AGNP AANP BOARDS |ADULT -GERONTOLOGY
NURSE PRACTITIONER EXAM REVIEW &
STUDY GUIDE WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
ANSWERS| FREQUENTLY TESTING VERSION |
ALREADY GRADED A+|NEWEST|EXPERT
VERIFIED FOR GUARANTEED PASS 2026
What is the principle organ for drug excretion?
kidneys
when should warfarin be discontinued before surgery?
7 days
a patient taking pioglitazone (Actos) suddenly develops dyspnea, weight gain, and
cough...the NP knows she must
discontinue the medication (signs of CHF-- Actos and cause of exacerbate CHF)
When prescribed atypical antipsychotics such as risperidone (Risperdal), Olanzapine
(Zyprexa), and Quetiapine (Seroquel) the NP must monitor....
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 ______________.
Erosive esophagitis; stop immediately; osteonecrosis of jaw
what are the main adverse effects of phenytoin?
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...
hyponatremia from SIADH
1|Page
,according to the BEERs criteria, ______________ and _____________ carry a higher
bleeding risk than warfarin and other DOACs
Rivaroxaban (Xarelto) and Dabigatran (Pradaxa)
For patients with valvular disease or prosthetic heart valves, the only appropriate
anticoagulation is...
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...
continue current warfarin dose; retest INR within 1-2 weeks
what class of anti-hypertensive meds should be avoided with aortic stenosis?
ACEis
It can take up to ________ days for platelet function to return to normal after a patient
stops taking clopidogrel (Plavix)
10
mayonnaise, canola oil and soybean oil all have high levels of _____________.
Vitamin K (caution when on warfarin)
Which ethnicity of patients may require lower starting and maintenance doses of
warfarin?
which herbal supplements can increase your bleeding risk if taken in high doses?
ginkgo biloba, garlic, ginseng, fish oil, feverfew, Dong quai
What is recommended as first line therapy in Black patients with HTN?
Thiazide Diuretics
thiazide and loop diuretics are contraindicated with which allergy?
sulfa
thiazide diuretics should not be combined with which medication due to the increased
for toxicity?
lithium
patients with both hypertension and osteoporosis receive an extra benefit from taking a
thiazide diuretic...why?
2|Page
,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
ototoxicity
what are contraindications to ACEIs/ARBs?
pregnancy, renal artery stenosis, angioedema, hyperkalemia
Avoid using diltiazem and verapamil (nondihydropyridine CCBs) in patients with
HFrEF (can worsen it)
what are some side effects of dihydropyridine CCBs (amlodipine, nifedipine,
nicardipine)?
peripheral edema, headaches, flushing, lightheadedness
what are the main symptoms of CCB poisoning (2)?
hypotension and bradycardia
which beta blockers are non-cardioselective?
propranolol and carvedilol
what are contraindications for beta blockers?
asthma, chronic bronchitis, COPD, emphysema, bradycardia/AV block, abrupt
discontinuation
what class of medication is first line therapy for Raynaud's phenomenon?
CCB
what is the recommended drug class for initial therapy of BPH and HTN?
selective alpha-1 blockers (-osin; relax smooth muscle of bladder neck and the
prostate); only first line if both BPH and HTN present
Which two drugs in the the alpha-1 blocking class improve BPH symptoms AND lower
BP?
Terazosin, Doxazosin
What is unique about Prazosin (Minipress), an alpha blocker, compared to the other
drugs in this class?
3|Page
, used to treat HTN, NOT BPH; Off label use for PTSD-related nightmares/sleep
dysfunction
Alpha blockers (for BPH/HTN) should not be given during which type of surgery?
cataract/glaucoma (floppy iris syndrome)
The NP should use alpha blockers cautiously in the elderly due to which adverse effect?
orthostatic hypotension, dizzines/syncope
When initiating Tamsulosin (Flomax) in a patient, the NP provides the following
education...
Take at bedtime, we will start at lowest dose possible; someone should be present
when you take your first dose because upon initiating a vasovagal response can occur
and bottom out the BP
what is a bactericidal vs bacteriostatic antibiotic?
bactericidal- kill bacteria
bacteriostatic- limit bacterial growth and replication
The NP provides what patient instructions before prescribing a tetracycline antibiotic?
photosensitivity- wear sunscreen
esophageal irritation/ulceration if capsule lodges in esophagus- drink w/ full glass of
water
pseudotumor cerebri (Intracranial HTN)- rare AE
Binds to minerals (iron, zinc, CA, Mg, dairy)- Take 1 hours before or 2 hours after meal
May decrease effectiveness of oral contraception- use backup
The NP know that the AEs of macrolide antibiotics include
GI distress (especially erythromycin)
Hepatotoxicity
QT prolongation
Exacerbates symptoms of MG
Many DDIs (Warfarin, Statins)
what is the first line treatment for Gonorrhea infections?
Ceftriaxone IM 500 mg
True of False: patient who have a true allergy to PCNs (angioedema, anaphylaxis) are
more likely to have an allergic reaction to cephalosporins (especially first generation)
true
what is first line therapy for MRSA skin infections (boils, abscesses)?
