ADULT-GERONTOLOGY PRIMARY CARE
NURSE PRACTITIONER CERTIFICATION
EXAMINATION QUESTION AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
INSTANT DOWNLOAD PDF
1. A 68-year-old man presents for routine follow-up. Which blood pressure
goal is most appropriate for most older adults with hypertension?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
D. <120/70 mmHg
Rationale: Current guidelines recommend a target of <130/80 mmHg for
most adults, including older adults, if tolerated, to reduce cardiovascular
risk.
2. A 45-year-old woman with type 2 diabetes has an A1c of 8.5%. Which initial
pharmacologic therapy is recommended if no contraindications exist?
A. Sulfonylurea
B. Insulin
C. DPP-4 inhibitor
D. Metformin
Rationale: Metformin is first-line therapy for type 2 diabetes due to
efficacy, safety, and cardiovascular benefit.
,3. A patient presents with fatigue, pallor, and spoon-shaped nails. Which
laboratory finding is most consistent with this condition?
A. Elevated ferritin
B. Normal MCV
C. Low serum iron and ferritin
D. Elevated reticulocyte count
Rationale: These findings are classic for iron-deficiency anemia.
4. Which screening is recommended for all adults aged 50–75 years?
A. Prostate cancer screening
B. Lung cancer screening
C. Colorectal cancer screening
D. Ovarian cancer screening
Rationale: Routine colorectal cancer screening is recommended for adults
aged 50–75.
5. A 72-year-old woman reports progressive memory loss affecting daily
activities. Which condition is most likely?
A. Delirium
B. Depression
C. Mild cognitive impairment
D. Alzheimer disease
Rationale: Progressive cognitive decline interfering with daily function
suggests dementia, most commonly Alzheimer disease.
6. A patient with asthma uses a rescue inhaler daily. What is the best next
step?
A. Increase short-acting beta-agonist use
B. Add an inhaled corticosteroid
C. Switch to anticholinergic therapy
D. Add oral steroids long-term
Rationale: Frequent rescue inhaler use indicates poor control and need for
controller therapy.
, 7. Which vaccine is recommended annually for adults ≥65 years?
A. Zoster
B. Pneumococcal
C. Influenza
D. Hepatitis B
Rationale: Annual influenza vaccination is recommended for all older
adults.
8. A patient with GERD has persistent symptoms despite lifestyle modification.
First-line medication?
A. Antacid
B. H2 blocker
C. Proton pump inhibitor
D. Prokinetic agent
Rationale: PPIs are the most effective therapy for GERD.
9. Which finding is most consistent with acute bacterial sinusitis?
A. Symptoms <5 days
B. Clear nasal discharge
C. Purulent nasal discharge lasting >10 days
D. Sneezing and itchy eyes
Rationale: Prolonged purulent discharge suggests bacterial sinusitis.
10.A 60-year-old smoker qualifies for lung cancer screening with:
A. Chest X-ray
B. PET scan
C. Low-dose CT annually
D. MRI
Rationale: Annual low-dose CT is recommended for eligible high-risk
adults.
11.A patient with osteoarthritis asks about first-line pharmacologic therapy.
A. Opioids
B. Acetaminophen
C. Oral steroids
NURSE PRACTITIONER CERTIFICATION
EXAMINATION QUESTION AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
INSTANT DOWNLOAD PDF
1. A 68-year-old man presents for routine follow-up. Which blood pressure
goal is most appropriate for most older adults with hypertension?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
D. <120/70 mmHg
Rationale: Current guidelines recommend a target of <130/80 mmHg for
most adults, including older adults, if tolerated, to reduce cardiovascular
risk.
2. A 45-year-old woman with type 2 diabetes has an A1c of 8.5%. Which initial
pharmacologic therapy is recommended if no contraindications exist?
A. Sulfonylurea
B. Insulin
C. DPP-4 inhibitor
D. Metformin
Rationale: Metformin is first-line therapy for type 2 diabetes due to
efficacy, safety, and cardiovascular benefit.
,3. A patient presents with fatigue, pallor, and spoon-shaped nails. Which
laboratory finding is most consistent with this condition?
A. Elevated ferritin
B. Normal MCV
C. Low serum iron and ferritin
D. Elevated reticulocyte count
Rationale: These findings are classic for iron-deficiency anemia.
4. Which screening is recommended for all adults aged 50–75 years?
A. Prostate cancer screening
B. Lung cancer screening
C. Colorectal cancer screening
D. Ovarian cancer screening
Rationale: Routine colorectal cancer screening is recommended for adults
aged 50–75.
5. A 72-year-old woman reports progressive memory loss affecting daily
activities. Which condition is most likely?
A. Delirium
B. Depression
C. Mild cognitive impairment
D. Alzheimer disease
Rationale: Progressive cognitive decline interfering with daily function
suggests dementia, most commonly Alzheimer disease.
6. A patient with asthma uses a rescue inhaler daily. What is the best next
step?
A. Increase short-acting beta-agonist use
B. Add an inhaled corticosteroid
C. Switch to anticholinergic therapy
D. Add oral steroids long-term
Rationale: Frequent rescue inhaler use indicates poor control and need for
controller therapy.
, 7. Which vaccine is recommended annually for adults ≥65 years?
A. Zoster
B. Pneumococcal
C. Influenza
D. Hepatitis B
Rationale: Annual influenza vaccination is recommended for all older
adults.
8. A patient with GERD has persistent symptoms despite lifestyle modification.
First-line medication?
A. Antacid
B. H2 blocker
C. Proton pump inhibitor
D. Prokinetic agent
Rationale: PPIs are the most effective therapy for GERD.
9. Which finding is most consistent with acute bacterial sinusitis?
A. Symptoms <5 days
B. Clear nasal discharge
C. Purulent nasal discharge lasting >10 days
D. Sneezing and itchy eyes
Rationale: Prolonged purulent discharge suggests bacterial sinusitis.
10.A 60-year-old smoker qualifies for lung cancer screening with:
A. Chest X-ray
B. PET scan
C. Low-dose CT annually
D. MRI
Rationale: Annual low-dose CT is recommended for eligible high-risk
adults.
11.A patient with osteoarthritis asks about first-line pharmacologic therapy.
A. Opioids
B. Acetaminophen
C. Oral steroids
