AANP AGPCNP PSI Test 1 & 2 Final Exam verified with correct
answers plus rationales 2026/2027 instant pdf
1. A 68-year-old patient reports new exertional chest pressure that resolves with
rest. Which diagnosis is most likely?
A. Stable angina
B. Acute pericarditis
C. Pulmonary embolism
D. Aortic dissection
Answer: A. Stable angina
Rationale: Predictable chest discomfort with exertion that resolves with rest is characteristic of
stable angina.
2. Which finding in an older adult with chest pain requires the most urgent
evaluation?
A. Chest pressure with diaphoresis and dyspnea
B. Mild intermittent heartburn
C. Pain reproducible with palpation
D. Brief discomfort after eating
Answer: A. Chest pressure with diaphoresis and dyspnea
Rationale: These symptoms may indicate acute coronary syndrome and require prompt
evaluation.
3. Which initial test is most appropriate for suspected acute coronary syndrome?
A. 12-lead ECG
B. Colonoscopy
C. Pulmonary function testing
D. DEXA scan
Answer: A. 12-lead ECG
,Rationale: A 12-lead ECG should be obtained promptly in patients with suspected ACS.
4. A 72-year-old patient has a blood pressure of 168/96 mmHg without acute
symptoms. Which approach is most appropriate?
A. Confirm the elevation and assess overall cardiovascular risk before choosing treatment
B. Send the patient to the emergency department solely because of the number
C. Ignore the result
D. Start multiple antihypertensive medications immediately without assessment
Answer: A. Confirm the elevation and assess overall cardiovascular risk before choosing
treatment
Rationale: Persistent hypertension requires confirmation, evaluation for target-organ disease and
cardiovascular risk, and individualized treatment.
5. Which lifestyle intervention is strongly recommended for patients with
hypertension?
A. Reduce sodium intake and increase physical activity as appropriate
B. Increase processed-food intake
C. Stop all exercise
D. Increase alcohol consumption
Answer: A. Reduce sodium intake and increase physical activity as appropriate
Rationale: Dietary sodium reduction, healthy weight, physical activity, and other lifestyle
interventions can meaningfully reduce blood pressure.
6. Which medication class is commonly first-line therapy for uncomplicated
hypertension?
A. Thiazide-type diuretic
B. Opioid analgesic
C. Benzodiazepine
D. Proton-pump inhibitor
Answer: A. Thiazide-type diuretic
,Rationale: Thiazide-type diuretics are among the established first-line antihypertensive classes.
7. An older adult taking an ACE inhibitor develops persistent dry cough. Which
adverse effect is most likely?
A. Bradycardia
B. ACE-inhibitor-associated cough
C. Hyperthyroidism
D. Hypocalcemia
Answer: B. ACE-inhibitor-associated cough
Rationale: A persistent dry cough is a well-known adverse effect of ACE inhibitors.
8. Which adverse effect of an ACE inhibitor requires urgent attention?
A. Angioedema
B. Mild fatigue
C. Mild nausea
D. Dry skin
Answer: A. Angioedema
Rationale: Angioedema can compromise the airway and requires urgent treatment.
9. Which laboratory value should be monitored after starting an ACE inhibitor?
A. Serum creatinine and potassium
B. Hemoglobin A1c only
C. Platelet count only
D. Amylase only
Answer: A. Serum creatinine and potassium
Rationale: ACE inhibitors can affect renal function and increase potassium levels.
10. Which symptom is classic for heart failure with reduced ejection fraction?
, A. Orthopnea
B. Polyuria without other symptoms
C. Hyperactivity
D. Increased appetite
Answer: A. Orthopnea
Rationale: Left-sided heart failure commonly causes dyspnea, orthopnea, paroxysmal nocturnal
dyspnea, and pulmonary congestion.
11. Which physical finding supports a diagnosis of heart failure?
A. Bilateral lower-extremity edema and elevated jugular venous pressure
B. Dry mucous membranes only
C. Increased bowel sounds
D. Unilateral hand tremor
Answer: A. Bilateral lower-extremity edema and elevated jugular venous pressure
Rationale: These findings are consistent with systemic venous congestion.
12. An older adult with atrial fibrillation has a CHA₂DS₂-VASc score indicating
elevated stroke risk. What is an important management consideration?
A. Anticoagulation assessment
B. Routine antibiotics
C. Long-term corticosteroids
D. Insulin therapy
Answer: A. Anticoagulation assessment
Rationale: Stroke-prevention therapy should be evaluated according to thromboembolic and
bleeding risk.
