BARKLEY ADULT-GERONTOLOGY PRIMARY
CARE NURSE PRACTITIONER (AGPCNP)
CERTIFICATION EXAM | 175 ACTUAL BOARD
EXAM QUESTIONS AND DETAILED ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
• Assessment, Diagnosis, and Geriatric Principles
• Health Promotion and Disease Prevention
• Cardiovascular and Pulmonary Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal, Genitourinary, and Renal Disorders
• Musculoskeletal, Neurologic, and Mental Health Disorders
• Integumentary and Hematopoietic/Immune Disorders
• Pharmacotherapeutics and Polypharmacy
• Professional Practice, Ethics, and Health Care Policy
Introduction
The Barkley AGPCNP Certification Exam assesses the knowledge
and clinical reasoning skills essential for advanced practice
nursing in adult-gerontology primary care. It evaluates
competencies in assessment, diagnosis, planning, and evaluation
across the lifespan, with emphasis on older adults. The exam
employs multiple-choice and scenario-based questions to test
critical thinking and clinical decision-making. Emphasis is placed
on applying foundational theory to real-world patient
presentations, ensuring competence in diagnosing and managing
,complex disease processes. This assessment prepares candidates
for advanced clinical roles by reinforcing evidence-based practice,
cultural humility, and professional standards.
SECTION ONE: QUESTIONS 1–175
1. An 80-year-old man is brought to the clinic by his daughter,
who reports he has become more forgetful over the past
year and has had two falls. Which assessment tool is most
appropriate to screen for cognitive impairment in this age
group?
A. Mini-Mental State Examination (MMSE)
B. Montreal Cognitive Assessment (MoCA)
C. Mini-Cog
D. Clock-drawing test alone
Correct answer C. Mini-Cog
RATIONALE: The Mini-Cog (3-word recall plus clock drawing)
is quick, sensitive, and less influenced by education, making it
ideal for routine screening in older adults. The MoCA is more
sensitive for mild cognitive impairment but takes longer to
administer.
2. A 75-year-old woman reports difficulty managing her
finances, using public transportation, and shopping. These
deficits reflect impairment in which functional domain?
A. Basic activities of daily living (BADLs)
B. Instrumental activities of daily living (IADLs)
C. Advanced activities of daily living (AADLs)
D. Mobility
, Correct answer B. Instrumental activities of daily living
(IADLs)
RATIONALE: IADLs include tasks required for independent
community living: managing money, transportation, shopping,
meal preparation, and telephone use. BADLs include bathing,
dressing, toileting, and eating.
3. Which of the following is a normal age-related change in the
cardiovascular system?
A. Increased resting heart rate
B. Decreased left ventricular compliance
C. Increased maximum heart rate response to exercise
D. Increased baroreceptor sensitivity
Correct answer B. Decreased left ventricular compliance
RATIONALE: Aging causes stiffening of the ventricles and
arteries, leading to decreased compliance and diastolic
dysfunction. Resting heart rate is unchanged; maximum heart
rate and baroreceptor sensitivity decrease with age.
4. An 82-year-old is hospitalized for pneumonia. To prevent
hospital-acquired functional decline, the NP should prioritize:
A. Strict bed rest to conserve energy
B. Early mobilization and physical therapy consultation
C. Use of sedatives to ensure sleep
D. Placement of a urinary catheter to prevent falls en route to the
bathroom
Correct answer B. Early mobilization and physical therapy
consultation
, RATIONALE: Older adults decondition rapidly; early mobility
and minimizing tethers (catheters, IVs, restraints) are key to
preserving function and preventing hospital-acquired disability.
5. The most common cause of unintentional weight loss in
community-dwelling older adults is:
A. Malignancy
B. Depression
C. Malabsorption
D. Hyperthyroidism
Correct answer B. Depression
RATIONALE: Depression is the most frequent reversible cause
of significant weight loss in older adults, though malignancy must
be ruled out. Other causes include social isolation, medication
side effects, and dysphagia.
6. Which of the following is a component of the comprehensive
geriatric assessment (CGA) that is not typically part of a
standard adult history and physical?
A. Review of systems
B. Functional status evaluation (ADLs, IADLs)
C. Medication reconciliation
D. Vital signs
Correct answer B. Functional status evaluation (ADLs, IADLs)
RATIONALE: CGA uniquely focuses on functional, cognitive,
affective, and social domains, not just medical diagnosis. It
assesses ADLs, IADLs, gait, balance, cognition, mood, and social
support.
