BARKLEY ADULT-GERONTOLOGY PRIMARY
CARE NURSE PRACTITIONER (AGPCNP)
REVIEW EXAM] QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
PDF
CORE DOMAINS
• Health Assessment and Physical Examination
• Pathophysiology and Disease Processes
• Pharmacology and Pharmacotherapeutics
• Diagnosis and Differential Diagnosis
• Plan of Care and Clinical Management
• Health Promotion and Disease Prevention
• Professional Practice, Ethics, and Legal Compliance
• Geriatric Syndromes and Age-Related Changes
INTRODUCTION
This comprehensive review examination is meticulously designed
for nurse practitioners preparing for the Adult-Gerontology
Primary Care Nurse Practitioner (AGPCNP) certification exam.
The assessment evaluates mastery of core competencies required
for national board certification, including advanced health
assessment, clinical decision-making, pharmacotherapeutics,
diagnosis, and care planning. Questions are presented in
multiple-choice and scenario-based formats that emphasize real-
,world application, critical thinking, and evidence-based
decision-making. Candidates will encounter clinical situations
spanning healthy adults to frail elderly patients, requiring
synthesis of assessment data, identification of urgent conditions,
and formulation of appropriate care plans. Success on this exam
indicates readiness for national certification and safe, competent
primary care practice across the adult-gerontology continuum.
SECTION ONE: QUESTIONS 1-100
1. A 72-year-old woman with a 50-pack-year smoking
history presents with dyspnea and a chronic cough.
Pulmonary function tests show FEV1/FVC <0.70 and an
FEV1 of 55% predicted without significant reversibility.
What is the correct GOLD classification?
A. GOLD 1 (mild)
B. GOLD 2 (moderate)
C. GOLD 3 (severe)
D. GOLD 4 (very severe)
B
RATIONALE: GOLD 2 (moderate) is defined as FEV1 50-
79% predicted after bronchodilator, with FEV1/FVC <0.70.
GOLD 1 is FEV1 ≥80%; GOLD 3 is 30-49%; GOLD 4 is <30%.
2. An 85-year-old man with BPH and hypertension presents
with acute onset of urinary retention, severe flank pain,
and hematuria. What is the most appropriate initial
diagnostic test?
,A. Abdominal ultrasound
B. Intravenous pyelogram
C. CT scan of the abdomen and pelvis without contrast
D. Plain abdominal X-ray
C
RATIONALE: CT scan without contrast is the gold standard
for diagnosing renal calculi, which is suspected given acute
flank pain and hematuria. Ultrasound may miss small stones.
IVP is less commonly used. CT is rapid, sensitive, and specific.
3. A 68-year-old woman with a history of type 2 diabetes
and hypertension has an LDL-C of 140 mg/dL. She is
already on atorvastatin 40 mg. What is the next step
according to the 2018 AHA/ACC cholesterol guidelines?
A. Add ezetimibe
B. Increase atorvastatin to 80 mg
C. Start a PCSK9 inhibitor
D. No change; LDL-C is at goal
A
RATIONALE: For very high-risk patients (diabetes plus
ASCVD or multiple risk factors) on maximally tolerated statin
with LDL-C ≥70 mg/dL, adding ezetimibe is recommended.
She is on high-intensity statin, but LDL-C remains elevated.
Adding ezetimibe is the next step before considering PCSK9
inhibitors.
4. A 75-year-old male with long-standing hypertension and
atrial fibrillation on warfarin presents with acute-onset
, confusion, right-sided weakness, and aphasia. CT head is
negative for hemorrhage. What is the most likely
diagnosis?
A. Transient ischemic attack
B. Ischemic stroke
C. Subdural hematoma
D. Cerebral amyloid angiopathy
B
RATIONALE: Sudden focal neurological deficits with
negative CT (but MRI would show infarction) is classic for
ischemic stroke. TIA lasts <24 hours and typically resolves
without permanent deficit. Subdural hematoma may have
gradual onset. Warfarin increases risk of hemorrhagic stroke,
but CT is negative.
5. A 72-year-old man presents with progressive fatigue,
weight loss, and night sweats over 3 months. Physical
examination reveals splenomegaly. Complete blood count
shows leukocytosis with a left shift and basophilia. Which
diagnostic test is most appropriate to confirm the
suspected diagnosis?
