Spring 2025 AGACNP Exam Questions
and Answers
Which of the following sedative agents can act as a negative inotrope? Select all that
apply.
a. Propofol
b. Fentanyl
c. Dexmedetomidine
d. Midazolam - ANSWER-Propofol & Dexmedetomidine
Which of the following CSF findings is most likely in a patient with bacterial meningitis?
a. Lymphocyte predominance
b. Decreased opening pressures on lumbar puncture
c. increased glucose
d. increase protein - ANSWER-Increased protein
A NP's license can be jeopardized by improper actions. What's an example of an action
that would put an NP's license in jeopardy?
a. You appropriately delegate medication administration to a trusted RN employee who
administers a fatal dose
b. You delegate client assessment tasks to an LPN who has been floated to your unit
fort he day
c. You provide nursing care services consistent with established standards of practice in
your jurisdiction
d. The medical assistant in your supervision physician's office exceeds the scope of her
authority, but you take prompt action to correct the problem - ANSWER-B
A 19-year-old male college student presents with fever, headache and petechia rash. A
LP is performed. Grain stain of his CSF shows gram negative diplococci. Which of the
following organisms is the cause of his symptoms?
a. Streptococcus pneumonia
b. Cryptococcal meningitis
c. Neisseria meningitis
d. Listeria monocytogenes - ANSWER-Neisseria Meningitis
What differentiates delirium from dementia?
a. personality changes
b. global confusion
c. age of onset
d. reversibility
c. short-term memory impairment - ANSWER-Reversibility
,Pupil Abnormalities usually point to problems in the midbrain or CNIII. - ANSWER-True
A pt with uncontrolled HTN presents to ED w/ loss of consciousness at home. There is
no history of trauma or ingestion and his wife states that he complained of a headache
and vomiting earlier, and appeared to be drowsy. She checked on him after he had
returned to the bedroom to rest, but she was unable to arouse him. Exam is significant
for pinpoint pupils that are bilaterally reactive and total paralysis. Which is consistent
with the history & presentation?
a. Subarachnoid hemorrhage
b. Pontine hemorrhage
c. MCA ischemic stroke
d. Vertebrobasilar artery stroke - ANSWER-Pontine hemorrhage
Contraindication for tPA - ANSWER-Prior intracranial hemorrhage at any time
Headache described as: severe, unilateral throbbing pain that is aggravated by
movement, associated with nausea and sensitivity to light. Physical exam is completely
normal - what is the likely diagnosis?
a. Migraine headache
b. Tension headache
c. Cluster headache
d. nummular headache - ANSWER-Migraine
50 y/o male with weakness in legs that has progressed over 2 days. PMH: DM, HTN &
recent resp. infection. He reports numbness and tingling in his feet and his exam is
significant for decreased ankle jerk reflexes. The NP suspect Guillian-Barre Syndrome.
Which of the following is true?
a. It is caused by autoantibodies to acetylcholine receptors
b. Creatinine phosphokinase may be elevated
c. ESR will be decreased
d. CSF protein is reduced - ANSWER-Creatinine phosphokinase may be elevated
Which of the following characterizes a patient who is experiences a simple partial
seizure? - ANSWER-Abnormal motor behavior in an awake state that lasts 2 minutes
Which of the following would you expect in the evaluation of a patient with Parkinson's
disease?
a. Ataxia and occulomotor dysfunction
b. Sensory loss and muscle weakness
c. Shuffling gait and rigidity
d. Aphasia and dementia - ANSWER-Shuffling gait and rigidity
Nonmaleficence - ANSWER-Avoidance of harm
, 37 y/o female presents with c/o fatigue, increasing extremity weakness, ptosis, diplopia
that began 12 hours ago. The ACNP knows these are signs of?
