10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The AGACNP exam has 175 questions and runs 3 hours 30 minutes.
These 10 free AGACNP questions are organized by exam domain, so you can see how each part of the Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC) blueprint is tested. Reveal the answer and explanation under each question.
Despite a PaO2 of 94 mm Hg and arterial oxygen saturation of 97% on room air, a 72-year-old with chronic gastrointestinal blood loss is confused and dyspneic. Hemoglobin is 5.8 g/dL, lactate is 4.2 mmol/L, and the lungs are clear. Which mechanism best explains the tissue hypoxia?
Correct answer: A - Reduced arterial oxygen content because most oxygen is hemoglobin-bound
In diabetic ketoacidosis, the ABG shows pH 7.18, bicarbonate 10 mEq/L, and PaCO2 32 mm Hg. For metabolic acidosis, expected PaCO2 equals 1.5 times the bicarbonate plus 8, with a range of plus or minus 2 mm Hg. Which interpretation is correct?
Correct answer: A - Metabolic acidosis with a superimposed respiratory acidosis
After one sublingual nitroglycerin dose, an adult with an inferior STEMI becomes more hypotensive. Examination shows elevated jugular venous pressure and clear lungs; the ECG has ST elevation in V4R. Which order should be questioned before another dose is given?
Correct answer: D - Continue nitroglycerin for persistent ischemic chest discomfort
Following 30 mL/kg of balanced crystalloid for pneumonia-associated septic shock, a 69-year-old still has a MAP of 56 mm Hg, capillary refill of 5 seconds, and lactate of 5.4 mmol/L. Central venous access will not be available for at least 25 minutes. What is the best immediate step?
Correct answer: C - Start norepinephrine through a well-functioning peripheral IV with frequent site checks
Minutes after intubation and positive-pressure ventilation, a trauma patient develops abrupt hypotension, oxygen saturation of 78%, distended neck veins, and absent breath sounds on the left. The trachea remains midline. What should happen before confirmatory imaging?
Correct answer: C - Decompress the left chest immediately, followed by tube thoracostomy
CAM-ICU assessment of an older adult shows an acute fluctuating change from baseline, clear inattention on a validated attention test, a RASS score of 0, and disorganized thinking. How should the result be recorded?
Correct answer: B - Positive, because Features 1 and 2 plus Feature 4 are present
On arrival for a COPD exacerbation, a 71-year-old is alert and cooperative but using accessory muscles. Respiratory rate is 30/min, pH is 7.28, PaCO2 is 68 mm Hg, and SpO2 is 89% on titrated oxygen. The airway is protected and secretions are manageable. Which respiratory strategy fits this presentation?
Correct answer: B - Begin bilevel noninvasive ventilation and reassess gas exchange and work of breathing
A newly hired AGACNP holds current national certification and has extensive prior experience placing central lines but has not been granted that procedure privilege at the new hospital. A stable patient needs a nonemergent central line. What is the appropriate course?
Correct answer: B - Arrange for a privileged clinician and complete local privileging before performing the procedure
At a Medicare-participating rural emergency department, imaging confirms a leaking abdominal aortic aneurysm. The hospital lacks vascular surgery, has provided treatment within its capability to minimize transfer risk, and a tertiary center with capacity has accepted the patient. Which transfer plan meets EMTALA requirements?
Correct answer: B - Certify that benefits outweigh risks and send records with qualified, appropriately equipped transport
Barcode scanning intercepts a look-alike medication vial before administration. The nurse followed the established workflow, selected the vial inadvertently, and has no pattern of unsafe choices. Which response is most consistent with Just Culture?
Correct answer: C - Treat it as human error, support the nurse, and redesign storage and labeling risks
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