AGACNP GI, Hepatology & Professional
Role Review 2026: High-Yield Study Guide
for Acute Care NP Boards (AANP/ANCC)
Part 1: GI & Hepatology Questions (Questions 1-75)
Peptic Ulcer Disease & H. pylori
Question 1:
What bacteria is associated with >90% of duodenal ulcers and >75% of gastric ulcers?
A) Escherichia coli
B) Helicobacter pylori
C) Streptococcus faecalis
D) Clostridium difficile
Answer: B
Rationale: H. pylori is the primary cause of peptic ulcer disease. Its eradication is essential for
ulcer healing and prevention of recurrence .
Question 2:
Which medications are known to cause peptic ulcer disease? (Select all that apply)
A) NSAIDs
B) Aspirin
C) Glucocorticoids
D) Acetaminophen
Answer: A, B, C
Rationale: NSAIDs, aspirin, and glucocorticoids disrupt the gastric mucosal barrier and increase
risk of peptic ulcer disease. Acetaminophen does not have this effect .
Question 3:
At what age do duodenal ulcers typically present?
,A) 15-25 years
B) 30-55 years
C) 55-65 years
D) 65-75 years
Answer: B
*Rationale: Duodenal ulcers most commonly present between ages 30-55 years, while gastric
ulcers typically present in older adults aged 55-65 years .*
Question 4:
A patient presents with gnawing epigastric pain that is relieved by eating. This is most
characteristic of:
A) Gastric ulcer
B) Duodenal ulcer
C) Pancreatitis
D) Cholecystitis
Answer: B
Rationale: Duodenal ulcers classically cause gnawing epigastric pain that is relieved by food,
whereas gastric ulcer pain may worsen with eating .
Question 5:
Treatment of H. pylori includes all of the following EXCEPT:
A) Antibiotics
B) Proton pump inhibitor (PPI)
C) H2 receptor blockers (H2RBs)
D) Antacids
Answer: D
*Rationale: H. pylori eradication requires antibiotics, PPIs, and H2RBs. Antacids are not
effective for eradication and are reserved for symptom management in non-H. pylori PUD .*
Question 6:
H. pylori infection is definitively diagnosed by:
A) Blood serology
B) Stool antigen test
,C) Gastric biopsy
D) Urea breath test
Answer: C
Rationale: Gastric biopsy during endoscopy is the gold standard for H. pylori diagnosis. Serology
may show false negatives, especially if the patient has taken antibiotics or PPIs .
Hepatitis
Question 7:
This form of hepatitis has an acute illness with recovery and is most contagious 2 weeks prior to
showing signs/symptoms:
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis D
Answer: A
Rationale: Hepatitis A is transmitted via fecal-oral route, with highest contagiousness in the
prodromal period before jaundice appears. It does not cause chronic infection .
Question 8:
This form of hepatitis is curable with new medications but can become chronic if not treated:
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis E
Answer: C
Rationale: Hepatitis C is curable with direct-acting antiviral agents (DAAs). Without treatment, it
progresses to chronic infection in most patients .
Question 9:
Which hepatitis virus has no cure and can become chronic, especially in immunocompromised
patients?
A) Hepatitis A
B) Hepatitis B
, C) Hepatitis C
D) Hepatitis E
Answer: B
Rationale: Hepatitis B has no cure, though antiviral therapy can suppress viral replication.
Chronic infection occurs more frequently in immunocompromised individuals .
Question 10:
Which hepatitis virus requires Hepatitis B for replication?
A) Hepatitis A
B) Hepatitis C
C) Hepatitis D
D) Hepatitis E
Answer: C
Rationale: Hepatitis D is a defective virus that requires the presence of Hepatitis B surface
antigen (HBsAg) for replication and infectivity .
Question 11:
A healthcare worker sustains a needlestick injury from a patient known to have Hepatitis B.
What is the appropriate plan of care?
A) Give hepatitis B vaccine immediately only
B) Obtain baseline LFTs and observe
C) Give hepatitis B immune globulin (HBIG) and hepatitis B vaccine immediately
D) Give HBIG only within 1 week
Answer: C
Rationale: HBIG provides immediate passive immunity, while the vaccine provides lasting active
immunity. This combination is the standard post-exposure prophylaxis for HBV .
Question 12:
Which serologic marker indicates acute Hepatitis A infection?
