ANCC AGACNP Adult-Gerontology
Acute Care Nurse Practitioner
(AGACNP-BC) Exam With Actual
Questions & Verified Answers ,Plus
Explained Rationales/Expert Verified
For Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
1. A 68-year-old patient presents with acute shortness of breath,
elevated jugular venous pressure, and bilateral crackles on
auscultation. Which condition is most likely?
A. Pneumothorax
B. Pulmonary embolism
C. Acute decompensated heart failure
D. Asthma exacerbation
C. Acute decompensated heart failure
Rationale: Elevated JVP, crackles, and dyspnea suggest volume
overload, characteristic of acute decompensated heart failure.
2. Which of the following lab findings is most indicative of acute
kidney injury (AKI)?
A. Increased BUN and creatinine
B. Decreased potassium
C. Decreased BUN
D. Normal creatinine
,A. Increased BUN and creatinine
Rationale: AKI is characterized by azotemia, reflected as elevated
BUN and creatinine levels.
3. A patient with COPD presents with worsening dyspnea and
purulent sputum. Which intervention is most appropriate?
A. Oral corticosteroids only
B. Antibiotics
C. Oxygen therapy and bronchodilators
D. Immediate intubation
C. Oxygen therapy and bronchodilators
Rationale: Exacerbation of COPD is managed with supplemental
oxygen and bronchodilators; antibiotics are used if bacterial
infection is suspected.
4. Which medication is first-line for acute management of atrial
fibrillation with rapid ventricular response?
A. Digoxin
B. Beta-blockers
C. Amiodarone
D. Lidocaine
B. Beta-blockers
Rationale: Beta-blockers are first-line for rate control in acute atrial
fibrillation.
5. Which of the following is a contraindication to thrombolytic
therapy in acute ischemic stroke?
A. Symptom onset within 2 hours
B. Blood pressure 180/105 mmHg
C. History of intracranial hemorrhage
D. Age >80
,C. History of intracranial hemorrhage
Rationale: Prior intracranial hemorrhage significantly increases the
risk of bleeding with thrombolytics.
6. A patient with sepsis has hypotension and poor urine output.
Initial fluid resuscitation should include:
A. 0.9% normal saline 30 mL/kg bolus
B. Dextrose 5% in water
C. Lactated Ringer 5 mL/kg over 24 hours
D. Albumin infusion
A. 0.9% normal saline 30 mL/kg bolus
Rationale: Early aggressive fluid resuscitation with crystalloids is
recommended in sepsis with hypotension.
7. In a patient with suspected acute coronary syndrome, which
cardiac biomarker rises first?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
C. Myoglobin
Rationale: Myoglobin rises within 1-4 hours of myocardial injury,
earlier than CK-MB or troponin.
8. Which antibiotic is first-line for community-acquired pneumonia
in a hospitalized adult without comorbidities?
A. Azithromycin
B. Vancomycin
C. Piperacillin-tazobactam
D. Cefepime
, A. Azithromycin
Rationale: Macrolides are recommended for empiric treatment of
non-severe community-acquired pneumonia without comorbidities.
9. A 72-year-old with chronic kidney disease presents with
hyperkalemia (K+ 6.5 mEq/L) and ECG changes. Immediate
management should include:
A. Oral sodium polystyrene sulfonate
B. IV calcium gluconate
C. Furosemide
D. Hemodialysis
B. IV calcium gluconate
Rationale: IV calcium stabilizes cardiac membranes in life-
threatening hyperkalemia.
10. Which finding is most consistent with bacterial
meningitis?
A. Clear CSF, normal glucose
B. Cloudy CSF, low glucose, elevated protein
C. High CSF glucose, normal WBC
D. Xanthochromia
B. Cloudy CSF, low glucose, elevated protein
Rationale: Bacterial meningitis typically presents with low CSF
glucose, high protein, and neutrophilic pleocytosis.
11. Which condition is associated with a pulsus paradoxus on
physical examination?
