Barkley Adult-Gerontology Primary Care Nurse
Practitioner (AGPCNP) Certification Exam | 175 Actual
Board Exam Questions and Detailed Answers
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-
20)
Question 1
A 72-year-old male with a history of CAD presents with crushing substernal chest pain
radiating to the left arm. Which initial intervention is MOST appropriate?
A) Administer morphine IV
B) Administer 325 mg aspirin PO
C) Start heparin infusion
D) Obtain cardiac enzymes
Answer: B) Administer 325 mg aspirin PO
Rationale: Aspirin should be administered immediately to inhibit platelet aggregation
and reduce mortality in acute MI. Other interventions (morphine, heparin, enzymes)
follow afterward .
Question 2
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is the best
management to reduce stroke risk?
A) No anticoagulation needed
B) Dual antiplatelet therapy
C) Oral anticoagulation (e.g., apixaban)
D) Rate control with beta-blocker
,Answer: C) Oral anticoagulation (e.g., apixaban)
Rationale: A CHA₂DS₂-VASc score ≥2 in men (≥3 in women) warrants oral
anticoagulation to reduce stroke risk. Antiplatelet therapy alone is insufficient .
Question 3
In cardiogenic shock, which hemodynamic profile is expected?
A) High CI, low SVR, high PCWP
B) Low CI, high SVR, high PCWP
C) Low CI, low SVR, low PCWP
D) High CI, high SVR, normal PCWP
Answer: B) Low CI, high SVR, high PCWP
Rationale: Cardiogenic shock presents with low cardiac index (reduced forward flow),
high afterload (compensatory vasoconstriction/SVR), and pulmonary congestion (high
wedge pressure/PCWP) .
Question 4
Which ECG finding is most suggestive of pericarditis?
A) ST elevation in V1-V4
B) Diffuse ST elevation and PR depression
C) ST depression in leads II, III, aVF
D) T-wave inversion only in V5-V6
Answer: B) Diffuse ST elevation and PR depression
,Rationale: Pericarditis classically shows diffuse ST elevation and PR depression across
multiple leads (not localized like MI) .
Question 5
A patient with decompensated HFrEF is admitted. Which medication improves long-
term mortality?
A) IV furosemide
B) Digoxin
C) Sacubitril/valsartan
D) IV milrinone
Answer: C) Sacubitril/valsartan
Rationale: ARNI (sacubitril/valsartan) improves survival in HFrEF, while diuretics and
inotropes only provide symptomatic relief without mortality benefit .
Question 6
A patient with heart failure with preserved ejection fraction (HFpEF) is most likely to
have which comorbidity?
A) Hypertension
B) Dilated cardiomyopathy
C) Severe aortic regurgitation
D) Pericardial effusion
Answer: A) Hypertension
, Rationale: Hypertension is the most common comorbidity in HFpEF, leading to left
ventricular hypertrophy and diastolic dysfunction .
Question 7
The most common cause of death in the first 24 hours after an acute MI is:
A) Cardiogenic shock
B) Ventricular fibrillation
C) Cardiac rupture
D) Heart block
Answer: B) Ventricular fibrillation
Rationale: Ventricular fibrillation is the most common cause of death in the first 24
hours after acute MI .
Question 8
A 74-year-old male with a history of CHF presents with an audible S3 gallop and
increased jugular venous distention. This finding most likely indicates:
A) Decreased cardiac output
B) Fluid volume overload
C) Pericardial effusion
D) Valvular stenosis
Answer: B) Fluid volume overload
Practitioner (AGPCNP) Certification Exam | 175 Actual
Board Exam Questions and Detailed Answers
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-
20)
Question 1
A 72-year-old male with a history of CAD presents with crushing substernal chest pain
radiating to the left arm. Which initial intervention is MOST appropriate?
A) Administer morphine IV
B) Administer 325 mg aspirin PO
C) Start heparin infusion
D) Obtain cardiac enzymes
Answer: B) Administer 325 mg aspirin PO
Rationale: Aspirin should be administered immediately to inhibit platelet aggregation
and reduce mortality in acute MI. Other interventions (morphine, heparin, enzymes)
follow afterward .
Question 2
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is the best
management to reduce stroke risk?
A) No anticoagulation needed
B) Dual antiplatelet therapy
C) Oral anticoagulation (e.g., apixaban)
D) Rate control with beta-blocker
,Answer: C) Oral anticoagulation (e.g., apixaban)
Rationale: A CHA₂DS₂-VASc score ≥2 in men (≥3 in women) warrants oral
anticoagulation to reduce stroke risk. Antiplatelet therapy alone is insufficient .
Question 3
In cardiogenic shock, which hemodynamic profile is expected?
A) High CI, low SVR, high PCWP
B) Low CI, high SVR, high PCWP
C) Low CI, low SVR, low PCWP
D) High CI, high SVR, normal PCWP
Answer: B) Low CI, high SVR, high PCWP
Rationale: Cardiogenic shock presents with low cardiac index (reduced forward flow),
high afterload (compensatory vasoconstriction/SVR), and pulmonary congestion (high
wedge pressure/PCWP) .
Question 4
Which ECG finding is most suggestive of pericarditis?
A) ST elevation in V1-V4
B) Diffuse ST elevation and PR depression
C) ST depression in leads II, III, aVF
D) T-wave inversion only in V5-V6
Answer: B) Diffuse ST elevation and PR depression
,Rationale: Pericarditis classically shows diffuse ST elevation and PR depression across
multiple leads (not localized like MI) .
Question 5
A patient with decompensated HFrEF is admitted. Which medication improves long-
term mortality?
A) IV furosemide
B) Digoxin
C) Sacubitril/valsartan
D) IV milrinone
Answer: C) Sacubitril/valsartan
Rationale: ARNI (sacubitril/valsartan) improves survival in HFrEF, while diuretics and
inotropes only provide symptomatic relief without mortality benefit .
Question 6
A patient with heart failure with preserved ejection fraction (HFpEF) is most likely to
have which comorbidity?
A) Hypertension
B) Dilated cardiomyopathy
C) Severe aortic regurgitation
D) Pericardial effusion
Answer: A) Hypertension
, Rationale: Hypertension is the most common comorbidity in HFpEF, leading to left
ventricular hypertrophy and diastolic dysfunction .
Question 7
The most common cause of death in the first 24 hours after an acute MI is:
A) Cardiogenic shock
B) Ventricular fibrillation
C) Cardiac rupture
D) Heart block
Answer: B) Ventricular fibrillation
Rationale: Ventricular fibrillation is the most common cause of death in the first 24
hours after acute MI .
Question 8
A 74-year-old male with a history of CHF presents with an audible S3 gallop and
increased jugular venous distention. This finding most likely indicates:
A) Decreased cardiac output
B) Fluid volume overload
C) Pericardial effusion
D) Valvular stenosis
Answer: B) Fluid volume overload
