AGACNP EXAM 2025|ACTUAL EXAM QUESTIONS WITH
COMPREHENSIVE ANSWERS AND DETAILED
ANSWERS|EXPERT VERIFIED FOR GUARANTEED
PASS|LATEST UPDATE
1.
A 52-year-old post-operative day (POD) 2 patient develops a fever of 38.3°C (101°F). He is
hemodynamically stable with no obvious source of infection on exam. What is the best initial
management?
A. Start broad-spectrum IV antibiotics
B. Obtain a wound culture and start vancomycin
C. Provide supportive fluids and acetaminophen
D. Schedule immediate surgical exploration
Answer: C. Provide supportive fluids and acetaminophen
Rationale: Early post-op fever without clear source is often inflammatory or mild infection;
initial approach is hydration, antipyretics, and observation unless new focal findings appear.
2.
When managing a patient with a suspected surgical site infection (SSI), which organism is most
commonly implicated?
A. Pseudomonas aeruginosa
B. Staphylococcus aureus
C. Escherichia coli
D. Klebsiella pneumoniae
Answer: B. Staphylococcus aureus
Rationale: S. aureus is the most common pathogen in wound infections (SSIs).
3.
A patient on POD 3 after an abdominal surgery has a fever of 39°C (102.2°F) and a red, tender
surgical incision. Which initial investigation is most appropriate?
A. CT scan of the abdomen
B. Probe the wound for dehiscence and obtain a wound culture
C. Start piperacillin-tazobactam IV immediately
D. Check for peripheral IV infiltration
Answer: B. Probe the wound for dehiscence and obtain a wound culture
Rationale: Evaluating the wound directly and obtaining a culture is crucial to identify the
pathogen before initiating targeted antibiotic therapy.
,4.
A patient has persistent fever 48 hours after admission for pneumonia. Blood cultures are
pending. What is the most appropriate action at this point?
A. Escalate antibiotics immediately
B. Obtain further imaging or cultures based on clinical suspicion
C. Stop all antibiotics to prevent resistance
D. Switch to narrow-spectrum antibiotics
Answer: B. Obtain further imaging or cultures based on clinical suspicion
Rationale: Persistent fever may indicate complications or alternative infection sites (e.g.,
abscess). Additional, targeted diagnostic workup is warranted.
5.
An elderly patient in a skilled nursing facility has had a fever of unknown origin (FUO) for three
weeks. Workup has been unrevealing thus far. Which statement best reflects standard
management?
A. Empirically treat with antibiotics
B. Perform invasive surgical biopsy immediately
C. Continue workup without empirical therapy until a diagnosis is confirmed
D. Prescribe high-dose corticosteroids
Answer: C. Continue workup without empirical therapy until a diagnosis is confirmed
Rationale: In true FUO, avoid “shotgun” therapies that may mask the underlying cause; keep
searching for the definitive diagnosis.
6.
Which is not a recognized cause of postoperative fever as described by the “Wind, Water,
Wound, Walking, Wonder drugs” mnemonic?
A. Atelectasis (Wind)
B. Catheter infection (Water)
C. Deep vein thrombosis (Walking)
D. Hyperglycemia (Wonder drugs)
Answer: D. Hyperglycemia (Wonder drugs)
Rationale: Wonder drugs typically refer to medication-related fever, not hyperglycemia.
Hyperglycemia can be a complication but is not one of the classic “W’s.”
7.
A patient develops a fever and chills one week after a central venous catheter was placed. What
is the most appropriate initial step?
A. Remove the catheter and culture the tip
,B. Start vancomycin
C. Flush the catheter with saline
D. Order a transesophageal echocardiogram
Answer: A. Remove the catheter and culture the tip
Rationale: If a central line infection is suspected, the line should be removed and sent for
culture. Empiric antibiotics can follow if indicated.
8.
Which of the following most strongly suggests a central line-associated bloodstream infection
(CLABSI) rather than pneumonia as a cause for a patient’s fever?
A. Productive cough with sputum
B. Infiltrate on chest X-ray
C. Erythema around the catheter insertion site
D. Mild leukocytosis
Answer: C. Erythema around the catheter insertion site
Rationale: Signs of infection at the catheter site (redness, tenderness, purulent drainage) point
toward a catheter-related infection rather than pneumonia.
9.
A 40-year-old POD 2 patient experiences new-onset confusion and fever. The surgical incision
looks clean; no respiratory findings. Which other area is most important to evaluate next for a
potential infection source?
