BARKLEY AGACNP DIAGNOSTIC READINESS TEST QUESTIONS AND ANSWERS ALREADY GRADED A+| 100%
VERIFIED SOLUTIONS………...
Core Domains:
Acute and Critical Care Assessment and Differential Diagnosis
Advanced Pharmacology and Prescriptive Authority in Acute Care
Pathophysiology and Disease Management in Acutely Ill Adults
Evidence-Based Practice and Clinical Guidelines for Acute Care
Hemodynamic Monitoring and Management
Ethical, Legal, and Regulatory Standards in Acute Care Practice
Invasive Procedures and Advanced Technical Skills
Multisystem Organ Failure and Complex Case Management
End-of-Life Care and Palliative Medicine
Introduction:
This Adult-Gerontology Acute Care Nurse Practitioner Diagnostic Readiness Test is a comprehensive assessment
designed to evaluate the candidate's clinical competence and readiness for certification examination. The exam
measures advanced diagnostic reasoning, pharmacologic knowledge, and the ability to apply evidence-based
guidelines in the care of critically and acutely ill adults and older adults. The structure includes multiple-choice
questions that test foundational theory, regulatory compliance, ethical decision-making, and critical thinking. Each
,question emphasizes real-world application, challenging the test-taker to synthesize complex information,
prioritize interventions, and make sound clinical judgments. Success on this examination indicates mastery of the
core competencies required for safe, effective, and independent practice as an Adult-Gerontology Acute Care Nurse
Practitioner.
SECTION ONE: QUESTIONS 1–100
1. A 74-year-old male with a history of heart failure is admitted to the ICU with acute respiratory distress. His
blood pressure is 90/55 mmHg, heart rate is 125 bpm, and oxygen saturation is 85% on 4 L nasal cannula. An
arterial blood gas shows pH 7.22, PaCO2 58 mmHg, and PaO2 52 mmHg. Which of the following is the most
appropriate next step in management?
A. Increase oxygen to 6 L via nasal cannula
B. Initiate non-invasive positive pressure ventilation (NIPPV)
C. Intubate and initiate mechanical ventilation
D. Administer IV furosemide
🟢 C. Intubate and initiate mechanical ventilation
🔴 RATIONALE: This patient has acute respiratory failure with hypercapnia (PaCO2 58) and hypoxemia (PaO2 52)
with signs of impending respiratory failure and hemodynamic instability. Intubation is indicated due to the
severity of respiratory distress and failure of non-invasive measures.
,2. A 70-year-old female with septic shock presents with a blood pressure of 82/44 mmHg despite fluid
resuscitation. Which of the following is the most appropriate initial vasopressor to administer?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
🟢 B. Norepinephrine
🔴 RATIONALE: Norepinephrine is the first-line vasopressor for septic shock according to the Surviving Sepsis
Campaign guidelines. It is a potent alpha-agonist with moderate beta-agonist effects, making it ideal for
vasodilatory shock.
3. A 63-year-old male is admitted with acute ST-elevation myocardial infarction (STEMI). He is receiving
aspirin and clopidogrel. Which of the following is the most appropriate additional antiplatelet therapy?
A. Cangrelor
B. Ticagrelor
C. Prasugrel
D. Abciximab
🟢 B. Ticagrelor
🔴 RATIONALE: Ticagrelor is a P2Y12 inhibitor recommended for patients with acute coronary syndromes,
including STEMI. It provides more potent and consistent platelet inhibition compared to clopidogrel and is
preferred in patients undergoing PCI.
, 4. A 72-year-old male with a history of COPD is admitted with an acute exacerbation. He is on 2 L nasal
cannula oxygen and has an oxygen saturation of 89%. Which of the following is the most appropriate target
oxygen saturation for this patient?
A. 88-92%
B. 92-96%
C. 94-98%
D. 98-100%
🟢 A. 88-92%
🔴 RATIONALE: For patients with COPD, the target oxygen saturation is 88-92% to avoid the risk of hypercapnic
respiratory failure. Higher oxygen levels can suppress hypoxic drive and lead to increased CO2 retention.
5. A 76-year-old male with atrial fibrillation is admitted with an acute ischemic stroke. He has a history of
hypertension and diabetes. Which of the following is the most appropriate initial treatment for his stroke if
he is within 3 hours of symptom onset?
