AGACNP MIRROR EXAM – ADULT GERONTOLOGY ACUTE CARE
NP PRACTICE TEST EXAM - (175 QUESTIONS) UP-TO-DATE
ACTUAL EXAM QUESTIONS AND 100% ACCURATE SOLUTIONS |
VERIFIED ANSWERS - INSTANT PDF DOWNLOAD
Examiner/Administrator: American Nurses Credentialing Center (ANCC) /
American Association of Critical-Care Nurses (AACN)
CANDIDATE INFORMATION
Candidate Name: ________________________________
Candidate ID: __________________________________
Date: _________________________________________
Examination Center: _____________________________
AGACNP CERTIFICATION PRACTICE EXAMINATION
Time Allocation: 3 Hours
Total Questions: 175 (Simulation; this section contains Questions 1–30)
INSTRUCTIONS TO CANDIDATES
• Read each question carefully before selecting the best answer.
• Each question has only one correct answer.
• Manage your time effectively; do not spend too long on one question.
• Clinical judgment, prioritization, and evidence-based reasoning are
essential.
• No external materials are permitted during this examination.
• Ensure all answers are clearly marked.
DISCLAIMER
This is an original simulation designed for preparation purposes. It is not
affiliated with or endorsed by any official certifying body. The content reflects
the structure, rigor, and domains typical of AGACNP certification exams.
, CORE DOMAINS & INTRODUCTION
This assessment evaluates advanced clinical knowledge and decision-making
skills required of Adult-Gerontology Acute Care Nurse Practitioners
(AGACNPs). Candidates are expected to demonstrate competency in
managing complex acute, critical, and chronic conditions in adult and elderly
populations. Emphasis is placed on diagnostic reasoning, pharmacologic
management, procedural awareness, and interprofessional care coordination.
Core domains include: Acute and Critical Care Management, Cardiovascular
Disorders, Pulmonary and Respiratory Care, Neurological Emergencies,
Renal and Metabolic Disorders, Infectious Diseases, Pharmacology, and
Ethical/Professional Practice.
Q1. A 68-year-old male with a history of COPD presents with worsening
dyspnea, confusion, and somnolence. ABG shows pH 7.28, PaCO₂ 62 mmHg,
PaO₂ 55 mmHg, HCO₃⁻ 28 mEq/L. What is the most appropriate next step?
A. Initiate high-flow oxygen via non-rebreather
B. Begin BiPAP therapy
C. Intubate immediately
D. Administer IV bicarbonate
Correct Answer: B. Begin BiPAP therapy
Explanation:
This patient has acute-on-chronic respiratory acidosis due to COPD
exacerbation. BiPAP reduces CO₂ retention and improves ventilation while
avoiding intubation.
A is incorrect: Excess oxygen may suppress respiratory drive.
C is premature unless BiPAP fails or patient deteriorates.
D is inappropriate as bicarbonate does not treat respiratory acidosis.
,Q2. A patient with septic shock remains hypotensive after adequate fluid
resuscitation. Which vasopressor is first-line?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Phenylephrine
Correct Answer: C. Norepinephrine
Explanation:
Norepinephrine is the preferred first-line agent in septic shock due to strong
alpha-adrenergic vasoconstriction and improved MAP.
A increases arrhythmia risk.
B is second-line.
D may reduce cardiac output.
Q3. A 72-year-old female develops sudden unilateral weakness and aphasia. CT
scan is negative for hemorrhage. Symptom onset was 2 hours ago. What is the
next step?
A. Start aspirin immediately
B. Administer tPA
C. Perform MRI first
D. Wait 24 hours
Correct Answer: B. Administer tPA
Explanation:
Within 4.5 hours of ischemic stroke onset, tPA is indicated if no
, contraindications exist.
A delays definitive treatment.
C is unnecessary before thrombolysis.
D increases risk of permanent damage.
Q4. A patient with acute MI develops bradycardia and hypotension. Which
medication is indicated?
A. Metoprolol
B. Atropine
C. Nitroglycerin
D. Lidocaine
Correct Answer: B. Atropine
Explanation:
Atropine treats symptomatic bradycardia by increasing heart rate.
A worsens bradycardia.
C reduces preload and may worsen hypotension.
D is for arrhythmias, not bradycardia.
Q5. Which finding is most consistent with tension pneumothorax?
