200+ Free ANCC AGPCNP-BC Practice Questions

Pass your ANCC Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP-BC) exam on the first try — instant access, no signup required.

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Question 1

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A 68-year-old male presents for his annual wellness visit. He has a history of hypertension and type 2 diabetes. Which screening test is most appropriate to recommend at this visit?

Chest X-ray

Low-dose CT scan for lung cancer

Carotid artery ultrasound

Cardiac stress test

to track

2026 Statistics

Key Facts: ANCC AGPCNP-BC Exam

175

Total Questions

ANCC AGPCNP page

150

Scored Questions

ANCC AGPCNP page

3.5h

Exam Time

ANCC AGPCNP page

85%

First-Time Pass Rate (2024)

ANCC

60%

Plan of Care Domain

ANCC AGPCNP outline

$132K

NP Median Salary

BLS 2024

ANCC lists AGPCNP-BC as a 175-question exam with 150 scored and 25 unscored pretest items, administered over 3.5 hours. The content outline weights are Patient Assessment Process 24%, Plan of Care 60%, and Professional Practice 16%. ANCC reports an 85% first-time pass rate in 2024. BLS projects 35% NP employment growth (2024-2034) with median pay of $132,050.

Sample ANCC AGPCNP-BC Practice Questions

Try these sample questions to test your ANCC AGPCNP-BC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1A 68-year-old male presents for his annual wellness visit. He has a history of hypertension and type 2 diabetes. Which screening test is most appropriate to recommend at this visit?

A.Chest X-ray

B.Low-dose CT scan for lung cancer

C.Carotid artery ultrasound

D.Cardiac stress test

Explanation: Low-dose CT scan for lung cancer screening is recommended annually for adults aged 50-80 with a 20 pack-year smoking history who currently smoke or quit within the past 15 years. The USPSTF recommends this as a Grade B screening. Chest X-ray is not recommended for lung cancer screening. Carotid ultrasound and cardiac stress test are not routine screening tests for asymptomatic patients without specific indications.

2During the cardiovascular examination of a 72-year-old female, the NP auscultates an S4 heart sound. This finding most commonly indicates:

A.Mitral valve regurgitation

B.Left ventricular hypertrophy

C.Aortic stenosis

D.Atrial fibrillation

Explanation: An S4 heart sound (atrial gallop) is caused by atrial contraction against a stiff, non-compliant left ventricle. It is most commonly associated with left ventricular hypertrophy due to hypertension, which is prevalent in older adults. S4 is rarely heard in normal adults but is common in elderly patients due to reduced ventricular compliance. Mitral regurgitation typically causes a holosystolic murmur, aortic stenosis causes a crescendo-decrescendo systolic murmur, and atrial fibrillation is characterized by an irregularly irregular rhythm without distinct heart sounds.

3A 55-year-old patient reports progressive hearing loss in both ears over the past year. The NP performs the whisper test and notes decreased hearing bilaterally. The next most appropriate step is:

A.Immediate referral to an audiologist

B.Prescribe hearing aids

C.Perform pneumatic otoscopy and order audiometry

D.Order CT scan of the temporal bones

Explanation: For suspected hearing loss, the NP should first perform a complete ear examination including pneumatic otoscopy to assess for cerumen impaction, infection, or structural abnormalities. Audiometry (hearing test) should then be ordered to quantify the degree and type of hearing loss. Referral to an audiologist is appropriate after initial evaluation or if hearing aids are needed. CT scan is reserved for suspected structural lesions or asymmetric sensorineural hearing loss.

4Which finding on musculoskeletal examination of a 65-year-old patient is consistent with normal age-related changes?

A.Decreased range of motion in all joints

B.Mild decreased spinal flexibility

C.Significant joint deformities

D.Marked muscle atrophy

Explanation: Mild decreased spinal flexibility is a normal age-related change due to decreased water content in intervertebral discs and ligamentous changes. Decreased ROM in all joints, significant joint deformities, and marked muscle atrophy are pathological findings requiring further evaluation. Normal aging may include mild decreased ROM in weight-bearing joints but not all joints.

5A 58-year-old female with a BMI of 32 and family history of type 2 diabetes has a fasting plasma glucose of 110 mg/dL. According to ADA guidelines, how often should she be screened for diabetes?

A.Every 3 years

B.Annually

C.Every 6 months

D.Only if symptoms develop

Explanation: The ADA recommends screening adults with prediabetes (FPG 100-125 mg/dL) annually for type 2 diabetes. This patient has prediabetes and is overweight (BMI >25) with a family history, placing her at high risk. Annual screening allows for early detection and intervention to prevent or delay the onset of diabetes.

6The NP is conducting a fall risk assessment on a 76-year-old patient. Which factor places this patient at highest risk for falls?

A.Taking a daily multivitamin

B.History of previous falls

C.Living with a spouse

D.Walking 30 minutes daily

Explanation: A history of previous falls is the strongest predictor of future falls. Other significant risk factors include age over 80, gait or balance abnormalities, use of sedating medications, cognitive impairment, and lower extremity weakness. Regular exercise like walking and social support are protective factors against falls.

7According to USPSTF guidelines, at what age should routine colorectal cancer screening begin for average-risk adults?

A.40 years

B.45 years

C.50 years

D.55 years

Explanation: The USPSTF updated their guidelines in 2021 to recommend that colorectal cancer screening begin at age 45 for average-risk adults (Grade B recommendation). This change was made due to increasing incidence of colorectal cancer in younger adults. Screening should continue through age 75, with individualized decisions for adults aged 76-85.

