Adult-Gerontology Nurse Practitioner (AGNP)
Certification Review 2025/2026 | Complex
Adult & Older Adult Management, Acute &
Chronic Care, Diagnostic Reasoning, &
Advanced Pharmacology | Board-Style Practice
Questions with Verified Answers & Detailed
Rationales
1. A 72-year-old male patient presents with confusion, increased urination, and a history of
hypertension. After conducting a urinalysis, you find a high level of glucose and ketones.
What is the most likely diagnosis?
• A. Hyperthyroidism
• B. Diabetes Mellitus
• C. Acute Kidney Injury
• D. Chronic Heart Failure
CORRECT ANSWER: B. Diabetes Mellitus
RATIONALE: This patient's symptoms and urinalysis findings suggest uncontrolled
diabetes mellitus. The presence of glucose and ketones indicates a possible state of diabetic
ketoacidosis, especially in an older adult.
2. A 68-year-old female patient with a history of chronic obstructive pulmonary disease
(COPD) comes to the clinic for a follow-up. She has recently started using a nebulizer at
home. Which assessment finding would indicate the need for further intervention?
• A. Oxygen saturation of 89% on room air
• B. Improved breath sounds on auscultation
• C. Reduced dyspnea during physical activity
• D. Use of accessory muscles for breathing
CORRECT ANSWER: A. Oxygen saturation of 89% on room air
, RATIONALE: An oxygen saturation below 90% indicates hypoxemia and requires further
assessment and possibly supplemental oxygen or other interventions to ensure adequate
oxygenation.
3. An 80-year-old patient with atrial fibrillation is being treated with warfarin. Which
laboratory test is essential to monitor this patient’s therapy?
• A. Complete blood count (CBC)
• B. Prothrombin time (PT)/International Normalized Ratio (INR)
• C. Liver function tests (LFTs)
• D. Electrolyte panel
CORRECT ANSWER: B. Prothrombin time (PT)/International Normalized Ratio
(INR)
RATIONALE: The PT/INR is crucial for monitoring patients on warfarin therapy to ensure
therapeutic levels are maintained and to prevent complications such as bleeding.
4. A patient in end-stage renal disease is on dialysis. Which dietary restriction is most
critical for this patient?
• A. Low fiber intake
• B. Low potassium intake
• C. Low fat intake
• D. Low protein intake
CORRECT ANSWER: B. Low potassium intake
RATIONALE: Patients with end-stage renal disease often have difficulty excreting
potassium, which can lead to hyperkalemia and life-threatening cardiac events. Thus, dietary
potassium restriction is critical.
5. A 75-year-old male patient with a history of heart failure presents with a new dry cough
and increased shortness of breath. What is the most appropriate next step in management?
• A. Start a beta-blocker
Certification Review 2025/2026 | Complex
Adult & Older Adult Management, Acute &
Chronic Care, Diagnostic Reasoning, &
Advanced Pharmacology | Board-Style Practice
Questions with Verified Answers & Detailed
Rationales
1. A 72-year-old male patient presents with confusion, increased urination, and a history of
hypertension. After conducting a urinalysis, you find a high level of glucose and ketones.
What is the most likely diagnosis?
• A. Hyperthyroidism
• B. Diabetes Mellitus
• C. Acute Kidney Injury
• D. Chronic Heart Failure
CORRECT ANSWER: B. Diabetes Mellitus
RATIONALE: This patient's symptoms and urinalysis findings suggest uncontrolled
diabetes mellitus. The presence of glucose and ketones indicates a possible state of diabetic
ketoacidosis, especially in an older adult.
2. A 68-year-old female patient with a history of chronic obstructive pulmonary disease
(COPD) comes to the clinic for a follow-up. She has recently started using a nebulizer at
home. Which assessment finding would indicate the need for further intervention?
• A. Oxygen saturation of 89% on room air
• B. Improved breath sounds on auscultation
• C. Reduced dyspnea during physical activity
• D. Use of accessory muscles for breathing
CORRECT ANSWER: A. Oxygen saturation of 89% on room air
, RATIONALE: An oxygen saturation below 90% indicates hypoxemia and requires further
assessment and possibly supplemental oxygen or other interventions to ensure adequate
oxygenation.
3. An 80-year-old patient with atrial fibrillation is being treated with warfarin. Which
laboratory test is essential to monitor this patient’s therapy?
• A. Complete blood count (CBC)
• B. Prothrombin time (PT)/International Normalized Ratio (INR)
• C. Liver function tests (LFTs)
• D. Electrolyte panel
CORRECT ANSWER: B. Prothrombin time (PT)/International Normalized Ratio
(INR)
RATIONALE: The PT/INR is crucial for monitoring patients on warfarin therapy to ensure
therapeutic levels are maintained and to prevent complications such as bleeding.
4. A patient in end-stage renal disease is on dialysis. Which dietary restriction is most
critical for this patient?
• A. Low fiber intake
• B. Low potassium intake
• C. Low fat intake
• D. Low protein intake
CORRECT ANSWER: B. Low potassium intake
RATIONALE: Patients with end-stage renal disease often have difficulty excreting
potassium, which can lead to hyperkalemia and life-threatening cardiac events. Thus, dietary
potassium restriction is critical.
5. A 75-year-old male patient with a history of heart failure presents with a new dry cough
and increased shortness of breath. What is the most appropriate next step in management?
• A. Start a beta-blocker
