S
AGPCNP Board Exam ACTUAL EXAM
2026/2027 | Verified Questions and Answers |
ANCC & AANP Style | Lifespan Primary Care
Focus | Exam Pass Target - A+ Graded
Q1: A 68-year-old male presents to the clinic with a 2-week history of progressive dyspnea on
exertion and orthopnea. Physical exam reveals bilateral crackles at lung bases, elevated JVP at 6
cm, and 2+ pitting edema in bilateral lower extremities. ECG shows sinus rhythm with left
ventricular hypertrophy. Which diagnostic test is MOST appropriate to confirm the suspected
diagnosis?
A. D-dimer
B. Brain natriuretic peptide (BNP) or NT-proBNP [CORRECT]
C. Troponin I
D. Pulmonary function tests
Correct Answer: B
Q2: A 72-year-old female with a history of osteoporosis reports two falls in the past month at
home. She takes amlodipine 5 mg daily and alprazolam 0.5 mg at bedtime. Her Timed Up and
Go (TUG) test takes 14 seconds. Which intervention should be prioritized FIRST?
A. Start vitamin D 50,000 IU weekly
B. Discontinue alprazolam and conduct a comprehensive medication review [CORRECT]
C. Recommend a cane for ambulation
D. Order lumbar spine X-ray
Correct Answer: B
Q3: A 45-year-old male with type 2 diabetes presents for routine follow-up. He reports no
symptoms. Physical exam is unremarkable. His last comprehensive metabolic panel was 6
months ago. According to current guidelines, which screening test should be performed at this
visit?
A. Annual urine microalbumin-to-creatinine ratio [CORRECT]
B. Quarterly HbA1c only
C. Fasting lipid panel every 2 years
,S
D. Dilated eye exam every 2 years
Correct Answer: A
Q4: A 78-year-old female is brought by family for evaluation of memory loss. Her Montreal
Cognitive Assessment (MoCA) score is 18/30, with deficits in visuospatial/executive function
and delayed recall. She lives alone and recently got lost driving to a familiar grocery store.
Which is the MOST appropriate NEXT step?
A. Start donepezil 10 mg daily immediately
B. Order MRI brain with and without contrast and basic laboratory workup [CORRECT]
C. Recommend immediate placement in assisted living
D. Reassure family that this is normal aging
Correct Answer: B
Q5: A 52-year-old female presents with fatigue, weight gain, and constipation. Physical exam
reveals dry skin and delayed deep tendon reflexes. Laboratory results: TSH 12.5 mIU/L (normal
0.4-4.0), free T4 0.8 ng/dL (normal 0.8-1.8). Which medication should be initiated?
A. Liothyronine (T3) monotherapy
B. Levothyroxine 1.6 mcg/kg/day [CORRECT]
C. Methimazole 10 mg daily
D. Propylthiouracil 100 mg TID
Correct Answer: B
Q6: A 34-year-old male presents with acute onset right knee pain, swelling, and erythema. He
denies trauma. Synovial fluid analysis reveals: WBC 85,000/mm³ with 90% neutrophils, gram
stain negative, crystals negative. Which is the MOST likely diagnosis?
A. Osteoarthritis
B. Septic arthritis [CORRECT]
C. Gout
D. Pseudogout
Correct Answer: B
Q7: A 65-year-old male with a 40 pack-year smoking history presents for a wellness visit. He has
no respiratory symptoms. According to USPSTF guidelines, which screening should be
recommended?
,S
A. Annual chest X-ray
B. Low-dose CT scan of the chest [CORRECT]
C. Sputum cytology
D. PET scan
Correct Answer: B
Q8: A 58-year-old female with hypertension and hyperlipidemia presents with acute onset left-
sided weakness and facial droop. Symptoms started 45 minutes ago. Blood pressure is 220/110
mmHg. Which is the MOST appropriate IMMEDIATE action?
A. Administer aspirin 325 mg immediately
B. Obtain emergent CT head without contrast and lower BP cautiously [CORRECT]
C. Start tissue plasminogen activator (tPA) immediately
D. Schedule outpatient MRI brain
Correct Answer: B
Q9: A 71-year-old male presents with urinary frequency, urgency, and nocturia. Digital rectal
exam reveals a smooth, enlarged prostate. Post-void residual is 75 mL. PSA is 2.5 ng/mL. Which
is the FIRST-line pharmacologic treatment?
