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Kaplan AGNP Predictor Exam | 150 Comprehensive
Readiness Questions and Rationales
Domain I: Health Promotion and Disease Prevention (Questions 1–25)
1. A 62-year-old woman with a 40-pack-year smoking history quit 5 years ago.
She asks about lung cancer screening. According to the USPSTF, what is the
appropriate recommendation?
A. Annual chest X-ray
B. Annual low-dose CT scan until age 80 if she continues to meet the criteria
C. Sputum cytology every 6 months
D. No screening is indicated because she quit more than 15 years ago
: Correct Answer : B
Rationale: The USPSTF recommends annual screening for lung cancer with low-
dose CT in adults aged 50–80 who have a 20-pack-year smoking history and
currently smoke or have quit within the past 15 years. Since she quit 5 years ago
(within 15 years), she meets criteria.
2. A 70-year-old man with hypertension and diabetes asks about aspirin for
primary prevention of cardiovascular disease. What is the current USPSTF
recommendation for his age group?
A. Low-dose aspirin is recommended for all adults over 60
B. Low-dose aspirin is not routinely recommended for primary prevention in
adults ≥60 years
C. High-dose aspirin is preferred
D. Aspirin should only be used if he has had a prior MI
: Correct Answer : B
Rationale: The USPSTF recommends against routine low-dose aspirin for primary
prevention of CVD in adults ≥60 years due to increased bleeding risk that
outweighs potential benefits. Shared decision-making is key.
pg. 1
,2
3. A 58-year-old postmenopausal woman asks about calcium and vitamin D
supplementation for osteoporosis prevention. She has a BMI of 24. What is the
USPSTF recommendation?
A. 1,200 mg calcium and 800–1,000 IU vitamin D daily for all postmenopausal
women
B. No routine supplementation; evidence is insufficient for primary prevention in
community-dwelling postmenopausal women
C. Vitamin D alone without calcium
D. Only for women with prior fractures
: Correct Answer : B
Rationale: The USPSTF states that current evidence is insufficient to assess the
balance of benefits and harms of vitamin D and calcium supplementation for
primary prevention of fractures in community-dwelling postmenopausal women.
Recommendations differ for those with osteoporosis or living in institutions.
4. A 65-year-old man is due for vaccinations. He received Tdap 8 years ago and
PPSV23 at age 60. Which vaccines should he receive today?
A. Td booster and PCV20
B. Tdap and PPSV23
C. Shingrix only
D. MMR and varicella
: Correct Answer : A
Rationale: Tdap is given once, then a Td or Tdap booster every 10 years; his last
was 8 years ago, so he is due for Td. For pneumococcal, he previously received
PPSV23; now he should receive PCV20 or PCV15 at least 1 year later. PCV20 alone
is sufficient.
5. A 55-year-old woman with a BMI of 33 and no other risk factors asks about
diabetes screening. What is the appropriate interval?
A. Every 5 years
B. Screening not needed until age 65
pg. 2
,3
C. Screen now; if normal, repeat at least every 3 years
D. Only if she develops symptoms
: Correct Answer : C
Rationale: The USPSTF recommends screening for prediabetes and type 2
diabetes in adults aged 35–70 who are overweight or obese. Screening should be
repeated every 3 years if normal.
6. A 72-year-old woman with hypertension and a 10-year history of type 2
diabetes asks about statin therapy. Her calculated ASCVD risk is 18%. What is
the recommendation?
A. No statin needed
B. Moderate-intensity statin
C. High-intensity statin
D. Only if LDL >190 mg/dL
: Correct Answer : C
Rationale: Adults with diabetes aged 40–75 with an ASCVD risk ≥20% (or with
multiple risk factors) should be on high-intensity statin therapy. Her risk is 18%;
the guideline says ≥20% for high-intensity; but many would still recommend high-
intensity given diabetes duration and age. However, moderate-intensity is for
those with risk <20% or without risk enhancers. Given ASCVD risk 18% and
diabetes duration >10 years, a risk enhancer, high-intensity is reasonable. I'll go
with C for this scenario as many guidelines favor high-intensity for long-standing
diabetes. But per strict USPSTF, if risk is 7.5-<20%, moderate-intensity is
recommended. I'll adjust: the answer is B if risk <20% and no additional risk
enhancers? Actually, diabetes itself is a risk enhancer; the ACC/AHA guidelines
often recommend high-intensity for diabetes with ≥1 risk enhancer. So I'll stick
with high-intensity.
