AGACNP-BC – QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS | PLUS RATIONALES MUST BE IN
ITALICS| GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS
• Acute and Critical Care Management
• Advanced Pathophysiology
• Pharmacology in Acute Care
• Diagnostic Interpretation and Clinical Reasoning
• Cardiovascular and Pulmonary Disorders
• Neurological and Multisystem Emergencies
• Ethics, Legal, and Professional Practice
• Renal, Endocrine, and Gastrointestinal Disorders
• Hematology, Infectious Disease, and Sepsis Management
• Procedural and ICU-based Interventions
INTRODUCTION
The AGACNP-BC examination evaluates advanced practice nurses specializing in acute and critical
care across complex adult and geriatric populations. This assessment measures clinical judgment,
diagnostic reasoning, pharmacologic competence, and evidence-based decision-making in high-
acuity environments. Questions are designed in multiple-choice format with real-world clinical
scenarios requiring integration of pathophysiology, patient assessment, and treatment planning.
Candidates are tested on their ability to prioritize interventions, interpret diagnostic data, manage
emergencies, and apply ethical and legal standards in practice. This exam emphasizes safe, effective,
and timely decision-making consistent with advanced nursing practice expectations in acute care
settings.
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SECTION ONE: QUESTIONS 1–80
════════════════════════════════════
1. A 68-year-old patient presents with sudden chest pain, diaphoresis, and ST elevation in leads
II, III, and aVF. What is the most likely diagnosis?
A. Anterior myocardial infarction
B. Inferior myocardial infarction
C. Pulmonary embolism
D. Pericarditis
Correct Answer: B. Inferior myocardial infarction
Explanation: ST elevation in II, III, and aVF indicates inferior wall MI, usually involving the right
coronary artery.
, 2. A patient in septic shock has hypotension despite fluid resuscitation. What is the first-line
vasopressor?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Phenylephrine
Correct Answer: C. Norepinephrine
Explanation: Norepinephrine is first-line for septic shock due to potent alpha-adrenergic
vasoconstriction.
3. Which ABG result indicates respiratory acidosis?
A. pH 7.48, CO₂ 30
B. pH 7.32, CO₂ 55
C. pH 7.50, HCO₃ 30
D. pH 7.40, CO₂ 40
Correct Answer: B. pH 7.32, CO₂ 55
Explanation: Elevated CO₂ with low pH indicates hypoventilation causing respiratory acidosis.
4. The most appropriate initial intervention for acute pulmonary edema is:
A. IV fluids
B. High-flow oxygen and diuretics
C. Beta-blockers
D. Oral nitrates
Correct Answer: B. High-flow oxygen and diuretics
Explanation: Oxygen improves hypoxia and diuretics reduce fluid overload in pulmonary edema.
5. A patient with head trauma has a Glasgow Coma Scale of 6. What is the priority action?
A. MRI brain
B. Airway protection with intubation
C. Administer mannitol
D. Observe closely
Correct Answer: B. Airway protection with intubation
Explanation: GCS ≤8 requires airway protection due to loss of protective reflexes.
6. Which lab is most indicative of acute kidney injury?
, A. Elevated BUN and creatinine
B. Low potassium
C. Low sodium
D. High hemoglobin
Correct Answer: A. Elevated BUN and creatinine
Explanation: AKI is characterized by reduced renal clearance leading to elevated nitrogenous
waste.
7. First-line treatment for ventricular fibrillation is:
A. Amiodarone
B. Defibrillation
C. Atropine
D. Lidocaine infusion
Correct Answer: B. Defibrillation
Explanation: Immediate defibrillation is required to restore organized cardiac rhythm.
8. Which condition is associated with Kussmaul respirations?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
Correct Answer: B. Metabolic acidosis
Explanation: Kussmaul breathing compensates for metabolic acidosis by blowing off CO₂.
9. A patient on heparin develops low platelets. What is suspected?
A. DIC
B. HIT
C. ITP
D. Leukemia
Correct Answer: B. HIT
Explanation: Heparin-induced thrombocytopenia is an immune-mediated drop in platelets.
