ADULT-GERONTOLOGY NURSE PRACTITIONER AGNP-BC EXAM – PRACTICE QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
• Advanced Health Assessment and Physical Examination• Advanced Pathophysiology and Pharmacology• Health Promotion, Maintenance, and
Disease Prevention• Management of Acute and Chronic Illnesses• Geriatric Syndromes and Palliative Care• Professional Role, Ethics, and Healthcare
Policy• Evidence-Based Practice and Research Utilization• Transitions of Care and Interprofessional Collaboration
INTRODUCTION
The Adult-Gerontology Nurse Practitioner (AGNP-BC) practice assessment is designed to evaluate the clinical readiness of candidates seeking board
certification. This comprehensive examination assesses the integration of advanced nursing knowledge, clinical decision-making, and specialized care
for patients from adolescence through the end of life. The assessment utilizes a blend of foundational multiple-choice questions and complex clinical
scenarios to mirror real-world practice environments. Emphasis is placed on diagnostic reasoning, pharmacological management, and the application
of ethical standards in diverse healthcare settings. This tool ensures that the practitioner possesses the critical thinking skills necessary to provide
high-quality, evidence-based care to the adult-geriatric population.
SECTION ONE: QUESTIONS 1–100
1. A 72-year-old male presents with a sudden onset of excruciating eye pain, blurred vision, and seeing halos around lights. On examination,
the pupil is mid-dilated and non-reactive. What is the most likely diagnosis?
A. Cataracts
B. Macular degeneration
C. Acute angle-closure glaucoma
D. Retinal detachment
🟢 C. Acute angle-closure glaucoma
🔴 RATIONALE: Acute angle-closure glaucoma is a medical emergency characterized by a rapid increase in intraocular pressure. Symptoms
include severe pain, halos, and a non-reactive mid-dilated pupil, distinguishing it from the gradual vision loss seen in cataracts or macular
degeneration.
2. Which of the following heart sounds is considered a common and often normal finding in a healthy, well-conditioned 22-year-old athlete?
A. S3 gallop
B. S4 gallop
,C. Diastolic murmur
D. Holosystolic murmur
🟢 A. S3 gallop
🔴 RATIONALE: An S3 heart sound, or ventricular gallop, can be a normal physiological finding in children, young adults, and athletes due to rapid
ventricular filling. In older adults, however, it often indicates fluid overload or heart failure.
3. An 82-year-old female resident of a long-term care facility has developed a stage 3 pressure injury on her sacrum. Which nutritional
intervention is most critical for wound healing?
A. Restricting fluid intake
B. Increasing protein and caloric intake
C. Implementing a low-sodium diet
D. Reducing Vitamin C supplementation
🟢 B. Increasing protein and caloric intake
🔴 RATIONALE: Wound healing requires significant metabolic resources. Adequate protein is essential for tissue repair and collagen synthesis,
while increased calories prevent the body from using protein for energy instead of healing.
4. A patient with chronic obstructive pulmonary disease (COPD) is being managed on a long-acting beta-agonist (LABA). What is the primary
mechanism of action for this medication class?
A. Reducing airway inflammation
B. Inhibiting muscarinic receptors
C. Relaxing bronchial smooth muscle
D. Thinning pulmonary secretions
🟢 C. Relaxing bronchial smooth muscle
🔴 RATIONALE: LABAs work by stimulating beta-2 adrenergic receptors in the lungs, which leads to the relaxation of bronchial smooth muscle
and prolonged bronchodilation. They do not primarily address inflammation like corticosteroids do.
5. According to the Beers Criteria, which of the following medications should be avoided in older adults due to a high risk of orthostatic
hypotension and falls?
A. Metformin
B. Lisinopril
,C. Doxazosin
D. Atorvastatin
🟢 C. Doxazosin
🔴 RATIONALE: Doxazosin is an alpha-1 blocker. The Beers Criteria identifies it as a medication to avoid for the treatment of hypertension in older
adults because of the significant risk of orthostatic hypotension and subsequent falls.
6. A 65-year-old male smoker presents with painless gross hematuria. What is the most appropriate next step in the diagnostic workup?
A. Start a course of Ciprofloxacin for presumed UTI
B. Order a renal ultrasound and refer for cystoscopy
C. Recheck urine in three months
D. Prescribe Finasteride for BPH
🟢 B. Order a renal ultrasound and refer for cystoscopy
🔴 RATIONALE: Painless gross hematuria in an older adult, especially one with a smoking history, is highly suspicious for bladder or renal
malignancy until proven otherwise. Referral for visualization of the bladder (cystoscopy) is mandatory.
