AGPCNP-BC ANCC Practice Exam with correct answers and rationales
2026/2027 version A+ Graded
1. An older adult reports difficulty managing several chronic conditions. Which approach best
reflects comprehensive geriatric assessment?
A. Focus only on the chief complaint
B. Assess medical, functional, cognitive, psychological, and social factors
C. Order laboratory tests before taking a history
D. Focus only on medication management
Answer: B. Assess medical, functional, cognitive, psychological, and social factors
Rationale: Comprehensive geriatric assessment considers the whole person, including medical
conditions, function, cognition, mental health, medications, and social support.
2. Which finding is most concerning for frailty?
A. Independent ambulation
B. Regular physical activity
C. Unintentional weight loss and decreased physical performance
D. Stable chronic disease
Answer: C. Unintentional weight loss and decreased physical performance
Rationale: Frailty is associated with reduced physiologic reserve, weakness, exhaustion, weight
loss, and reduced physical performance.
3. Which intervention is most appropriate for an older adult at risk for functional decline?
A. Encourage prolonged inactivity
B. Promote appropriate physical activity and strength training
C. Recommend bed rest
D. Limit mobility
Answer: B. Promote appropriate physical activity and strength training
Rationale: Exercise, including strength and balance activities, helps preserve function and
independence.
4. Which assessment is particularly important when evaluating an older adult's ability to live
independently?
A. Hair color
B. Activities of daily living and instrumental activities of daily living
,C. Blood type
D. Childhood illnesses
Answer: B. Activities of daily living and instrumental activities of daily living
Rationale: ADLs and IADLs help determine functional independence and the need for support.
5. Which is an instrumental activity of daily living?
A. Bathing
B. Dressing
C. Feeding oneself
D. Managing finances
Answer: D. Managing finances
Rationale: Managing finances, medications, transportation, shopping, and communication are
examples of IADLs.
6. An older adult has difficulty hearing during the visit. Which intervention is most appropriate?
A. Speak rapidly
B. Face away from the patient
C. Reduce background noise and face the patient while speaking
D. Assume cognitive impairment
Answer: C. Reduce background noise and face the patient while speaking
Rationale: Good communication includes minimizing background noise, facing the patient,
speaking clearly, and confirming understanding.
7. Which factor increases the risk of medication-related adverse events in older adults?
A. Polypharmacy
B. Improved renal function
C. Increased muscle mass
D. Reduced medication use
Answer: A. Polypharmacy
Rationale: Multiple medications increase the risk of drug interactions, adverse effects, and
adherence problems.
8. What is deprescribing?
,A. Increasing all medications
B. Systematically reducing or stopping medications when appropriate
C. Replacing prescriptions with supplements
D. Avoiding medication review
Answer: B. Systematically reducing or stopping medications when appropriate
Rationale: Deprescribing involves evaluating medication benefits and harms and safely reducing
or stopping medications when appropriate.
9. Which factor should be considered before deprescribing a medication?
A. Medication color
B. Patient goals, indication, benefits, risks, and withdrawal considerations
C. Cost alone
D. Convenience for the clinician
Answer: B. Patient goals, indication, benefits, risks, and withdrawal considerations
Rationale: Deprescribing should be individualized and based on clinical indication, risks,
benefits, and patient goals.
10. Which approach is most appropriate when discussing advance care planning?
A. Wait until the patient becomes critically ill
B. Introduce the discussion proactively while the patient can participate
C. Discuss only with family members
D. Avoid discussing patient preferences
Answer: B. Introduce the discussion proactively while the patient can participate
Rationale: Advance care planning is ideally discussed before a healthcare crisis occurs.
11. Which document allows a person to designate someone to make healthcare decisions if they
become unable to do so?
A. Living will only
B. Healthcare power of attorney
C. Medication list
D. Discharge summary
Answer: B. Healthcare power of attorney
Rationale: A healthcare power of attorney designates an individual to make healthcare decisions
when the patient lacks decision-making capacity, subject to applicable law.
, 12. Which finding may indicate depression in an older adult?
A. Persistent loss of interest in previously enjoyable activities
B. Improved social engagement
C. Increased energy without sleep changes
D. Consistently positive mood
Answer: A. Persistent loss of interest in previously enjoyable activities
Rationale: Loss of interest or pleasure, known as anhedonia, is a key symptom of depression.
13. Which screening tool is commonly used to assess alcohol use?
A. AUDIT-C
B. Mini-Cog
C. PHQ-9
D. GAD-7
Answer: A. AUDIT-C
Rationale: AUDIT-C is a validated screening tool for unhealthy alcohol use.
14. Which approach is most appropriate when screening an older adult for intimate partner
violence?
A. Ask only when a partner is present
B. Ask privately and use a nonjudgmental approach
C. Avoid screening older adults
D. Ask the family member instead
Answer: B. Ask privately and use a nonjudgmental approach
Rationale: Private, respectful screening improves safety and encourages honest disclosure.
15. Which finding could indicate financial exploitation of an older adult?
A. Independent management of finances
B. Unexplained changes in financial documents or unusual withdrawals
C. Regular bill payments
D. Appropriate family support
Answer: B. Unexplained changes in financial documents or unusual withdrawals
Rationale: Unexplained financial changes may indicate exploitation and require further
assessment.