a. GBS
b. MS
c. Myasthenia gravis
d. CVA - ANSWER-Myasthenia gravis
Which are risk factors for developing critical illness myopathy? - ANSWER-1. Patients
who receive high dose corticosteroids
2. Patients who receive prolong neuromuscular blockage
3. Patients who have a prolonged ICU stay
Patients who have multi organ failure
A GCS less than _ supports intubation - ANSWER-8
The first priority of the evaluation of a patient with bak pain to exclude a treatable
compression of the spinal cord - ANSWER-True
78 y/o with a history of epilepsy after severe head trauma in MVC several hours ago
arrives by ambulance. She is unresponsive with urinary incontinence and tonic clonic
activity that began approx. 10 minutes prior to arrival. Which of the following is the best
choice for the initial treatment of this patient?
a. Lorazepam
b. Levetiracetam
c. Dilantin
Lamotrigine - ANSWER-Lorazepam
A 60 year old male with a past medical history significant for hypertension, CAD, and
atrial fibrillation presents by ambulance from local shopping mall after he slipped and hit
his head. He denies LOC or headache, however bystanders stated that he appeared
confused. His medications include metoprolol, pravastatin, baby aspirin, nitroglycerin
SLT, and warfarin. He is alert and oriented to person, place and time. His head is
atraumatic.
Pupils are symmetric and reactive bilaterally. Extraocular muscles and visual fields are
intact. Funduscopic exam reveals no papilledema., Neck is non-tender without bony
deformity or step-off. Motor strength and reflexes are intact and symmetric in bilateral
upper and lower extremities. He tandem walks without difficulty, and his finger-to-nose
and thumb-to-finger tests are normal. His Romberg test is negative. He can recall 5/5
objects immediately and 4/5 after 5 minutes. He his able - ANSWER-He should undergo
CT scan of brain due to anticoagulation therapy.
A 58-year-old male presents to the ER with acute onset weakness of the right side of
his body and dysarthria that started 30 minutes earlier. Besides a diagnosis of
hypertension 5 years ago his medical and drug history are unremarkable. A cof the
brain reveals no evidence of hemorrhage. His VS are as follows: T98.2, HR 68, BP
and Answers
Which of the following sedative agents can act as a negative inotrope? Select all that
apply.
a. Propofol
b. Fentanyl
c. Dexmedetomidine
d. Midazolam - ANSWER-Propofol & Dexmedetomidine
Which of the following CSF findings is most likely in a patient with bacterial meningitis?
a. Lymphocyte predominance
b. Decreased opening pressures on lumbar puncture
c. increased glucose
d. increase protein - ANSWER-Increased protein
A NP's license can be jeopardized by improper actions. What's an example of an action
that would put an NP's license in jeopardy?
a. You appropriately delegate medication administration to a trusted RN employee who
administers a fatal dose
b. You delegate client assessment tasks to an LPN who has been floated to your unit
fort he day
c. You provide nursing care services consistent with established standards of practice in
your jurisdiction
d. The medical assistant in your supervision physician's office exceeds the scope of her
authority, but you take prompt action to correct the problem - ANSWER-B
A 19-year-old male college student presents with fever, headache and petechia rash. A
LP is performed. Grain stain of his CSF shows gram negative diplococci. Which of the
following organisms is the cause of his symptoms?
a. Streptococcus pneumonia
b. Cryptococcal meningitis
c. Neisseria meningitis
d. Listeria monocytogenes - ANSWER-Neisseria Meningitis
What differentiates delirium from dementia?
a. personality changes
b. global confusion
c. age of onset
d. reversibility
c. short-term memory impairment - ANSWER-Reversibility
,Pupil Abnormalities usually point to problems in the midbrain or CNIII. - ANSWER-True
A pt with uncontrolled HTN presents to ED w/ loss of consciousness at home. There is
no history of trauma or ingestion and his wife states that he complained of a headache
and vomiting earlier, and appeared to be drowsy. She checked on him after he had
returned to the bedroom to rest, but she was unable to arouse him. Exam is significant
for pinpoint pupils that are bilaterally reactive and total paralysis. Which is consistent
with the history & presentation?
