AACN ACNPC-AG (AGACNP) Certification Exam Prep |
400 Verified Questions & Correct Answers, PSI
Proctored Practice Test, Complete Study Guide for
Adult-Gerontology Acute Care Nurse Practitioner
AACN ACNPC-AG (AGACNP) CERTIFICATION EXAM PREP 400 Verified Practice
Questions | Complete Study Guide
Adult-Gerontology Acute Care Nurse Practitioner
Question 1
A 68-year-old male presents with crushing chest pain radiating to the left arm,
diaphoresis, and nausea. ECG shows ST elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
E. Posterior descending artery
CORRECT ANSWER: C. Right coronary artery
RATIONALE: ST elevation in leads II, III, and aVF is characteristic of an
inferior STEMI, which is most commonly caused by occlusion of the right coronary
artery (RCA). The RCA supplies the inferior wall of the left ventricle and the right
ventricle.
Question 2
A patient in the ICU develops new-onset atrial fibrillation with a ventricular rate of 148
bpm and is hemodynamically unstable (BP 80/50 mmHg). What is the most appropriate
immediate intervention?
,A. IV amiodarone infusion
B. IV diltiazem bolus
C. Synchronized cardioversion
D. IV digoxin loading
E. Oral metoprolol
CORRECT ANSWER: C. Synchronized cardioversion
RATIONALE: Hemodynamically unstable atrial fibrillation (hypotension,
signs of shock) requires immediate synchronized cardioversion regardless of the
duration of arrhythmia. Rate or rhythm control medications are not indicated when the
patient is unstable.
Question 3
A 72-year-old woman with a history of heart failure presents with worsening dyspnea,
orthopnea, and bilateral crackles. Her BNP is 1,450 pg/mL. What does BNP elevation
indicate?
A. Pulmonary embolism
B. Ventricular wall stress and volume overload
C. Myocardial infarction
D. Pericardial effusion
E. Pulmonary hypertension exclusively
CORRECT ANSWER: B. Ventricular wall stress and volume overload
, RATIONALE: BNP (B-type natriuretic peptide) is released by ventricular
myocytes in response to increased wall stress, pressure, and volume overload.
Elevated BNP is a sensitive marker of heart failure exacerbation and guides diuretic
therapy.
Question 4
A patient is admitted with NSTEMI. Which of the following is the most appropriate
antiplatelet regimen upon diagnosis?
A. Aspirin alone
B. Aspirin plus clopidogrel
C. Clopidogrel alone
D. Warfarin plus aspirin
E. Ticagrelor alone
CORRECT ANSWER: B. Aspirin plus clopidogrel
RATIONALE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12
inhibitor (clopidogrel, ticagrelor, or prasugrel) is the standard of care for NSTEMI to
reduce the risk of recurrent ischemic events. Aspirin alone is insufficient.
Question 5
A 65-year-old male with known CAD presents with exertional chest pain. Stress
testing reveals significant ischemia. Coronary angiography shows 85% stenosis of the
LAD. What is the preferred revascularization strategy?
, A. Medical management alone
B. Percutaneous coronary intervention (PCI)
C. Coronary artery bypass grafting (CABG)
D. Thrombolytic therapy
E. Intra-aortic balloon pump
CORRECT ANSWER: B. Percutaneous coronary intervention (PCI)
RATIONALE: For single-vessel disease with significant stenosis and
evidence of ischemia, PCI with stenting is the preferred revascularization strategy.
CABG is typically reserved for multi-vessel disease, left main disease, or diabetics with
multi-vessel disease.
Question 6
A patient with acute decompensated heart failure has a cardiac output of 2.8 L/min
and elevated PCWP. Which hemodynamic profile best describes this patient?
A. Warm and dry
B. Warm and wet
C. Cold and dry
D. Cold and wet
E. Normal hemodynamics
CORRECT ANSWER: D. Cold and wet
RATIONALE: Cold and wet describes cardiogenic shock with low cardiac
output (cold/hypoperfused) and elevated filling pressures (wet/congested). This patient
has low CO and high PCWP, consistent with the cold and wet profile requiring both
diuresis and inotropic support.