A. Peripheral blood smear
B. PCR for BCR-ABL fusion gene
C. Bone marrow biopsy
D. C-reactive protein level
B
CARE NURSE PRACTITIONER (AGPCNP)
REVIEW EXAM] QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
CORE DOMAINS
• Health Assessment and Physical Examination
• Pathophysiology and Disease Processes
• Pharmacology and Pharmacotherapeutics
• Diagnosis and Differential Diagnosis
• Plan of Care and Clinical Management
• Health Promotion and Disease Prevention
• Professional Practice, Ethics, and Legal Compliance
• Geriatric Syndromes and Age-Related Changes
INTRODUCTION
This comprehensive review examination is meticulously designed
for nurse practitioners preparing for the Adult-Gerontology
Primary Care Nurse Practitioner (AGPCNP) certification exam.
The assessment evaluates mastery of core competencies required
for national board certification, including advanced health
assessment, clinical decision-making, pharmacotherapeutics,
diagnosis, and care planning. Questions are presented in
multiple-choice and scenario-based formats that emphasize real-
,world application, critical thinking, and evidence-based
decision-making. Candidates will encounter clinical situations
spanning healthy adults to frail elderly patients, requiring
synthesis of assessment data, identification of urgent conditions,
and formulation of appropriate care plans. Success on this exam
indicates readiness for national certification and safe, competent
primary care practice across the adult-gerontology continuum.
SECTION ONE: QUESTIONS 1-100
1. A 72-year-old woman with a 50-pack-year smoking
history presents with dyspnea and a chronic cough.
Pulmonary function tests show FEV1/FVC <0.70 and an
FEV1 of 55% predicted without significant reversibility.
What is the correct GOLD classification?
A. GOLD 1 (mild)
B. GOLD 2 (moderate)
C. GOLD 3 (severe)
D. GOLD 4 (very severe)
B
RATIONALE: GOLD 2 (moderate) is defined as FEV1 50-
79% predicted after bronchodilator, with FEV1/FVC <0.70.
GOLD 1 is FEV1 ≥80%; GOLD 3 is 30-49%; GOLD 4 is <30%.
2. An 85-year-old man with BPH and hypertension presents
with acute onset of urinary retention, severe flank pain,
and hematuria. What is the most appropriate initial
diagnostic test?
,A. Abdominal ultrasound
B. Intravenous pyelogram
C. CT scan of the abdomen and pelvis without contrast
D. Plain abdominal X-ray
C
RATIONALE: CT scan without contrast is the gold standard
for diagnosing renal calculi, which is suspected given acute
flank pain and hematuria. Ultrasound may miss small stones.
IVP is less commonly used. CT is rapid, sensitive, and specific.
3. A 68-year-old woman with a history of type 2 diabetes
and hypertension has an LDL-C of 140 mg/dL. She is
already on atorvastatin 40 mg. What is the next step
according to the 2018 AHA/ACC cholesterol guidelines?
A. Add ezetimibe
B. Increase atorvastatin to 80 mg
C. Start a PCSK9 inhibitor
D. No change; LDL-C is at goal
A
RATIONALE: For very high-risk patients (diabetes plus
ASCVD or multiple risk factors) on maximally tolerated statin
with LDL-C ≥70 mg/dL, adding ezetimibe is recommended.
She is on high-intensity statin, but LDL-C remains elevated.
Adding ezetimibe is the next step before considering PCSK9
inhibitors.
4. A 75-year-old male with long-standing hypertension and
atrial fibrillation on warfarin presents with acute-onset
, confusion, right-sided weakness, and aphasia. CT head is
negative for hemorrhage. What is the most likely
diagnosis?
A. Transient ischemic attack
B. Ischemic stroke
C. Subdural hematoma
D. Cerebral amyloid angiopathy
B
RATIONALE: Sudden focal neurological deficits with
negative CT (but MRI would show infarction) is classic for
ischemic stroke. TIA lasts <24 hours and typically resolves
without permanent deficit. Subdural hematoma may have
gradual onset. Warfarin increases risk of hemorrhagic stroke,
but CT is negative.
5. A 72-year-old man presents with progressive fatigue,
weight loss, and night sweats over 3 months. Physical
examination reveals splenomegaly. Complete blood count
shows leukocytosis with a left shift and basophilia. Which
diagnostic test is most appropriate to confirm the
suspected diagnosis?
A. Peripheral blood smear
B. PCR for BCR-ABL fusion gene
C. Bone marrow biopsy
D. C-reactive protein level
B