13. Which symptom may be associated with atrial fibrillation?
A. Palpitations
B. Hematuria only
C. Constipation only
D. Hearing loss
answers plus rationales 2026/2027 instant pdf
1. A 68-year-old patient reports new exertional chest pressure that resolves with
rest. Which diagnosis is most likely?
A. Stable angina
B. Acute pericarditis
C. Pulmonary embolism
D. Aortic dissection
Answer: A. Stable angina
Rationale: Predictable chest discomfort with exertion that resolves with rest is characteristic of
stable angina.
2. Which finding in an older adult with chest pain requires the most urgent
evaluation?
A. Chest pressure with diaphoresis and dyspnea
B. Mild intermittent heartburn
C. Pain reproducible with palpation
D. Brief discomfort after eating
Answer: A. Chest pressure with diaphoresis and dyspnea
Rationale: These symptoms may indicate acute coronary syndrome and require prompt
evaluation.
3. Which initial test is most appropriate for suspected acute coronary syndrome?
A. 12-lead ECG
B. Colonoscopy
C. Pulmonary function testing
D. DEXA scan
Answer: A. 12-lead ECG
,Rationale: A 12-lead ECG should be obtained promptly in patients with suspected ACS.
4. A 72-year-old patient has a blood pressure of 168/96 mmHg without acute
symptoms. Which approach is most appropriate?
A. Confirm the elevation and assess overall cardiovascular risk before choosing treatment
B. Send the patient to the emergency department solely because of the number
C. Ignore the result
D. Start multiple antihypertensive medications immediately without assessment
Answer: A. Confirm the elevation and assess overall cardiovascular risk before choosing
treatment
Rationale: Persistent hypertension requires confirmation, evaluation for target-organ disease and
cardiovascular risk, and individualized treatment.
5. Which lifestyle intervention is strongly recommended for patients with
hypertension?
A. Reduce sodium intake and increase physical activity as appropriate
B. Increase processed-food intake
C. Stop all exercise
D. Increase alcohol consumption
Answer: A. Reduce sodium intake and increase physical activity as appropriate
Rationale: Dietary sodium reduction, healthy weight, physical activity, and other lifestyle
interventions can meaningfully reduce blood pressure.
6. Which medication class is commonly first-line therapy for uncomplicated
hypertension?
A. Thiazide-type diuretic
B. Opioid analgesic
C. Benzodiazepine
D. Proton-pump inhibitor
Answer: A. Thiazide-type diuretic
,Rationale: Thiazide-type diuretics are among the established first-line antihypertensive classes.
7. An older adult taking an ACE inhibitor develops persistent dry cough. Which
adverse effect is most likely?
A. Bradycardia
B. ACE-inhibitor-associated cough
C. Hyperthyroidism
D. Hypocalcemia
Answer: B. ACE-inhibitor-associated cough
Rationale: A persistent dry cough is a well-known adverse effect of ACE inhibitors.
8. Which adverse effect of an ACE inhibitor requires urgent attention?
A. Angioedema
B. Mild fatigue
C. Mild nausea
D. Dry skin
Answer: A. Angioedema
Rationale: Angioedema can compromise the airway and requires urgent treatment.
9. Which laboratory value should be monitored after starting an ACE inhibitor?
A. Serum creatinine and potassium
B. Hemoglobin A1c only
C. Platelet count only
D. Amylase only
Answer: A. Serum creatinine and potassium
Rationale: ACE inhibitors can affect renal function and increase potassium levels.
10. Which symptom is classic for heart failure with reduced ejection fraction?
, A. Orthopnea
B. Polyuria without other symptoms
C. Hyperactivity
D. Increased appetite
Answer: A. Orthopnea
Rationale: Left-sided heart failure commonly causes dyspnea, orthopnea, paroxysmal nocturnal
dyspnea, and pulmonary congestion.
11. Which physical finding supports a diagnosis of heart failure?
A. Bilateral lower-extremity edema and elevated jugular venous pressure
B. Dry mucous membranes only
C. Increased bowel sounds
D. Unilateral hand tremor
Answer: A. Bilateral lower-extremity edema and elevated jugular venous pressure
Rationale: These findings are consistent with systemic venous congestion.
12. An older adult with atrial fibrillation has a CHA₂DS₂-VASc score indicating
elevated stroke risk. What is an important management consideration?
A. Anticoagulation assessment
B. Routine antibiotics
C. Long-term corticosteroids
D. Insulin therapy
Answer: A. Anticoagulation assessment
Rationale: Stroke-prevention therapy should be evaluated according to thromboembolic and
bleeding risk.
13. Which symptom may be associated with atrial fibrillation?
A. Palpitations
B. Hematuria only
C. Constipation only
D. Hearing loss