A. Finasteride 5 mg daily
B. Tamsulosin 0.4 mg daily [CORRECT]
C. Oxybutynin 5 mg BID
D. Dutasteride 0.5 mg daily
Correct Answer: B
Q10: A 42-year-old female presents with intermittent palpitations and lightheadedness. ECG in
clinic shows normal sinus rhythm. Which is the BEST diagnostic test to capture intermittent
arrhythmia?
A. 12-lead ECG repeated daily
B. 30-day event monitor [CORRECT]
C. Echocardiogram
D. Cardiac catheterization
Correct Answer: B
, S
Q11: A 76-year-old female presents after a mechanical fall. She takes warfarin 5 mg daily for
atrial fibrillation. CT head reveals a 12 mm subdural hematoma with midline shift. INR is 3.2.
Which is the MOST appropriate intervention?
A. Vitamin K 10 mg orally only
B. Hold warfarin, give vitamin K 10 mg IV, and consider prothrombin complex concentrate
[CORRECT]
C. Continue warfarin and observe
D. Aspirin 325 mg daily
Correct Answer: B
Q12: A 55-year-old male with diabetes presents with a 3-month history of progressive numbness
and tingling in bilateral feet, described as "walking on cotton." Monofilament testing reveals loss
of protective sensation. Which is the MOST appropriate NEXT step in management?
A. Start gabapentin 300 mg TID
B. Order nerve conduction studies immediately
C. Implement intensive foot care education and ulcer prevention strategies [CORRECT]
D. Refer for immediate amputation evaluation
Correct Answer: C
Q13: A 63-year-old female presents with fatigue and dyspnea. Laboratory studies reveal:
Hemoglobin 8.2 g/dL, MCV 68 fL, ferritin 15 ng/mL, TIBC 450 mcg/dL. Which is the MOST
likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia [CORRECT]
C. Anemia of chronic disease
D. Folate deficiency
Correct Answer: B
Q14: A 38-year-old male presents with epigastric pain, nausea, and black tarry stools for 2 days.
Vital signs: HR 108, BP 98/62. Hemoglobin is 9.8 g/dL (baseline 14.2). Which is the MOST
appropriate immediate management?
A. Start oral iron supplementation
B. Outpatient referral for upper endoscopy in 2 weeks
AGPCNP Board Exam ACTUAL EXAM
2026/2027 | Verified Questions and Answers |
ANCC & AANP Style | Lifespan Primary Care
Focus | Exam Pass Target - A+ Graded
Q1: A 68-year-old male presents to the clinic with a 2-week history of progressive dyspnea on
exertion and orthopnea. Physical exam reveals bilateral crackles at lung bases, elevated JVP at 6
cm, and 2+ pitting edema in bilateral lower extremities. ECG shows sinus rhythm with left
ventricular hypertrophy. Which diagnostic test is MOST appropriate to confirm the suspected
diagnosis?
A. D-dimer
B. Brain natriuretic peptide (BNP) or NT-proBNP [CORRECT]
C. Troponin I
D. Pulmonary function tests
Correct Answer: B
Q2: A 72-year-old female with a history of osteoporosis reports two falls in the past month at
home. She takes amlodipine 5 mg daily and alprazolam 0.5 mg at bedtime. Her Timed Up and
Go (TUG) test takes 14 seconds. Which intervention should be prioritized FIRST?
A. Start vitamin D 50,000 IU weekly
B. Discontinue alprazolam and conduct a comprehensive medication review [CORRECT]
C. Recommend a cane for ambulation
D. Order lumbar spine X-ray
Correct Answer: B
Q3: A 45-year-old male with type 2 diabetes presents for routine follow-up. He reports no
symptoms. Physical exam is unremarkable. His last comprehensive metabolic panel was 6
months ago. According to current guidelines, which screening test should be performed at this
visit?
A. Annual urine microalbumin-to-creatinine ratio [CORRECT]
B. Quarterly HbA1c only
C. Fasting lipid panel every 2 years
,S
D. Dilated eye exam every 2 years
Correct Answer: A
Q4: A 78-year-old female is brought by family for evaluation of memory loss. Her Montreal
Cognitive Assessment (MoCA) score is 18/30, with deficits in visuospatial/executive function
and delayed recall. She lives alone and recently got lost driving to a familiar grocery store.
Which is the MOST appropriate NEXT step?
