1
ANCC AGPCNP 2026 Practice Exam: 200
Questions with Rationales Covering
Geriatrics, Cardiology, Pulmonology,
Pharmacology, and Primary Care
Management for Adult-Gerontology
Nurse Practitioner Certification Success.
📝 Full Sample Questions with Rationales
1. A 58yo F reports 2 weeks of right ear
pain, decreased hearing. Exam: canal
erythema, edema, purulent discharge.
Tragus tenderness +. TM intact. Best tx?
A. Amoxicillin PO
B. Ciprofloxacin/dexamethasone otic drops
C. PO azithromycin
D. Refer ENT
,2
Rationale: This presentation is classic for
otitis externa (swimmer's ear),
characterized by tragus pain and canal
edema. Topical fluoroquinolone + steroid
drops are the first-line treatment. Oral
antibiotics are only used if the cellulitis
extends beyond the ear canal.
2. A 65yo M, no DM, BP 138/86 in office x2
visits. Home BP avg 128/76. Diagnosis?
A. Stage 1 HTN
B. White coat HTN
C. Masked HTN
D. Normotensive
Rationale: This is a classic example of white
coat hypertension, where office readings
are elevated but home readings are normal.
The opposite is masked hypertension.
,3
Treatment is not initiated immediately;
monitoring is recommended.
3. Which heart sound is best heard at the
left 5th ICS, midclavicular line?
A. S1 at base
B. S1 at apex
C. S2 at apex
D. S3 at base
Rationale: The left 5th intercostal space
(ICS) at the midclavicular line (MCL) is the
mitral area, located at the apex of the heart.
The S1 heart sound (closure of mitral and
tricuspid valves) is best heard here.
4. 45yo F, BMI 24, no risk factors. USPSTF
cervical cancer screening?
A. Pap q3yr age 21-65
B. Pap + HPV q5yr starting 30
, 4
C. Pap yearly
D. Stop at 50
Rationale: For a 45-year-old woman in the
30-65 age group, USPSTF guidelines
recommend cervical cancer screening with
cytology (Pap) every 3 years, OR co-testing
(Pap + HPV) every 5 years, OR HPV testing
alone every 5 years.
5. 70yo M, sudden vision loss "curtain
coming down" right eye, 10 min, resolved.
Next test?
A. Carotid ultrasound
B. MRI brain
C. EKG
D. Ophthalmology referral only
Rationale: This transient, painless
monocular vision loss is amaurosis fugax,
ANCC AGPCNP 2026 Practice Exam: 200
Questions with Rationales Covering
Geriatrics, Cardiology, Pulmonology,
Pharmacology, and Primary Care
Management for Adult-Gerontology
Nurse Practitioner Certification Success.
📝 Full Sample Questions with Rationales
1. A 58yo F reports 2 weeks of right ear
pain, decreased hearing. Exam: canal
erythema, edema, purulent discharge.
Tragus tenderness +. TM intact. Best tx?
A. Amoxicillin PO
B. Ciprofloxacin/dexamethasone otic drops
C. PO azithromycin
D. Refer ENT
,2
Rationale: This presentation is classic for
otitis externa (swimmer's ear),
characterized by tragus pain and canal
edema. Topical fluoroquinolone + steroid
drops are the first-line treatment. Oral
antibiotics are only used if the cellulitis
extends beyond the ear canal.
2. A 65yo M, no DM, BP 138/86 in office x2
visits. Home BP avg 128/76. Diagnosis?
A. Stage 1 HTN
B. White coat HTN
C. Masked HTN
D. Normotensive
Rationale: This is a classic example of white
coat hypertension, where office readings
are elevated but home readings are normal.
The opposite is masked hypertension.
,3
Treatment is not initiated immediately;
monitoring is recommended.
3. Which heart sound is best heard at the
left 5th ICS, midclavicular line?
A. S1 at base
B. S1 at apex
C. S2 at apex
D. S3 at base
Rationale: The left 5th intercostal space
(ICS) at the midclavicular line (MCL) is the
mitral area, located at the apex of the heart.
The S1 heart sound (closure of mitral and
tricuspid valves) is best heard here.
4. 45yo F, BMI 24, no risk factors. USPSTF
cervical cancer screening?
A. Pap q3yr age 21-65
B. Pap + HPV q5yr starting 30
, 4
C. Pap yearly
D. Stop at 50
Rationale: For a 45-year-old woman in the
30-65 age group, USPSTF guidelines
recommend cervical cancer screening with
cytology (Pap) every 3 years, OR co-testing
(Pap + HPV) every 5 years, OR HPV testing
alone every 5 years.
5. 70yo M, sudden vision loss "curtain
coming down" right eye, 10 min, resolved.
Next test?
A. Carotid ultrasound
B. MRI brain
C. EKG
D. Ophthalmology referral only
Rationale: This transient, painless
monocular vision loss is amaurosis fugax,
