1
Kaplan AGNP Certification Review | 150Board-
Style Questions and Verified Answers
SECTION 1 – HEALTH PROMOTION & SCREENING (1–15)
1. A 65-year-old woman with no chronic medical conditions presents for a
routine visit. She has never had a pneumococcal vaccine. According to the CDC,
which vaccine(s) should she receive?
A. PCV13 followed by PPSV23 12 months later
B. A single dose of PCV20 alone
C. PPSV23 only
D. No pneumococcal vaccine is needed after age 65
: Correct Answer : B
Rationale: Current CDC guidelines for adults ≥65 who have not previously
received a pneumococcal conjugate vaccine recommend a single dose of PCV20
(or PCV15 followed by PPSV23). The previous recommendation of PCV13 followed
by PPSV23 (A) has been updated. PCV20 alone provides coverage without the
need for a second vaccine.
2. A 72-year-old man with a 45-pack-year smoking history quit 20 years ago. He
asks if he should be screened for lung cancer. According to the USPSTF, he is:
A. Eligible for annual low-dose CT because of his smoking history
B. Not eligible because he quit more than 15 years ago
C. Eligible only if he has a family history of lung cancer
D. Eligible only if he has respiratory symptoms
: Correct Answer : B
Rationale: The USPSTF recommends annual low-dose CT screening for adults aged
50–80 who have a ≥20 pack-year smoking history and currently smoke or have
quit within the past 15 years. Since he quit 20 years ago, he no longer meets the
screening criteria.
pg. 1
,2
3. A 55-year-old woman at average risk for colorectal cancer asks about
screening options. The NP should offer all of the following EXCEPT:
A. Colonoscopy every 10 years
B. Fecal immunochemical test (FIT) annually
C. CT colonography every 5 years
D. Barium enema every 5 years
: Correct Answer : D
Rationale: The USPSTF recommends several screening modalities for colorectal
cancer: colonoscopy every 10 years, FIT annually, FIT-DNA every 3 years, CT
colonography every 5 years, or flexible sigmoidoscopy every 5 years (with FIT
annually). Barium enema is not a recommended screening method.
4. A 58-year-old postmenopausal woman with a BMI of 24 and no fractures asks
about bone density testing. According to the USPSTF, screening DXA is
recommended:
A. For all women at age 50
B. For women age 65 and older, and for younger postmenopausal women at
increased risk
C. Only if she has a family history of osteoporosis
D. Only if she has lost height
: Correct Answer : B
Rationale: The USPSTF recommends screening for osteoporosis with DXA in all
women ≥65 years and in postmenopausal women <65 years with elevated risk
factors (e.g., parental history of hip fracture, smoking, excessive alcohol, low body
weight). She is 58 and low risk, so screening is not yet indicated unless risk factors
develop.
5. A 70-year-old man has a blood pressure of 128/76 mmHg at today's visit. He
has no history of hypertension. According to the 2017 ACC/AHA guidelines, this
blood pressure is classified as:
A. Normal
B. Elevated
pg. 2
,3
C. Stage 1 hypertension
D. Stage 2 hypertension
: Correct Answer : B
Rationale: Elevated blood pressure is defined as systolic 120–129 mmHg and
diastolic <80 mmHg. Stage 1 hypertension is 130–139/80–89. Normal is <120/<80.
His reading of 128/76 fits the elevated category, warranting lifestyle modifications
and follow-up.
6. An 82-year-old woman with advanced dementia, multiple pressure ulcers,
and a life expectancy of less than 6 months is due for a screening mammogram.
The NP should:
A. Order the mammogram as it is recommended up to age 85
B. Discuss with the family and recommend against screening, as the harms
outweigh the benefits given her limited life expectancy
C. Perform a clinical breast exam instead
D. Refer to oncology for decision
: Correct Answer : B
Rationale: The USPSTF recommends against screening mammography in women
with a life expectancy <10 years because the time to benefit exceeds expected
survival. The potential harms of false positives, overdiagnosis, and unnecessary
treatment outweigh any benefits in this frail patient.
