AGPCNP BOARD FINAL EXAM PAPER 2025/2026 QUESTIONS WITH
SOLUTIONS GRADED A+
✔✔most common inflammatory eye disorder with itching, burning, increases tearing,
blurred vision (possible), sensation of foreign body in the eye which may be caused by
allergies, chemical irritation, bacterial, viral or gonococcal/chlamydial infection -
✔✔conjunctivitis (pink-eye)
✔✔results from an increased intraocular pressure - ✔✔glaucoma
✔✔acute increase in IOP, opthalmic emergency - ✔✔closed-angle glaucoma
✔✔a patient who presents with extreme eye pain, blurred vision, pupils that are dilated
or fixed and HALOS AROUND LIGHTS should be: - ✔✔referred to opthlamology for
emergent suspicion of closed-angel glaucoma
✔✔screening for glaucoma should begin at age - ✔✔40
✔✔results from clouding and opacification of the normally clear lens of the eye -
✔✔cataracts
✔✔highest cause of treatable blindness is: - ✔✔cataracts
✔✔most common surgical procedure in patients 65+ - ✔✔cataract surgery
✔✔a patient presents with painless, clouded or dim vision with halos around lights, no
red reflex and DIPLOPIA IN A SINGLE EYE would be suspected of - ✔✔cataract
✔✔floaters in the eye is the most concerning symptom for: - ✔✔retinal detachment
✔✔the most important diagnostic indicator in the evaluation of headache is: -
✔✔chronology
✔✔patient describes a "vise-like", generalized headache that is more intense about his
neck and back of head. The most probable diagnosis is: - ✔✔tension headache
✔✔duration of tension headaches are usually: - ✔✔no more than a few hours
✔✔management of tension headache include: - ✔✔OTC analgesics and relaxation
✔✔the pathophysiology of most migraines is: - ✔✔a result of dilation and excessive
pulsation of the external carotid artery
,✔✔migraine's typically last: - ✔✔at least 2 but no more than 72 hours
✔✔migraines without aura are classified as: - ✔✔common migraine
✔✔migraines with aura are classified as: - ✔✔classic migraine
✔✔migraine headaches, which affect females > males can commonly be triggered by
this inciting event in women: - ✔✔hormonal changes seen with onset of the menstrual
cycle
✔✔patient reports a unilateral throbbing headache that occurs episodically. she states
reports "seeing stars" and some weakness. she has no history of migraines. the
appropriate first step is: - ✔✔all patients with new migraines must be worked up to R/O
organic causes of disease. the provider should order:
CBC
CMP
VDRL
ESR
CT scan
✔✔the priority management of chronic migraine includes: - ✔✔1. avoidance of triggers
2. relaxation / stress avoidance
3. prophylactic daily therapy if attacks occur more than 2-3 times per month
✔✔if amitriptyline (Elavil) is being used for migraine prophylaxis, the provider knows to
monitor for: - ✔✔prolongation of the QT interval which is a BLACK BOX warning on all
tricyclics
✔✔abortive therapy for migraines include: - ✔✔sumatriptan 6mg sub-q, repeated every
other to max of 3 doses OR
sumatriptan 25 mg PO an onset
✔✔a patient presents with unilateral periorbital pain with no prior history of migraine. the
most likely diagnosis is: - ✔✔cluster headache
✔✔abortive therapy for cluster headache - ✔✔usually includes sumatriptan and 100%
O2
✔✔for which two headache types is sumitriptan indicated: - ✔✔cluster and migraine
✔✔patient presents with hx of diagnosed parkinson's and onset of tremors that had
previously been controlled. which medication should the NP add: - ✔✔an anticholinergic
to help alleviate the tremor, e.g. trihexyphenidyl (Artane)
, ✔✔on physical exam a patient who has a positive glabellar reflex when repetitively
tapped over the bridge of the nose is illiciting what sign? name the sign and the
commonly associated clinical condition - ✔✔myerson's sign (blinks in response to tap
on the nose) which is suggestive of parkinsons
✔✔the classic triad of parkinson's is represented by what clinical symptoms: -
✔✔tremor
rigidity
bradykinesia
✔✔contraction of the facial muscles when the facial nerve (VII) is tapped briskly in front
of the ear is termed:
what does the condition result from - ✔✔chvostek's sign usually resulting from low
calcium
✔✔the group with the highest prevalence of cluster headaches are: - ✔✔middle-aged
men
✔✔name the two most common types of dementia in order of prevalence: -
✔✔Alzheimer's disease
Vascular Dementia
✔✔first line agents for migraine prophylaxis include: - ✔✔propranolol (Inderal)
amitriptyline (Elavil)
sodium valproate
topiramate
✔✔the gag reflex is a function of which cranial nerve - ✔✔X - the vagus nerve. the gag
reflex evaluates nasopharyngeal sensation
✔✔acute onset of headaches behind one eye with eye pain, autonomic s/sx with hazy
cornea or partial dilation of the affected pupil: - ✔✔acute/narrow angle-close glaucoma
requiring referral to ED
✔✔a patient who demonstrates resistance to a flex hip (or back pain) that is attempted
to be straightened while keeping the hip flexed shows: - ✔✔positive kernig's sign
indicative of inflammation on lumbar nerve roots which may indicate menigeal irritation
✔✔patient reflexes the hips and knee to relieve pressure when the provider flexes the
patients head toward the chest - ✔✔positive brudzinski's sign indicative of menigeal
