AANP AGPCNP PRACTICE 2023 TEST 2
LATEST UPdATEd QUESTIoNS wITh
VERIfIEd SoLUTIoNS ALREAdY GRAdEd
A+
EXAM INSTRUCTIONS
This document contains 50 high-yield practice questions based on the 2023 AANP Adult-
Gerontology Primary Care Nurse Practitioner (AGPCNP) PSI Test 2 format. Each question
includes the correct answer and detailed rationale to support exam preparation and knowledge
reinforcement.
Exam Domains:
• Patient Assessment Process
• Plan of Care
• Professional Practice
PRACTICE QUESTIONS
Question 1
An older adult presents with severe abdominal pain. The husband reports that earlier in the
afternoon, the patient's abdominal hernia had been firm and bulged out 4 inches (10.2 cm). The
patient had him press on the hernia and immediately felt burning pain throughout the
abdomen. Which of the following is the nurse practitioner's NEXT action?
A) Abdominal CT scan
B) Complete blood count with differential
C) Abdominal ultrasound
D) Referral to the ED
Correct Answer: D) Referral to the ED
Rationale: An incarcerated or strangulated hernia is a surgical emergency. The patient's
symptoms of a firm, bulging hernia with sudden onset of burning pain throughout the abdomen
suggest bowel compromise or strangulation. Urgent ED referral is required for immediate
surgical evaluation .
,Question 2
A young adult female who is 34 weeks pregnant presents with the complaint of urinary
frequency every 1 to 2 hours. The patient has no fever and denies back pain. A urine dipstick
test is positive for leukocyte esterase and nitrites. Microscopic analysis reveals 15-20 WBCs/hpf
and a few bacteria. The BEST choice for treatment of this patient's urinary tract infection would
be:
A) Trimethoprim-sulfamethoxazole (Bactrim), 160 mg/800 mg twice daily for 3 days
B) Cephalexin (Keflex), 500 mg four times daily for 7 days
C) Ciprofloxacin (Cipro), 500 mg twice daily for 7 days
D) Nitrofurantoin (Macrobid), 100 mg twice daily for 5 days
Correct Answer: B) Cephalexin (Keflex), 500 mg four times daily for 7 days
Rationale: Cephalexin is safe in pregnancy and appropriate for UTI treatment. Trimethoprim-
sulfamethoxazole should be avoided in the third trimester due to risk of kernicterus.
Ciprofloxacin is generally avoided in pregnancy due to risk of arthropathy. Nitrofurantoin is safe
but should be avoided near term (38+ weeks) .
Question 3
An adult male presents with new-onset pain and tenderness in the low back and pain in the
right great toe after a weekend of golf. He denies experiencing numbness and tingling. Which of
the following would the nurse practitioner expect to find in investigation of this patient's low
back pain?
A) Exacerbation of extremity symptoms with straight-leg raising
B) Loss of bowel and bladder function
C) Increased ankle jerk on evaluation of deep tendon reflexes
D) Increased lumbar lordosis
Correct Answer: A) Exacerbation of extremity symptoms with straight-leg raising
Rationale: This presentation suggests lumbar radiculopathy, likely from a herniated disc.
Straight-leg raising (Lasègue's sign) exacerbates symptoms in radiculopathy due to nerve root
irritation. The history of golf suggests acute injury. Bowel/bladder dysfunction would indicate
cauda equina syndrome, a surgical emergency .
Question 4
A true statement about essential tremors is that they:
A) Often begin with "pill-rolling" of one hand and may affect the legs, feet, and toes
B) Are often barely visible, rapid tremors
, C) Are a characteristic of Parkinson's disease
D) Are slow tremors that are absent or minimal at rest and usually involve the hands
Correct Answer: D) Are slow tremors that are absent or minimal at rest and usually involve
the hands
Rationale: Essential tremors are slow tremors that are absent or minimal at rest and typically
involve the hands. They are action tremors (occurring with voluntary movement) and are not
associated with Parkinson's disease. "Pill-rolling" tremor is characteristic of Parkinson's disease,
not essential tremor .
Question 5
Which opioid medication is the MOST potent?
A) Codeine
B) Morphine
C) Oxycodone
D) Hydromorphone
Correct Answer: D) Hydromorphone
Rationale: Hydromorphone (Dilaudid) is significantly more potent than morphine, oxycodone,
and codeine on a milligram-to-milligram basis. It has a potency ratio approximately 5-7 times
that of morphine .
Question 6
Which symptom documented in a menstrual diary is diagnostic of PMS?
A) Irritability
B) Decreased libido
C) Menstrual cramps
D) Dyspareunia
Correct Answer: A) Irritability
Rationale: Premenstrual syndrome (PMS) is diagnosed by the presence of at least one affective
symptom (irritability, depression, anxiety, mood swings) and one physical symptom (breast
tenderness, bloating, headache). Symptoms must occur in the luteal phase and resolve within a
few days of menses onset .
