2026 AGNP CERTIFICATION
PRACTICE EXAM Adult-Gerontology
Primary Care Nurse Practitioner
Question 1
A 72-year-old male presents with progressive fatigue, pallor, and shortness of breath on exertion. His
CBC reveals: Hgb 9.2 g/dL, MCV 68 fL, RDW 18%. Which additional test is MOST important to order?
A) Vitamin B12 level
B) Reticulocyte count
C) Serum ferritin and iron studies
D) Hemoglobin electrophoresis
Question 2
When performing a cardiovascular examination on a 68-year-old female, you auscultate a systolic
crescendo-decrescendo murmur best heard at the right upper sternal border with radiation to the
carotids. This finding is MOST consistent with:
A) Mitral regurgitation
B) Aortic stenosis
C) Mitral stenosis
D) Aortic regurgitation
,Question 3
A 55-year-old male presents for an annual wellness visit. He has no symptoms and a 25 pack-year
smoking history (quit 10 years ago). According to current USPSTF guidelines, which screening is
recommended?
A) Chest X-ray annually
B) Sputum cytology
C) Low-dose CT scan of the chest
D) No lung cancer screening needed
Question 4
An 80-year-old patient presents with acute confusion. Which assessment tool is MOST appropriate for
initial evaluation of delirium?
A) Mini-Mental State Examination (MMSE)
B) Confusion Assessment Method (CAM)
C) Montreal Cognitive Assessment (MoCA)
D) Geriatric Depression Scale (GDS)
Question 5
A 45-year-old female presents with fatigue, cold intolerance, and weight gain. Physical exam reveals
delayed relaxation of deep tendon reflexes. Which laboratory finding would you expect?
A) Low TSH, high free T4
B) High TSH, low free T4
C) Normal TSH, low free T3
D) Low TSH, low free T4
Question 6
When evaluating a 65-year-old male with suspected peripheral arterial disease, which finding is MOST
specific?
, A) Hair loss on lower extremities
B) Cool extremities
C) Ankle-brachial index (ABI) < 0.9
D) Diminished pedal pulses
Question 7
A 58-year-old diabetic patient presents for follow-up. To assess long-term glycemic control over the past
2-3 months, which test is MOST appropriate?
A) Fasting blood glucose
B) Random blood glucose
C) Hemoglobin A1C
D) Oral glucose tolerance test
Question 8
During a well-woman exam, a 52-year-old female reports hot flashes, night sweats, and irregular
menses. Which laboratory test BEST confirms perimenopause?
A) Estradiol level
B) Progesterone level
C) FSH level
D) LH level
DOMAIN 2: PLAN OF CARE (60%)
Question 9
A 70-year-old male with newly diagnosed hypertension and type 2 diabetes presents for medication
initiation. Which antihypertensive class is FIRST-LINE for this patient?
A) Beta-blocker
B) Calcium channel blocker
PRACTICE EXAM Adult-Gerontology
Primary Care Nurse Practitioner
Question 1
A 72-year-old male presents with progressive fatigue, pallor, and shortness of breath on exertion. His
CBC reveals: Hgb 9.2 g/dL, MCV 68 fL, RDW 18%. Which additional test is MOST important to order?
A) Vitamin B12 level
B) Reticulocyte count
C) Serum ferritin and iron studies
D) Hemoglobin electrophoresis
Question 2
When performing a cardiovascular examination on a 68-year-old female, you auscultate a systolic
crescendo-decrescendo murmur best heard at the right upper sternal border with radiation to the
carotids. This finding is MOST consistent with:
A) Mitral regurgitation
B) Aortic stenosis
C) Mitral stenosis
D) Aortic regurgitation
,Question 3
A 55-year-old male presents for an annual wellness visit. He has no symptoms and a 25 pack-year
smoking history (quit 10 years ago). According to current USPSTF guidelines, which screening is
recommended?
A) Chest X-ray annually
B) Sputum cytology
C) Low-dose CT scan of the chest
D) No lung cancer screening needed
Question 4
An 80-year-old patient presents with acute confusion. Which assessment tool is MOST appropriate for
initial evaluation of delirium?
A) Mini-Mental State Examination (MMSE)
B) Confusion Assessment Method (CAM)
C) Montreal Cognitive Assessment (MoCA)
D) Geriatric Depression Scale (GDS)
Question 5
A 45-year-old female presents with fatigue, cold intolerance, and weight gain. Physical exam reveals
delayed relaxation of deep tendon reflexes. Which laboratory finding would you expect?
A) Low TSH, high free T4
B) High TSH, low free T4
C) Normal TSH, low free T3
D) Low TSH, low free T4
Question 6
When evaluating a 65-year-old male with suspected peripheral arterial disease, which finding is MOST
specific?
, A) Hair loss on lower extremities
B) Cool extremities
C) Ankle-brachial index (ABI) < 0.9
D) Diminished pedal pulses
Question 7
A 58-year-old diabetic patient presents for follow-up. To assess long-term glycemic control over the past
2-3 months, which test is MOST appropriate?
A) Fasting blood glucose
B) Random blood glucose
C) Hemoglobin A1C
D) Oral glucose tolerance test
Question 8
During a well-woman exam, a 52-year-old female reports hot flashes, night sweats, and irregular
menses. Which laboratory test BEST confirms perimenopause?
A) Estradiol level
B) Progesterone level
C) FSH level
D) LH level
DOMAIN 2: PLAN OF CARE (60%)
Question 9
A 70-year-old male with newly diagnosed hypertension and type 2 diabetes presents for medication
initiation. Which antihypertensive class is FIRST-LINE for this patient?
A) Beta-blocker
B) Calcium channel blocker
