AACN AGACNP Review Exam Reviewed
Questions and Answers Latest 2025/2026
GRADED A
Addison's disease - CORRECT ANSWER-Primary
Caused by damage to the adrenal cortex (autoimmune, TB, metastatic disease,
deposition diseases, and drug induced) leading to a decrease in cortisol production.
Secondary
Caused by pituitary failure to release ACTH (in any hypopituitary disorder) causing a
decrease in cortisol production.
Sudden withdrawal of systemic corticosteroids leading to a decrease in cortisol
production from induced corticosteroid suppression.
Aortic regurgitation - CORRECT ANSWER-Grade 1-3/4 high pitched blowing diastolic
murmur heard best at 3rd LICS.
May be enhanced by forced expiration, leaning forward.
Usually S3, wide pulse pressure, sustained thrusting apical impulses.
More common in men usually from rheumatic heart disease and occasionally due to
tertiary Syphilis.
Aortic sclerosis - CORRECT ANSWER-Grade 2-3/6 systolic ejection murmur best
heard at RICS.
Carotid upstroke full, not delayed, no S4, absence of symptoms.
Benign thickening of the aortic valve leaflets.
No change in valve pressure gradient.
50 over 50 (found in 50% of those over 50)
Aortic Stenosis Murmur - CORRECT ANSWER-Grade 1-4/6 harsh systolic murmur,
usually crescendo-decrescendo pattern.
Heard best at 2nd RICS, apex, and softens with standing.
Radiates to carotids, may have diminished S2, slow filling carotid pulse, narrow pulse
pressure, loud S4, heaving PMI.
Great the degree of stenosis the later the peak of murmur.
Younger adults due to bicuspid valve.
Older adults due to calcific /rheumatic.
, Dizziness and syncope are an ominous sign pointing to severely decreased cardiac
output.
Atrial Septal Defect ASD - CORRECT ANSWER-Grade 1-3/6 systolic ejection murmur in
the pulmonic area.
Widely split S2, right ventricular heave.
Typically without symptoms and then middle aged HF.
Persistent ostium secundium in mid septum.
Will resolve with ASD correction.
Bacterial Meningitis - CORRECT ANSWER-Glucose <45 mg/dl
Protein >50 mg/dl
Opening pressure is markedly high.
Cell count 200-20,000 PMN/microliter.
Bouchard's nodes - CORRECT ANSWER-Middle Joint of finger.
Brudzinski's Sign - CORRECT ANSWER-Severe neck stiffness causes a patient's hips
and knees to flex when the neck is flexed.
Cushing's Syndrome/Disease - CORRECT ANSWER-cortisol excess typically caused by
pituitary adenoma 60-70% of cases.
Central obesity w/ extremity wasting.
dorsocervical fat pad.
rounded facies.
spontaneous bruising.
purple striae
hyperpigmentation
poor wound healing/ skin infections.
Dexamethasone suppression test.
1mg dexamethasone at 2300 hours and measure serum cortisol at 0800.
Remove sources of excess and manage consequences ( HTN, hypokalemia,
hyperglycemia.)
diabetes insipidus (DI) - CORRECT ANSWER-Insufficient ADH or decreased sensitivity
to ADH
Nephron cannot conserve water.
Questions and Answers Latest 2025/2026
GRADED A
Addison's disease - CORRECT ANSWER-Primary
Caused by damage to the adrenal cortex (autoimmune, TB, metastatic disease,
deposition diseases, and drug induced) leading to a decrease in cortisol production.
Secondary
Caused by pituitary failure to release ACTH (in any hypopituitary disorder) causing a
decrease in cortisol production.
Sudden withdrawal of systemic corticosteroids leading to a decrease in cortisol
production from induced corticosteroid suppression.
Aortic regurgitation - CORRECT ANSWER-Grade 1-3/4 high pitched blowing diastolic
murmur heard best at 3rd LICS.
May be enhanced by forced expiration, leaning forward.
Usually S3, wide pulse pressure, sustained thrusting apical impulses.
More common in men usually from rheumatic heart disease and occasionally due to
tertiary Syphilis.
Aortic sclerosis - CORRECT ANSWER-Grade 2-3/6 systolic ejection murmur best
heard at RICS.
Carotid upstroke full, not delayed, no S4, absence of symptoms.
Benign thickening of the aortic valve leaflets.
No change in valve pressure gradient.
50 over 50 (found in 50% of those over 50)
Aortic Stenosis Murmur - CORRECT ANSWER-Grade 1-4/6 harsh systolic murmur,
usually crescendo-decrescendo pattern.
Heard best at 2nd RICS, apex, and softens with standing.
Radiates to carotids, may have diminished S2, slow filling carotid pulse, narrow pulse
pressure, loud S4, heaving PMI.
Great the degree of stenosis the later the peak of murmur.
Younger adults due to bicuspid valve.
Older adults due to calcific /rheumatic.
, Dizziness and syncope are an ominous sign pointing to severely decreased cardiac
output.
Atrial Septal Defect ASD - CORRECT ANSWER-Grade 1-3/6 systolic ejection murmur in
the pulmonic area.
Widely split S2, right ventricular heave.
Typically without symptoms and then middle aged HF.
Persistent ostium secundium in mid septum.
Will resolve with ASD correction.
Bacterial Meningitis - CORRECT ANSWER-Glucose <45 mg/dl
Protein >50 mg/dl
Opening pressure is markedly high.
Cell count 200-20,000 PMN/microliter.
Bouchard's nodes - CORRECT ANSWER-Middle Joint of finger.
Brudzinski's Sign - CORRECT ANSWER-Severe neck stiffness causes a patient's hips
and knees to flex when the neck is flexed.
Cushing's Syndrome/Disease - CORRECT ANSWER-cortisol excess typically caused by
pituitary adenoma 60-70% of cases.
Central obesity w/ extremity wasting.
dorsocervical fat pad.
rounded facies.
spontaneous bruising.
purple striae
hyperpigmentation
poor wound healing/ skin infections.
Dexamethasone suppression test.
1mg dexamethasone at 2300 hours and measure serum cortisol at 0800.
Remove sources of excess and manage consequences ( HTN, hypokalemia,
hyperglycemia.)
diabetes insipidus (DI) - CORRECT ANSWER-Insufficient ADH or decreased sensitivity
to ADH
Nephron cannot conserve water.
