ANCC Adult-Gerontology Primary Care AGPCNP-
BC Certification Exam New Latest Version with All
175 Multiple Choice Questions, 100% Correct
Answers and Rationale
Section 1: Assessment (Questions 1–18)
1. A 65-year-old male presents with fatigue and shortness of breath on exertion. What is the
most appropriate initial assessment for suspected heart failure?
A) B-type natriuretic peptide (BNP) level.
B) Complete blood count (CBC).
C) Chest X-ray.
D) Electrocardiogram (ECG). Correct Answer: A) B-type natriuretic peptide (BNP) level.
Rationale: BNP is a sensitive initial screening test for heart failure in older adults, helping
differentiate cardiac from non-cardiac causes. ANCC Domain 1: Assessment of
cardiovascular disorders in geriatrics.
2. A 50-year-old female reports hot flashes and irregular periods. What is the recommended
initial assessment for perimenopause?
A) Follicle-stimulating hormone (FSH) level.
B) Thyroid-stimulating hormone (TSH).
C) Pregnancy test.
D) Mammogram. Correct Answer: A) Follicle-stimulating hormone (FSH) level.
Rationale: Elevated FSH confirms ovarian decline in perimenopause. ANCC Domain 1:
Endocrine assessment in midlife adults.
3. An 80-year-old male with chronic low back pain. What physical exam maneuver assesses
for spinal stenosis?
A) Flexion and extension testing.
B) Straight-leg raise.
C) McMurray's test.
D) Phalen's test. Correct Answer: A) Flexion and extension testing.
Rationale: Flexion relieves symptoms in spinal stenosis, while extension worsens them.
ANCC Domain 1: Musculoskeletal assessment in geriatrics.
4. A 55-year-old male with urinary frequency and weak stream. What is the initial
assessment for benign prostatic hyperplasia (BPH)?
A) Digital rectal exam (DRE) and prostate-specific antigen (PSA).
B) Urinalysis only.
C) Renal ultrasound.
D) No exam needed. Correct Answer: A) Digital rectal exam (DRE) and prostate-specific
antigen (PSA).
Rationale: DRE evaluates prostate size, and PSA screens for malignancy in BPH. ANCC
Domain 1: Genitourinary assessment in adult males.
5. A 70-year-old female with cognitive decline. What screening tool for mild cognitive
impairment?
A) Montreal Cognitive Assessment (MoCA).
, B) Mini-Mental State Examination (MMSE).
C) Clock-drawing test only.
D) No screening. Correct Answer: A) Montreal Cognitive Assessment (MoCA).
Rationale: MoCA is more sensitive for MCI than MMSE. ANCC Domain 1:
Neurological assessment in geriatrics.
6. A 45-year-old female with joint pain and stiffness. What initial lab for suspected
rheumatoid arthritis?
A) Rheumatoid factor (RF) and anti-CCP antibodies.
B) ESR only.
C) X-ray.
D) No labs. Correct Answer: A) Rheumatoid factor (RF) and anti-CCP antibodies.
Rationale: Specific serologic markers for RA. ANCC Domain 1: Rheumatologic
assessment in adults.
7. A 60-year-old male with chronic cough. What assessment for COPD?
A) Spirometry with FEV1/FVC ratio.
B) Chest X-ray only.
C) ABG.
D) No assessment. Correct Answer: A) Spirometry with FEV1/FVC ratio.
Rationale: Gold standard for diagnosing obstructive disease. ANCC Domain 1:
Pulmonary assessment in adults.
8. A 75-year-old with falls. What comprehensive geriatric assessment includes?
A) Timed Up and Go (TUG) test and multifactorial evaluation.
B) No assessment.
C) Vision test only.
D) BP check. Correct Answer: A) Timed Up and Go (TUG) test and multifactorial
evaluation.
Rationale: Assesses mobility and risk factors. ANCC Domain 1: Geriatric fall risk
assessment.
9. A 50-year-old with abdominal pain and fever. What assessment for diverticulitis?
A) Left lower quadrant tenderness.
B) No exam.
C) Rectal exam only.
D) Pelvic exam. Correct Answer: A) Left lower quadrant tenderness.
Rationale: Localizes inflammation. ANCC Domain 1: GI assessment in adults.
10. A 65-year-old female with memory loss. What assessment for depression as differential?
A) Geriatric Depression Scale (GDS).
B) No screening.
C) MMSE only.
D) Labs only. Correct Answer: A) Geriatric Depression Scale (GDS).
Rationale: Screens for pseudodementia. ANCC Domain 1: Psychiatric assessment in
geriatrics.
11. A 55-year-old male with erectile dysfunction. What initial assessment?
A) History for vascular risk factors and testosterone level.
B) No assessment.
C) PSA only.
