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AGPCNP Board Exam ACTUAL EXAM
2026/2027 | Verified Questions and Answers |
ANCC & AANP Style | Lifespan Primary Care
Focus | Exam Pass Target - A+ Graded
Domain 1: Assessment and Diagnosis (35 questions)
Q1: A 68-year-old male presents with fatigue and dyspnea on exertion. Vital signs: BP 142/88,
HR 88, RR 18, SpO2 94% on room air. Labs show: Hgb 9.2 g/dL, MCV 78 fL, Ferritin 15
ng/mL, TSH 2.5 mIU/L. Stool guaiac is positive. What is the most appropriate next step?
A. Start oral iron supplementation
B. Refer for colonoscopy [CORRECT]
C. Repeat CBC in 3 months
D. Order CT abdomen/pelvis
Correct Answer: B
Q2: [Select All That Apply] A 72-year-old female with a history of falls is assessed using the
Timed Up and Go (TUG) test. Which findings indicate increased fall risk? Select all that apply.
A. TUG time >12 seconds [CORRECT]
B. Unsteady gait during turn [CORRECT]
C. Use of arms to rise from chair [CORRECT]
D. TUG time <10 seconds
E. Steady gait without assistive device
Correct Answers: A, B, C
Q3: A 45-year-old female presents with polyuria, polydipsia, and blurred vision. Random glucose
is 320 mg/dL. HbA1c is 10.2%. Which additional assessment is priority before initiating
metformin?
A. Liver function tests
B. Serum creatinine and eGFR [CORRECT]
C. Thyroid function tests
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D. Lipid panel
Correct Answer: B
Q4: A 78-year-old male presents with confusion and lethargy. His caregiver reports he has been
taking over-the-counter diphenhydramine for sleep. Vital signs are stable. Which assessment
finding is most consistent with anticholinergic toxicity?
A. Bradycardia and miosis
B. Tachycardia, dry skin, urinary retention, and delirium [CORRECT]
C. Hypertension and diaphoresis
D. Hypothermia and lacrimation
Correct Answer: B
Q5: [Sequencing - Drag and Drop] Place the following steps in the correct order for evaluating a
newly discovered thyroid nodule in a 55-year-old patient.
A. Check TSH level
B. Perform thyroid ultrasound
C. Perform fine-needle aspiration if indicated
D. Perform physical examination
Correct Order: D, A, B, C
Q6: A 62-year-old female with COPD presents with increased dyspnea and purulent sputum.
Vital signs: Temp 38.2°C, HR 96, RR 22, BP 138/82, SpO2 88% on room air. Which finding on
chest X-ray would confirm the suspected diagnosis?
A. Hyperinflation with flattened diaphragms
B. New infiltrate or consolidation [CORRECT]
C. Bilateral pleural effusions
D. Cardiomegaly with pulmonary edema
Correct Answer: B
Q7: [Select All That Apply] A 35-year-old male presents with fatigue and joint pain. Which
findings support a diagnosis of systemic lupus erythematosus (SLE)? Select all that apply.
A. Positive ANA titer >1:80 [CORRECT]
B. Malar rash [CORRECT]
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C. Oral ulcers [CORRECT]
D. Leukocytosis
E. Proteinuria >0.5 g/day [CORRECT]
Correct Answers: A, B, C, E
Q8: A 58-year-old female presents with episodic chest pain described as pressure, radiating to the
left arm, occurring with exertion and relieved by rest. ECG shows ST depression in leads V4-V6
during pain. Which test is most appropriate for definitive diagnosis?
A. Chest X-ray
B. Exercise stress test or coronary angiography [CORRECT]
C. CT pulmonary angiography
D. Echocardiogram only
Correct Answer: B
Q9: A 71-year-old male presents with acute onset right-sided weakness and aphasia. Symptoms
started 45 minutes ago. Vital signs are stable. CT head shows no hemorrhage. Which is the
priority intervention?
A. Start aspirin 325 mg immediately
B. Evaluate for IV thrombolysis with tPA if within window [CORRECT]
C. Order MRI brain with contrast
D. Start warfarin anticoagulation
Correct Answer: B
Q10: [Lab Analysis] A 52-year-old female with type 2 diabetes presents for follow-up. Labs
show: eGFR 45 mL/min/1.73m², UACR 45 mg/g, K+ 4.8 mEq/L. Which adjustment to her
diabetes regimen is indicated?
