin and hematocrit
D) Liver function tests
Answer: A
Rationale: ACE inhibitors (lisinopril) can cause hyperkalemia and acute kidney
injury (elevated creatinine). Serum potassium and creatinine should be
monitored within 1-2 weeks of starting therapy or after dose adjustments.
Sodium, calcium, hemoglobin, and liver function are not the primary monitoring
parameters for ACE inhibitors.
Question 5
A 70-year-old patient with a history of heart failure presents with worsening
dyspnea, orthopnea, and weight gain of 5 pounds in 3 days. Which intervention
should the nurse practitioner implement first?
A) Increase the patient's diuretic dose
B) Prescribe a beta-blocker
C) Recommend a low-sodium diet
, D) Order a chest X-ray and BNP level
Answer: A
Rationale: The patient is experiencing acute decompensated heart failure with
fluid overload, as evidenced by weight gain, worsening dyspnea, and orthopnea.
The first intervention should be to increase the diuretic dose to reduce
fluid volume and relieve symptoms. A low-sodium diet is important but is
long-term management, not acute intervention. Beta-blockers are not initiated
during acute decompensation. A chest X-ray and BNP level may help confirm
the diagnosis but should not delay treatment.
Question 6
A 62-year-old patient presents with a blood pressure of 150/92 mm Hg on two
separate occasions. The patient has no other comorbidities. According to the
Eighth Joint National Committee (JNC 8) guidelines, what is the target blood
pressure for this patient?
A) < 120/80 mm Hg
B) < 130/80 mm Hg
C) < 140/90 mm Hg
D) < 150/90 mm Hg
Answer: C
Rationale: According to JNC 8 guidelines, the target blood pressure for
patients aged 60 years or older without diabetes or chronic kidney disease is
< 150/90 mm Hg. However, the more recent ACC/AHA guidelines recommend a
target
of < 130/80 mm Hg for all adults with hypertension. For a patient without
comorbidities, the JNC 8 target is < 150/90 mm Hg. The most current ACC/AHA
guidelines would suggest < 130/80 mm Hg, but JNC 8 is commonly tested.
Question 7
A 78-year-old patient reports lightheadedness and dizziness upon standing. The
ACTUAL EXAM COMPLETE 300 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH RATIONALES|ALREADY
GRADED A+||BRAND NEW VERSION!!
Key Content Areas Covered:
• Health Promotion & Disease Prevention
• Cardiovascular Disorders
• Respiratory Disorders
• Endocrine Disorders
• Neurological Disorders
• Musculoskeletal Disorders
• Gastrointestinal Disorders
• Genitourinary & Renal Disorders
• Reproductive Health
• Dermatological Conditions
• Ophthalmologic & ENT Conditions
• Hematologic & Oncologic Disorders
• Infectious Diseases
• Mental Health & Psychiatric Conditions
• Pharmacology
• Geriatric Syndromes & Special Considerations
• Evidence-Based Practice & Clinical Guidelines
PSI TEST 1 – QUESTIONS 1-150
SECTION 1 – CARDIOVASCULAR DISORDERS (Questions 1–30)
Question 1
A 68-year-old patient presents with shortness of breath, lower extremity edema,
and fatigue. On auscultation, the nurse practitioner notes an S3 gallop and
crackles in the lung bases. Which condition is most likely?
A) Left-sided heart failure
B) Right-sided heart failure
C) Pericarditis
D) Aortic stenosis
,Answer: A
Rationale: Left-sided heart failure is characterized by pulmonary congestion
(crackles, dyspnea) and an S3 gallop (ventricular gallop). Right-sided heart
failure presents with peripheral edema, JVD, and hepatomegaly. Pericarditis
typically presents with chest pain that worsens with inspiration and improves
leaning forward. Aortic stenosis presents with a systolic ejection murmur and
syncope.
Question 2
A 72-year-old patient with a history of hypertension is newly diagnosed with
atrial fibrillation. Which medication should the nurse practitioner prescribe
to reduce the risk of thromboembolic events?
A) Aspirin
B) Clopidogrel
C) Warfarin
D) Heparin
Answer: C
Rationale: Warfarin is the standard anticoagulant for stroke prevention in
patients with atrial fibrillation and a CHA₂DS₂-VASc score ≥ 2. Aspirin is less
effective for stroke prevention in afib. Clopidogrel is used in combination
with aspirin for patients who cannot take warfarin but is not first-line.
Heparin is used for acute management, not long-term prophylaxis.
Question 3
A 65-year-old patient reports substernal chest pain that occurs with exertion
and is relieved by rest. The pain radiates to the left arm. What is the most
likely diagnosis?
A) Unstable angina
B) Stable angina
C) Myocardial infarction
D) Pericarditis
,Answer: B
Rationale: Stable angina is characterized by predictable chest pain that occurs
with exertion and is relieved by rest or nitroglycerin. Unstable angina occurs
at rest or with minimal exertion and is not relieved by rest. Myocardial
infarction presents with persistent pain not relieved by rest or nitroglycerin,
often with EKG changes and elevated cardiac enzymes. Pericarditis pain worsens
with inspiration and improves leaning forward.
Question 4
A 75-year-old patient with hypertension is started on lisinopril. Which
laboratory value should the nurse practitioner monitor within 1-2 weeks of
initiating therapy?
A) Serum potassium and creatinine
B) Serum sodium and calcium
C) Hemoglobin and hematocrit
D) Liver function tests
Answer: A
Rationale: ACE inhibitors (lisinopril) can cause hyperkalemia and acute kidney
injury (elevated creatinine). Serum potassium and creatinine should be
monitored within 1-2 weeks of starting therapy or after dose adjustments.
Sodium, calcium, hemoglobin, and liver function are not the primary monitoring
parameters for ACE inhibitors.
Question 5
A 70-year-old patient with a history of heart failure presents with worsening
dyspnea, orthopnea, and weight gain of 5 pounds in 3 days. Which intervention
should the nurse practitioner implement first?
A) Increase the patient's diuretic dose
B) Prescribe a beta-blocker
C) Recommend a low-sodium diet
, D) Order a chest X-ray and BNP level
Answer: A
Rationale: The patient is experiencing acute decompensated heart failure with
fluid overload, as evidenced by weight gain, worsening dyspnea, and orthopnea.
The first intervention should be to increase the diuretic dose to reduce
fluid volume and relieve symptoms. A low-sodium diet is important but is
long-term management, not acute intervention. Beta-blockers are not initiated
during acute decompensation. A chest X-ray and BNP level may help confirm
the diagnosis but should not delay treatment.
Question 6
A 62-year-old patient presents with a blood pressure of 150/92 mm Hg on two
separate occasions. The patient has no other comorbidities. According to the
Eighth Joint National Committee (JNC 8) guidelines, what is the target blood
pressure for this patient?
A) < 120/80 mm Hg
B) < 130/80 mm Hg
C) < 140/90 mm Hg
D) < 150/90 mm Hg
Answer: C
Rationale: According to JNC 8 guidelines, the target blood pressure for
patients aged 60 years or older without diabetes or chronic kidney disease is
< 150/90 mm Hg. However, the more recent ACC/AHA guidelines recommend a
target
of < 130/80 mm Hg for all adults with hypertension. For a patient without
comorbidities, the JNC 8 target is < 150/90 mm Hg. The most current ACC/AHA
guidelines would suggest < 130/80 mm Hg, but JNC 8 is commonly tested.
Question 7
A 78-year-old patient reports lightheadedness and dizziness upon standing. The