D) DRE only. Correct Answer: A) History for vascular risk factors and testosterone level.
, Rationale: Identifies causes like CVD or hypogonadism. ANCC Domain 1: Sexual health
assessment in adult males.
12. A 70-year-old with dysphagia. What assessment for aspiration risk?
A) Bedside swallow evaluation.
B) No assessment.
C) Endoscopy.
D) Barium swallow. Correct Answer: A) Bedside swallow evaluation.
Rationale: Initial screening for swallowing disorders. ANCC Domain 1: Geriatric GI
assessment.
13. A 45-year-old with chronic fatigue. What assessment for sleep apnea?
A) Epworth Sleepiness Scale.
B) No screening.
C) Polysomnography.
D) Thyroid test only. Correct Answer: A) Epworth Sleepiness Scale.
Rationale: Screens for daytime somnolence. ANCC Domain 1: Sleep disorder assessment
in adults.
14. A 60-year-old with skin lesions. What assessment for melanoma?
A) ABCDE criteria (asymmetry, border, color, diameter, evolution).
B) No exam.
C) Biopsy first.
D) Dermatoscope. Correct Answer: A) ABCDE criteria (asymmetry, border, color,
diameter, evolution).
Rationale: Risk stratification for lesions. ANCC Domain 1: Dermatological assessment in
adults.
15. A 75-year-old with polypharmacy. What assessment for interactions?
A) Beers Criteria review.
B) No review.
C) Medication list only.
D) Labs only. Correct Answer: A) Beers Criteria review.
Rationale: Identifies inappropriate medications in elderly. ANCC Domain 1: Geriatric
pharmacology assessment.
16. A 50-year-old with joint swelling. What assessment for gout?
A) Podagra (big toe pain) and uric acid level.
B) No assessment.
C) X-ray only.
D) ESR only. Correct Answer: A) Podagra (big toe pain) and uric acid level.
Rationale: Classic presentation and lab confirmation. ANCC Domain 1: Rheumatologic
assessment.
17. A 65-year-old with vision changes. What assessment for cataract?
A) Slit-lamp exam.
B) No exam.
C) Fundoscopy only.
D) Visual acuity test. Correct Answer: A) Slit-lamp exam.
Rationale: Visualizes lens opacity. ANCC Domain 1: Ophthalmic assessment in
geriatrics.
18. A 55-year-old with hoarseness. What assessment for vocal cord nodules?
BC Certification Exam New Latest Version with All
175 Multiple Choice Questions, 100% Correct
Answers and Rationale
Section 1: Assessment (Questions 1–18)
1. A 65-year-old male presents with fatigue and shortness of breath on exertion. What is the
most appropriate initial assessment for suspected heart failure?
A) B-type natriuretic peptide (BNP) level.
B) Complete blood count (CBC).
C) Chest X-ray.
D) Electrocardiogram (ECG). Correct Answer: A) B-type natriuretic peptide (BNP) level.
Rationale: BNP is a sensitive initial screening test for heart failure in older adults, helping
differentiate cardiac from non-cardiac causes. ANCC Domain 1: Assessment of
cardiovascular disorders in geriatrics.
2. A 50-year-old female reports hot flashes and irregular periods. What is the recommended
initial assessment for perimenopause?
A) Follicle-stimulating hormone (FSH) level.
B) Thyroid-stimulating hormone (TSH).
C) Pregnancy test.
D) Mammogram. Correct Answer: A) Follicle-stimulating hormone (FSH) level.
Rationale: Elevated FSH confirms ovarian decline in perimenopause. ANCC Domain 1:
Endocrine assessment in midlife adults.
3. An 80-year-old male with chronic low back pain. What physical exam maneuver assesses
for spinal stenosis?
A) Flexion and extension testing.
B) Straight-leg raise.
C) McMurray's test.
D) Phalen's test. Correct Answer: A) Flexion and extension testing.
Rationale: Flexion relieves symptoms in spinal stenosis, while extension worsens them.
ANCC Domain 1: Musculoskeletal assessment in geriatrics.
4. A 55-year-old male with urinary frequency and weak stream. What is the initial
assessment for benign prostatic hyperplasia (BPH)?
A) Digital rectal exam (DRE) and prostate-specific antigen (PSA).
B) Urinalysis only.
C) Renal ultrasound.
D) No exam needed. Correct Answer: A) Digital rectal exam (DRE) and prostate-specific
antigen (PSA).
Rationale: DRE evaluates prostate size, and PSA screens for malignancy in BPH. ANCC
Domain 1: Genitourinary assessment in adult males.
5. A 70-year-old female with cognitive decline. What screening tool for mild cognitive
impairment?
A) Montreal Cognitive Assessment (MoCA).