8A 62-year-old patient presents with fatigue, weight loss, and night sweats. Laboratory studies show Hgb 9.2 g/dL, MCV 88 fL, and elevated LDH. What is the most likely diagnosis?

A.Iron deficiency anemia

B.Vitamin B12 deficiency

C.Lymphoma

D.Chronic kidney disease

Explanation: The combination of constitutional symptoms (fatigue, weight loss, night sweats - "B symptoms"), normocytic anemia (MCV 80-100 fL), and elevated LDH is highly suggestive of lymphoma. B symptoms and elevated LDH are characteristic of lymphoid malignancies. Iron deficiency would show microcytic anemia, B12 deficiency would show macrocytic anemia, and CKD typically presents with normocytic anemia but without B symptoms or elevated LDH.

9A 70-year-old male with a history of hypertension presents with acute onset of dyspnea, pleuritic chest pain, and tachycardia. His D-dimer is elevated. The next best step in management is:

A.Begin empiric anticoagulation therapy

B.Order CT pulmonary angiography (CTPA)

C.Obtain ventilation-perfusion scan

D.Start antibiotics for pneumonia

Explanation: Given the clinical presentation highly suggestive of pulmonary embolism (dyspnea, pleuritic chest pain, tachycardia) with elevated D-dimer, CT pulmonary angiography (CTPA) is the diagnostic test of choice. CTPA provides excellent visualization of pulmonary vasculature and is widely available. While empiric anticoagulation may be considered in high-probability cases, imaging confirmation is preferred when the patient is hemodynamically stable. V/Q scans are reserved for patients with contraindications to CT contrast.

10A 45-year-old patient presents with polyuria, polydipsia, and blurred vision. Random blood glucose is 280 mg/dL. Which test is most appropriate to confirm the diagnosis?

A.Fasting plasma glucose

B.Hemoglobin A1c

C.Oral glucose tolerance test

D.All of the above

Explanation: According to ADA criteria, diabetes can be diagnosed by any one of the following: fasting plasma glucose ≥126 mg/dL, hemoglobin A1c ≥6.5%, 2-hour OGTT ≥200 mg/dL, or random plasma glucose ≥200 mg/dL with classic symptoms of hyperglycemia. This patient already has symptoms and a random glucose of 280 mg/dL, which meets diagnostic criteria. However, any of these tests can confirm the diagnosis if positive.

About the ANCC AGPCNP-BC Exam

The ANCC AGPCNP-BC exam validates entry-level adult-gerontology primary care NP competency across assessment, plan of care, and professional practice domains. The exam focuses on care for adolescents through older adults in primary care settings.

Questions

175 scored questions

Time Limit

3.5 hours

Passing Score

350/500 scale score

Exam Fee

$295 ANA members / $395 non-members (ANCC)

ANCC AGPCNP-BC Exam Content Outline

24%

Patient Assessment Process

Health history, physical examination, risk assessment, diagnostic reasoning, age-appropriate screening, and health promotion across the adult lifespan

60%

Plan of Care

Clinical management including cardiovascular, endocrine, respiratory, GI, renal, musculoskeletal, neurological, dermatologic, infectious disease, reproductive, and age-related care

16%

Professional Practice

Scope of practice, ethics, legal issues, evidence-based practice, quality improvement, cultural competence, care coordination, and population health

How to Pass the ANCC AGPCNP-BC Exam

What You Need to Know

Passing score: 350/500 scale score
Exam length: 175 questions
Time limit: 3.5 hours
Exam fee: $295 ANA members / $395 non-members

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ANCC AGPCNP-BC Study Tips from Top Performers

1Master the Plan of Care domain (60%) - focus on disease management across body systems

2Study age-related changes and how they affect assessment and treatment decisions

3Practice medication management and pharmacology for older adults with polypharmacy

4Review professional practice topics including scope of practice variations by state

5Focus on health promotion and disease prevention strategies across the adult lifespan

6Study common geriatric syndromes: falls, cognitive impairment, functional decline

Frequently Asked Questions

How many questions are on the AGPCNP-BC exam?

ANCC lists 175 total questions: 150 scored items and 25 unscored pretest items. You have 3 hours and 30 minutes to complete the exam.

What is the AGPCNP-BC pass rate?

ANCC reports an 85% first-time pass rate for AGPCNP-BC in 2024. The exam is challenging and requires comprehensive preparation across all three content domains.

What are the AGPCNP-BC content weights?

The ANCC AGPCNP-BC test content outline weights domains as: Patient Assessment Process 24% (~42 items), Plan of Care 60% (~90 items), and Professional Practice 16% (~24 items).

How much does AGPCNP-BC certification cost?

ANCC publishes a tiered fee structure: $295 for ANA members, $340 for AANP members, and $395 for nonmembers. Additional eligibility-related costs may apply.

What is the difference between AGPCNP and FNP?

AGPCNP focuses on care for adolescents through older adults (13+ years) in primary care settings. FNP cares for patients across the entire lifespan including pediatrics. Both are primary care certifications but serve different patient populations.

How should I study for the AGPCNP-BC exam?

Focus on the Plan of Care domain (60% of exam) covering body systems management. Practice with age-specific scenarios across the adult lifespan. Review professional practice topics including scope, ethics, and evidence-based practice.