Adult-Gerontology Primary Care Nurse
Practitioner (AGPCNP) Certification Exam
Practice Test Questions And Correct
Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. A 68-year-old male presents with exertional chest pain relieved by rest.
Which is the most likely diagnosis?
A. Gastroesophageal reflux disease
B. Stable angina pectoris
C. Unstable angina
D. Myocardial infarction
Rationale: Stable angina presents with predictable chest pain on exertion
relieved by rest or nitroglycerin.
2. Which of the following is the most appropriate first-line treatment for
isolated systolic hypertension in older adults?
A. Beta-blocker
,B. Alpha-blocker
C. Thiazide diuretic
D. Loop diuretic
Rationale: Thiazide diuretics are first-line agents for isolated systolic
hypertension due to proven cardiovascular benefit.
3. A 75-year-old woman with type 2 diabetes reports dizziness when
standing. What is the most likely cause?
A. Hypoglycemia
B. Orthostatic hypotension
C. Stroke
D. Dehydration
Rationale: Older adults with diabetes often develop autonomic
neuropathy, leading to orthostatic hypotension.
4. Which of the following findings is consistent with Alzheimer’s disease?
A. Sudden onset of memory loss
B. Gradual decline in memory and executive function
C. Fluctuating cognition and alertness
D. Visual hallucinations
Rationale: Alzheimer’s disease is characterized by progressive and gradual
cognitive decline.
,5. Which immunization should be given to all adults aged 65 and older if not
previously administered?
A. MMR vaccine
B. Hepatitis A vaccine
C. Pneumococcal conjugate vaccine
D. Varicella vaccine
Rationale: Pneumococcal vaccination is recommended for adults ≥65 years
to prevent pneumonia and bacteremia.
6. A 60-year-old man presents with a productive cough for 3 months each
year for the last 3 years. What is the likely diagnosis?
A. Chronic bronchitis
B. Emphysema
C. Asthma
D. Bronchiectasis
Rationale: Chronic bronchitis is defined as productive cough for at least 3
months in 2 consecutive years.
7. The most appropriate screening test for colorectal cancer in a 65-year-old
man with no prior screening is:
A. Sigmoidoscopy every 5 years
, B. Colonoscopy every 10 years
C. CT colonography every 3 years
D. Annual fecal occult blood test only
Rationale: Colonoscopy every 10 years is the preferred gold standard for
colorectal cancer screening.
8. Which medication should be avoided in older adults due to risk of
delirium?
A. Lisinopril
B. Diphenhydramine
C. Metformin
D. Amlodipine
Rationale: Diphenhydramine, an anticholinergic, increases the risk of
confusion and falls in older adults.
9. A 70-year-old woman presents with a new, painless thyroid nodule. What
is the most appropriate next step?
A. Start levothyroxine
B. Repeat thyroid exam in 6 months
C. Order thyroid ultrasound with fine-needle aspiration
D. Start antibiotics
Rationale: Evaluation of a thyroid nodule in older adults should include
ultrasound and biopsy to rule out malignancy.
Practitioner (AGPCNP) Certification Exam
Practice Test Questions And Correct
Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. A 68-year-old male presents with exertional chest pain relieved by rest.
Which is the most likely diagnosis?
A. Gastroesophageal reflux disease
B. Stable angina pectoris
C. Unstable angina
D. Myocardial infarction
Rationale: Stable angina presents with predictable chest pain on exertion
relieved by rest or nitroglycerin.
2. Which of the following is the most appropriate first-line treatment for
isolated systolic hypertension in older adults?
A. Beta-blocker
,B. Alpha-blocker
C. Thiazide diuretic
D. Loop diuretic
Rationale: Thiazide diuretics are first-line agents for isolated systolic
hypertension due to proven cardiovascular benefit.
3. A 75-year-old woman with type 2 diabetes reports dizziness when
standing. What is the most likely cause?
A. Hypoglycemia
B. Orthostatic hypotension
C. Stroke
D. Dehydration
Rationale: Older adults with diabetes often develop autonomic
neuropathy, leading to orthostatic hypotension.
4. Which of the following findings is consistent with Alzheimer’s disease?
A. Sudden onset of memory loss
B. Gradual decline in memory and executive function
C. Fluctuating cognition and alertness
D. Visual hallucinations
Rationale: Alzheimer’s disease is characterized by progressive and gradual
cognitive decline.
,5. Which immunization should be given to all adults aged 65 and older if not
previously administered?
A. MMR vaccine
B. Hepatitis A vaccine
C. Pneumococcal conjugate vaccine
D. Varicella vaccine
Rationale: Pneumococcal vaccination is recommended for adults ≥65 years
to prevent pneumonia and bacteremia.
6. A 60-year-old man presents with a productive cough for 3 months each
year for the last 3 years. What is the likely diagnosis?
A. Chronic bronchitis
B. Emphysema
C. Asthma
D. Bronchiectasis
Rationale: Chronic bronchitis is defined as productive cough for at least 3
months in 2 consecutive years.
7. The most appropriate screening test for colorectal cancer in a 65-year-old
man with no prior screening is:
A. Sigmoidoscopy every 5 years
, B. Colonoscopy every 10 years
C. CT colonography every 3 years
D. Annual fecal occult blood test only
Rationale: Colonoscopy every 10 years is the preferred gold standard for
colorectal cancer screening.
8. Which medication should be avoided in older adults due to risk of
delirium?
A. Lisinopril
B. Diphenhydramine
C. Metformin
D. Amlodipine
Rationale: Diphenhydramine, an anticholinergic, increases the risk of
confusion and falls in older adults.
9. A 70-year-old woman presents with a new, painless thyroid nodule. What
is the most appropriate next step?
A. Start levothyroxine
B. Repeat thyroid exam in 6 months
C. Order thyroid ultrasound with fine-needle aspiration
D. Start antibiotics
Rationale: Evaluation of a thyroid nodule in older adults should include
ultrasound and biopsy to rule out malignancy.