7. A 22-year-old sexually active woman presents for STI screening. She has no
symptoms. Which screening is recommended by the CDC?
A. HIV only
B. Gonorrhea and chlamydia annually
pg. 3
, 4
C. Syphilis and herpes
D. HPV DNA test
: Correct Answer : B
Rationale: The CDC recommends annual chlamydia and gonorrhea screening for
all sexually active women under 25. HIV screening is also recommended at least
once.
8. A 50-year-old man with a family history of colon cancer in a first-degree
relative at age 55 asks when to start colon cancer screening. What is the
recommendation?
A. Age 40, or 10 years before the age at which the relative was diagnosed
B. Age 50
C. Age 60
D. No screening needed
: Correct Answer : A
Rationale: For individuals with a first-degree relative diagnosed with colorectal
cancer before age 60, screening should begin at age 40 or 10 years before the age
at which the relative was diagnosed, whichever is earlier.
9. A 66-year-old woman asks about shingles vaccination. She had chickenpox as
a child. What is the appropriate recommendation?
A. No vaccine needed if she already had chickenpox
B. Recombinant zoster vaccine (RZV, Shingrix) two-dose series
C. Live zoster vaccine (Zostavax) single dose
D. Only if she has recurrent herpes
: Correct Answer : B
Rationale: The CDC recommends Shingrix for all immunocompetent adults ≥50
years, regardless of prior chickenpox or shingles history. It is a two-dose series
and preferred over Zostavax.
pg. 4
Kaplan AGNP Predictor Exam | 150 Comprehensive
Readiness Questions and Rationales
Domain I: Health Promotion and Disease Prevention (Questions 1–25)
1. A 62-year-old woman with a 40-pack-year smoking history quit 5 years ago.
She asks about lung cancer screening. According to the USPSTF, what is the
appropriate recommendation?
A. Annual chest X-ray
B. Annual low-dose CT scan until age 80 if she continues to meet the criteria
C. Sputum cytology every 6 months
D. No screening is indicated because she quit more than 15 years ago
: Correct Answer : B
Rationale: The USPSTF recommends annual screening for lung cancer with low-
dose CT in adults aged 50–80 who have a 20-pack-year smoking history and
currently smoke or have quit within the past 15 years. Since she quit 5 years ago
(within 15 years), she meets criteria.
2. A 70-year-old man with hypertension and diabetes asks about aspirin for
primary prevention of cardiovascular disease. What is the current USPSTF
recommendation for his age group?
A. Low-dose aspirin is recommended for all adults over 60
B. Low-dose aspirin is not routinely recommended for primary prevention in
adults ≥60 years
C. High-dose aspirin is preferred
D. Aspirin should only be used if he has had a prior MI
: Correct Answer : B
Rationale: The USPSTF recommends against routine low-dose aspirin for primary
prevention of CVD in adults ≥60 years due to increased bleeding risk that
outweighs potential benefits. Shared decision-making is key.
pg. 1
,2
3. A 58-year-old postmenopausal woman asks about calcium and vitamin D
supplementation for osteoporosis prevention. She has a BMI of 24. What is the
USPSTF recommendation?
A. 1,200 mg calcium and 800–1,000 IU vitamin D daily for all postmenopausal
women
B. No routine supplementation; evidence is insufficient for primary prevention in
community-dwelling postmenopausal women
C. Vitamin D alone without calcium
D. Only for women with prior fractures
: Correct Answer : B
Rationale: The USPSTF states that current evidence is insufficient to assess the
balance of benefits and harms of vitamin D and calcium supplementation for
primary prevention of fractures in community-dwelling postmenopausal women.