7. Which of the following is a legal requirement of the Emergency Medical Treatment and Labor Act (EMTALA)?
A. Providing free primary care to all citizens
B. Ensuring patients are stable before transfer to another facility
C. Requiring private insurance for emergency room visits
D. Mandating that all nurse practitioners work in emergency departments
🟢 B. Ensuring patients are stable before transfer to another facility
🔴 RATIONALE: EMTALA requires Medicare-participating hospitals to provide a medical screening exam and stabilizing treatment to anyone
coming to the emergency department, regardless of their ability to pay, before a transfer can occur.
8. A patient presents with a "curtain" coming down over their field of vision and floaters. This clinical presentation is classic for:
A. Retinal detachment
B. Vitreous hemorrhage
C. Diabetic retinopathy
D. Glaucoma
🟢 A. Retinal detachment
, 🔴 RATIONALE: Retinal detachment is often described by patients as a dark curtain or shadow moving across the vision field, frequently preceded
by a sudden increase in floaters or flashes of light (photopsia).
9. When treating an 18-year-old for Community-Acquired Pneumonia (CAP) who is otherwise healthy and has no recent antibiotic use, which is
the first-line treatment according to current guidelines?
A. Levofloxacin
B. Amoxicillin or Doxycycline
C. Vancomycin
D. Gentamicin
🟢 B. Amoxicillin or Doxycycline
🔴 RATIONALE: For healthy outpatients without comorbidities, high-dose Amoxicillin or Doxycycline is recommended as first-line therapy to cover
the most common pathogens like Streptococcus pneumoniae.
10. Which physical exam finding is most indicative of appendicitis?
A. Murphy’s sign
B. McBurney’s point tenderness
C. Chvostek’s sign
D. Babinski’s sign
🟢 B. McBurney’s point tenderness
🔴 RATIONALE: McBurney’s point (one-third the distance from the anterior superior iliac spine to the umbilicus) is the localized site of maximum
tenderness in acute appendicitis. Murphy's sign is associated with cholecystitis.
11. An NP is reviewing the lab results of a patient with suspected primary hypothyroidism. Which pattern of results confirms this diagnosis?
A. Low TSH, Low Free T4
B. High TSH, High Free T4
C. High TSH, Low Free T4
D. Low TSH, High Free T4
🟢 C. High TSH, Low Free T4
🔴 RATIONALE: In primary hypothyroidism, the thyroid gland fails to produce enough T4. The pituitary gland responds to the low T4 levels by
increasing the production of Thyroid Stimulating Hormone (TSH) to compensate.
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
• Advanced Health Assessment and Physical Examination• Advanced Pathophysiology and Pharmacology• Health Promotion, Maintenance, and
Disease Prevention• Management of Acute and Chronic Illnesses• Geriatric Syndromes and Palliative Care• Professional Role, Ethics, and Healthcare
Policy• Evidence-Based Practice and Research Utilization• Transitions of Care and Interprofessional Collaboration
INTRODUCTION
The Adult-Gerontology Nurse Practitioner (AGNP-BC) practice assessment is designed to evaluate the clinical readiness of candidates seeking board
certification. This comprehensive examination assesses the integration of advanced nursing knowledge, clinical decision-making, and specialized care
for patients from adolescence through the end of life. The assessment utilizes a blend of foundational multiple-choice questions and complex clinical
scenarios to mirror real-world practice environments. Emphasis is placed on diagnostic reasoning, pharmacological management, and the application
of ethical standards in diverse healthcare settings. This tool ensures that the practitioner possesses the critical thinking skills necessary to provide
high-quality, evidence-based care to the adult-geriatric population.
SECTION ONE: QUESTIONS 1–100
1. A 72-year-old male presents with a sudden onset of excruciating eye pain, blurred vision, and seeing halos around lights. On examination,
the pupil is mid-dilated and non-reactive. What is the most likely diagnosis?
A. Cataracts
B. Macular degeneration
C. Acute angle-closure glaucoma
D. Retinal detachment
🟢 C. Acute angle-closure glaucoma
🔴 RATIONALE: Acute angle-closure glaucoma is a medical emergency characterized by a rapid increase in intraocular pressure. Symptoms
include severe pain, halos, and a non-reactive mid-dilated pupil, distinguishing it from the gradual vision loss seen in cataracts or macular
degeneration.
2. Which of the following heart sounds is considered a common and often normal finding in a healthy, well-conditioned 22-year-old athlete?
A. S3 gallop
B. S4 gallop
,C. Diastolic murmur
D. Holosystolic murmur
🟢 A. S3 gallop
🔴 RATIONALE: An S3 heart sound, or ventricular gallop, can be a normal physiological finding in children, young adults, and athletes due to rapid
ventricular filling. In older adults, however, it often indicates fluid overload or heart failure.
