Maria Leik AGNP Exam Study Guide
(2026/2027) -, Clinical Terms &
Answers for Adult-Gerontology NP
Board Exam Prep (PDF) | Verified
Maria Leik AGNP Exam Study Guide (2026/2027) |
Comprehensive Examination
Maria Leik AGNP Exam Study Guide (2026/2027) -, Clinical
Terms & Answers for Adult-Gerontology NP Board Exam
Prep (PDF) actual exam preparation document with verified
INTRODUCTION
This document is an important and very helpful preparation
resource for Maria Leik AGNP Exam Study Guide (2026/2027)
-, Clinical Terms & Answers for Adult-Gerontology NP Board
Exam Prep (PDF). Every item uses a focused exam stem, four
response options, a keyed response, and a clear rationale,
making it easier to understand the subject, spot distractors, and
build real exam confidence.
Page 1
, Question 1
Which finding best differentiates delirium from dementia in an older adult with
acute mental status change?
A. Insidious onset with progressive decline
B. Fluctuating level of consciousness and inattention
C. Preserved short-term memory with impaired long-term recall
D. Stable cognitive deficits over the past six months
Correct Answer: B - Fluctuating level of consciousness and
inattention
RATIONALE
Delirium is characterized by acute onset, fluctuating course, and
impaired attention, which are not typical of dementia. Dementia
typically has an insidious onset and progressive, stable decline without
fluctuating consciousness. The other options describe features of
dementia or are incorrect.
Question 2
A patient on warfarin for atrial fibrillation is prescribed
trimethoprim-sulfamethoxazole for a UTI. Which is the most appropriate
monitoring parameter?
A. Serum creatinine and potassium
B. INR within 3-5 days and dose adjustment
C. CBC with differential
D. Liver function tests
Correct Answer: B - INR within 3-5 days and dose adjustment
Page 2
, RATIONALE
Trimethoprim-sulfamethoxazole inhibits CYP2C9 and can potentiate
warfarin, increasing bleeding risk. Close INR monitoring and possible
warfarin dose reduction are essential. While renal function and
potassium may be affected, the primary concern is the drug interaction
on INR.
Question 3
Which spirometry pattern is expected in a patient with obesity and preserved
ratio impaired spirometry (PRISm)?
A. FEV1/FVC < 0.70, reduced FVC
B. FEV1/FVC 0.70, reduced FVC and FEV1
C. FEV1/FVC < 0.70, normal FVC
D. Normal FEV1/FVC and normal FVC
Correct Answer: B - FEV1/FVC 0.70, reduced FVC and FEV1
RATIONALE
PRISm is defined by a preserved FEV1/FVC ratio (0.70) with reduced
FEV1 and/or FVC, often seen in obesity due to restrictive physiology.
It is distinct from obstructive patterns where the ratio is <0.70. Normal
spirometry would not meet PRISm criteria.
Question 4
In an older adult with heart failure and reduced ejection fraction, which
medication class has the strongest evidence for reducing mortality?
A. Loop diuretics
B. ACE inhibitors
C. Beta-blockers (e.g., carvedilol, metoprolol succinate)
D. Digoxin
Correct Answer: C - Beta-blockers (e.g., carvedilol, metoprolol
succinate)
Page 3
, RATIONALE
Beta-blockers, specifically carvedilol, metoprolol succinate, and
bisoprolol, have robust evidence for reducing mortality in HFrEF.
ACE inhibitors also reduce mortality but beta-blockers are a
cornerstone. Diuretics improve symptoms but not mortality; digoxin
reduces hospitalizations but not mortality.
Question 5
Which statement accurately reflects the 2023 ADA Standards of Care for
hypertension in diabetes?
A. Target blood pressure is <150/90 mm Hg for all adults with diabetes.
B. ACE inhibitors or ARBs are first-line for hypertension in diabetes with
albuminuria.
C. Beta-blockers are preferred first-line agents for hypertension in
diabetes.
D. Thiazide diuretics are contraindicated in diabetes.
Correct Answer: B - ACE inhibitors or ARBs are first-line for
hypertension in diabetes with albuminuria.
RATIONALE
The ADA recommends ACE inhibitors or ARBs as first-line for
hypertension in patients with diabetes and albuminuria to slow kidney
disease progression. The target BP is <130/80 mm Hg for most.
Beta-blockers and thiazides are not first-line but can be used.
Question 6
A patient presents with sudden onset of severe unilateral headache, ptosis, and
miosis. Which is the most likely diagnosis?