2026/2027 version A+ Graded
1. An older adult reports difficulty managing several chronic conditions. Which approach best
reflects comprehensive geriatric assessment?
A. Focus only on the chief complaint
B. Assess medical, functional, cognitive, psychological, and social factors
C. Order laboratory tests before taking a history
D. Focus only on medication management
Answer: B. Assess medical, functional, cognitive, psychological, and social factors
Rationale: Comprehensive geriatric assessment considers the whole person, including medical
conditions, function, cognition, mental health, medications, and social support.
2. Which finding is most concerning for frailty?
A. Independent ambulation
B. Regular physical activity
C. Unintentional weight loss and decreased physical performance
D. Stable chronic disease
Answer: C. Unintentional weight loss and decreased physical performance
Rationale: Frailty is associated with reduced physiologic reserve, weakness, exhaustion, weight
loss, and reduced physical performance.
3. Which intervention is most appropriate for an older adult at risk for functional decline?
A. Encourage prolonged inactivity
B. Promote appropriate physical activity and strength training
C. Recommend bed rest
D. Limit mobility
Answer: B. Promote appropriate physical activity and strength training
Rationale: Exercise, including strength and balance activities, helps preserve function and
independence.
4. Which assessment is particularly important when evaluating an older adult's ability to live
independently?
A. Hair color
B. Activities of daily living and instrumental activities of daily living
,C. Blood type
D. Childhood illnesses
Answer: B. Activities of daily living and instrumental activities of daily living
Rationale: ADLs and IADLs help determine functional independence and the need for support.
5. Which is an instrumental activity of daily living?
A. Bathing
B. Dressing
C. Feeding oneself
D. Managing finances
Answer: D. Managing finances
Rationale: Managing finances, medications, transportation, shopping, and communication are
examples of IADLs.
6. An older adult has difficulty hearing during the visit. Which intervention is most appropriate?
A. Speak rapidly
B. Face away from the patient
C. Reduce background noise and face the patient while speaking
D. Assume cognitive impairment
Answer: C. Reduce background noise and face the patient while speaking
Rationale: Good communication includes minimizing background noise, facing the patient,
speaking clearly, and confirming understanding.
7. Which factor increases the risk of medication-related adverse events in older adults?
A. Polypharmacy
B. Improved renal function
C. Increased muscle mass
D. Reduced medication use
Answer: A. Polypharmacy
Rationale: Multiple medications increase the risk of drug interactions, adverse effects, and
adherence problems.
8. What is deprescribing?
,A. Increasing all medications
B. Systematically reducing or stopping medications when appropriate
C. Replacing prescriptions with supplements
D. Avoiding medication review
Answer: B. Systematically reducing or stopping medications when appropriate
Rationale: Deprescribing involves evaluating medication benefits and harms and safely reducing
or stopping medications when appropriate.
9. Which factor should be considered before deprescribing a medication?
A. Medication color
B. Patient goals, indication, benefits, risks, and withdrawal considerations
C. Cost alone
D. Convenience for the clinician
Answer: B. Patient goals, indication, benefits, risks, and withdrawal considerations
Rationale: Deprescribing should be individualized and based on clinical indication, risks,
benefits, and patient goals.
10. Which approach is most appropriate when discussing advance care planning?
A. Wait until the patient becomes critically ill
B. Introduce the discussion proactively while the patient can participate
C. Discuss only with family members
D. Avoid discussing patient preferences
Answer: B. Introduce the discussion proactively while the patient can participate
Rationale: Advance care planning is ideally discussed before a healthcare crisis occurs.
11. Which document allows a person to designate someone to make healthcare decisions if they
become unable to do so?
A. Living will only
B. Healthcare power of attorney
C. Medication list
D. Discharge summary
Answer: B. Healthcare power of attorney
Rationale: A healthcare power of attorney designates an individual to make healthcare decisions
when the patient lacks decision-making capacity, subject to applicable law.
, 12. Which finding may indicate depression in an older adult?
A. Persistent loss of interest in previously enjoyable activities
B. Improved social engagement
C. Increased energy without sleep changes
D. Consistently positive mood
Answer: A. Persistent loss of interest in previously enjoyable activities
Rationale: Loss of interest or pleasure, known as anhedonia, is a key symptom of depression.
13. Which screening tool is commonly used to assess alcohol use?
A. AUDIT-C
B. Mini-Cog
C. PHQ-9
D. GAD-7
Answer: A. AUDIT-C
Rationale: AUDIT-C is a validated screening tool for unhealthy alcohol use.
14. Which approach is most appropriate when screening an older adult for intimate partner
violence?
A. Ask only when a partner is present
B. Ask privately and use a nonjudgmental approach
C. Avoid screening older adults
D. Ask the family member instead
Answer: B. Ask privately and use a nonjudgmental approach
Rationale: Private, respectful screening improves safety and encourages honest disclosure.
15. Which finding could indicate financial exploitation of an older adult?
A. Independent management of finances
B. Unexplained changes in financial documents or unusual withdrawals
C. Regular bill payments
D. Appropriate family support
Answer: B. Unexplained changes in financial documents or unusual withdrawals
Rationale: Unexplained financial changes may indicate exploitation and require further
assessment.