7. A 62-year-old woman with a 35-pack-year smoking history asks about
abdominal aortic aneurysm (AAA) screening. The NP should:
A. Order an abdominal ultrasound; she meets screening criteria
B. Tell her AAA screening is only recommended for men
C. Order a CT scan
D. Only screen if she has a family history of AAA
: Correct Answer : B
Rationale: The USPSTF recommends one-time AAA screening with ultrasound in
men aged 65–75 who have ever smoked. The evidence for routine screening in
pg. 3
, 4
women who have smoked is insufficient; therefore, screening is not routinely
recommended for her.
8. A 75-year-old man has a PSA of 5.5 ng/mL. He has severe COPD with a life
expectancy of approximately 5 years. The NP should:
A. Refer to urology for prostate biopsy
B. Discuss that the potential harms of further evaluation and treatment likely
outweigh the benefits given his comorbidities
C. Repeat PSA in 6 months
D. Start finasteride
: Correct Answer : B
Rationale: The USPSTF recommends against PSA-based prostate cancer screening
in men ≥70 years and in any man with a life expectancy <10–15 years. The risks of
biopsy complications, overdiagnosis, and treatment side effects outweigh the
potential benefit.
9. A 56-year-old woman with type 2 diabetes has an A1c of 7.8%. She is
functionally independent and has no significant comorbidities. According to the
ADA, her glycemic target should be:
A. <7.0%
B. <7.5%
C. <8.0%
D. <8.5%
: Correct Answer : B
Rationale: For healthy older adults with intact cognitive and functional status and
few comorbidities, the ADA recommends an A1c goal of <7.5%. For those with
multiple comorbidities or limited life expectancy, higher targets (<8.0–8.5%) are
appropriate.
10. A 68-year-old man with hypertension and hyperlipidemia is up to date on
immunizations. Which vaccine should he receive at today's visit?
pg. 4
Kaplan AGNP Certification Review | 150Board-
Style Questions and Verified Answers
SECTION 1 – HEALTH PROMOTION & SCREENING (1–15)
1. A 65-year-old woman with no chronic medical conditions presents for a
routine visit. She has never had a pneumococcal vaccine. According to the CDC,
which vaccine(s) should she receive?
A. PCV13 followed by PPSV23 12 months later
B. A single dose of PCV20 alone
C. PPSV23 only
D. No pneumococcal vaccine is needed after age 65
: Correct Answer : B
Rationale: Current CDC guidelines for adults ≥65 who have not previously
received a pneumococcal conjugate vaccine recommend a single dose of PCV20
(or PCV15 followed by PPSV23). The previous recommendation of PCV13 followed
by PPSV23 (A) has been updated. PCV20 alone provides coverage without the
need for a second vaccine.
2. A 72-year-old man with a 45-pack-year smoking history quit 20 years ago. He
asks if he should be screened for lung cancer. According to the USPSTF, he is:
A. Eligible for annual low-dose CT because of his smoking history
B. Not eligible because he quit more than 15 years ago
C. Eligible only if he has a family history of lung cancer
D. Eligible only if he has respiratory symptoms
: Correct Answer : B
Rationale: The USPSTF recommends annual low-dose CT screening for adults aged
50–80 who have a ≥20 pack-year smoking history and currently smoke or have
quit within the past 15 years. Since he quit 20 years ago, he no longer meets the
screening criteria.
pg. 1
,2
3. A 55-year-old woman at average risk for colorectal cancer asks about
screening options. The NP should offer all of the following EXCEPT:
A. Colonoscopy every 10 years
B. Fecal immunochemical test (FIT) annually
C. CT colonography every 5 years
D. Barium enema every 5 years
: Correct Answer : D
Rationale: The USPSTF recommends several screening modalities for colorectal
cancer: colonoscopy every 10 years, FIT annually, FIT-DNA every 3 years, CT
colonography every 5 years, or flexible sigmoidoscopy every 5 years (with FIT
annually). Barium enema is not a recommended screening method.