10. What is the most appropriate treatment for anaphylaxis?
A. Oral antihistamines
B. IV steroids only
C. IM epinephrine
D. Nebulized albuterol only
WELL DETAILED ANSWERS | PLUS RATIONALES MUST BE IN
ITALICS| GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS
• Acute and Critical Care Management
• Advanced Pathophysiology
• Pharmacology in Acute Care
• Diagnostic Interpretation and Clinical Reasoning
• Cardiovascular and Pulmonary Disorders
• Neurological and Multisystem Emergencies
• Ethics, Legal, and Professional Practice
• Renal, Endocrine, and Gastrointestinal Disorders
• Hematology, Infectious Disease, and Sepsis Management
• Procedural and ICU-based Interventions
INTRODUCTION
The AGACNP-BC examination evaluates advanced practice nurses specializing in acute and critical
care across complex adult and geriatric populations. This assessment measures clinical judgment,
diagnostic reasoning, pharmacologic competence, and evidence-based decision-making in high-
acuity environments. Questions are designed in multiple-choice format with real-world clinical
scenarios requiring integration of pathophysiology, patient assessment, and treatment planning.
Candidates are tested on their ability to prioritize interventions, interpret diagnostic data, manage
emergencies, and apply ethical and legal standards in practice. This exam emphasizes safe, effective,
and timely decision-making consistent with advanced nursing practice expectations in acute care
settings.
════════════════════════════════════
SECTION ONE: QUESTIONS 1–80
════════════════════════════════════
1. A 68-year-old patient presents with sudden chest pain, diaphoresis, and ST elevation in leads
II, III, and aVF. What is the most likely diagnosis?
A. Anterior myocardial infarction
B. Inferior myocardial infarction
C. Pulmonary embolism
D. Pericarditis
Correct Answer: B. Inferior myocardial infarction
Explanation: ST elevation in II, III, and aVF indicates inferior wall MI, usually involving the right
coronary artery.
, 2. A patient in septic shock has hypotension despite fluid resuscitation. What is the first-line
vasopressor?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Phenylephrine
Correct Answer: C. Norepinephrine
Explanation: Norepinephrine is first-line for septic shock due to potent alpha-adrenergic
vasoconstriction.
3. Which ABG result indicates respiratory acidosis?
A. pH 7.48, CO₂ 30
B. pH 7.32, CO₂ 55
C. pH 7.50, HCO₃ 30
D. pH 7.40, CO₂ 40
Correct Answer: B. pH 7.32, CO₂ 55
Explanation: Elevated CO₂ with low pH indicates hypoventilation causing respiratory acidosis.
4. The most appropriate initial intervention for acute pulmonary edema is:
A. IV fluids
B. High-flow oxygen and diuretics
C. Beta-blockers
D. Oral nitrates
Correct Answer: B. High-flow oxygen and diuretics
Explanation: Oxygen improves hypoxia and diuretics reduce fluid overload in pulmonary edema.
5. A patient with head trauma has a Glasgow Coma Scale of 6. What is the priority action?
A. MRI brain
B. Airway protection with intubation
C. Administer mannitol
D. Observe closely
Correct Answer: B. Airway protection with intubation
Explanation: GCS ≤8 requires airway protection due to loss of protective reflexes.
6. Which lab is most indicative of acute kidney injury?
, A. Elevated BUN and creatinine
B. Low potassium
C. Low sodium
D. High hemoglobin
Correct Answer: A. Elevated BUN and creatinine
Explanation: AKI is characterized by reduced renal clearance leading to elevated nitrogenous
waste.
7. First-line treatment for ventricular fibrillation is:
A. Amiodarone
B. Defibrillation
C. Atropine
D. Lidocaine infusion
Correct Answer: B. Defibrillation
Explanation: Immediate defibrillation is required to restore organized cardiac rhythm.
8. Which condition is associated with Kussmaul respirations?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
Correct Answer: B. Metabolic acidosis
Explanation: Kussmaul breathing compensates for metabolic acidosis by blowing off CO₂.
9. A patient on heparin develops low platelets. What is suspected?
A. DIC
B. HIT
C. ITP
D. Leukemia
Correct Answer: B. HIT
Explanation: Heparin-induced thrombocytopenia is an immune-mediated drop in platelets.
10. What is the most appropriate treatment for anaphylaxis?
A. Oral antihistamines
B. IV steroids only
C. IM epinephrine
D. Nebulized albuterol only
