ANCC AGPCNP PRACTICE EXAM 2025
QUESTIONS AND ANSWERS
An 18-year-old female patient is being followed up for acne by the nurse practitioner. During
the facial exam, papules and pustules are noted mostly on the forehead and the chin areas. The
patient has been using over-the-counter topical antibiotic gels and medicated soap daily for 6
months without much improvement. The nurse practitioner will recommend:
a. Isotretinoin (Accutane)
b. Tetracycline (Sumycin)
c. Clindamycin topical solution (Cleocin- T)
d. Minoxidil (Rogaine) - ANS b. Tetracycline (Sumycin)
First-line treatment for acne vulgaris includes over-the-counter medicated soap and water with
topical antibiotic gels. The next step in treatment would be the initiation of oral tetracycline.
A young adult presents for reassessment of uncontrolled asthma symptoms. The patient is
currently taking an inhaled short-acting beta2-agonist (SABA) as needed and reports daytime
symptoms more than 3 days/week, but not daily, and nighttime awakenings 4 to 5 times/week.
The patient's forced expiratory volume (FEV1) is 80% of predicted. The nurse practitioner
upgrades the patient to the next stage of treatment, which includes:
a. Budesonide with formoterol
b. Budesonide with montelukast
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c. Cromolyn or nedocromil
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, d. Fluticasone with salmeterol - ANS a. Budesonide with formoterol.
The patient has moved from step 2 to step 3 on the asthma classification scale. Therefore, a
low-dose inhaled corticosteroid (ICS) plus long-acting beta-agonist (LABA) such as budesonide
with formoterol is an appropriate starting point. Fluticasone with salmeterol is prescribed if the
patient is at step 4; budesonide with montelukast is an alternative. Cromolyn and nedocromil
have been discontinued in the United States.
Which of the following drugs can increase the risk of bleeding in patients who are receiving
anticoagulation therapy with warfarin sodium (Coumadin)?
a. Trimethoprim-sulfamethoxazole (Bactrim DS)
b. Carafate (Sucralfate)
c. Losartan (Cozaar)
d. Furosemide (Lasix) - ANS a. Trimethoprim-sulfamethoxazole (Bactrim DS).
Warfarin sodium (Coumadin) interacts with Bactrim and will increase the risk of bleeding;
therefore, concurrent use is contraindicated.
A 22-year-old woman is going on a 5-day cruise for her honeymoon. She reports a history of
severe motion sickness. Which of the following medicines can be prescribed for motion
sickness?
a. Dimenhydrinate (Dramamine)
b. Metoclopramide (Reglan)
c. Ondansetron (Zofran)
d. Scopolamine patch (Transderm Scop) - ANS d. Scopolamine patch (Transderm Scop)
Scopolamine patch (Transderm Scop) is a prescription medicine that is used for motion/sea
2
Page
sickness. It is a small, circular patch that is placed behind the ear and is effective for 3 days.
@COPYRIGHT @THEBRIGHT 2025/2026
, Advise the patient to apply it 4 hours before the trip to be effective. Because the question is
asking about a "prescribed" medication, an over-the-counter (OTC) medicine, such as
Dramamine, is an incorrect response. Zofran is indicated for cancer-related nausea and
vomiting (chemotherapy, radiation, surgery).
The nurse practitioner is completing a health assessment on a 15-year-old female patient who
is in the office for her annual physical. The patient reports feelings of hopelessness and sadness
for several months, no history of suicidal ideations, and a struggle with anorexia. The patient
scores an 11 on Beck's Depression Inventory. Which antidepressant will the nurse practitioner
prescribe?
a. Sertraline (Zoloft)
b. Lithium carbonate (Eskalith)
c. Bupropion (Wellbutrin)
d. Escitalopram (Lexapro) - ANS d. Escitalopram [Lexapro]
Escitalopram is a safe antidepressant for an adolescent who has severe depression and no
history of suicidal ideations. Sertraline is not a safe option for patients younger than 24 years of
age because of increased risk of suicidal ideation. Bupropion is an atypical antidepressant and is
not a first-line therapy for depression. It is contraindicated in patients with anorexia nervosa.
Lithium is indicated for patients with bipolar disorder.
