BARKLEY AGACNP DRT NEWEST
2026/2027 ACTUAL EXAM TEST BANK |
ADULT-GERONTOLOGY ACUTE CARE
NP BARKLEY EXAM REVIEW WITH
COMPLETE 450 REAL EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+
(MOST RECENT!!) | INSTANT
DOWNLOAD PDF.
Core Domains
• Cardiovascular Disorders and Hemodynamic Management
• Pulmonary and Respiratory Critical Care
• Neurological and Neurocritical Care
• Renal and Fluid/Electrolyte Management
• Endocrine and Metabolic Emergencies
• Infectious Disease and Sepsis Management
• Gastrointestinal and Hepatic Emergencies
• Hematologic and Oncologic Emergencies
• Shock States and Multisystem Organ Dysfunction
• Pharmacology and Medication Management
• Professional Role, Ethics, and End-of-Life Care
,Introduction
This comprehensive practice examination is designed to prepare
candidates for the Barkley AGACNP board certification examination, a
rigorous assessment of advanced practice nursing competence in acute
care settings. The test covers the full spectrum of adult-gerontology
acute care practice including hemodynamic monitoring, mechanical
ventilation, sepsis management, and critical care pharmacology.
Questions are structured to reflect the complexity and clinical decision-
making required in intensive care units, emergency departments, and
acute care hospital settings. Emphasis is placed on evidence-based
practice, rapid clinical assessment, and prioritization of interventions in
life-threatening situations.
SECTION ONE: QUESTIONS 1–450
CARDIOVASCULAR DISORDERS AND HEMODYNAMIC
MANAGEMENT
1. A 68-year-old male with a history of heart failure presents with
increasing dyspnea and an S3 gallop. The BNP is 850 pg/mL. Which
diagnostic finding is most consistent with acute decompensated
heart failure?
A. Pulmonary artery wedge pressure of 8 mmHg
B. Cardiac index of 3.2 L/min/m²
C. Pulmonary artery wedge pressure of 22 mmHg
D. Systemic vascular resistance of 800 dynes/sec/cm⁻⁵
RATIONALE: An elevated pulmonary artery wedge pressure (>18
mmHg) is a hallmark of left-sided heart failure and pulmonary
congestion.
,2. A patient in the ICU develops new-onset atrial fibrillation with
rapid ventricular response. Blood pressure is 82/50 mmHg. What is
the priority intervention?
A. Amiodarone infusion
B. Synchronized cardioversion
C. Diltiazem bolus
D. Beta-blocker administration
RATIONALE: Hemodynamic instability in the setting of new-onset
tachycardia requires immediate synchronized cardioversion to restore
perfusion.
3. A patient presents with acute onset of severe tearing chest pain
radiating to the back. Blood pressure is 180/110 mmHg. What is the
priority diagnostic study?
A. ECG
B. CT angiography of the chest
C. Chest X-ray
D. Transthoracic echocardiogram
RATIONALE: Tearing chest pain radiating to the back with severe
hypertension is classic for aortic dissection. CT angiography is the
diagnostic study of choice.
4. A 65-year-old man with hypertension and diabetes presents with
substernal chest pressure, diaphoresis, and nausea for 2 hours. ECG
shows ST-segment elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery (LAD)
B. Left circumflex artery (LCx)
, C. Right coronary artery (RCA)
D. Left main coronary artery
RATIONALE: ST elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction. The RCA supplies the inferior wall
in the majority of patients.
5. A patient with an acute anterior STEMI undergoes percutaneous
coronary intervention (PCI) and receives a drug-eluting stent. Dual
antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor
should be continued for at least:
A. 1 month
B. 3 months
C. 6–12 months
D. Indefinitely, only aspirin after the first year
RATIONALE: For patients with acute coronary syndrome treated
with a drug-eluting stent, current guidelines recommend DAPT for at
least 6–12 months.
6. A 60-year-old man with a known history of heart failure with
reduced ejection fraction (HFrEF, EF 30%) presents with worsening
dyspnea, orthopnea, and 3+ pitting edema. BNP is 1,500 pg/mL.
Which of the following medication classes has been shown to reduce
mortality in HFrEF?