A. Aspirin 324 mg
B. IV alteplase
C. Heparin drip
D. Mechanical thrombectomy
VERIFIED SOLUTIONS………...
Core Domains:
Acute and Critical Care Assessment and Differential Diagnosis
Advanced Pharmacology and Prescriptive Authority in Acute Care
Pathophysiology and Disease Management in Acutely Ill Adults
Evidence-Based Practice and Clinical Guidelines for Acute Care
Hemodynamic Monitoring and Management
Ethical, Legal, and Regulatory Standards in Acute Care Practice
Invasive Procedures and Advanced Technical Skills
Multisystem Organ Failure and Complex Case Management
End-of-Life Care and Palliative Medicine
Introduction:
This Adult-Gerontology Acute Care Nurse Practitioner Diagnostic Readiness Test is a comprehensive assessment
designed to evaluate the candidate's clinical competence and readiness for certification examination. The exam
measures advanced diagnostic reasoning, pharmacologic knowledge, and the ability to apply evidence-based
guidelines in the care of critically and acutely ill adults and older adults. The structure includes multiple-choice
questions that test foundational theory, regulatory compliance, ethical decision-making, and critical thinking. Each
,question emphasizes real-world application, challenging the test-taker to synthesize complex information,
prioritize interventions, and make sound clinical judgments. Success on this examination indicates mastery of the
core competencies required for safe, effective, and independent practice as an Adult-Gerontology Acute Care Nurse
Practitioner.
SECTION ONE: QUESTIONS 1–100
1. A 74-year-old male with a history of heart failure is admitted to the ICU with acute respiratory distress. His
blood pressure is 90/55 mmHg, heart rate is 125 bpm, and oxygen saturation is 85% on 4 L nasal cannula. An
arterial blood gas shows pH 7.22, PaCO2 58 mmHg, and PaO2 52 mmHg. Which of the following is the most
appropriate next step in management?
A. Increase oxygen to 6 L via nasal cannula
B. Initiate non-invasive positive pressure ventilation (NIPPV)
C. Intubate and initiate mechanical ventilation
D. Administer IV furosemide
🟢 C. Intubate and initiate mechanical ventilation
🔴 RATIONALE: This patient has acute respiratory failure with hypercapnia (PaCO2 58) and hypoxemia (PaO2 52)
with signs of impending respiratory failure and hemodynamic instability. Intubation is indicated due to the
severity of respiratory distress and failure of non-invasive measures.
,2. A 70-year-old female with septic shock presents with a blood pressure of 82/44 mmHg despite fluid
resuscitation. Which of the following is the most appropriate initial vasopressor to administer?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
🟢 B. Norepinephrine
🔴 RATIONALE: Norepinephrine is the first-line vasopressor for septic shock according to the Surviving Sepsis
Campaign guidelines. It is a potent alpha-agonist with moderate beta-agonist effects, making it ideal for
vasodilatory shock.
3. A 63-year-old male is admitted with acute ST-elevation myocardial infarction (STEMI). He is receiving
aspirin and clopidogrel. Which of the following is the most appropriate additional antiplatelet therapy?
A. Cangrelor
B. Ticagrelor
C. Prasugrel
D. Abciximab
🟢 B. Ticagrelor
🔴 RATIONALE: Ticagrelor is a P2Y12 inhibitor recommended for patients with acute coronary syndromes,
including STEMI. It provides more potent and consistent platelet inhibition compared to clopidogrel and is
preferred in patients undergoing PCI.
, 4. A 72-year-old male with a history of COPD is admitted with an acute exacerbation. He is on 2 L nasal
cannula oxygen and has an oxygen saturation of 89%. Which of the following is the most appropriate target
oxygen saturation for this patient?
A. 88-92%
B. 92-96%
C. 94-98%
D. 98-100%
🟢 A. 88-92%
🔴 RATIONALE: For patients with COPD, the target oxygen saturation is 88-92% to avoid the risk of hypercapnic
respiratory failure. Higher oxygen levels can suppress hypoxic drive and lead to increased CO2 retention.
5. A 76-year-old male with atrial fibrillation is admitted with an acute ischemic stroke. He has a history of
hypertension and diabetes. Which of the following is the most appropriate initial treatment for his stroke if
he is within 3 hours of symptom onset?
A. Aspirin 324 mg
B. IV alteplase
C. Heparin drip
D. Mechanical thrombectomy