A. Increase metformin dose
B. Start ACE inhibitor or ARB for renal protection [CORRECT]
C. Stop all diabetes medications
D. Start SGLT2 inhibitor as monotherapy
Correct Answer: B
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Q11: A 25-year-old female presents with dysuria, frequency, and urgency. Urinalysis shows
pyuria and nitrites. Which is the first-line treatment for uncomplicated cystitis?
A. Ciprofloxacin 500 mg BID x 3 days
B. Nitrofurantoin 100 mg BID x 5 days [CORRECT]
C. Amoxicillin 500 mg TID x 7 days
D. Trimethoprim-sulfamethoxazole DS BID x 10 days
Correct Answer: B
Q12: [Select All That Apply] A 67-year-old male is being evaluated for possible dementia.
Which assessment tools are appropriate for cognitive screening? Select all that apply.
A. Mini-Mental State Examination (MMSE) [CORRECT]
B. Montreal Cognitive Assessment (MoCA) [CORRECT]
C. Mini-Cog [CORRECT]
D. Glasgow Coma Scale
E. Geriatric Depression Scale
Correct Answers: A, B, C
Q13: A 48-year-old male presents with epigastric pain, nausea, and black tarry stools. Vital signs:
HR 108, BP 98/62. Hemoglobin is 7.8 g/dL. What is the priority immediate action?
A. Start oral iron supplementation
B. Urgent GI consultation and blood transfusion consideration [CORRECT]
C. Outpatient H. pylori testing
D. Start proton pump inhibitor and follow up in 2 weeks
Correct Answer: B
Q14: A 73-year-old female presents with tremor at rest, rigidity, and bradykinesia. Which finding
on examination would support a diagnosis of Parkinson's disease?
A. Intention tremor that worsens with movement
B. Asymmetric resting tremor with cogwheel rigidity [CORRECT]
C. Orthostatic hypotension with urinary incontinence only
D. Vertical gaze palsy
AGPCNP Board Exam ACTUAL EXAM
2026/2027 | Verified Questions and Answers |
ANCC & AANP Style | Lifespan Primary Care
Focus | Exam Pass Target - A+ Graded
Domain 1: Assessment and Diagnosis (35 questions)
Q1: A 68-year-old male presents with fatigue and dyspnea on exertion. Vital signs: BP 142/88,
HR 88, RR 18, SpO2 94% on room air. Labs show: Hgb 9.2 g/dL, MCV 78 fL, Ferritin 15
ng/mL, TSH 2.5 mIU/L. Stool guaiac is positive. What is the most appropriate next step?
A. Start oral iron supplementation
B. Refer for colonoscopy [CORRECT]
C. Repeat CBC in 3 months
D. Order CT abdomen/pelvis
Correct Answer: B
Q2: [Select All That Apply] A 72-year-old female with a history of falls is assessed using the
Timed Up and Go (TUG) test. Which findings indicate increased fall risk? Select all that apply.
A. TUG time >12 seconds [CORRECT]
B. Unsteady gait during turn [CORRECT]
C. Use of arms to rise from chair [CORRECT]
D. TUG time <10 seconds
E. Steady gait without assistive device
Correct Answers: A, B, C
Q3: A 45-year-old female presents with polyuria, polydipsia, and blurred vision. Random glucose
is 320 mg/dL. HbA1c is 10.2%. Which additional assessment is priority before initiating
metformin?
A. Liver function tests
B. Serum creatinine and eGFR [CORRECT]
C. Thyroid function tests
,S
D. Lipid panel
Correct Answer: B
Q4: A 78-year-old male presents with confusion and lethargy. His caregiver reports he has been
taking over-the-counter diphenhydramine for sleep. Vital signs are stable. Which assessment
finding is most consistent with anticholinergic toxicity?
A. Bradycardia and miosis
B. Tachycardia, dry skin, urinary retention, and delirium [CORRECT]
C. Hypertension and diaphoresis
D. Hypothermia and lacrimation
Correct Answer: B
Q5: [Sequencing - Drag and Drop] Place the following steps in the correct order for evaluating a
newly discovered thyroid nodule in a 55-year-old patient.