Which initial treatment will the nurse practitioner prescribe to a 23-year-old female allergic to
sulfa drugs who is diagnosed with acute cystitis?
a. Cephalexin (Keflex) 500 mg BID × 5 days
b. Ciprofloxacin (Cipro) 250 mg BID × 3 days
c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
d. Amoxicillin 500 mg BID × 5 days - ANS c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
3
Page
@COPYRIGHT @THEBRIGHT 2025/2026
, Nitrofurantoin can be safely administered to a patient with a sulfa allergy to treat acute cystitis
and is the first line of treatment. Cephalexin and amoxicillin are beta-lactam antibiotics that can
be prescribed for a patient who has an allergy to sulfa and nitrofurantoin. A fluoroquinolone,
such as ciprofloxacin, is recommended for a patient who is allergic to sulfa and beta-lactam
drugs or has a sulfa allergy and a known resistance to beta-lactam antibiotics.
A 68-year-old patient recently prescribed caridopa-levodopa (Sinemet) tells the nurse
practitioner that he has been bloated and experiencing difficulty with bowel movements.
Which medication will the nurse practitioner consider incorporating into the treatment plan?
a. Senna
b. Methylnaltrexone
c. Magnesium citrate
d. Polyethylene glycol - ANS d. Polyethylene glycol
Levodopa, an antiparkinsonian drug, can cause constipation in an older patient. The first-line
treatment for the patient's constipation is osmotic laxatives such as polyethylene glycol. Senna
is a stimulant laxative that is a second-line treatment for constipation in an older adult.
Methylnaltrexone is a peripherally acting mu-opioid antagonist that acts on the gastrointestinal
tract to decrease opioid-induced constipation. Magnesium-based laxatives (e.g., magnesium
citrate) taken over the long term should be avoided because of the potential of toxicity.
A patient recently returned from a trip to Africa and is experiencing 10 to 12 loose stools every
day. The patient takes metformin every morning and otherwise is in good health. Which
medication will the nurse practitioner prescribe to treat the diarrhea?
a. Levofloxacin daily
b. Ofloxacin BID
c. Trimethoprim-sulfamethoxazole BID
d. Ciprofloxacin in a single dose - ANS d. Ciprofloxacin in a single dose
4
Page
@COPYRIGHT @THEBRIGHT 2025/2026
QUESTIONS AND ANSWERS
An 18-year-old female patient is being followed up for acne by the nurse practitioner. During
the facial exam, papules and pustules are noted mostly on the forehead and the chin areas. The
patient has been using over-the-counter topical antibiotic gels and medicated soap daily for 6
months without much improvement. The nurse practitioner will recommend:
a. Isotretinoin (Accutane)
b. Tetracycline (Sumycin)
c. Clindamycin topical solution (Cleocin- T)
d. Minoxidil (Rogaine) - ANS b. Tetracycline (Sumycin)
First-line treatment for acne vulgaris includes over-the-counter medicated soap and water with
topical antibiotic gels. The next step in treatment would be the initiation of oral tetracycline.
A young adult presents for reassessment of uncontrolled asthma symptoms. The patient is
currently taking an inhaled short-acting beta2-agonist (SABA) as needed and reports daytime
symptoms more than 3 days/week, but not daily, and nighttime awakenings 4 to 5 times/week.
The patient's forced expiratory volume (FEV1) is 80% of predicted. The nurse practitioner
upgrades the patient to the next stage of treatment, which includes:
a. Budesonide with formoterol
b. Budesonide with montelukast
1
Page
c. Cromolyn or nedocromil
@COPYRIGHT @THEBRIGHT 2025/2026
, d. Fluticasone with salmeterol - ANS a. Budesonide with formoterol.
The patient has moved from step 2 to step 3 on the asthma classification scale. Therefore, a
low-dose inhaled corticosteroid (ICS) plus long-acting beta-agonist (LABA) such as budesonide
with formoterol is an appropriate starting point. Fluticasone with salmeterol is prescribed if the
patient is at step 4; budesonide with montelukast is an alternative. Cromolyn and nedocromil
have been discontinued in the United States.
Which of the following drugs can increase the risk of bleeding in patients who are receiving
anticoagulation therapy with warfarin sodium (Coumadin)?
a. Trimethoprim-sulfamethoxazole (Bactrim DS)
b. Carafate (Sucralfate)
c. Losartan (Cozaar)
d. Furosemide (Lasix) - ANS a. Trimethoprim-sulfamethoxazole (Bactrim DS).
