Page |1
AANP AGPCNP PSI Exam 1 & 2 – Comprehensive Practice Questions | 130
Questions with Detailed Rationales
Content Areas: Cardiovascular, Respiratory, Endocrine,
Hematology/Oncology, Musculoskeletal, Neurology,
Integument, Gastrointestinal, Genitourinary, Reproductive,
Mental Health, Infectious Disease, Health Promotion,
Professional Role
SECTION 1: CARDIOVASCULAR (Questions)
Question 1
A 65-year-old Black male with hypertension and no other
comorbid conditions asks about first-line antihypertensive
therapy. Which medication should the NP prescribe?
A. Lisinopril
B. Amlodipine
C. Thiazide diuretic
D. Both B or C are appropriate first-line
Answer: D
Rationale: According to JNC 8/ACC/AHA guidelines, first-line
agents include thiazide diuretics, calcium channel blockers
(CCBs), ACE inhibitors, or ARBs. For Black patients, thiazides and
, Page |2
CCBs are often preferred, but ACEIs/ARBs may be used if
compelling indications exist.
Question 2
A 72-year-old female with atrial fibrillation has HTN and
diabetes. What is her CHA₂DS₂-VASc score?
A. 2
B. 3
C. 4
D. 5
Answer: D
Rationale: Female (1) + age ≥75 (2) + HTN (1) + diabetes (1) = 5.
Score ≥2 in men or ≥3 in women indicates anticoagulation.
Question 3
A patient with heart failure presents with dyspnea, orthopnea,
and an S3 gallop. Which type of heart failure is most likely?
A. Heart failure with preserved ejection fraction (HFpEF)
B. Heart failure with reduced ejection fraction (HFrEF)
C. Right-sided heart failure only
D. High-output heart failure
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Answer: B
Rationale: S3 gallop and symptoms of left-sided heart failure
suggest reduced ejection fraction (HFrEF).
Question 4
Which patient should be screened for abdominal aortic
aneurysm (AAA)?
A. 50-year-old female smoker
B. 65-year-old male with a history of smoking
C. 70-year-old never-smoker female
D. 40-year-old male with HTN
Answer: B
Rationale: USPSTF recommends one-time ultrasound screening
for AAA in men ages 65–75 who have ever smoked.
Question 5
First-line treatment for HFrEF includes which medication class?
A. Calcium channel blockers
B. ACE inhibitors or ARNI
C. NSAIDs
D. Metformin
, Page |4
Answer: B
Rationale: Guideline-directed medical therapy for HFrEF
includes ACE inhibitors/ARBs or ARNI (sacubitril-valsartan),
beta-blockers, mineralocorticoid receptor antagonists, and
SGLT2 inhibitors.
Question 6
Which patient should be offered a statin for primary prevention
based on ASCVD risk?
A. 45-year-old with LDL 120 and 10-year ASCVD risk 5%
B. 60-year-old with HTN and 10-year ASCVD risk 8%
C. 50-year-old with diabetes
D. B and C
Answer: D
Rationale: Statins are recommended for primary prevention if
10-year ASCVD risk ≥7.5%, or if diabetes is present (ages 40–75
with LDL ≥70). Diabetes is a high-risk condition.
Question 7
An ABI of 0.7 indicates:
A. Normal arterial flow
B. Peripheral arterial disease
AANP AGPCNP PSI Exam 1 & 2 – Comprehensive Practice Questions | 130
Questions with Detailed Rationales
Content Areas: Cardiovascular, Respiratory, Endocrine,
Hematology/Oncology, Musculoskeletal, Neurology,
Integument, Gastrointestinal, Genitourinary, Reproductive,
Mental Health, Infectious Disease, Health Promotion,
Professional Role
SECTION 1: CARDIOVASCULAR (Questions)
Question 1
A 65-year-old Black male with hypertension and no other
comorbid conditions asks about first-line antihypertensive
therapy. Which medication should the NP prescribe?
A. Lisinopril
B. Amlodipine
C. Thiazide diuretic
D. Both B or C are appropriate first-line
Answer: D
Rationale: According to JNC 8/ACC/AHA guidelines, first-line
agents include thiazide diuretics, calcium channel blockers
(CCBs), ACE inhibitors, or ARBs. For Black patients, thiazides and
, Page |2
CCBs are often preferred, but ACEIs/ARBs may be used if
compelling indications exist.
Question 2
A 72-year-old female with atrial fibrillation has HTN and
diabetes. What is her CHA₂DS₂-VASc score?
A. 2
B. 3
C. 4
D. 5
Answer: D
Rationale: Female (1) + age ≥75 (2) + HTN (1) + diabetes (1) = 5.
Score ≥2 in men or ≥3 in women indicates anticoagulation.
Question 3
A patient with heart failure presents with dyspnea, orthopnea,
and an S3 gallop. Which type of heart failure is most likely?
A. Heart failure with preserved ejection fraction (HFpEF)
B. Heart failure with reduced ejection fraction (HFrEF)
C. Right-sided heart failure only
D. High-output heart failure
, Page |3
Answer: B
Rationale: S3 gallop and symptoms of left-sided heart failure
suggest reduced ejection fraction (HFrEF).
Question 4
Which patient should be screened for abdominal aortic
aneurysm (AAA)?
A. 50-year-old female smoker
B. 65-year-old male with a history of smoking
C. 70-year-old never-smoker female
D. 40-year-old male with HTN
Answer: B
Rationale: USPSTF recommends one-time ultrasound screening
for AAA in men ages 65–75 who have ever smoked.
Question 5
First-line treatment for HFrEF includes which medication class?
A. Calcium channel blockers
B. ACE inhibitors or ARNI
C. NSAIDs
D. Metformin
, Page |4
Answer: B
Rationale: Guideline-directed medical therapy for HFrEF
includes ACE inhibitors/ARBs or ARNI (sacubitril-valsartan),
beta-blockers, mineralocorticoid receptor antagonists, and
SGLT2 inhibitors.
Question 6
Which patient should be offered a statin for primary prevention
based on ASCVD risk?
A. 45-year-old with LDL 120 and 10-year ASCVD risk 5%
B. 60-year-old with HTN and 10-year ASCVD risk 8%
C. 50-year-old with diabetes
D. B and C
Answer: D
Rationale: Statins are recommended for primary prevention if
10-year ASCVD risk ≥7.5%, or if diabetes is present (ages 40–75
with LDL ≥70). Diabetes is a high-risk condition.
Question 7
An ABI of 0.7 indicates:
A. Normal arterial flow
B. Peripheral arterial disease