A. Pericardial tamponade
B. Pulmonary embolism
C. Heart failure
D. Aortic stenosis
Acute Care Nurse Practitioner
(AGACNP-BC) Exam With Actual
Questions & Verified Answers ,Plus
Explained Rationales/Expert Verified
For Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
1. A 68-year-old patient presents with acute shortness of breath,
elevated jugular venous pressure, and bilateral crackles on
auscultation. Which condition is most likely?
A. Pneumothorax
B. Pulmonary embolism
C. Acute decompensated heart failure
D. Asthma exacerbation
C. Acute decompensated heart failure
Rationale: Elevated JVP, crackles, and dyspnea suggest volume
overload, characteristic of acute decompensated heart failure.
2. Which of the following lab findings is most indicative of acute
kidney injury (AKI)?
A. Increased BUN and creatinine
B. Decreased potassium
C. Decreased BUN
D. Normal creatinine
,A. Increased BUN and creatinine
Rationale: AKI is characterized by azotemia, reflected as elevated
BUN and creatinine levels.
3. A patient with COPD presents with worsening dyspnea and
purulent sputum. Which intervention is most appropriate?
A. Oral corticosteroids only
B. Antibiotics
C. Oxygen therapy and bronchodilators
D. Immediate intubation
C. Oxygen therapy and bronchodilators
Rationale: Exacerbation of COPD is managed with supplemental
oxygen and bronchodilators; antibiotics are used if bacterial
infection is suspected.
4. Which medication is first-line for acute management of atrial
fibrillation with rapid ventricular response?
A. Digoxin
B. Beta-blockers
C. Amiodarone
D. Lidocaine
B. Beta-blockers
Rationale: Beta-blockers are first-line for rate control in acute atrial
fibrillation.
5. Which of the following is a contraindication to thrombolytic
therapy in acute ischemic stroke?
A. Symptom onset within 2 hours
B. Blood pressure 180/105 mmHg
C. History of intracranial hemorrhage
D. Age >80
,C. History of intracranial hemorrhage
Rationale: Prior intracranial hemorrhage significantly increases the
risk of bleeding with thrombolytics.
6. A patient with sepsis has hypotension and poor urine output.
Initial fluid resuscitation should include:
A. 0.9% normal saline 30 mL/kg bolus
B. Dextrose 5% in water
C. Lactated Ringer 5 mL/kg over 24 hours
D. Albumin infusion
A. 0.9% normal saline 30 mL/kg bolus
Rationale: Early aggressive fluid resuscitation with crystalloids is
recommended in sepsis with hypotension.
7. In a patient with suspected acute coronary syndrome, which
cardiac biomarker rises first?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
C. Myoglobin
Rationale: Myoglobin rises within 1-4 hours of myocardial injury,
earlier than CK-MB or troponin.
8. Which antibiotic is first-line for community-acquired pneumonia
in a hospitalized adult without comorbidities?
A. Azithromycin
B. Vancomycin
C. Piperacillin-tazobactam
D. Cefepime
, A. Azithromycin
Rationale: Macrolides are recommended for empiric treatment of
non-severe community-acquired pneumonia without comorbidities.
9. A 72-year-old with chronic kidney disease presents with
hyperkalemia (K+ 6.5 mEq/L) and ECG changes. Immediate
management should include:
A. Oral sodium polystyrene sulfonate
B. IV calcium gluconate
C. Furosemide
D. Hemodialysis
B. IV calcium gluconate
Rationale: IV calcium stabilizes cardiac membranes in life-
threatening hyperkalemia.
10. Which finding is most consistent with bacterial
meningitis?
A. Clear CSF, normal glucose
B. Cloudy CSF, low glucose, elevated protein
C. High CSF glucose, normal WBC
D. Xanthochromia
B. Cloudy CSF, low glucose, elevated protein
Rationale: Bacterial meningitis typically presents with low CSF
glucose, high protein, and neutrophilic pleocytosis.
11. Which condition is associated with a pulsus paradoxus on
physical examination?
A. Pericardial tamponade
B. Pulmonary embolism
C. Heart failure
D. Aortic stenosis