400 Verified Questions & Correct Answers, PSI
Proctored Practice Test, Complete Study Guide for
Adult-Gerontology Acute Care Nurse Practitioner
AACN ACNPC-AG (AGACNP) CERTIFICATION EXAM PREP 400 Verified Practice
Questions | Complete Study Guide
Adult-Gerontology Acute Care Nurse Practitioner
Question 1
A 68-year-old male presents with crushing chest pain radiating to the left arm,
diaphoresis, and nausea. ECG shows ST elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
E. Posterior descending artery
CORRECT ANSWER: C. Right coronary artery
RATIONALE: ST elevation in leads II, III, and aVF is characteristic of an
inferior STEMI, which is most commonly caused by occlusion of the right coronary
artery (RCA). The RCA supplies the inferior wall of the left ventricle and the right
ventricle.
Question 2
A patient in the ICU develops new-onset atrial fibrillation with a ventricular rate of 148
bpm and is hemodynamically unstable (BP 80/50 mmHg). What is the most appropriate
immediate intervention?
,A. IV amiodarone infusion
B. IV diltiazem bolus
C. Synchronized cardioversion
D. IV digoxin loading
E. Oral metoprolol
CORRECT ANSWER: C. Synchronized cardioversion
RATIONALE: Hemodynamically unstable atrial fibrillation (hypotension,
signs of shock) requires immediate synchronized cardioversion regardless of the
duration of arrhythmia. Rate or rhythm control medications are not indicated when the
patient is unstable.
Question 3
A 72-year-old woman with a history of heart failure presents with worsening dyspnea,
orthopnea, and bilateral crackles. Her BNP is 1,450 pg/mL. What does BNP elevation
indicate?
A. Pulmonary embolism
B. Ventricular wall stress and volume overload
C. Myocardial infarction
D. Pericardial effusion
E. Pulmonary hypertension exclusively
CORRECT ANSWER: B. Ventricular wall stress and volume overload
, RATIONALE: BNP (B-type natriuretic peptide) is released by ventricular
myocytes in response to increased wall stress, pressure, and volume overload.
Elevated BNP is a sensitive marker of heart failure exacerbation and guides diuretic
therapy.
Question 4
A patient is admitted with NSTEMI. Which of the following is the most appropriate
antiplatelet regimen upon diagnosis?
A. Aspirin alone
B. Aspirin plus clopidogrel
C. Clopidogrel alone
D. Warfarin plus aspirin
E. Ticagrelor alone
CORRECT ANSWER: B. Aspirin plus clopidogrel
RATIONALE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12
inhibitor (clopidogrel, ticagrelor, or prasugrel) is the standard of care for NSTEMI to
reduce the risk of recurrent ischemic events. Aspirin alone is insufficient.
Question 5
A 65-year-old male with known CAD presents with exertional chest pain. Stress
testing reveals significant ischemia. Coronary angiography shows 85% stenosis of the
LAD. What is the preferred revascularization strategy?
, A. Medical management alone
B. Percutaneous coronary intervention (PCI)
C. Coronary artery bypass grafting (CABG)
D. Thrombolytic therapy
E. Intra-aortic balloon pump
CORRECT ANSWER: B. Percutaneous coronary intervention (PCI)
RATIONALE: For single-vessel disease with significant stenosis and
evidence of ischemia, PCI with stenting is the preferred revascularization strategy.
CABG is typically reserved for multi-vessel disease, left main disease, or diabetics with
multi-vessel disease.
Question 6
A patient with acute decompensated heart failure has a cardiac output of 2.8 L/min
and elevated PCWP. Which hemodynamic profile best describes this patient?
A. Warm and dry
B. Warm and wet
C. Cold and dry
D. Cold and wet
E. Normal hemodynamics
CORRECT ANSWER: D. Cold and wet
RATIONALE: Cold and wet describes cardiogenic shock with low cardiac
output (cold/hypoperfused) and elevated filling pressures (wet/congested). This patient
has low CO and high PCWP, consistent with the cold and wet profile requiring both
diuresis and inotropic support.
