Barkley AGPCNP Predictor/Readiness
Exam
Table of Contents
1. Introduction and Exam Overview
2. Section 1: Assessment & Diagnosis (Questions 1-35)
3. Section 2: Health Promotion & Disease Prevention (Questions 36-
60)
4. Section 3: Cardiovascular Disorders (Questions 61-85)
5. Section 4: Endocrine & Metabolic Disorders (Questions 86-105)
6. Section 5: Respiratory Disorders (Questions 106-125)
7. Section 6: Musculoskeletal & Rheumatologic Disorders (Questions
126-145)
8. Section 7: Gastrointestinal & Genitourinary Disorders (Questions
146-165)
9. Section 8: Neurological & Psychiatric Disorders (Questions 166-180)
10. Section 9: Geriatric Syndromes & Complex Care (Questions
181-200)
11. Answer Key Summary with Rationales
Introduction and Exam Overview
The Barkley AGPCNP Predictor/Readiness Exam is designed to prepare
candidates for the ANCC and AANP Adult-Gerontology Primary Care
Nurse Practitioner board certification examinations. This practice exam
covers all major AGPCNP domains including assessment and diagnosis,
health promotion, management of acute and chronic conditions,
geriatric syndromes, and professional practice .
The exam contains 200 questions across nine content areas. Each
question includes the correct answer marked in italics with a detailed
rationale in bold.
,Section 1: Assessment & Diagnosis (Questions 1-35)
1. A 65-year-old male with a 40-pack-year smoking history presents
with a persistent cough and unintentional weight loss. Which of the
following is the most appropriate initial screening test for lung
cancer?
A. Annual chest X-ray
B. Sputum cytology
C. Low-dose CT (LDCT) of the chest
D. CT pulmonary angiography
Correct Answer: C
Rationale: The USPSTF recommends annual LDCT for adults aged
50-80 years with a ≥20 pack-year smoking history who currently
smoke or have quit within the past 15 years. LDCT reduces lung-
cancer mortality, while chest X-ray is not recommended for
screening .
2. An 80-year-old man is brought to the clinic by his daughter, who
reports he has become more forgetful over the past year and has
had two falls. Which assessment tool is most appropriate to screen
for cognitive impairment in this age group?
A. Mini-Mental State Examination (MMSE)
B. Montreal Cognitive Assessment (MoCA)
C. Mini-Cog
D. Clock-drawing test alone
Correct Answer: C
Rationale: The Mini-Cog (3-word recall + clock drawing) is quick,
sensitive, and less influenced by education, making it ideal for
routine screening. The MoCA is more sensitive for mild cognitive
impairment but takes longer .
,3. A 75-year-old woman reports difficulty managing her finances,
using public transportation, and shopping. These deficits reflect
impairment in which functional domain?
A. Basic activities of daily living (BADLs)
B. Instrumental activities of daily living (IADLs)
C. Advanced activities of daily living (AADLs)
D. Mobility
Correct Answer: B
Rationale: IADLs include tasks required for independent community
living: managing money, transportation, shopping, meal
preparation, telephone use .
4. The Timed Up and Go (TUG) test assesses:
A. Cognitive function
B. Functional mobility and fall risk
C. Depression
D. Peripheral neuropathy
Correct Answer: B
Rationale: The TUG measures the time to stand, walk 3 meters, turn,
return, and sit; a time ≥12 seconds indicates increased fall risk .
5. A 72-year-old man with a history of hypertension and
osteoarthritis presents with acute knee swelling, erythema, and
pain. Joint aspiration reveals 20,000 WBCs/μL (80% neutrophils).
What is the most appropriate next step?
A. Apply a compression wrap and prescribe ibuprofen
B. Obtain Gram stain and culture of the aspirate
C. Inject intra-articular corticosteroid
D. Prescribe colchicine for suspected gout
Correct Answer: B
Rationale: The synovial fluid findings are inflammatory and could
indicate septic arthritis, which is a medical emergency. Gram stain
, and culture are essential to rule out infection before empiric
treatment .
6. A 68-year-old female has a blood pressure of 154/92 mmHg on
three separate occasions. She has no diabetes or known
cardiovascular disease. According to the 2017 ACC/AHA guideline,
what is her stage of hypertension?
A. Elevated
B. Stage 1
C. Stage 2
D. Hypertensive crisis
Correct Answer: C
Rationale: Stage 2 hypertension is defined as systolic ≥140 mmHg
or diastolic ≥90 mmHg. Her BP of 154/92 mmHg meets criteria for
Stage 2 hypertension .
7. A 50-year-old male presents with nocturia, weak stream, and
post-void dribbling. Digital rectal exam reveals a symmetrically
enlarged, smooth prostate. What is the most likely diagnosis?
A. Prostate cancer
B. Acute prostatitis
C. Benign prostatic hyperplasia (BPH)
D. Chronic pelvic pain syndrome
Correct Answer: C
Rationale: BPH is a non-malignant enlargement of the prostate that
causes obstructive LUTS. The prostate is smooth and symmetric;
cancer typically presents as a hard, irregular nodule .
8. A 75-year-old female with a history of atrial fibrillation is on
warfarin and has an INR of 4.5 without bleeding. What is the most
appropriate next step?