A. Cluster headache
B. Migraine with aura
C. Tension headache
D. Temporal arteritis
Page 4
(2026/2027) -, Clinical Terms &
Answers for Adult-Gerontology NP
Board Exam Prep (PDF) | Verified
Maria Leik AGNP Exam Study Guide (2026/2027) |
Comprehensive Examination
Maria Leik AGNP Exam Study Guide (2026/2027) -, Clinical
Terms & Answers for Adult-Gerontology NP Board Exam
Prep (PDF) actual exam preparation document with verified
INTRODUCTION
This document is an important and very helpful preparation
resource for Maria Leik AGNP Exam Study Guide (2026/2027)
-, Clinical Terms & Answers for Adult-Gerontology NP Board
Exam Prep (PDF). Every item uses a focused exam stem, four
response options, a keyed response, and a clear rationale,
making it easier to understand the subject, spot distractors, and
build real exam confidence.
Page 1
, Question 1
Which finding best differentiates delirium from dementia in an older adult with
acute mental status change?
A. Insidious onset with progressive decline
B. Fluctuating level of consciousness and inattention
C. Preserved short-term memory with impaired long-term recall
D. Stable cognitive deficits over the past six months
Correct Answer: B - Fluctuating level of consciousness and
inattention
RATIONALE
Delirium is characterized by acute onset, fluctuating course, and
impaired attention, which are not typical of dementia. Dementia
typically has an insidious onset and progressive, stable decline without
fluctuating consciousness. The other options describe features of
dementia or are incorrect.
Question 2
A patient on warfarin for atrial fibrillation is prescribed
trimethoprim-sulfamethoxazole for a UTI. Which is the most appropriate
monitoring parameter?
A. Serum creatinine and potassium
B. INR within 3-5 days and dose adjustment
C. CBC with differential
D. Liver function tests
Correct Answer: B - INR within 3-5 days and dose adjustment
Page 2
, RATIONALE
Trimethoprim-sulfamethoxazole inhibits CYP2C9 and can potentiate
warfarin, increasing bleeding risk. Close INR monitoring and possible
warfarin dose reduction are essential. While renal function and
potassium may be affected, the primary concern is the drug interaction
on INR.
Question 3
Which spirometry pattern is expected in a patient with obesity and preserved
ratio impaired spirometry (PRISm)?
A. FEV1/FVC < 0.70, reduced FVC
B. FEV1/FVC 0.70, reduced FVC and FEV1
C. FEV1/FVC < 0.70, normal FVC
D. Normal FEV1/FVC and normal FVC
Correct Answer: B - FEV1/FVC 0.70, reduced FVC and FEV1
RATIONALE
PRISm is defined by a preserved FEV1/FVC ratio (0.70) with reduced
FEV1 and/or FVC, often seen in obesity due to restrictive physiology.
It is distinct from obstructive patterns where the ratio is <0.70. Normal
spirometry would not meet PRISm criteria.
Question 4
In an older adult with heart failure and reduced ejection fraction, which
medication class has the strongest evidence for reducing mortality?
A. Loop diuretics
B. ACE inhibitors
C. Beta-blockers (e.g., carvedilol, metoprolol succinate)
D. Digoxin
Correct Answer: C - Beta-blockers (e.g., carvedilol, metoprolol
succinate)
Page 3
, RATIONALE
Beta-blockers, specifically carvedilol, metoprolol succinate, and
bisoprolol, have robust evidence for reducing mortality in HFrEF.
ACE inhibitors also reduce mortality but beta-blockers are a
cornerstone. Diuretics improve symptoms but not mortality; digoxin
reduces hospitalizations but not mortality.
Question 5
Which statement accurately reflects the 2023 ADA Standards of Care for
hypertension in diabetes?
A. Target blood pressure is <150/90 mm Hg for all adults with diabetes.
B. ACE inhibitors or ARBs are first-line for hypertension in diabetes with
albuminuria.
C. Beta-blockers are preferred first-line agents for hypertension in
diabetes.
D. Thiazide diuretics are contraindicated in diabetes.
Correct Answer: B - ACE inhibitors or ARBs are first-line for
hypertension in diabetes with albuminuria.
RATIONALE
The ADA recommends ACE inhibitors or ARBs as first-line for
hypertension in patients with diabetes and albuminuria to slow kidney
disease progression. The target BP is <130/80 mm Hg for most.
Beta-blockers and thiazides are not first-line but can be used.
Question 6
A patient presents with sudden onset of severe unilateral headache, ptosis, and
miosis. Which is the most likely diagnosis?
A. Cluster headache
B. Migraine with aura
C. Tension headache
D. Temporal arteritis
Page 4