4|Page
NURSE PRACTITIONER EXAM REVIEW &
STUDY GUIDE WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
ANSWERS| FREQUENTLY TESTING VERSION |
ALREADY GRADED A+|NEWEST|EXPERT
VERIFIED FOR GUARANTEED PASS 2026
What is the principle organ for drug excretion?
kidneys
when should warfarin be discontinued before surgery?
7 days
a patient taking pioglitazone (Actos) suddenly develops dyspnea, weight gain, and
cough...the NP knows she must
discontinue the medication (signs of CHF-- Actos and cause of exacerbate CHF)
When prescribed atypical antipsychotics such as risperidone (Risperdal), Olanzapine
(Zyprexa), and Quetiapine (Seroquel) the NP must monitor....
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 ______________.
Erosive esophagitis; stop immediately; osteonecrosis of jaw
what are the main adverse effects of phenytoin?
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...
hyponatremia from SIADH
1|Page
,according to the BEERs criteria, ______________ and _____________ carry a higher
bleeding risk than warfarin and other DOACs
Rivaroxaban (Xarelto) and Dabigatran (Pradaxa)
For patients with valvular disease or prosthetic heart valves, the only appropriate
anticoagulation is...
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...
continue current warfarin dose; retest INR within 1-2 weeks
what class of anti-hypertensive meds should be avoided with aortic stenosis?
ACEis
It can take up to ________ days for platelet function to return to normal after a patient
stops taking clopidogrel (Plavix)
10
mayonnaise, canola oil and soybean oil all have high levels of _____________.
Vitamin K (caution when on warfarin)
Which ethnicity of patients may require lower starting and maintenance doses of
warfarin?
which herbal supplements can increase your bleeding risk if taken in high doses?
ginkgo biloba, garlic, ginseng, fish oil, feverfew, Dong quai
What is recommended as first line therapy in Black patients with HTN?
Thiazide Diuretics
thiazide and loop diuretics are contraindicated with which allergy?
sulfa
thiazide diuretics should not be combined with which medication due to the increased
for toxicity?
lithium
patients with both hypertension and osteoporosis receive an extra benefit from taking a
thiazide diuretic...why?
2|Page
,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
ototoxicity
what are contraindications to ACEIs/ARBs?
pregnancy, renal artery stenosis, angioedema, hyperkalemia
Avoid using diltiazem and verapamil (nondihydropyridine CCBs) in patients with
HFrEF (can worsen it)
what are some side effects of dihydropyridine CCBs (amlodipine, nifedipine,
nicardipine)?
peripheral edema, headaches, flushing, lightheadedness
what are the main symptoms of CCB poisoning (2)?
hypotension and bradycardia
which beta blockers are non-cardioselective?
propranolol and carvedilol
what are contraindications for beta blockers?
asthma, chronic bronchitis, COPD, emphysema, bradycardia/AV block, abrupt
discontinuation
what class of medication is first line therapy for Raynaud's phenomenon?
CCB
what is the recommended drug class for initial therapy of BPH and HTN?
selective alpha-1 blockers (-osin; relax smooth muscle of bladder neck and the
prostate); only first line if both BPH and HTN present
Which two drugs in the the alpha-1 blocking class improve BPH symptoms AND lower
BP?
Terazosin, Doxazosin
What is unique about Prazosin (Minipress), an alpha blocker, compared to the other
drugs in this class?
3|Page
, used to treat HTN, NOT BPH; Off label use for PTSD-related nightmares/sleep
dysfunction
Alpha blockers (for BPH/HTN) should not be given during which type of surgery?
cataract/glaucoma (floppy iris syndrome)
The NP should use alpha blockers cautiously in the elderly due to which adverse effect?
orthostatic hypotension, dizzines/syncope
When initiating Tamsulosin (Flomax) in a patient, the NP provides the following
education...
Take at bedtime, we will start at lowest dose possible; someone should be present
when you take your first dose because upon initiating a vasovagal response can occur
and bottom out the BP
what is a bactericidal vs bacteriostatic antibiotic?
bactericidal- kill bacteria
bacteriostatic- limit bacterial growth and replication
The NP provides what patient instructions before prescribing a tetracycline antibiotic?
photosensitivity- wear sunscreen
esophageal irritation/ulceration if capsule lodges in esophagus- drink w/ full glass of
water
pseudotumor cerebri (Intracranial HTN)- rare AE
Binds to minerals (iron, zinc, CA, Mg, dairy)- Take 1 hours before or 2 hours after meal
May decrease effectiveness of oral contraception- use backup
The NP know that the AEs of macrolide antibiotics include
GI distress (especially erythromycin)
Hepatotoxicity
QT prolongation
Exacerbates symptoms of MG
Many DDIs (Warfarin, Statins)
what is the first line treatment for Gonorrhea infections?
Ceftriaxone IM 500 mg
True of False: patient who have a true allergy to PCNs (angioedema, anaphylaxis) are
more likely to have an allergic reaction to cephalosporins (especially first generation)
true
what is first line therapy for MRSA skin infections (boils, abscesses)?
4|Page