, B) Mini-Mental State Examination (MMSE).
C) Clock-drawing test only.
D) No screening. Correct Answer: A) Montreal Cognitive Assessment (MoCA).
Rationale: MoCA is more sensitive for MCI than MMSE. ANCC Domain 1:
Neurological assessment in geriatrics.
6. A 45-year-old female with joint pain and stiffness. What initial lab for suspected
rheumatoid arthritis?
A) Rheumatoid factor (RF) and anti-CCP antibodies.
B) ESR only.
C) X-ray.
D) No labs. Correct Answer: A) Rheumatoid factor (RF) and anti-CCP antibodies.
Rationale: Specific serologic markers for RA. ANCC Domain 1: Rheumatologic
assessment in adults.
7. A 60-year-old male with chronic cough. What assessment for COPD?
A) Spirometry with FEV1/FVC ratio.
B) Chest X-ray only.
C) ABG.
D) No assessment. Correct Answer: A) Spirometry with FEV1/FVC ratio.
Rationale: Gold standard for diagnosing obstructive disease. ANCC Domain 1:
Pulmonary assessment in adults.
8. A 75-year-old with falls. What comprehensive geriatric assessment includes?
A) Timed Up and Go (TUG) test and multifactorial evaluation.
B) No assessment.
C) Vision test only.
D) BP check. Correct Answer: A) Timed Up and Go (TUG) test and multifactorial
evaluation.
Rationale: Assesses mobility and risk factors. ANCC Domain 1: Geriatric fall risk
assessment.
9. A 50-year-old with abdominal pain and fever. What assessment for diverticulitis?
A) Left lower quadrant tenderness.
B) No exam.
C) Rectal exam only.
D) Pelvic exam. Correct Answer: A) Left lower quadrant tenderness.
Rationale: Localizes inflammation. ANCC Domain 1: GI assessment in adults.
10. A 65-year-old female with memory loss. What assessment for depression as differential?
A) Geriatric Depression Scale (GDS).
B) No screening.
C) MMSE only.
D) Labs only. Correct Answer: A) Geriatric Depression Scale (GDS).
Rationale: Screens for pseudodementia. ANCC Domain 1: Psychiatric assessment in
geriatrics.
11. A 55-year-old male with erectile dysfunction. What initial assessment?
A) History for vascular risk factors and testosterone level.
B) No assessment.
C) PSA only.
D) DRE only. Correct Answer: A) History for vascular risk factors and testosterone level.
, Rationale: Identifies causes like CVD or hypogonadism. ANCC Domain 1: Sexual health
assessment in adult males.
12. A 70-year-old with dysphagia. What assessment for aspiration risk?
A) Bedside swallow evaluation.
B) No assessment.
C) Endoscopy.
D) Barium swallow. Correct Answer: A) Bedside swallow evaluation.
Rationale: Initial screening for swallowing disorders. ANCC Domain 1: Geriatric GI
assessment.
13. A 45-year-old with chronic fatigue. What assessment for sleep apnea?
A) Epworth Sleepiness Scale.
B) No screening.
C) Polysomnography.
D) Thyroid test only. Correct Answer: A) Epworth Sleepiness Scale.
Rationale: Screens for daytime somnolence. ANCC Domain 1: Sleep disorder assessment
in adults.
14. A 60-year-old with skin lesions. What assessment for melanoma?
A) ABCDE criteria (asymmetry, border, color, diameter, evolution).
B) No exam.
C) Biopsy first.
D) Dermatoscope. Correct Answer: A) ABCDE criteria (asymmetry, border, color,
diameter, evolution).
Rationale: Risk stratification for lesions. ANCC Domain 1: Dermatological assessment in
adults.
15. A 75-year-old with polypharmacy. What assessment for interactions?
A) Beers Criteria review.
B) No review.
C) Medication list only.
D) Labs only. Correct Answer: A) Beers Criteria review.
Rationale: Identifies inappropriate medications in elderly. ANCC Domain 1: Geriatric
pharmacology assessment.
16. A 50-year-old with joint swelling. What assessment for gout?
A) Podagra (big toe pain) and uric acid level.
B) No assessment.
C) X-ray only.
D) ESR only. Correct Answer: A) Podagra (big toe pain) and uric acid level.
Rationale: Classic presentation and lab confirmation. ANCC Domain 1: Rheumatologic
assessment.
17. A 65-year-old with vision changes. What assessment for cataract?
A) Slit-lamp exam.
B) No exam.
C) Fundoscopy only.
D) Visual acuity test. Correct Answer: A) Slit-lamp exam.
Rationale: Visualizes lens opacity. ANCC Domain 1: Ophthalmic assessment in
geriatrics.
18. A 55-year-old with hoarseness. What assessment for vocal cord nodules?