a. Subarachnoid hemorrhage
b. Pontine hemorrhage
c. MCA ischemic stroke
d. Vertebrobasilar artery stroke - ANSWER-Pontine hemorrhage
Contraindication for tPA - ANSWER-Prior intracranial hemorrhage at any time
Headache described as: severe, unilateral throbbing pain that is aggravated by
movement, associated with nausea and sensitivity to light. Physical exam is completely
normal - what is the likely diagnosis?
a. Migraine headache
b. Tension headache
c. Cluster headache
d. nummular headache - ANSWER-Migraine
50 y/o male with weakness in legs that has progressed over 2 days. PMH: DM, HTN &
recent resp. infection. He reports numbness and tingling in his feet and his exam is
significant for decreased ankle jerk reflexes. The NP suspect Guillian-Barre Syndrome.
Which of the following is true?
a. It is caused by autoantibodies to acetylcholine receptors
b. Creatinine phosphokinase may be elevated
c. ESR will be decreased
d. CSF protein is reduced - ANSWER-Creatinine phosphokinase may be elevated
Which of the following characterizes a patient who is experiences a simple partial
seizure? - ANSWER-Abnormal motor behavior in an awake state that lasts 2 minutes
Which of the following would you expect in the evaluation of a patient with Parkinson's
disease?
a. Ataxia and occulomotor dysfunction
b. Sensory loss and muscle weakness
c. Shuffling gait and rigidity
d. Aphasia and dementia - ANSWER-Shuffling gait and rigidity
Nonmaleficence - ANSWER-Avoidance of harm
, 37 y/o female presents with c/o fatigue, increasing extremity weakness, ptosis, diplopia
that began 12 hours ago. The ACNP knows these are signs of?
a. GBS
b. MS
c. Myasthenia gravis
d. CVA - ANSWER-Myasthenia gravis
Which are risk factors for developing critical illness myopathy? - ANSWER-1. Patients
who receive high dose corticosteroids
2. Patients who receive prolong neuromuscular blockage
3. Patients who have a prolonged ICU stay
Patients who have multi organ failure
A GCS less than _ supports intubation - ANSWER-8
The first priority of the evaluation of a patient with bak pain to exclude a treatable
compression of the spinal cord - ANSWER-True
78 y/o with a history of epilepsy after severe head trauma in MVC several hours ago
arrives by ambulance. She is unresponsive with urinary incontinence and tonic clonic
activity that began approx. 10 minutes prior to arrival. Which of the following is the best
choice for the initial treatment of this patient?
a. Lorazepam
b. Levetiracetam
c. Dilantin
Lamotrigine - ANSWER-Lorazepam
A 60 year old male with a past medical history significant for hypertension, CAD, and
atrial fibrillation presents by ambulance from local shopping mall after he slipped and hit
his head. He denies LOC or headache, however bystanders stated that he appeared
confused. His medications include metoprolol, pravastatin, baby aspirin, nitroglycerin
SLT, and warfarin. He is alert and oriented to person, place and time. His head is
atraumatic.
Pupils are symmetric and reactive bilaterally. Extraocular muscles and visual fields are
intact. Funduscopic exam reveals no papilledema., Neck is non-tender without bony
deformity or step-off. Motor strength and reflexes are intact and symmetric in bilateral
upper and lower extremities. He tandem walks without difficulty, and his finger-to-nose
and thumb-to-finger tests are normal. His Romberg test is negative. He can recall 5/5
objects immediately and 4/5 after 5 minutes. He his able - ANSWER-He should undergo
CT scan of brain due to anticoagulation therapy.
A 58-year-old male presents to the ER with acute onset weakness of the right side of
his body and dysarthria that started 30 minutes earlier. Besides a diagnosis of
hypertension 5 years ago his medical and drug history are unremarkable. A cof the
brain reveals no evidence of hemorrhage. His VS are as follows: T98.2, HR 68, BP