4. A 58-year-old postmenopausal woman with a BMI of 24 and no fractures asks
about bone density testing. According to the USPSTF, screening DXA is
recommended:
A. For all women at age 50
B. For women age 65 and older, and for younger postmenopausal women at
increased risk
C. Only if she has a family history of osteoporosis
D. Only if she has lost height
: Correct Answer : B
Rationale: The USPSTF recommends screening for osteoporosis with DXA in all
women ≥65 years and in postmenopausal women <65 years with elevated risk
factors (e.g., parental history of hip fracture, smoking, excessive alcohol, low body
weight). She is 58 and low risk, so screening is not yet indicated unless risk factors
develop.
5. A 70-year-old man has a blood pressure of 128/76 mmHg at today's visit. He
has no history of hypertension. According to the 2017 ACC/AHA guidelines, this
blood pressure is classified as:
A. Normal
B. Elevated
pg. 2
,3
C. Stage 1 hypertension
D. Stage 2 hypertension
: Correct Answer : B
Rationale: Elevated blood pressure is defined as systolic 120–129 mmHg and
diastolic <80 mmHg. Stage 1 hypertension is 130–139/80–89. Normal is <120/<80.
His reading of 128/76 fits the elevated category, warranting lifestyle modifications
and follow-up.
6. An 82-year-old woman with advanced dementia, multiple pressure ulcers,
and a life expectancy of less than 6 months is due for a screening mammogram.
The NP should:
A. Order the mammogram as it is recommended up to age 85
B. Discuss with the family and recommend against screening, as the harms
outweigh the benefits given her limited life expectancy
C. Perform a clinical breast exam instead
D. Refer to oncology for decision
: Correct Answer : B
Rationale: The USPSTF recommends against screening mammography in women
with a life expectancy <10 years because the time to benefit exceeds expected
survival. The potential harms of false positives, overdiagnosis, and unnecessary
treatment outweigh any benefits in this frail patient.
7. A 62-year-old woman with a 35-pack-year smoking history asks about
abdominal aortic aneurysm (AAA) screening. The NP should:
A. Order an abdominal ultrasound; she meets screening criteria
B. Tell her AAA screening is only recommended for men
C. Order a CT scan
D. Only screen if she has a family history of AAA
: Correct Answer : B
Rationale: The USPSTF recommends one-time AAA screening with ultrasound in
men aged 65–75 who have ever smoked. The evidence for routine screening in
pg. 3
, 4
women who have smoked is insufficient; therefore, screening is not routinely
recommended for her.
8. A 75-year-old man has a PSA of 5.5 ng/mL. He has severe COPD with a life
expectancy of approximately 5 years. The NP should:
A. Refer to urology for prostate biopsy
B. Discuss that the potential harms of further evaluation and treatment likely
outweigh the benefits given his comorbidities
C. Repeat PSA in 6 months
D. Start finasteride
: Correct Answer : B
Rationale: The USPSTF recommends against PSA-based prostate cancer screening
in men ≥70 years and in any man with a life expectancy <10–15 years. The risks of
biopsy complications, overdiagnosis, and treatment side effects outweigh the
potential benefit.
9. A 56-year-old woman with type 2 diabetes has an A1c of 7.8%. She is
functionally independent and has no significant comorbidities. According to the
ADA, her glycemic target should be:
A. <7.0%
B. <7.5%
C. <8.0%
D. <8.5%
: Correct Answer : B
Rationale: For healthy older adults with intact cognitive and functional status and
few comorbidities, the ADA recommends an A1c goal of <7.5%. For those with
multiple comorbidities or limited life expectancy, higher targets (<8.0–8.5%) are
appropriate.
10. A 68-year-old man with hypertension and hyperlipidemia is up to date on
immunizations. Which vaccine should he receive at today's visit?
pg. 4
