Adult-Gerontology Acute Care Nurse
Practitioner Certification Exam Practice
Test Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A 72-year-old male presents with shortness of breath, jugular venous
distention, and bilateral pitting edema. Which medication is most
appropriate to reduce his preload?
A. Lisinopril
B. Furosemide
C. Metoprolol
D. Digoxin
Rationale: Furosemide is a loop diuretic that reduces preload by decreasing
intravascular volume through diuresis, improving symptoms of volume
overload.
,2. A patient in septic shock has a mean arterial pressure (MAP) of 55
mmHg despite fluid resuscitation. The next step is to initiate:
A. Norepinephrine
B. Dopamine
C. Epinephrine
D. Vasopressin
Rationale: Norepinephrine is the first-line vasopressor for septic shock to
restore adequate perfusion pressure when fluids alone are insufficient.
3. In managing acute decompensated heart failure, which laboratory test
best differentiates between cardiac and non-cardiac causes of dyspnea?
A. D-dimer
B. Troponin I
C. B-type natriuretic peptide (BNP)
D. Creatine kinase
Rationale: BNP is released in response to ventricular stretch and volume
overload, helping to distinguish cardiac from pulmonary causes of
dyspnea.
4. The hallmark of delirium in older adults is:
A. Memory loss
B. Gradual cognitive decline
C. Acute onset of confusion with fluctuating course
,D. Visual hallucinations
Rationale: Delirium presents acutely with fluctuating levels of
consciousness and inattention, differentiating it from dementia.
5. A 68-year-old with COPD presents with respiratory acidosis. The ABG
shows pH 7.30, PaCO₂ 60 mmHg, HCO₃⁻ 28. The best intervention is:
A. Initiate noninvasive positive pressure ventilation (BiPAP)
B. Increase IV fluids
C. Begin antibiotics
D. Administer bronchodilator only
Rationale: BiPAP improves ventilation, reducing CO₂ retention and
correcting acidosis in acute COPD exacerbations.
6. The most common pathogen in hospital-acquired pneumonia is:
A. Streptococcus pneumoniae
B. Pseudomonas aeruginosa
C. Haemophilus influenzae
D. Mycoplasma pneumoniae
Rationale: Pseudomonas aeruginosa is frequently isolated in hospital-
acquired and ventilator-associated pneumonias, especially in critically ill
patients.
, 7. A patient with atrial fibrillation develops acute chest pain and
hypotension. The first diagnostic test should be:
A. 12-lead ECG
B. Troponin
C. Chest X-ray
D. Echocardiogram
Rationale: A 12-lead ECG identifies acute ischemic changes or arrhythmia-
related hemodynamic compromise requiring urgent management.
8. Which medication should be avoided in a patient with decompensated
heart failure?
A. Furosemide
B. Diltiazem
C. Digoxin
D. Hydralazine
Rationale: Calcium channel blockers like diltiazem can worsen heart failure
by decreasing myocardial contractility.
9. The earliest sign of sepsis in older adults may be:
A. Fever
B. Altered mental status
C. Tachycardia
D. Hypotension
Practitioner Certification Exam Practice
Test Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A 72-year-old male presents with shortness of breath, jugular venous
distention, and bilateral pitting edema. Which medication is most
appropriate to reduce his preload?
A. Lisinopril
B. Furosemide
C. Metoprolol
D. Digoxin
Rationale: Furosemide is a loop diuretic that reduces preload by decreasing
intravascular volume through diuresis, improving symptoms of volume
overload.
,2. A patient in septic shock has a mean arterial pressure (MAP) of 55
mmHg despite fluid resuscitation. The next step is to initiate:
A. Norepinephrine
B. Dopamine
C. Epinephrine
D. Vasopressin
Rationale: Norepinephrine is the first-line vasopressor for septic shock to
restore adequate perfusion pressure when fluids alone are insufficient.
3. In managing acute decompensated heart failure, which laboratory test
best differentiates between cardiac and non-cardiac causes of dyspnea?
A. D-dimer
B. Troponin I
C. B-type natriuretic peptide (BNP)
D. Creatine kinase
Rationale: BNP is released in response to ventricular stretch and volume
overload, helping to distinguish cardiac from pulmonary causes of
dyspnea.
4. The hallmark of delirium in older adults is:
A. Memory loss
B. Gradual cognitive decline
C. Acute onset of confusion with fluctuating course
,D. Visual hallucinations
Rationale: Delirium presents acutely with fluctuating levels of
consciousness and inattention, differentiating it from dementia.
5. A 68-year-old with COPD presents with respiratory acidosis. The ABG
shows pH 7.30, PaCO₂ 60 mmHg, HCO₃⁻ 28. The best intervention is:
A. Initiate noninvasive positive pressure ventilation (BiPAP)
B. Increase IV fluids
C. Begin antibiotics
D. Administer bronchodilator only
Rationale: BiPAP improves ventilation, reducing CO₂ retention and
correcting acidosis in acute COPD exacerbations.
6. The most common pathogen in hospital-acquired pneumonia is:
A. Streptococcus pneumoniae
B. Pseudomonas aeruginosa
C. Haemophilus influenzae
D. Mycoplasma pneumoniae
Rationale: Pseudomonas aeruginosa is frequently isolated in hospital-
acquired and ventilator-associated pneumonias, especially in critically ill
patients.
, 7. A patient with atrial fibrillation develops acute chest pain and
hypotension. The first diagnostic test should be:
A. 12-lead ECG
B. Troponin
C. Chest X-ray
D. Echocardiogram
Rationale: A 12-lead ECG identifies acute ischemic changes or arrhythmia-
related hemodynamic compromise requiring urgent management.
8. Which medication should be avoided in a patient with decompensated
heart failure?
A. Furosemide
B. Diltiazem
C. Digoxin
D. Hydralazine
Rationale: Calcium channel blockers like diltiazem can worsen heart failure
by decreasing myocardial contractility.
9. The earliest sign of sepsis in older adults may be:
A. Fever
B. Altered mental status
C. Tachycardia
D. Hypotension