Question 7
LATEST UPdATEd QUESTIoNS wITh
VERIfIEd SoLUTIoNS ALREAdY GRAdEd
A+
EXAM INSTRUCTIONS
This document contains 50 high-yield practice questions based on the 2023 AANP Adult-
Gerontology Primary Care Nurse Practitioner (AGPCNP) PSI Test 2 format. Each question
includes the correct answer and detailed rationale to support exam preparation and knowledge
reinforcement.
Exam Domains:
• Patient Assessment Process
• Plan of Care
• Professional Practice
PRACTICE QUESTIONS
Question 1
An older adult presents with severe abdominal pain. The husband reports that earlier in the
afternoon, the patient's abdominal hernia had been firm and bulged out 4 inches (10.2 cm). The
patient had him press on the hernia and immediately felt burning pain throughout the
abdomen. Which of the following is the nurse practitioner's NEXT action?
A) Abdominal CT scan
B) Complete blood count with differential
C) Abdominal ultrasound
D) Referral to the ED
Correct Answer: D) Referral to the ED
Rationale: An incarcerated or strangulated hernia is a surgical emergency. The patient's
symptoms of a firm, bulging hernia with sudden onset of burning pain throughout the abdomen
suggest bowel compromise or strangulation. Urgent ED referral is required for immediate
surgical evaluation .
,Question 2
A young adult female who is 34 weeks pregnant presents with the complaint of urinary
frequency every 1 to 2 hours. The patient has no fever and denies back pain. A urine dipstick
test is positive for leukocyte esterase and nitrites. Microscopic analysis reveals 15-20 WBCs/hpf
and a few bacteria. The BEST choice for treatment of this patient's urinary tract infection would
be:
A) Trimethoprim-sulfamethoxazole (Bactrim), 160 mg/800 mg twice daily for 3 days
B) Cephalexin (Keflex), 500 mg four times daily for 7 days
C) Ciprofloxacin (Cipro), 500 mg twice daily for 7 days
D) Nitrofurantoin (Macrobid), 100 mg twice daily for 5 days
Correct Answer: B) Cephalexin (Keflex), 500 mg four times daily for 7 days
Rationale: Cephalexin is safe in pregnancy and appropriate for UTI treatment. Trimethoprim-
sulfamethoxazole should be avoided in the third trimester due to risk of kernicterus.
Ciprofloxacin is generally avoided in pregnancy due to risk of arthropathy. Nitrofurantoin is safe
but should be avoided near term (38+ weeks) .
Question 3
An adult male presents with new-onset pain and tenderness in the low back and pain in the
right great toe after a weekend of golf. He denies experiencing numbness and tingling. Which of
the following would the nurse practitioner expect to find in investigation of this patient's low
back pain?
A) Exacerbation of extremity symptoms with straight-leg raising
B) Loss of bowel and bladder function
C) Increased ankle jerk on evaluation of deep tendon reflexes
D) Increased lumbar lordosis
Correct Answer: A) Exacerbation of extremity symptoms with straight-leg raising
Rationale: This presentation suggests lumbar radiculopathy, likely from a herniated disc.
Straight-leg raising (Lasègue's sign) exacerbates symptoms in radiculopathy due to nerve root
irritation. The history of golf suggests acute injury. Bowel/bladder dysfunction would indicate
cauda equina syndrome, a surgical emergency .
Question 4
A true statement about essential tremors is that they:
A) Often begin with "pill-rolling" of one hand and may affect the legs, feet, and toes
B) Are often barely visible, rapid tremors
, C) Are a characteristic of Parkinson's disease
D) Are slow tremors that are absent or minimal at rest and usually involve the hands
Correct Answer: D) Are slow tremors that are absent or minimal at rest and usually involve
the hands
Rationale: Essential tremors are slow tremors that are absent or minimal at rest and typically
involve the hands. They are action tremors (occurring with voluntary movement) and are not
associated with Parkinson's disease. "Pill-rolling" tremor is characteristic of Parkinson's disease,
not essential tremor .
Question 5
Which opioid medication is the MOST potent?
A) Codeine
B) Morphine
C) Oxycodone
D) Hydromorphone
Correct Answer: D) Hydromorphone
Rationale: Hydromorphone (Dilaudid) is significantly more potent than morphine, oxycodone,
and codeine on a milligram-to-milligram basis. It has a potency ratio approximately 5-7 times
that of morphine .
Question 6
Which symptom documented in a menstrual diary is diagnostic of PMS?
A) Irritability
B) Decreased libido
C) Menstrual cramps
D) Dyspareunia
Correct Answer: A) Irritability
Rationale: Premenstrual syndrome (PMS) is diagnosed by the presence of at least one affective
symptom (irritability, depression, anxiety, mood swings) and one physical symptom (breast
tenderness, bloating, headache). Symptoms must occur in the luteal phase and resolve within a
few days of menses onset .
Question 7