3. An 82-year-old female resident of a long-term care facility has developed a stage 3 pressure injury on her sacrum. Which nutritional
intervention is most critical for wound healing?
A. Restricting fluid intake
B. Increasing protein and caloric intake
C. Implementing a low-sodium diet
D. Reducing Vitamin C supplementation
🟢 B. Increasing protein and caloric intake
🔴 RATIONALE: Wound healing requires significant metabolic resources. Adequate protein is essential for tissue repair and collagen synthesis,
while increased calories prevent the body from using protein for energy instead of healing.
4. A patient with chronic obstructive pulmonary disease (COPD) is being managed on a long-acting beta-agonist (LABA). What is the primary
mechanism of action for this medication class?
A. Reducing airway inflammation
B. Inhibiting muscarinic receptors
C. Relaxing bronchial smooth muscle
D. Thinning pulmonary secretions
🟢 C. Relaxing bronchial smooth muscle
🔴 RATIONALE: LABAs work by stimulating beta-2 adrenergic receptors in the lungs, which leads to the relaxation of bronchial smooth muscle
and prolonged bronchodilation. They do not primarily address inflammation like corticosteroids do.
5. According to the Beers Criteria, which of the following medications should be avoided in older adults due to a high risk of orthostatic
hypotension and falls?
A. Metformin
B. Lisinopril
,C. Doxazosin
D. Atorvastatin
🟢 C. Doxazosin
🔴 RATIONALE: Doxazosin is an alpha-1 blocker. The Beers Criteria identifies it as a medication to avoid for the treatment of hypertension in older
adults because of the significant risk of orthostatic hypotension and subsequent falls.
6. A 65-year-old male smoker presents with painless gross hematuria. What is the most appropriate next step in the diagnostic workup?
A. Start a course of Ciprofloxacin for presumed UTI
B. Order a renal ultrasound and refer for cystoscopy
C. Recheck urine in three months
D. Prescribe Finasteride for BPH
🟢 B. Order a renal ultrasound and refer for cystoscopy
🔴 RATIONALE: Painless gross hematuria in an older adult, especially one with a smoking history, is highly suspicious for bladder or renal
malignancy until proven otherwise. Referral for visualization of the bladder (cystoscopy) is mandatory.
7. Which of the following is a legal requirement of the Emergency Medical Treatment and Labor Act (EMTALA)?
A. Providing free primary care to all citizens
B. Ensuring patients are stable before transfer to another facility
C. Requiring private insurance for emergency room visits
D. Mandating that all nurse practitioners work in emergency departments
🟢 B. Ensuring patients are stable before transfer to another facility
🔴 RATIONALE: EMTALA requires Medicare-participating hospitals to provide a medical screening exam and stabilizing treatment to anyone
coming to the emergency department, regardless of their ability to pay, before a transfer can occur.
8. A patient presents with a "curtain" coming down over their field of vision and floaters. This clinical presentation is classic for:
A. Retinal detachment
B. Vitreous hemorrhage
C. Diabetic retinopathy
D. Glaucoma
🟢 A. Retinal detachment
, 🔴 RATIONALE: Retinal detachment is often described by patients as a dark curtain or shadow moving across the vision field, frequently preceded
by a sudden increase in floaters or flashes of light (photopsia).
9. When treating an 18-year-old for Community-Acquired Pneumonia (CAP) who is otherwise healthy and has no recent antibiotic use, which is
the first-line treatment according to current guidelines?
A. Levofloxacin
B. Amoxicillin or Doxycycline
C. Vancomycin
D. Gentamicin
🟢 B. Amoxicillin or Doxycycline
🔴 RATIONALE: For healthy outpatients without comorbidities, high-dose Amoxicillin or Doxycycline is recommended as first-line therapy to cover
the most common pathogens like Streptococcus pneumoniae.
10. Which physical exam finding is most indicative of appendicitis?
A. Murphy’s sign
B. McBurney’s point tenderness
C. Chvostek’s sign
D. Babinski’s sign
🟢 B. McBurney’s point tenderness
🔴 RATIONALE: McBurney’s point (one-third the distance from the anterior superior iliac spine to the umbilicus) is the localized site of maximum
tenderness in acute appendicitis. Murphy's sign is associated with cholecystitis.
11. An NP is reviewing the lab results of a patient with suspected primary hypothyroidism. Which pattern of results confirms this diagnosis?
A. Low TSH, Low Free T4
B. High TSH, High Free T4
C. High TSH, Low Free T4
D. Low TSH, High Free T4
🟢 C. High TSH, Low Free T4
🔴 RATIONALE: In primary hypothyroidism, the thyroid gland fails to produce enough T4. The pituitary gland responds to the low T4 levels by
increasing the production of Thyroid Stimulating Hormone (TSH) to compensate.