A) Hepatitis A IgM positive
B) Hepatitis A IgG positive
C) Hepatitis A IgM negative
D) Both IgM and IgG positive
Role Review 2026: High-Yield Study Guide
for Acute Care NP Boards (AANP/ANCC)
Part 1: GI & Hepatology Questions (Questions 1-75)
Peptic Ulcer Disease & H. pylori
Question 1:
What bacteria is associated with >90% of duodenal ulcers and >75% of gastric ulcers?
A) Escherichia coli
B) Helicobacter pylori
C) Streptococcus faecalis
D) Clostridium difficile
Answer: B
Rationale: H. pylori is the primary cause of peptic ulcer disease. Its eradication is essential for
ulcer healing and prevention of recurrence .
Question 2:
Which medications are known to cause peptic ulcer disease? (Select all that apply)
A) NSAIDs
B) Aspirin
C) Glucocorticoids
D) Acetaminophen
Answer: A, B, C
Rationale: NSAIDs, aspirin, and glucocorticoids disrupt the gastric mucosal barrier and increase
risk of peptic ulcer disease. Acetaminophen does not have this effect .
Question 3:
At what age do duodenal ulcers typically present?
,A) 15-25 years
B) 30-55 years
C) 55-65 years
D) 65-75 years
Answer: B
*Rationale: Duodenal ulcers most commonly present between ages 30-55 years, while gastric
ulcers typically present in older adults aged 55-65 years .*
Question 4:
A patient presents with gnawing epigastric pain that is relieved by eating. This is most
characteristic of:
A) Gastric ulcer
B) Duodenal ulcer
C) Pancreatitis
D) Cholecystitis
Answer: B
Rationale: Duodenal ulcers classically cause gnawing epigastric pain that is relieved by food,
whereas gastric ulcer pain may worsen with eating .
Question 5:
Treatment of H. pylori includes all of the following EXCEPT:
A) Antibiotics
B) Proton pump inhibitor (PPI)
C) H2 receptor blockers (H2RBs)
D) Antacids
Answer: D
*Rationale: H. pylori eradication requires antibiotics, PPIs, and H2RBs. Antacids are not
effective for eradication and are reserved for symptom management in non-H. pylori PUD .*
Question 6:
H. pylori infection is definitively diagnosed by:
A) Blood serology
B) Stool antigen test
,C) Gastric biopsy
D) Urea breath test
Answer: C
Rationale: Gastric biopsy during endoscopy is the gold standard for H. pylori diagnosis. Serology
may show false negatives, especially if the patient has taken antibiotics or PPIs .
Hepatitis
Question 7:
This form of hepatitis has an acute illness with recovery and is most contagious 2 weeks prior to
showing signs/symptoms:
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis D
Answer: A
Rationale: Hepatitis A is transmitted via fecal-oral route, with highest contagiousness in the
prodromal period before jaundice appears. It does not cause chronic infection .
Question 8:
This form of hepatitis is curable with new medications but can become chronic if not treated:
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis E
Answer: C
Rationale: Hepatitis C is curable with direct-acting antiviral agents (DAAs). Without treatment, it
progresses to chronic infection in most patients .
Question 9:
Which hepatitis virus has no cure and can become chronic, especially in immunocompromised
patients?
A) Hepatitis A
B) Hepatitis B
, C) Hepatitis C
D) Hepatitis E
Answer: B
Rationale: Hepatitis B has no cure, though antiviral therapy can suppress viral replication.
Chronic infection occurs more frequently in immunocompromised individuals .
Question 10:
Which hepatitis virus requires Hepatitis B for replication?
A) Hepatitis A
B) Hepatitis C
C) Hepatitis D
D) Hepatitis E
Answer: C
Rationale: Hepatitis D is a defective virus that requires the presence of Hepatitis B surface
antigen (HBsAg) for replication and infectivity .
Question 11:
A healthcare worker sustains a needlestick injury from a patient known to have Hepatitis B.
What is the appropriate plan of care?
A) Give hepatitis B vaccine immediately only
B) Obtain baseline LFTs and observe
C) Give hepatitis B immune globulin (HBIG) and hepatitis B vaccine immediately
D) Give HBIG only within 1 week
Answer: C
Rationale: HBIG provides immediate passive immunity, while the vaccine provides lasting active
immunity. This combination is the standard post-exposure prophylaxis for HBV .
Question 12:
Which serologic marker indicates acute Hepatitis A infection?
A) Hepatitis A IgM positive
B) Hepatitis A IgG positive
C) Hepatitis A IgM negative
D) Both IgM and IgG positive
