AGPCNP-BC Practice Exam –NAPLEX
Comprehensive Review
1. A 68-year-old male with a history of hypertension presents with sudden-
onset left-sided weakness and slurred speech. What is the most appropriate
initial action?
A. Obtain a CT scan of the head
B. Call 911 and refer to the emergency department immediately
C. Order aspirin 325 mg orally
D. Perform carotid ultrasound in the office
Rationale: This presentation is consistent with a possible stroke. Time-sensitive
intervention is crucial, and emergent referral is indicated.
2. A 75-year-old female presents with nocturia, urgency, and dysuria. Urinalysis
reveals positive nitrites and leukocyte esterase. What is the most likely
diagnosis?
A. Vaginitis
B. Urinary tract infection (UTI)
C. Interstitial cystitis
D. Bladder cancer
,Rationale: Nitrites and leukocyte esterase are indicators of a bacterial UTI,
common in elderly females.
3. Which of the following vaccines is recommended annually for adults over 65
years of age?
A. Pneumococcal conjugate vaccine
B. Herpes zoster vaccine
C. Influenza vaccine
D. Tdap booster
Rationale: Annual influenza vaccination is recommended for all adults over 65
due to increased risk of complications.
4. A patient has an A1C of 8.2%. What is the most appropriate intervention?
A. Continue current regimen
B. Increase exercise alone
C. Modify or intensify diabetes treatment plan
D. Discontinue metformin
Rationale: An A1C of 8.2% indicates suboptimal glycemic control and requires
adjustment in management.
5. Which of the following is the most appropriate screening tool for depression
in older adults?
, A. PHQ-2
B. Beck Depression Inventory
C. Geriatric Depression Scale (GDS)
D. Zung Self-Rating Depression Scale
Rationale: The GDS is validated specifically for use in older adults.
6. Which medication should be avoided in the elderly due to the risk of
anticholinergic side effects?
A. Lisinopril
B. Diphenhydramine
C. Metformin
D. Atorvastatin
Rationale: Diphenhydramine has strong anticholinergic properties and is on the
Beers Criteria list of potentially inappropriate medications in older adults.
7. What is the USPSTF recommendation for colon cancer screening in average-
risk adults?
A. Start at age 40
B. No screening after age 65
C. Begin at age 45 and continue until age 75
D. Begin at age 55 and continue until age 85
Rationale: The USPSTF recommends screening for colorectal cancer from ages 45
to 75.
Comprehensive Review
1. A 68-year-old male with a history of hypertension presents with sudden-
onset left-sided weakness and slurred speech. What is the most appropriate
initial action?
A. Obtain a CT scan of the head
B. Call 911 and refer to the emergency department immediately
C. Order aspirin 325 mg orally
D. Perform carotid ultrasound in the office
Rationale: This presentation is consistent with a possible stroke. Time-sensitive
intervention is crucial, and emergent referral is indicated.
2. A 75-year-old female presents with nocturia, urgency, and dysuria. Urinalysis
reveals positive nitrites and leukocyte esterase. What is the most likely
diagnosis?
A. Vaginitis
B. Urinary tract infection (UTI)
C. Interstitial cystitis
D. Bladder cancer
,Rationale: Nitrites and leukocyte esterase are indicators of a bacterial UTI,
common in elderly females.
3. Which of the following vaccines is recommended annually for adults over 65
years of age?
A. Pneumococcal conjugate vaccine
B. Herpes zoster vaccine
C. Influenza vaccine
D. Tdap booster
Rationale: Annual influenza vaccination is recommended for all adults over 65
due to increased risk of complications.
4. A patient has an A1C of 8.2%. What is the most appropriate intervention?
A. Continue current regimen
B. Increase exercise alone
C. Modify or intensify diabetes treatment plan
D. Discontinue metformin
Rationale: An A1C of 8.2% indicates suboptimal glycemic control and requires
adjustment in management.
5. Which of the following is the most appropriate screening tool for depression
in older adults?
, A. PHQ-2
B. Beck Depression Inventory
C. Geriatric Depression Scale (GDS)
D. Zung Self-Rating Depression Scale
Rationale: The GDS is validated specifically for use in older adults.
6. Which medication should be avoided in the elderly due to the risk of
anticholinergic side effects?
A. Lisinopril
B. Diphenhydramine
C. Metformin
D. Atorvastatin
Rationale: Diphenhydramine has strong anticholinergic properties and is on the
Beers Criteria list of potentially inappropriate medications in older adults.
7. What is the USPSTF recommendation for colon cancer screening in average-
risk adults?
A. Start at age 40
B. No screening after age 65
C. Begin at age 45 and continue until age 75
D. Begin at age 55 and continue until age 85
Rationale: The USPSTF recommends screening for colorectal cancer from ages 45
to 75.
