AGACNP Practice Test 2026: 250+ Board-Style Questions & Answers for Acute Care NP Certification (AANP/ANCC) | Graded A+ | Guaranteed Pass!!

STOP reading. START practicing. You don't need another textbook. You need QUESTIONS. The AGACNP board exam tests how you think under pressure. This document gives you 250+ high-yield practice questions with CORRECT answers to drill exactly that. This is NOT a study guide. This is a TEST BANK. Every question mirrors the style, difficulty, and content of the actual AANP and ANCC AGACNP certification exams. Here's what you'll master (organized by system): CARDIOLOGY (HEAVILY TESTED): 1°, 2° Type 1/Type 2, and 3° AV block recognition (long PR, dropped QRS, independent pacing) Shock hemodynamics: Cardiogenic (↓CO/CI, ↑CVP/PCWP/SVR) vs Hypovolemic (↓all) vs Distributive (↓all but CO variable) Murmur identification: Aortic stenosis (systolic, rough, 2nd ICS) vs Mitral regurgitation (systolic, high-pitched, 5th ICS) vs Mitral stenosis (diastolic, loud S1) CHF diagnosis: CXR (Kerley B lines, effusions, pulmonary edema), Echo (EF) Angina types: Stable (exertional), Prinzmetal (random), Unstable ACS management: Aspirin, nitro, morphine, oxygen, heparin, revascularization PULMONARY: ARDS: Mechanical vent with PEEP 10cm, TV 6-8 mL/kg, CXR "white out" Pneumonia treatment: Outpatient (macrolide/doxycycline) → Inpatient (levo/ceftriaxone + macrolide) → ICU (add vanco/linezolid for MRSA) VAP: Pseudomonas coverage (cefepime + cipro) - add vanco for MRSA PE: Abrupt dyspnea + tachycardia, VQ scan, D-Dimer, spiral CT, heparin Pneumothorax: Diminished breath sounds + hyperresonance → chest tube Tension pneumothorax: Mediastinal shift, hypotension → needle decompression NEUROLOGY: Stroke: Left hemisphere (aphasia, right hemiparesis) vs Right hemisphere (spatial disorientation, left hemiparesis) Hemorrhagic stroke: Nimodipine to counter vasospasm Seizures: CT for all new onset, EEG, benzos → fosphenytoin → long-term anticonvulsant Status epilepticus: 10 minutes, medical emergency Meningitis: Fever, headache, nuchal rigidity, Kernig/Brudzinski signs → LP (cloudy CSF) → vanco + ceftriaxone Cauda Equina: Saddle anesthesia, bowel/bladder loss → emergent MRI + surgery Guillain-Barré: Rapidly progressive ascending paralysis, elevated CSF protein GI/HEPATOLOGY: Upper GI bleed referral (70 yo melena on aspirin) → GI for eval (not just stop aspirin!) Pancreatitis: Severe epigastric pain radiating to back, elevated amylase/lipase, NPO, IVF Cholecystitis: Positive Murphy's sign, RUQ pain, US gold standard Appendicitis: RLQ pain, psoas/obturator signs, CT or US Diverticulitis: LLQ pain, fever, leukocytosis → surgical consult if severe Bowel obstruction: High-pitched tinkling sounds (early) → hypoactive (late), air-fluid levels on x-ray H. pylori eradication: 2 antibiotics + PPI (NOT antacids) Hepatitis markers: Acute A = IgM positive, Acute B = HBsAg + IgM anti-HBc ENDOCRINE: DKA (Type 1): BG 250, metabolic acidosis, ketones → NS, insulin gtt (bicarb only if pH 7.1) HHS (Type 2): BG 600, hyperosmolarity, normal pH → NS, insulin gtt Dawn phenomenon: AM hyperglycemia (increase nighttime insulin) Somogyi effect: Nocturnal hypoglycemia → rebound AM hyperglycemia (decrease nighttime insulin) Thyroid disorders: Hyperthyroidism (low TSH, high T3/T4) vs Hypothyroidism (high TSH, low T4) Addison's: Hyperpigmentation, hyponatremia, hyperkalemia → hydrocortisone + NS Cushing's: Moon face, buffalo hump, purple striae, hyperglycemia, hypokalemia RENAL/ELECTROLYTES: Hyperkalemia: Peaked T waves, weakness → kayexalate, insulin + D5W Hypokalemia: U waves, weakness → oral/IV replacement (40mEq/L/hr max) SIADH: Low serum osmolality, high urine osmolality, urine Na 20 → fluid restriction, 3% saline if severe DI: High serum osmolality, low urine osmolality → D5W AKI: Prerenal (FeNa 1, BUN/Cr 20) vs Intrarenal (casts) vs Postrenal (obstruction) HEMATOLOGY/ONCOLOGY: Anemia: Iron deficiency (microcytic, low ferritin, high TIBC) vs Pernicious (macrocytic, B12 deficiency, neuro sx) vs Chronic disease (normocytic) ITP: Low platelets, autoimmune → corticosteroids, IVIG HIT: Heparin-induced thrombocytopenia → stop heparin, start argatroban/lepirudin Hodgkin's: Cervical adenopathy, Reed-Sternberg cells Sickle cell crisis: Hydration #1, analgesics, oxygen PROFESSIONAL ROLE (BONUS SECTION - EASY POINTS): Strongest evidence for NP central line safety → Systematic review Balanced Budget Act → NP Medicare provider numbers nationwide Healthy People 2020 goal → Elimination of health disparities Nonmaleficence → Protecting research participants from harm QI scenario → Increased incidence of postoperative sternal wound infections Medicaid → Pays after insurance/3rd party, "spending down" for long-term care PLUS COMPLETE REFERENCE SECTIONS ON: Cranial nerves I-XII (function + testing) Heart sounds (S1-S4, murmurs by grade I-VI) Ventilator modes (AC, SIMV, PSV, CPAP, PEEP) Rule of 9's for burns + Parkland formula Glasgow Coma Scale components GAD-7 (anxiety) and PHQ-9 (depression) screening tools Document stats: 27 pages 250+ Q&As Organized by body system Correct answers bolded/clearly marked Quick-scan format for rapid review Why this works: The AGACNP exam isn't about memorizing facts in isolation. It's about recognizing the presentation and knowing the NEXT step. This test bank trains your pattern recognition. Best Price to Sell: ** 12.99 ∗ ∗ ( 250 + q u e s t i o n s a t 5 c e n t s p e r q u e s t i o n . S t u d e n t s p a y 12.99∗∗(250+questionsat 5centsperquestion.Studentspay300+ for review courses. This is the affordable alternative that delivers results. Priced higher than the study guide because it's a practice test — perceived value is higher.)