A. Look for signs of deep vein thrombosis
B. Look at intravenous catheters and drains
C. Order an ECG for arrhythmias
D. Assess medication list for possible side effects
Answer: B. Look at intravenous catheters and drains
Rationale: In acute confusional states with fever, check for line infections, urinary catheters, or
other invasive device issues.
10.
A diabetic patient with poor glycemic control is POD 3 after foot surgery. She has fever,
tachycardia, and the surgical site appears erythematous with purulent discharge. The best next
step is:
A. Start broad-spectrum IV antibiotics and obtain wound cultures
B. Increase IV fluids only
C. Give acetaminophen and observe
D. Remove external sutures/staples to let the wound drain, then culture
, Answer: D. Remove external sutures/staples to let the wound drain, then culture
Rationale: For an obviously infected wound, open it to drain the abscess or infected fluid, obtain
cultures, and begin targeted antibiotic therapy.
11.
A 25-year-old experiences unilateral throbbing headaches that last for hours and are preceded by
an aura (visual changes). Which abortive therapy is first-line?
A. High-flow oxygen
B. Acetaminophen alone
C. Subcutaneous sumatriptan
D. IV morphine
Answer: C. Subcutaneous sumatriptan
Rationale: Migraine with aura often responds best to triptans at onset.
12.
A 40-year-old male has severe unilateral periorbital headaches, lacrimation, and nasal congestion
that occur in clusters for several weeks at a time. What is the best acute treatment?
A. 100% oxygen via non-rebreather mask
B. Oral sumatriptan 25 mg
C. Acetaminophen
D. Verapamil
Answer: A. 100% oxygen via non-rebreather mask
Rationale: Cluster headaches are acutely treated with high-flow oxygen. SubQ or intranasal
sumatriptan is also effective, but oxygen is usually first-line.
13.
A 30-year-old with “tight band-like” headaches around the forehead denies photophobia or
phonophobia. Neurological exam is normal. What is the most appropriate management?
A. MRI of the brain
B. High-dose opioid therapy
C. NSAIDs or acetaminophen plus stress management
D. Urgent lumbar puncture
Answer: C. NSAIDs or acetaminophen plus stress management
Rationale: Tension-type headaches typically respond to simple analgesics and relaxation
techniques.
14.
COMPREHENSIVE ANSWERS AND DETAILED
ANSWERS|EXPERT VERIFIED FOR GUARANTEED
PASS|LATEST UPDATE
1.
A 52-year-old post-operative day (POD) 2 patient develops a fever of 38.3°C (101°F). He is
hemodynamically stable with no obvious source of infection on exam. What is the best initial
management?
A. Start broad-spectrum IV antibiotics
B. Obtain a wound culture and start vancomycin
C. Provide supportive fluids and acetaminophen
D. Schedule immediate surgical exploration
Answer: C. Provide supportive fluids and acetaminophen
Rationale: Early post-op fever without clear source is often inflammatory or mild infection;
initial approach is hydration, antipyretics, and observation unless new focal findings appear.
2.
When managing a patient with a suspected surgical site infection (SSI), which organism is most
commonly implicated?
A. Pseudomonas aeruginosa
B. Staphylococcus aureus
C. Escherichia coli
D. Klebsiella pneumoniae
Answer: B. Staphylococcus aureus
Rationale: S. aureus is the most common pathogen in wound infections (SSIs).
3.
A patient on POD 3 after an abdominal surgery has a fever of 39°C (102.2°F) and a red, tender
surgical incision. Which initial investigation is most appropriate?
A. CT scan of the abdomen
B. Probe the wound for dehiscence and obtain a wound culture
C. Start piperacillin-tazobactam IV immediately
D. Check for peripheral IV infiltration
Answer: B. Probe the wound for dehiscence and obtain a wound culture
Rationale: Evaluating the wound directly and obtaining a culture is crucial to identify the
pathogen before initiating targeted antibiotic therapy.
,4.
A patient has persistent fever 48 hours after admission for pneumonia. Blood cultures are
pending. What is the most appropriate action at this point?
A. Escalate antibiotics immediately
B. Obtain further imaging or cultures based on clinical suspicion
C. Stop all antibiotics to prevent resistance
D. Switch to narrow-spectrum antibiotics
Answer: B. Obtain further imaging or cultures based on clinical suspicion
Rationale: Persistent fever may indicate complications or alternative infection sites (e.g.,
abscess). Additional, targeted diagnostic workup is warranted.
