AACN ACNPC-AG Certification PSI Proctored Exam Complete 175 Questions Adult -Gerontology Acute Care Nurse Practitioner Certification AACN ACNPCAG Exam Review with Answers and Rationales | 100% Pass Guaranteed | Graded A+ | 2026

AACN ACNPC-AG Certification PSI Proctored Exam
Complete 175 Questions Adult -Gerontology Acute
Care Nurse Practitioner Certification AACN ACNPC-
AG Exam Review with Answers and Rationales |
100% Pass Guaranteed | Graded A+ | 2026




1. A 72-year-old male presents with sudden onset of severe, "tearing" chest pain radiating to the back.
His blood pressure is 190/110 mmHg in the right arm and 140/90 mmHg in the left arm. What is the
most appropriate initial diagnostic step?

 A. 12-lead ECG

 B. Chest X-ray

 C. Computed Tomography Angiography (CTA)

,  D. Transthoracic Echocardiogram (TTE)

Answer: C. CTA is the gold standard for rapid diagnosis of an aortic dissection, which is strongly
suspected given the tearing pain and blood pressure discrepancy between arms.

2. In managing a patient with Acute Respiratory Distress Syndrome (ARDS) on mechanical ventilation,
which strategy is recommended to reduce ventilator-induced lung injury (VILI)?

 A. High tidal volume (10–12 mL/kg)

 B. Low tidal volume (4–6 mL/kg)

 C. Low Positive End-Expiratory Pressure (PEEP)

 D. High fraction of inspired oxygen ($FiO_2$) above 0.60 for extended periods

Answer: B. Lung-protective ventilation using low tidal volumes is essential in ARDS to prevent
volutrauma and barotrauma.

3. Which of the following is the first-line treatment for a patient diagnosed with Idiopathic
Thrombocytopenic Purpura (ITP) with a platelet count of 15,000/µL?

 A. Platelet transfusion

 B. Heparin infusion

 C. Corticosteroids (e.g., Prednisone)

 D. Splenectomy

Answer: C. Corticosteroids are the standard first-line therapy to decrease the immune destruction of
platelets in ITP.



Clinical Judgment: Endocrine & Renal

4. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA). The serum potassium
is 3.2 mEq/L. What is the priority intervention?

 A. Start an insulin bolus at 0.1 units/kg.

 B. Initiate an insulin drip at 0.1 units/kg/hr.

 C. Administer IV potassium replacement before starting insulin.

 D. Administer IV sodium bicarbonate.

,Answer: C. In DKA, insulin will drive potassium into the cells, potentially causing life-threatening
hypokalemia. If potassium is below 3.3 mEq/L, it must be replaced before starting insulin.

5. An 80-year-old female is admitted with a hip fracture. She has a history of Stage 3 Chronic Kidney
Disease (CKD). Which medication should be avoided for pain management?

 A. Acetaminophen

 B. Oxycodone

 C. Ketorolac (Toradol)

 D. Fentanyl patch

Answer: C. NSAIDs like Ketorolac should be avoided in patients with CKD due to the risk of inducing
Acute Kidney Injury (AKI) by inhibiting renal prostaglandins.



Clinical Judgment: Neurology & Multisystem

6. A patient with a Traumatic Brain Injury (TBI) has an Intracranial Pressure (ICP) of 25 mmHg. Which
position is most effective in promoting venous drainage and lowering ICP?

 A. Supine with legs elevated

 B. Trendelenburg position

 C. Head of bed (HOB) elevated to 30–45 degrees, neck in neutral alignment

 D. Prone position

Answer: C. Elevating the HOB and maintaining a neutral neck position facilitates venous outflow from
the brain, reducing ICP.

7. In a patient with septic shock, despite adequate fluid resuscitation (30 mL/kg), the mean arterial
pressure (MAP) remains 55 mmHg. What is the next priority?

 A. Administer a second 30 mL/kg fluid bolus.

 B. Start Norepinephrine (Levophed) to maintain MAP ≥ 65 mmHg.

 C. Administer Dopamine.

 D. Start a Vasopressin bolus.

Answer: B. Norepinephrine is the first-choice vasopressor recommended by the Surviving Sepsis
Guidelines for refractory hypotension in septic shock.

, Professional Caring & Ethical Practice

8. An AGACNP is working with a team to implement a new evidence-based protocol for sedation
interruption in the ICU. This represents which domain of the Synergy Model?

 A. Advocacy/Moral Agency

 B. Clinical Inquiry

 C. Systems Thinking

 D. Collaboration

Answer: B. Clinical Inquiry involves the use of research and evidence to improve patient outcomes and
nursing practice.

9. A patient with terminal cancer has an Advanced Directive stating "DNR" (Do Not Resuscitate). The
family is now demanding that "everything be done." What is the AGACNP's primary ethical
responsibility?

 A. Follow the family's wishes to avoid legal conflict.

 B. Resuscitate the patient if they arrest, then consult ethics.

 C. Honor the patient’s Advanced Directive and communicate this clearly to the family.

 D. Transfer the patient to another provider who will follow the family's wishes.

Answer: C. The patient's autonomy is paramount. A valid Advanced Directive should be honored even if
the family disagrees.

10. A staff nurse expresses concern about the hospital’s lack of a specific policy for bedside ultrasound
by NPs. The AGACNP gathers stakeholders to develop a credentialing policy. This is an example of:

 A. Response to Diversity

 B. Facilitation of Learning

 C. Collaboration

 D. Systems Thinking

Answer: D. Systems Thinking involves navigating the complexities of the healthcare system to drive
organizational change and ensure safe practice.

11 A 68-year-old male presents with acute onset of right lower quadrant pain. He has a history of
heart failure (EF 35%) and atrial fibrillation on warfarin. CT scan shows a thickened cecum with
pericolonic stranding. His INR is 3.2. What is the priority management step? A. Immediate
surgical consultation for right hemicolectomy