A. Check TSH level
B. Perform thyroid ultrasound
C. Perform fine-needle aspiration if indicated
D. Perform physical examination
Correct Order: D, A, B, C
Q6: A 62-year-old female with COPD presents with increased dyspnea and purulent sputum.
Vital signs: Temp 38.2°C, HR 96, RR 22, BP 138/82, SpO2 88% on room air. Which finding on
chest X-ray would confirm the suspected diagnosis?
A. Hyperinflation with flattened diaphragms
B. New infiltrate or consolidation [CORRECT]
C. Bilateral pleural effusions
D. Cardiomegaly with pulmonary edema
Correct Answer: B
Q7: [Select All That Apply] A 35-year-old male presents with fatigue and joint pain. Which
findings support a diagnosis of systemic lupus erythematosus (SLE)? Select all that apply.
A. Positive ANA titer >1:80 [CORRECT]
B. Malar rash [CORRECT]
,S
C. Oral ulcers [CORRECT]
D. Leukocytosis
E. Proteinuria >0.5 g/day [CORRECT]
Correct Answers: A, B, C, E
Q8: A 58-year-old female presents with episodic chest pain described as pressure, radiating to the
left arm, occurring with exertion and relieved by rest. ECG shows ST depression in leads V4-V6
during pain. Which test is most appropriate for definitive diagnosis?
A. Chest X-ray
B. Exercise stress test or coronary angiography [CORRECT]
C. CT pulmonary angiography
D. Echocardiogram only
Correct Answer: B
Q9: A 71-year-old male presents with acute onset right-sided weakness and aphasia. Symptoms
started 45 minutes ago. Vital signs are stable. CT head shows no hemorrhage. Which is the
priority intervention?
A. Start aspirin 325 mg immediately
B. Evaluate for IV thrombolysis with tPA if within window [CORRECT]
C. Order MRI brain with contrast
D. Start warfarin anticoagulation
Correct Answer: B
Q10: [Lab Analysis] A 52-year-old female with type 2 diabetes presents for follow-up. Labs
show: eGFR 45 mL/min/1.73m², UACR 45 mg/g, K+ 4.8 mEq/L. Which adjustment to her
diabetes regimen is indicated?
A. Increase metformin dose
B. Start ACE inhibitor or ARB for renal protection [CORRECT]
C. Stop all diabetes medications
D. Start SGLT2 inhibitor as monotherapy
Correct Answer: B
, S
Q11: A 25-year-old female presents with dysuria, frequency, and urgency. Urinalysis shows
pyuria and nitrites. Which is the first-line treatment for uncomplicated cystitis?
A. Ciprofloxacin 500 mg BID x 3 days
B. Nitrofurantoin 100 mg BID x 5 days [CORRECT]
C. Amoxicillin 500 mg TID x 7 days
D. Trimethoprim-sulfamethoxazole DS BID x 10 days
Correct Answer: B
Q12: [Select All That Apply] A 67-year-old male is being evaluated for possible dementia.
Which assessment tools are appropriate for cognitive screening? Select all that apply.
A. Mini-Mental State Examination (MMSE) [CORRECT]
B. Montreal Cognitive Assessment (MoCA) [CORRECT]
C. Mini-Cog [CORRECT]
D. Glasgow Coma Scale
E. Geriatric Depression Scale
Correct Answers: A, B, C
Q13: A 48-year-old male presents with epigastric pain, nausea, and black tarry stools. Vital signs:
HR 108, BP 98/62. Hemoglobin is 7.8 g/dL. What is the priority immediate action?
A. Start oral iron supplementation
B. Urgent GI consultation and blood transfusion consideration [CORRECT]
C. Outpatient H. pylori testing
D. Start proton pump inhibitor and follow up in 2 weeks
Correct Answer: B
Q14: A 73-year-old female presents with tremor at rest, rigidity, and bradykinesia. Which finding
on examination would support a diagnosis of Parkinson's disease?
A. Intention tremor that worsens with movement
B. Asymmetric resting tremor with cogwheel rigidity [CORRECT]
C. Orthostatic hypotension with urinary incontinence only
D. Vertical gaze palsy