A. Digoxin
B. Loop diuretics
C. Mineralocorticoid receptor antagonists
D. Calcium channel blockers
2026/2027 ACTUAL EXAM TEST BANK |
ADULT-GERONTOLOGY ACUTE CARE
NP BARKLEY EXAM REVIEW WITH
COMPLETE 450 REAL EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+
(MOST RECENT!!) | INSTANT
DOWNLOAD PDF.
Core Domains
• Cardiovascular Disorders and Hemodynamic Management
• Pulmonary and Respiratory Critical Care
• Neurological and Neurocritical Care
• Renal and Fluid/Electrolyte Management
• Endocrine and Metabolic Emergencies
• Infectious Disease and Sepsis Management
• Gastrointestinal and Hepatic Emergencies
• Hematologic and Oncologic Emergencies
• Shock States and Multisystem Organ Dysfunction
• Pharmacology and Medication Management
• Professional Role, Ethics, and End-of-Life Care
,Introduction
This comprehensive practice examination is designed to prepare
candidates for the Barkley AGACNP board certification examination, a
rigorous assessment of advanced practice nursing competence in acute
care settings. The test covers the full spectrum of adult-gerontology
acute care practice including hemodynamic monitoring, mechanical
ventilation, sepsis management, and critical care pharmacology.
Questions are structured to reflect the complexity and clinical decision-
making required in intensive care units, emergency departments, and
acute care hospital settings. Emphasis is placed on evidence-based
practice, rapid clinical assessment, and prioritization of interventions in
life-threatening situations.
SECTION ONE: QUESTIONS 1–450
CARDIOVASCULAR DISORDERS AND HEMODYNAMIC
MANAGEMENT
1. A 68-year-old male with a history of heart failure presents with
increasing dyspnea and an S3 gallop. The BNP is 850 pg/mL. Which
diagnostic finding is most consistent with acute decompensated
heart failure?
A. Pulmonary artery wedge pressure of 8 mmHg
B. Cardiac index of 3.2 L/min/m²
C. Pulmonary artery wedge pressure of 22 mmHg
D. Systemic vascular resistance of 800 dynes/sec/cm⁻⁵
RATIONALE: An elevated pulmonary artery wedge pressure (>18
mmHg) is a hallmark of left-sided heart failure and pulmonary
congestion.
,2. A patient in the ICU develops new-onset atrial fibrillation with
rapid ventricular response. Blood pressure is 82/50 mmHg. What is
the priority intervention?
A. Amiodarone infusion
B. Synchronized cardioversion
C. Diltiazem bolus
D. Beta-blocker administration
RATIONALE: Hemodynamic instability in the setting of new-onset
tachycardia requires immediate synchronized cardioversion to restore
perfusion.
3. A patient presents with acute onset of severe tearing chest pain
radiating to the back. Blood pressure is 180/110 mmHg. What is the
priority diagnostic study?
A. ECG
B. CT angiography of the chest
C. Chest X-ray
D. Transthoracic echocardiogram
RATIONALE: Tearing chest pain radiating to the back with severe
hypertension is classic for aortic dissection. CT angiography is the
diagnostic study of choice.
4. A 65-year-old man with hypertension and diabetes presents with
substernal chest pressure, diaphoresis, and nausea for 2 hours. ECG
shows ST-segment elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery (LAD)
B. Left circumflex artery (LCx)
, C. Right coronary artery (RCA)
D. Left main coronary artery
RATIONALE: ST elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction. The RCA supplies the inferior wall
in the majority of patients.
5. A patient with an acute anterior STEMI undergoes percutaneous
coronary intervention (PCI) and receives a drug-eluting stent. Dual
antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor
should be continued for at least:
A. 1 month
B. 3 months
C. 6–12 months
D. Indefinitely, only aspirin after the first year
RATIONALE: For patients with acute coronary syndrome treated
with a drug-eluting stent, current guidelines recommend DAPT for at
least 6–12 months.
6. A 60-year-old man with a known history of heart failure with
reduced ejection fraction (HFrEF, EF 30%) presents with worsening
dyspnea, orthopnea, and 3+ pitting edema. BNP is 1,500 pg/mL.
Which of the following medication classes has been shown to reduce
mortality in HFrEF?
A. Digoxin
B. Loop diuretics
C. Mineralocorticoid receptor antagonists
D. Calcium channel blockers
