Barkley AGPCNP Practice FLORIDA STATE FIRE
INSTRUCTOR 3 ACTUAL EXAM ALL QUESTIONS AND
ANSWERS ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST GUIDELINES |
GRADED A+
Health Promotion & Disease Prevention (Questions 1-10)
Question 1
A 72-year-old woman with a 50-pack-year smoking history presents with dyspnea and 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)
Correct Answer: B
Rationale: GOLD 2 (moderate) is defined as FEV1 50-79% predicted after bronchodilator use,
with FEV1/FVC <0.70. GOLD 1 is FEV1 ≥80%, GOLD 3 is 30-49%, and GOLD 4 is <30% .
Question 2
A 68-year-old woman with type 2 diabetes and hypertension has an LDL-C of 140 mg/dL despite
being 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
,Correct Answer: 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. Adding
ezetimibe is the next step before considering PCSK9 inhibitors .
Question 3
A 65-year-old woman with a family history of breast cancer asks about genetic testing. Which
genes are most commonly associated with hereditary breast and ovarian cancer syndrome?
A. BRCA1 and BRCA2
B. TP53 and PTEN
C. CHEK2 and ATM
D. PALB2 and RAD51C
Correct Answer: A
Rationale: BRCA1 and BRCA2 mutations are the most common genetic causes of hereditary
breast and ovarian cancer syndrome. Genetic testing and counseling should be offered to
women with high-risk family histories.
Question 4
A 45-year-old man with no symptoms asks about prostate cancer screening. According to
USPSTF, what is the most appropriate recommendation?
A. PSA screening annually starting at age 50
B. Shared decision-making discussion about risks and benefits
C. PSA screening only if family history of prostate cancer
D. No PSA screening under any circumstances
Correct Answer: B
Rationale: USPSTF recommends shared decision-making for PSA-based screening in men aged
55-69. The decision should be individualized based on patient values and risk factors. Screening
is not recommended for men ≥70.
Question 5
A 50-year-old woman with a body mass index (BMI) of 32 kg/m² is diagnosed with prediabetes
(A1c 6.0%). What is the most appropriate initial management?
,A. Metformin and lifestyle modification
B. Lifestyle modification alone
C. Insulin therapy
D. GLP-1 receptor agonist
Correct Answer: A
Rationale: For patients with prediabetes, particularly those with BMI ≥35, age <60, or history of
gestational diabetes, metformin is recommended in addition to lifestyle modification. Lifestyle
modification alone may be insufficient.
Question 6
A 60-year-old woman with no chronic conditions asks which screening tests are recommended.
According to USPSTF, which combination of screenings should the FNP recommend?
A. Mammogram every 2 years, colonoscopy every 10 years, annual Pap smear
B. Mammogram every 2 years, colonoscopy every 10 years, Pap smear every 3 years or HPV
testing every 5 years
C. Mammogram annually, colonoscopy every 5 years, Pap smear every 5 years
D. Mammogram annually, CT colonography every 5 years, Pap smear every year
Correct Answer: B
Rationale: For average-risk women aged 50-74, USPSTF recommends biennial mammography.
Colorectal cancer screening (colonoscopy every 10 years) is recommended from ages 45-75.
Cervical cancer screening: Pap smear every 3 years (age 21-65) or primary HPV testing every 5
years (age 30-65).
Question 7
A 55-year-old woman with a history of smoking and hypertension asks about osteoporosis
screening. What is the most appropriate recommendation?
A. DEXA scan at age 65
B. DEXA scan now due to risk factors
C. Vitamin D level only
D. Calcium supplementation without screening
Correct Answer: B
, Rationale: USPSTF recommends DEXA screening for all women age 65 and older. Women
younger than 65 with risk factors (smoking, low BMI, family history, chronic steroid use) should
be screened earlier.
Question 8
A 28-year-old woman is considering pregnancy. Which medication should be avoided due to
teratogenicity?
A. Folic acid
B. Valproic acid
C. Iron supplements
D. Prenatal vitamins
Correct Answer: B
Rationale: Valproic acid is a known teratogen associated with neural tube defects. It should be
avoided during pregnancy. Women of childbearing potential on valproic acid should use
effective contraception.
Question 9
A 70-year-old woman reports a fall at home. She has no injuries but is concerned about falls.
What is the most appropriate next step?
A. Reassure her and recommend home safety modifications
B. Perform a fall risk assessment and review medications
C. Refer to physical therapy
D. Order a bone density scan
Correct Answer: B
Rationale: All older adults should be screened for fall risk. A comprehensive fall risk assessment
includes review of medications (especially sedatives and antihypertensives), gait and balance
evaluation, and home safety assessment.
Question 10
A 55-year-old man with a history of hypertension presents with a blood pressure of 148/92
mmHg on two separate occasions. He has no other comorbidities. According to current
guidelines, what is the most appropriate initial management?