A. Administer vitamin K
B. Hold warfarin and recheck INR
Exam
Table of Contents
1. Introduction and Exam Overview
2. Section 1: Assessment & Diagnosis (Questions 1-35)
3. Section 2: Health Promotion & Disease Prevention (Questions 36-
60)
4. Section 3: Cardiovascular Disorders (Questions 61-85)
5. Section 4: Endocrine & Metabolic Disorders (Questions 86-105)
6. Section 5: Respiratory Disorders (Questions 106-125)
7. Section 6: Musculoskeletal & Rheumatologic Disorders (Questions
126-145)
8. Section 7: Gastrointestinal & Genitourinary Disorders (Questions
146-165)
9. Section 8: Neurological & Psychiatric Disorders (Questions 166-180)
10. Section 9: Geriatric Syndromes & Complex Care (Questions
181-200)
11. Answer Key Summary with Rationales
Introduction and Exam Overview
The Barkley AGPCNP Predictor/Readiness Exam is designed to prepare
candidates for the ANCC and AANP Adult-Gerontology Primary Care
Nurse Practitioner board certification examinations. This practice exam
covers all major AGPCNP domains including assessment and diagnosis,
health promotion, management of acute and chronic conditions,
geriatric syndromes, and professional practice .
The exam contains 200 questions across nine content areas. Each
question includes the correct answer marked in italics with a detailed
rationale in bold.
,Section 1: Assessment & Diagnosis (Questions 1-35)
1. A 65-year-old male with a 40-pack-year smoking history presents
with a persistent cough and unintentional weight loss. Which of the
following is the most appropriate initial screening test for lung
cancer?
A. Annual chest X-ray
B. Sputum cytology
C. Low-dose CT (LDCT) of the chest
D. CT pulmonary angiography
Correct Answer: C
Rationale: The USPSTF recommends annual LDCT for adults aged
50-80 years with a ≥20 pack-year smoking history who currently
smoke or have quit within the past 15 years. LDCT reduces lung-
cancer mortality, while chest X-ray is not recommended for
screening .
2. An 80-year-old man is brought to the clinic by his daughter, who
reports he has become more forgetful over the past year and has
had two falls. Which assessment tool is most appropriate to screen
for cognitive impairment in this age group?
A. Mini-Mental State Examination (MMSE)
B. Montreal Cognitive Assessment (MoCA)
C. Mini-Cog
D. Clock-drawing test alone
Correct Answer: C
Rationale: The Mini-Cog (3-word recall + clock drawing) is quick,
sensitive, and less influenced by education, making it ideal for
routine screening. The MoCA is more sensitive for mild cognitive
impairment but takes longer .
,3. A 75-year-old woman reports difficulty managing her finances,
using public transportation, and shopping. These deficits reflect
impairment in which functional domain?
A. Basic activities of daily living (BADLs)
B. Instrumental activities of daily living (IADLs)
C. Advanced activities of daily living (AADLs)
D. Mobility
Correct Answer: B
Rationale: IADLs include tasks required for independent community
living: managing money, transportation, shopping, meal
preparation, telephone use .
4. The Timed Up and Go (TUG) test assesses:
A. Cognitive function
B. Functional mobility and fall risk
C. Depression
D. Peripheral neuropathy
Correct Answer: B
Rationale: The TUG measures the time to stand, walk 3 meters, turn,
return, and sit; a time ≥12 seconds indicates increased fall risk .
5. A 72-year-old man with a history of hypertension and
osteoarthritis presents with acute knee swelling, erythema, and
pain. Joint aspiration reveals 20,000 WBCs/μL (80% neutrophils).
What is the most appropriate next step?
A. Apply a compression wrap and prescribe ibuprofen
B. Obtain Gram stain and culture of the aspirate
C. Inject intra-articular corticosteroid
D. Prescribe colchicine for suspected gout
Correct Answer: B
Rationale: The synovial fluid findings are inflammatory and could
indicate septic arthritis, which is a medical emergency. Gram stain
, and culture are essential to rule out infection before empiric
treatment .
6. A 68-year-old female has a blood pressure of 154/92 mmHg on
three separate occasions. She has no diabetes or known
cardiovascular disease. According to the 2017 ACC/AHA guideline,
what is her stage of hypertension?
A. Elevated
B. Stage 1
C. Stage 2
D. Hypertensive crisis
Correct Answer: C
Rationale: Stage 2 hypertension is defined as systolic ≥140 mmHg
or diastolic ≥90 mmHg. Her BP of 154/92 mmHg meets criteria for
Stage 2 hypertension .
7. A 50-year-old male presents with nocturia, weak stream, and
post-void dribbling. Digital rectal exam reveals a symmetrically
enlarged, smooth prostate. What is the most likely diagnosis?
A. Prostate cancer
B. Acute prostatitis
C. Benign prostatic hyperplasia (BPH)
D. Chronic pelvic pain syndrome
Correct Answer: C
Rationale: BPH is a non-malignant enlargement of the prostate that
causes obstructive LUTS. The prostate is smooth and symmetric;
cancer typically presents as a hard, irregular nodule .
8. A 75-year-old female with a history of atrial fibrillation is on
warfarin and has an INR of 4.5 without bleeding. What is the most
appropriate next step?
A. Administer vitamin K
B. Hold warfarin and recheck INR