A. Bilateral crackles
B. Tracheal deviation away from affected side
C. Bradycardia
D. Hyperactive bowel sounds
NP PRACTICE TEST EXAM - (175 QUESTIONS) UP-TO-DATE
ACTUAL EXAM QUESTIONS AND 100% ACCURATE SOLUTIONS |
VERIFIED ANSWERS - INSTANT PDF DOWNLOAD
Examiner/Administrator: American Nurses Credentialing Center (ANCC) /
American Association of Critical-Care Nurses (AACN)
CANDIDATE INFORMATION
Candidate Name: ________________________________
Candidate ID: __________________________________
Date: _________________________________________
Examination Center: _____________________________
AGACNP CERTIFICATION PRACTICE EXAMINATION
Time Allocation: 3 Hours
Total Questions: 175 (Simulation; this section contains Questions 1–30)
INSTRUCTIONS TO CANDIDATES
• Read each question carefully before selecting the best answer.
• Each question has only one correct answer.
• Manage your time effectively; do not spend too long on one question.
• Clinical judgment, prioritization, and evidence-based reasoning are
essential.
• No external materials are permitted during this examination.
• Ensure all answers are clearly marked.
DISCLAIMER
This is an original simulation designed for preparation purposes. It is not
affiliated with or endorsed by any official certifying body. The content reflects
the structure, rigor, and domains typical of AGACNP certification exams.
, CORE DOMAINS & INTRODUCTION
This assessment evaluates advanced clinical knowledge and decision-making
skills required of Adult-Gerontology Acute Care Nurse Practitioners
(AGACNPs). Candidates are expected to demonstrate competency in
managing complex acute, critical, and chronic conditions in adult and elderly
populations. Emphasis is placed on diagnostic reasoning, pharmacologic
management, procedural awareness, and interprofessional care coordination.
Core domains include: Acute and Critical Care Management, Cardiovascular
Disorders, Pulmonary and Respiratory Care, Neurological Emergencies,
Renal and Metabolic Disorders, Infectious Diseases, Pharmacology, and
Ethical/Professional Practice.
Q1. A 68-year-old male with a history of COPD presents with worsening
dyspnea, confusion, and somnolence. ABG shows pH 7.28, PaCO₂ 62 mmHg,
PaO₂ 55 mmHg, HCO₃⁻ 28 mEq/L. What is the most appropriate next step?
A. Initiate high-flow oxygen via non-rebreather
B. Begin BiPAP therapy
C. Intubate immediately
D. Administer IV bicarbonate
Correct Answer: B. Begin BiPAP therapy
Explanation:
This patient has acute-on-chronic respiratory acidosis due to COPD
exacerbation. BiPAP reduces CO₂ retention and improves ventilation while
avoiding intubation.
A is incorrect: Excess oxygen may suppress respiratory drive.
C is premature unless BiPAP fails or patient deteriorates.
D is inappropriate as bicarbonate does not treat respiratory acidosis.
,Q2. A patient with septic shock remains hypotensive after adequate fluid
resuscitation. Which vasopressor is first-line?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Phenylephrine
Correct Answer: C. Norepinephrine
Explanation:
Norepinephrine is the preferred first-line agent in septic shock due to strong
alpha-adrenergic vasoconstriction and improved MAP.
A increases arrhythmia risk.
B is second-line.
D may reduce cardiac output.
Q3. A 72-year-old female develops sudden unilateral weakness and aphasia. CT
scan is negative for hemorrhage. Symptom onset was 2 hours ago. What is the
next step?
A. Start aspirin immediately
B. Administer tPA
C. Perform MRI first
D. Wait 24 hours
Correct Answer: B. Administer tPA
Explanation:
Within 4.5 hours of ischemic stroke onset, tPA is indicated if no
, contraindications exist.
A delays definitive treatment.
C is unnecessary before thrombolysis.
D increases risk of permanent damage.
Q4. A patient with acute MI develops bradycardia and hypotension. Which
medication is indicated?
A. Metoprolol
B. Atropine
C. Nitroglycerin
D. Lidocaine
Correct Answer: B. Atropine
Explanation:
Atropine treats symptomatic bradycardia by increasing heart rate.
A worsens bradycardia.
C reduces preload and may worsen hypotension.
D is for arrhythmias, not bradycardia.
Q5. Which finding is most consistent with tension pneumothorax?
A. Bilateral crackles
B. Tracheal deviation away from affected side
C. Bradycardia
D. Hyperactive bowel sounds