A. Start donepezil 10 mg daily immediately
B. Order MRI brain with and without contrast and basic laboratory workup [CORRECT]
C. Recommend immediate placement in assisted living
D. Reassure family that this is normal aging
Correct Answer: B
Q5: A 52-year-old female presents with fatigue, weight gain, and constipation. Physical exam
reveals dry skin and delayed deep tendon reflexes. Laboratory results: TSH 12.5 mIU/L (normal
0.4-4.0), free T4 0.8 ng/dL (normal 0.8-1.8). Which medication should be initiated?
A. Liothyronine (T3) monotherapy
B. Levothyroxine 1.6 mcg/kg/day [CORRECT]
C. Methimazole 10 mg daily
D. Propylthiouracil 100 mg TID
Correct Answer: B
Q6: A 34-year-old male presents with acute onset right knee pain, swelling, and erythema. He
denies trauma. Synovial fluid analysis reveals: WBC 85,000/mm³ with 90% neutrophils, gram
stain negative, crystals negative. Which is the MOST likely diagnosis?
A. Osteoarthritis
B. Septic arthritis [CORRECT]
C. Gout
D. Pseudogout
Correct Answer: B
Q7: A 65-year-old male with a 40 pack-year smoking history presents for a wellness visit. He has
no respiratory symptoms. According to USPSTF guidelines, which screening should be
recommended?
,S
A. Annual chest X-ray
B. Low-dose CT scan of the chest [CORRECT]
C. Sputum cytology
D. PET scan
Correct Answer: B
Q8: A 58-year-old female with hypertension and hyperlipidemia presents with acute onset left-
sided weakness and facial droop. Symptoms started 45 minutes ago. Blood pressure is 220/110
mmHg. Which is the MOST appropriate IMMEDIATE action?
A. Administer aspirin 325 mg immediately
B. Obtain emergent CT head without contrast and lower BP cautiously [CORRECT]
C. Start tissue plasminogen activator (tPA) immediately
D. Schedule outpatient MRI brain
Correct Answer: B
Q9: A 71-year-old male presents with urinary frequency, urgency, and nocturia. Digital rectal
exam reveals a smooth, enlarged prostate. Post-void residual is 75 mL. PSA is 2.5 ng/mL. Which
is the FIRST-line pharmacologic treatment?
A. Finasteride 5 mg daily
B. Tamsulosin 0.4 mg daily [CORRECT]
C. Oxybutynin 5 mg BID
D. Dutasteride 0.5 mg daily
Correct Answer: B
Q10: A 42-year-old female presents with intermittent palpitations and lightheadedness. ECG in
clinic shows normal sinus rhythm. Which is the BEST diagnostic test to capture intermittent
arrhythmia?
A. 12-lead ECG repeated daily
B. 30-day event monitor [CORRECT]
C. Echocardiogram
D. Cardiac catheterization
Correct Answer: B
, S
Q11: A 76-year-old female presents after a mechanical fall. She takes warfarin 5 mg daily for
atrial fibrillation. CT head reveals a 12 mm subdural hematoma with midline shift. INR is 3.2.
Which is the MOST appropriate intervention?
A. Vitamin K 10 mg orally only
B. Hold warfarin, give vitamin K 10 mg IV, and consider prothrombin complex concentrate
[CORRECT]
C. Continue warfarin and observe
D. Aspirin 325 mg daily
Correct Answer: B
Q12: A 55-year-old male with diabetes presents with a 3-month history of progressive numbness
and tingling in bilateral feet, described as "walking on cotton." Monofilament testing reveals loss
of protective sensation. Which is the MOST appropriate NEXT step in management?
A. Start gabapentin 300 mg TID
B. Order nerve conduction studies immediately
C. Implement intensive foot care education and ulcer prevention strategies [CORRECT]
D. Refer for immediate amputation evaluation
Correct Answer: C
Q13: A 63-year-old female presents with fatigue and dyspnea. Laboratory studies reveal:
Hemoglobin 8.2 g/dL, MCV 68 fL, ferritin 15 ng/mL, TIBC 450 mcg/dL. Which is the MOST
likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia [CORRECT]
C. Anemia of chronic disease
D. Folate deficiency
Correct Answer: B
Q14: A 38-year-old male presents with epigastric pain, nausea, and black tarry stools for 2 days.
Vital signs: HR 108, BP 98/62. Hemoglobin is 9.8 g/dL (baseline 14.2). Which is the MOST
appropriate immediate management?
A. Start oral iron supplementation
B. Outpatient referral for upper endoscopy in 2 weeks