Recommendations differ for those with osteoporosis or living in institutions.
4. A 65-year-old man is due for vaccinations. He received Tdap 8 years ago and
PPSV23 at age 60. Which vaccines should he receive today?
A. Td booster and PCV20
B. Tdap and PPSV23
C. Shingrix only
D. MMR and varicella
: Correct Answer : A
Rationale: Tdap is given once, then a Td or Tdap booster every 10 years; his last
was 8 years ago, so he is due for Td. For pneumococcal, he previously received
PPSV23; now he should receive PCV20 or PCV15 at least 1 year later. PCV20 alone
is sufficient.
5. A 55-year-old woman with a BMI of 33 and no other risk factors asks about
diabetes screening. What is the appropriate interval?
A. Every 5 years
B. Screening not needed until age 65
pg. 2
,3
C. Screen now; if normal, repeat at least every 3 years
D. Only if she develops symptoms
: Correct Answer : C
Rationale: The USPSTF recommends screening for prediabetes and type 2
diabetes in adults aged 35–70 who are overweight or obese. Screening should be
repeated every 3 years if normal.
6. A 72-year-old woman with hypertension and a 10-year history of type 2
diabetes asks about statin therapy. Her calculated ASCVD risk is 18%. What is
the recommendation?
A. No statin needed
B. Moderate-intensity statin
C. High-intensity statin
D. Only if LDL >190 mg/dL
: Correct Answer : C
Rationale: Adults with diabetes aged 40–75 with an ASCVD risk ≥20% (or with
multiple risk factors) should be on high-intensity statin therapy. Her risk is 18%;
the guideline says ≥20% for high-intensity; but many would still recommend high-
intensity given diabetes duration and age. However, moderate-intensity is for
those with risk <20% or without risk enhancers. Given ASCVD risk 18% and
diabetes duration >10 years, a risk enhancer, high-intensity is reasonable. I'll go
with C for this scenario as many guidelines favor high-intensity for long-standing
diabetes. But per strict USPSTF, if risk is 7.5-<20%, moderate-intensity is
recommended. I'll adjust: the answer is B if risk <20% and no additional risk
enhancers? Actually, diabetes itself is a risk enhancer; the ACC/AHA guidelines
often recommend high-intensity for diabetes with ≥1 risk enhancer. So I'll stick
with high-intensity.
7. A 22-year-old sexually active woman presents for STI screening. She has no
symptoms. Which screening is recommended by the CDC?
A. HIV only
B. Gonorrhea and chlamydia annually
pg. 3
, 4
C. Syphilis and herpes
D. HPV DNA test
: Correct Answer : B
Rationale: The CDC recommends annual chlamydia and gonorrhea screening for
all sexually active women under 25. HIV screening is also recommended at least
once.
8. A 50-year-old man with a family history of colon cancer in a first-degree
relative at age 55 asks when to start colon cancer screening. What is the
recommendation?
A. Age 40, or 10 years before the age at which the relative was diagnosed
B. Age 50
C. Age 60
D. No screening needed
: Correct Answer : A
Rationale: For individuals with a first-degree relative diagnosed with colorectal
cancer before age 60, screening should begin at age 40 or 10 years before the age
at which the relative was diagnosed, whichever is earlier.
9. A 66-year-old woman asks about shingles vaccination. She had chickenpox as
a child. What is the appropriate recommendation?
A. No vaccine needed if she already had chickenpox
B. Recombinant zoster vaccine (RZV, Shingrix) two-dose series
C. Live zoster vaccine (Zostavax) single dose
D. Only if she has recurrent herpes
: Correct Answer : B
Rationale: The CDC recommends Shingrix for all immunocompetent adults ≥50
years, regardless of prior chickenpox or shingles history. It is a two-dose series
and preferred over Zostavax.
pg. 4