irritation
SOLUTIONS GRADED A+
✔✔most common inflammatory eye disorder with itching, burning, increases tearing,
blurred vision (possible), sensation of foreign body in the eye which may be caused by
allergies, chemical irritation, bacterial, viral or gonococcal/chlamydial infection -
✔✔conjunctivitis (pink-eye)
✔✔results from an increased intraocular pressure - ✔✔glaucoma
✔✔acute increase in IOP, opthalmic emergency - ✔✔closed-angle glaucoma
✔✔a patient who presents with extreme eye pain, blurred vision, pupils that are dilated
or fixed and HALOS AROUND LIGHTS should be: - ✔✔referred to opthlamology for
emergent suspicion of closed-angel glaucoma
✔✔screening for glaucoma should begin at age - ✔✔40
✔✔results from clouding and opacification of the normally clear lens of the eye -
✔✔cataracts
✔✔highest cause of treatable blindness is: - ✔✔cataracts
✔✔most common surgical procedure in patients 65+ - ✔✔cataract surgery
✔✔a patient presents with painless, clouded or dim vision with halos around lights, no
red reflex and DIPLOPIA IN A SINGLE EYE would be suspected of - ✔✔cataract
✔✔floaters in the eye is the most concerning symptom for: - ✔✔retinal detachment
✔✔the most important diagnostic indicator in the evaluation of headache is: -
✔✔chronology
✔✔patient describes a "vise-like", generalized headache that is more intense about his
neck and back of head. The most probable diagnosis is: - ✔✔tension headache
✔✔duration of tension headaches are usually: - ✔✔no more than a few hours
✔✔management of tension headache include: - ✔✔OTC analgesics and relaxation
✔✔the pathophysiology of most migraines is: - ✔✔a result of dilation and excessive
pulsation of the external carotid artery
,✔✔migraine's typically last: - ✔✔at least 2 but no more than 72 hours
✔✔migraines without aura are classified as: - ✔✔common migraine
✔✔migraines with aura are classified as: - ✔✔classic migraine
✔✔migraine headaches, which affect females > males can commonly be triggered by
this inciting event in women: - ✔✔hormonal changes seen with onset of the menstrual
cycle
✔✔patient reports a unilateral throbbing headache that occurs episodically. she states
reports "seeing stars" and some weakness. she has no history of migraines. the
appropriate first step is: - ✔✔all patients with new migraines must be worked up to R/O
organic causes of disease. the provider should order:
CBC
CMP
VDRL
ESR
CT scan
✔✔the priority management of chronic migraine includes: - ✔✔1. avoidance of triggers
2. relaxation / stress avoidance
3. prophylactic daily therapy if attacks occur more than 2-3 times per month
✔✔if amitriptyline (Elavil) is being used for migraine prophylaxis, the provider knows to
monitor for: - ✔✔prolongation of the QT interval which is a BLACK BOX warning on all
tricyclics
✔✔abortive therapy for migraines include: - ✔✔sumatriptan 6mg sub-q, repeated every
other to max of 3 doses OR
sumatriptan 25 mg PO an onset
✔✔a patient presents with unilateral periorbital pain with no prior history of migraine. the
most likely diagnosis is: - ✔✔cluster headache
✔✔abortive therapy for cluster headache - ✔✔usually includes sumatriptan and 100%
O2
✔✔for which two headache types is sumitriptan indicated: - ✔✔cluster and migraine
✔✔patient presents with hx of diagnosed parkinson's and onset of tremors that had
previously been controlled. which medication should the NP add: - ✔✔an anticholinergic
to help alleviate the tremor, e.g. trihexyphenidyl (Artane)
, ✔✔on physical exam a patient who has a positive glabellar reflex when repetitively
tapped over the bridge of the nose is illiciting what sign? name the sign and the
commonly associated clinical condition - ✔✔myerson's sign (blinks in response to tap
on the nose) which is suggestive of parkinsons
✔✔the classic triad of parkinson's is represented by what clinical symptoms: -
✔✔tremor
rigidity
bradykinesia
✔✔contraction of the facial muscles when the facial nerve (VII) is tapped briskly in front
of the ear is termed:
what does the condition result from - ✔✔chvostek's sign usually resulting from low
calcium
✔✔the group with the highest prevalence of cluster headaches are: - ✔✔middle-aged
men
✔✔name the two most common types of dementia in order of prevalence: -
✔✔Alzheimer's disease
Vascular Dementia
✔✔first line agents for migraine prophylaxis include: - ✔✔propranolol (Inderal)
amitriptyline (Elavil)
sodium valproate
topiramate
✔✔the gag reflex is a function of which cranial nerve - ✔✔X - the vagus nerve. the gag
reflex evaluates nasopharyngeal sensation
✔✔acute onset of headaches behind one eye with eye pain, autonomic s/sx with hazy
cornea or partial dilation of the affected pupil: - ✔✔acute/narrow angle-close glaucoma
requiring referral to ED
✔✔a patient who demonstrates resistance to a flex hip (or back pain) that is attempted
to be straightened while keeping the hip flexed shows: - ✔✔positive kernig's sign
indicative of inflammation on lumbar nerve roots which may indicate menigeal irritation
✔✔patient reflexes the hips and knee to relieve pressure when the provider flexes the
patients head toward the chest - ✔✔positive brudzinski's sign indicative of menigeal
irritation