5.
An elderly patient in a skilled nursing facility has had a fever of unknown origin (FUO) for three
weeks. Workup has been unrevealing thus far. Which statement best reflects standard
management?
A. Empirically treat with antibiotics
B. Perform invasive surgical biopsy immediately
C. Continue workup without empirical therapy until a diagnosis is confirmed
D. Prescribe high-dose corticosteroids
Answer: C. Continue workup without empirical therapy until a diagnosis is confirmed
Rationale: In true FUO, avoid “shotgun” therapies that may mask the underlying cause; keep
searching for the definitive diagnosis.
6.
Which is not a recognized cause of postoperative fever as described by the “Wind, Water,
Wound, Walking, Wonder drugs” mnemonic?
A. Atelectasis (Wind)
B. Catheter infection (Water)
C. Deep vein thrombosis (Walking)
D. Hyperglycemia (Wonder drugs)
Answer: D. Hyperglycemia (Wonder drugs)
Rationale: Wonder drugs typically refer to medication-related fever, not hyperglycemia.
Hyperglycemia can be a complication but is not one of the classic “W’s.”
7.
A patient develops a fever and chills one week after a central venous catheter was placed. What
is the most appropriate initial step?
A. Remove the catheter and culture the tip
,B. Start vancomycin
C. Flush the catheter with saline
D. Order a transesophageal echocardiogram
Answer: A. Remove the catheter and culture the tip
Rationale: If a central line infection is suspected, the line should be removed and sent for
culture. Empiric antibiotics can follow if indicated.
8.
Which of the following most strongly suggests a central line-associated bloodstream infection
(CLABSI) rather than pneumonia as a cause for a patient’s fever?
A. Productive cough with sputum
B. Infiltrate on chest X-ray
C. Erythema around the catheter insertion site
D. Mild leukocytosis
Answer: C. Erythema around the catheter insertion site
Rationale: Signs of infection at the catheter site (redness, tenderness, purulent drainage) point
toward a catheter-related infection rather than pneumonia.
9.
A 40-year-old POD 2 patient experiences new-onset confusion and fever. The surgical incision
looks clean; no respiratory findings. Which other area is most important to evaluate next for a
potential infection source?
A. Look for signs of deep vein thrombosis
B. Look at intravenous catheters and drains
C. Order an ECG for arrhythmias
D. Assess medication list for possible side effects
Answer: B. Look at intravenous catheters and drains
Rationale: In acute confusional states with fever, check for line infections, urinary catheters, or
other invasive device issues.
10.
A diabetic patient with poor glycemic control is POD 3 after foot surgery. She has fever,
tachycardia, and the surgical site appears erythematous with purulent discharge. The best next
step is:
A. Start broad-spectrum IV antibiotics and obtain wound cultures
B. Increase IV fluids only
C. Give acetaminophen and observe
D. Remove external sutures/staples to let the wound drain, then culture
, Answer: D. Remove external sutures/staples to let the wound drain, then culture
Rationale: For an obviously infected wound, open it to drain the abscess or infected fluid, obtain
cultures, and begin targeted antibiotic therapy.
11.
A 25-year-old experiences unilateral throbbing headaches that last for hours and are preceded by
an aura (visual changes). Which abortive therapy is first-line?
A. High-flow oxygen
B. Acetaminophen alone
C. Subcutaneous sumatriptan
D. IV morphine
Answer: C. Subcutaneous sumatriptan
Rationale: Migraine with aura often responds best to triptans at onset.
12.
A 40-year-old male has severe unilateral periorbital headaches, lacrimation, and nasal congestion
that occur in clusters for several weeks at a time. What is the best acute treatment?
A. 100% oxygen via non-rebreather mask
B. Oral sumatriptan 25 mg
C. Acetaminophen
D. Verapamil
Answer: A. 100% oxygen via non-rebreather mask
Rationale: Cluster headaches are acutely treated with high-flow oxygen. SubQ or intranasal
sumatriptan is also effective, but oxygen is usually first-line.
13.
A 30-year-old with “tight band-like” headaches around the forehead denies photophobia or
phonophobia. Neurological exam is normal. What is the most appropriate management?
A. MRI of the brain
B. High-dose opioid therapy
C. NSAIDs or acetaminophen plus stress management
D. Urgent lumbar puncture
Answer: C. NSAIDs or acetaminophen plus stress management
Rationale: Tension-type headaches typically respond to simple analgesics and relaxation
techniques.
14.