Warfarin sodium (Coumadin) interacts with Bactrim and will increase the risk of bleeding;
therefore, concurrent use is contraindicated.
A 22-year-old woman is going on a 5-day cruise for her honeymoon. She reports a history of
severe motion sickness. Which of the following medicines can be prescribed for motion
sickness?
a. Dimenhydrinate (Dramamine)
b. Metoclopramide (Reglan)
c. Ondansetron (Zofran)
d. Scopolamine patch (Transderm Scop) - ANS d. Scopolamine patch (Transderm Scop)
Scopolamine patch (Transderm Scop) is a prescription medicine that is used for motion/sea
2
Page
sickness. It is a small, circular patch that is placed behind the ear and is effective for 3 days.
@COPYRIGHT @THEBRIGHT 2025/2026
, Advise the patient to apply it 4 hours before the trip to be effective. Because the question is
asking about a "prescribed" medication, an over-the-counter (OTC) medicine, such as
Dramamine, is an incorrect response. Zofran is indicated for cancer-related nausea and
vomiting (chemotherapy, radiation, surgery).
The nurse practitioner is completing a health assessment on a 15-year-old female patient who
is in the office for her annual physical. The patient reports feelings of hopelessness and sadness
for several months, no history of suicidal ideations, and a struggle with anorexia. The patient
scores an 11 on Beck's Depression Inventory. Which antidepressant will the nurse practitioner
prescribe?
a. Sertraline (Zoloft)
b. Lithium carbonate (Eskalith)
c. Bupropion (Wellbutrin)
d. Escitalopram (Lexapro) - ANS d. Escitalopram [Lexapro]
Escitalopram is a safe antidepressant for an adolescent who has severe depression and no
history of suicidal ideations. Sertraline is not a safe option for patients younger than 24 years of
age because of increased risk of suicidal ideation. Bupropion is an atypical antidepressant and is
not a first-line therapy for depression. It is contraindicated in patients with anorexia nervosa.
Lithium is indicated for patients with bipolar disorder.
Which initial treatment will the nurse practitioner prescribe to a 23-year-old female allergic to
sulfa drugs who is diagnosed with acute cystitis?
a. Cephalexin (Keflex) 500 mg BID × 5 days
b. Ciprofloxacin (Cipro) 250 mg BID × 3 days
c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
d. Amoxicillin 500 mg BID × 5 days - ANS c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
3
Page
@COPYRIGHT @THEBRIGHT 2025/2026
, Nitrofurantoin can be safely administered to a patient with a sulfa allergy to treat acute cystitis
and is the first line of treatment. Cephalexin and amoxicillin are beta-lactam antibiotics that can
be prescribed for a patient who has an allergy to sulfa and nitrofurantoin. A fluoroquinolone,
such as ciprofloxacin, is recommended for a patient who is allergic to sulfa and beta-lactam
drugs or has a sulfa allergy and a known resistance to beta-lactam antibiotics.
A 68-year-old patient recently prescribed caridopa-levodopa (Sinemet) tells the nurse
practitioner that he has been bloated and experiencing difficulty with bowel movements.
Which medication will the nurse practitioner consider incorporating into the treatment plan?
a. Senna
b. Methylnaltrexone
c. Magnesium citrate
d. Polyethylene glycol - ANS d. Polyethylene glycol
Levodopa, an antiparkinsonian drug, can cause constipation in an older patient. The first-line
treatment for the patient's constipation is osmotic laxatives such as polyethylene glycol. Senna
is a stimulant laxative that is a second-line treatment for constipation in an older adult.
Methylnaltrexone is a peripherally acting mu-opioid antagonist that acts on the gastrointestinal
tract to decrease opioid-induced constipation. Magnesium-based laxatives (e.g., magnesium
citrate) taken over the long term should be avoided because of the potential of toxicity.
A patient recently returned from a trip to Africa and is experiencing 10 to 12 loose stools every
day. The patient takes metformin every morning and otherwise is in good health. Which
medication will the nurse practitioner prescribe to treat the diarrhea?
a. Levofloxacin daily
b. Ofloxacin BID
c. Trimethoprim-sulfamethoxazole BID
d. Ciprofloxacin in a single dose - ANS d. Ciprofloxacin in a single dose
4
Page
@COPYRIGHT @THEBRIGHT 2025/2026
