Adult-Gerontology Acute Care Nurse Practitioner
(AGACNP) Exam Final Questions and Correct
Answers (Verified Answers) with Rationales 2025
1. A 78-year-old patient presents with new-onset confusion, fever, and
leukocytosis. What is the most appropriate initial diagnostic test?
A. CT head
B. MRI brain
C. Urinalysis
D. EEG
Confusion in elderly patients is often due to infection, with urinary tract
infections being a common cause. A urinalysis is a quick and non-invasive
initial test.
2. A 65-year-old male with COPD exacerbation is started on high-dose
steroids. What electrolyte abnormality should be most closely monitored?
A. Hyperkalemia
B. Hyponatremia
C. Hypernatremia
D. Hypocalcemia
Steroids can lead to sodium retention and water loss, resulting in
hypernatremia.
3. A patient develops sudden chest pain and dyspnea. ECG shows S1Q3T3
pattern. What is the likely diagnosis?
, A. Acute coronary syndrome
B. Pulmonary embolism
C. Pneumothorax
D. Aortic dissection
S1Q3T3 is a classic ECG finding in pulmonary embolism due to right heart
strain.
4. What is the most appropriate treatment for hypertensive emergency with
acute renal failure?
A. Lisinopril
B. Nitroprusside
C. Hydralazine
D. Atenolol
Nitroprusside is preferred for rapid BP reduction in hypertensive
emergencies.
5. Which medication is contraindicated in acute decompensated heart failure?
A. Nitroglycerin
B. Metoprolol
C. Furosemide
D. Dobutamine
Beta-blockers can worsen acute decompensation and are typically held
initially.
6. A 69-year-old diabetic patient with a foot ulcer develops a fever and
confusion. What is the likely source of sepsis?
A. Lungs
, B. Urinary tract
C. Skin and soft tissue
D. Central line
Diabetic foot ulcers are common sources of skin-related sepsis.
7. Which parameter is most specific for acute pancreatitis?
A. AST
B. Lipase
C. Amylase
D. LDH
Lipase is more specific and remains elevated longer than amylase.
8. Which of the following is a contraindication to thrombolytic therapy in
ischemic stroke?
A. Age >75
B. Hypertension
C. Platelet count <150,000
D. Intracranial hemorrhage history
A history of intracranial hemorrhage is an absolute contraindication.
9. What is the gold standard for diagnosing pulmonary embolism?
A. Chest X-ray
B. ECG
C. CT pulmonary angiogram
D. V/Q scan
CT pulmonary angiogram provides direct visualization of emboli.
(AGACNP) Exam Final Questions and Correct
Answers (Verified Answers) with Rationales 2025
1. A 78-year-old patient presents with new-onset confusion, fever, and
leukocytosis. What is the most appropriate initial diagnostic test?
A. CT head
B. MRI brain
C. Urinalysis
D. EEG
Confusion in elderly patients is often due to infection, with urinary tract
infections being a common cause. A urinalysis is a quick and non-invasive
initial test.
2. A 65-year-old male with COPD exacerbation is started on high-dose
steroids. What electrolyte abnormality should be most closely monitored?
A. Hyperkalemia
B. Hyponatremia
C. Hypernatremia
D. Hypocalcemia
Steroids can lead to sodium retention and water loss, resulting in
hypernatremia.
3. A patient develops sudden chest pain and dyspnea. ECG shows S1Q3T3
pattern. What is the likely diagnosis?
, A. Acute coronary syndrome
B. Pulmonary embolism
C. Pneumothorax
D. Aortic dissection
S1Q3T3 is a classic ECG finding in pulmonary embolism due to right heart
strain.
4. What is the most appropriate treatment for hypertensive emergency with
acute renal failure?
A. Lisinopril
B. Nitroprusside
C. Hydralazine
D. Atenolol
Nitroprusside is preferred for rapid BP reduction in hypertensive
emergencies.
5. Which medication is contraindicated in acute decompensated heart failure?
A. Nitroglycerin
B. Metoprolol
C. Furosemide
D. Dobutamine
Beta-blockers can worsen acute decompensation and are typically held
initially.
6. A 69-year-old diabetic patient with a foot ulcer develops a fever and
confusion. What is the likely source of sepsis?
A. Lungs
, B. Urinary tract
C. Skin and soft tissue
D. Central line
Diabetic foot ulcers are common sources of skin-related sepsis.
7. Which parameter is most specific for acute pancreatitis?
A. AST
B. Lipase
C. Amylase
D. LDH
Lipase is more specific and remains elevated longer than amylase.
8. Which of the following is a contraindication to thrombolytic therapy in
ischemic stroke?
A. Age >75
B. Hypertension
C. Platelet count <150,000
D. Intracranial hemorrhage history
A history of intracranial hemorrhage is an absolute contraindication.
9. What is the gold standard for diagnosing pulmonary embolism?
A. Chest X-ray
B. ECG
C. CT pulmonary angiogram
D. V/Q scan
CT pulmonary angiogram provides direct visualization of emboli.