CARE NURSE PRACTITIONER (AGPCNP)
CERTIFICATION EXAM | 175 ACTUAL BOARD
EXAM QUESTIONS AND DETAILED ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
• Assessment, Diagnosis, and Geriatric Principles
• Health Promotion and Disease Prevention
• Cardiovascular and Pulmonary Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal, Genitourinary, and Renal Disorders
• Musculoskeletal, Neurologic, and Mental Health Disorders
• Integumentary and Hematopoietic/Immune Disorders
• Pharmacotherapeutics and Polypharmacy
• Professional Practice, Ethics, and Health Care Policy
Introduction
The Barkley AGPCNP Certification Exam assesses the knowledge
and clinical reasoning skills essential for advanced practice
nursing in adult-gerontology primary care. It evaluates
competencies in assessment, diagnosis, planning, and evaluation
across the lifespan, with emphasis on older adults. The exam
employs multiple-choice and scenario-based questions to test
critical thinking and clinical decision-making. Emphasis is placed
on applying foundational theory to real-world patient
presentations, ensuring competence in diagnosing and managing
,complex disease processes. This assessment prepares candidates
for advanced clinical roles by reinforcing evidence-based practice,
cultural humility, and professional standards.
SECTION ONE: QUESTIONS 1–175
1. An 80-year-old man is brought to the clinic by his daughter,
who reports he has become more forgetful over the past
year and has had two falls. Which assessment tool is most
appropriate to screen for cognitive impairment in this age
group?
A. Mini-Mental State Examination (MMSE)
B. Montreal Cognitive Assessment (MoCA)
C. Mini-Cog
D. Clock-drawing test alone
Correct answer C. Mini-Cog
RATIONALE: The Mini-Cog (3-word recall plus clock drawing)
is quick, sensitive, and less influenced by education, making it
ideal for routine screening in older adults. The MoCA is more
sensitive for mild cognitive impairment but takes longer to
administer.
2. A 75-year-old woman reports difficulty managing her
finances, using public transportation, and shopping. These
deficits reflect impairment in which functional domain?
A. Basic activities of daily living (BADLs)
B. Instrumental activities of daily living (IADLs)
C. Advanced activities of daily living (AADLs)
D. Mobility
, Correct answer B. Instrumental activities of daily living
(IADLs)
RATIONALE: IADLs include tasks required for independent
community living: managing money, transportation, shopping,
meal preparation, and telephone use. BADLs include bathing,
dressing, toileting, and eating.
3. Which of the following is a normal age-related change in the
cardiovascular system?
A. Increased resting heart rate
B. Decreased left ventricular compliance
C. Increased maximum heart rate response to exercise
D. Increased baroreceptor sensitivity
Correct answer B. Decreased left ventricular compliance
RATIONALE: Aging causes stiffening of the ventricles and
arteries, leading to decreased compliance and diastolic
dysfunction. Resting heart rate is unchanged; maximum heart
rate and baroreceptor sensitivity decrease with age.
4. An 82-year-old is hospitalized for pneumonia. To prevent
hospital-acquired functional decline, the NP should prioritize:
A. Strict bed rest to conserve energy
B. Early mobilization and physical therapy consultation
C. Use of sedatives to ensure sleep
D. Placement of a urinary catheter to prevent falls en route to the
bathroom
Correct answer B. Early mobilization and physical therapy
consultation
, RATIONALE: Older adults decondition rapidly; early mobility
and minimizing tethers (catheters, IVs, restraints) are key to
preserving function and preventing hospital-acquired disability.
5. The most common cause of unintentional weight loss in
community-dwelling older adults is:
A. Malignancy
B. Depression
C. Malabsorption
D. Hyperthyroidism
Correct answer B. Depression
RATIONALE: Depression is the most frequent reversible cause
of significant weight loss in older adults, though malignancy must
be ruled out. Other causes include social isolation, medication
side effects, and dysphagia.
6. Which of the following is a component of the comprehensive
geriatric assessment (CGA) that is not typically part of a
standard adult history and physical?
A. Review of systems
B. Functional status evaluation (ADLs, IADLs)
C. Medication reconciliation
D. Vital signs
Correct answer B. Functional status evaluation (ADLs, IADLs)
RATIONALE: CGA uniquely focuses on functional, cognitive,
affective, and social domains, not just medical diagnosis. It
assesses ADLs, IADLs, gait, balance, cognition, mood, and social
support.