INSTRUCTOR 3 ACTUAL EXAM ALL QUESTIONS AND
ANSWERS ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST GUIDELINES |
GRADED A+
Health Promotion & Disease Prevention (Questions 1-10)
Question 1
A 72-year-old woman with a 50-pack-year smoking history presents with dyspnea and 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)
Correct Answer: B
Rationale: GOLD 2 (moderate) is defined as FEV1 50-79% predicted after bronchodilator use,
with FEV1/FVC <0.70. GOLD 1 is FEV1 ≥80%, GOLD 3 is 30-49%, and GOLD 4 is <30% .
Question 2
A 68-year-old woman with type 2 diabetes and hypertension has an LDL-C of 140 mg/dL despite
being 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
,Correct Answer: 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. Adding
ezetimibe is the next step before considering PCSK9 inhibitors .
Question 3
A 65-year-old woman with a family history of breast cancer asks about genetic testing. Which
genes are most commonly associated with hereditary breast and ovarian cancer syndrome?
A. BRCA1 and BRCA2
B. TP53 and PTEN
C. CHEK2 and ATM
D. PALB2 and RAD51C
Correct Answer: A
Rationale: BRCA1 and BRCA2 mutations are the most common genetic causes of hereditary
breast and ovarian cancer syndrome. Genetic testing and counseling should be offered to
women with high-risk family histories.
Question 4
A 45-year-old man with no symptoms asks about prostate cancer screening. According to
USPSTF, what is the most appropriate recommendation?
A. PSA screening annually starting at age 50
B. Shared decision-making discussion about risks and benefits
C. PSA screening only if family history of prostate cancer
D. No PSA screening under any circumstances
Correct Answer: B
Rationale: USPSTF recommends shared decision-making for PSA-based screening in men aged
55-69. The decision should be individualized based on patient values and risk factors. Screening
is not recommended for men ≥70.
Question 5
A 50-year-old woman with a body mass index (BMI) of 32 kg/m² is diagnosed with prediabetes
(A1c 6.0%). What is the most appropriate initial management?
,A. Metformin and lifestyle modification
B. Lifestyle modification alone
C. Insulin therapy
D. GLP-1 receptor agonist
Correct Answer: A
Rationale: For patients with prediabetes, particularly those with BMI ≥35, age <60, or history of
gestational diabetes, metformin is recommended in addition to lifestyle modification. Lifestyle
modification alone may be insufficient.
Question 6
A 60-year-old woman with no chronic conditions asks which screening tests are recommended.
According to USPSTF, which combination of screenings should the FNP recommend?
A. Mammogram every 2 years, colonoscopy every 10 years, annual Pap smear
B. Mammogram every 2 years, colonoscopy every 10 years, Pap smear every 3 years or HPV
testing every 5 years
C. Mammogram annually, colonoscopy every 5 years, Pap smear every 5 years
D. Mammogram annually, CT colonography every 5 years, Pap smear every year
Correct Answer: B
Rationale: For average-risk women aged 50-74, USPSTF recommends biennial mammography.
Colorectal cancer screening (colonoscopy every 10 years) is recommended from ages 45-75.
Cervical cancer screening: Pap smear every 3 years (age 21-65) or primary HPV testing every 5
years (age 30-65).
Question 7
A 55-year-old woman with a history of smoking and hypertension asks about osteoporosis
screening. What is the most appropriate recommendation?
A. DEXA scan at age 65
B. DEXA scan now due to risk factors
C. Vitamin D level only
D. Calcium supplementation without screening
Correct Answer: B
, Rationale: USPSTF recommends DEXA screening for all women age 65 and older. Women
younger than 65 with risk factors (smoking, low BMI, family history, chronic steroid use) should
be screened earlier.
Question 8
A 28-year-old woman is considering pregnancy. Which medication should be avoided due to
teratogenicity?
A. Folic acid
B. Valproic acid
C. Iron supplements
D. Prenatal vitamins
Correct Answer: B
Rationale: Valproic acid is a known teratogen associated with neural tube defects. It should be
avoided during pregnancy. Women of childbearing potential on valproic acid should use
effective contraception.
Question 9
A 70-year-old woman reports a fall at home. She has no injuries but is concerned about falls.
What is the most appropriate next step?
A. Reassure her and recommend home safety modifications
B. Perform a fall risk assessment and review medications
C. Refer to physical therapy
D. Order a bone density scan
Correct Answer: B
Rationale: All older adults should be screened for fall risk. A comprehensive fall risk assessment
includes review of medications (especially sedatives and antihypertensives), gait and balance
evaluation, and home safety assessment.
Question 10
A 55-year-old man with a history of hypertension presents with a blood pressure of 148/92
mmHg on two separate occasions. He has no other comorbidities. According to current
guidelines, what is the most appropriate initial management?
