ANCC Adult-Gerontology Primary Care Nurse Practitioner Certification Examination Practice Test
Adult-gerontology primary care practice spans health promotion, preventive screening, and evaluation of new or ongoing concerns in adults and older adults. The available questions include situations involving blood pressure, falls, anemia, breast or lymph-node findings, positive screening tests, sexual health, and exertional breathlessness. They emphasize choosing an appropriate initial assessment or next step based on the patient’s presentation.
Exam overview
About the ANCC Adult-Gerontology Primary Care Nurse Practitioner Certificati… Exam
Clinical judgment in primary care includes distinguishing a screening need from evaluation of a new symptom, identifying findings that warrant further workup, and selecting an appropriate initial investigation. Care of older adults also calls for attention to function, fall risk, medication effects, and changes in vital signs with position. Preventive counseling may address cardiovascular risk, home safety, and sexually transmitted infection prevention. Questions also call for interpreting common clinical cues—for example, recognizing that a positive fecal immunochemical test requires follow-up, or that a persistent unexplained lymph node needs assessment rather than routine observation. When a patient reports dyspnea without acute distress, the clinician must gather focused history and examination findings to guide further evaluation. These scenarios support practice in prioritizing concerns, explaining recommendations, and planning follow-up while accounting for age and the details provided.
Sample Practice Questions
Review a selection from this exam's published US Practice Tests practice bank.
A 67-year-old with a history of recurrent falls asks about reducing fall risk at home. Which practical change is most appropriate?
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Correct answer: ARemoving loose rugs and improving lighting reduce common environmental fall hazards. Home safety changes should be individualized and can be combined with assessment of gait, medications, vision, and strength.
A 70-year-old with newly diagnosed hypertension has no known cardiovascular disease or diabetes. Which initial lifestyle recommendation is most likely to help lower blood pressure?
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Correct answer: BA DASH-style eating pattern and sodium reduction can lower blood pressure and support cardiovascular health. Regular physical activity and weight management are also useful. Potassium-containing salt substitutes require caution in people with kidney disease or medications that raise potassium.
A 72-year-old has a new, firm, painless cervical lymph node that has persisted for six weeks without a recent infection. What is the most appropriate approach?
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Correct answer: BA persistent, unexplained lymph node in an older adult warrants timely evaluation for important causes, including malignancy. The workup should be guided by its location, characteristics, associated symptoms, and examination rather than delayed or treated empirically without evidence of infection.
A 60-year-old reports a new breast lump that has persisted for three weeks. The patient is not due for routine screening for another year. What is the appropriate approach?
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Correct answer: BA persistent palpable breast mass is a symptom requiring diagnostic assessment, not routine screening. Evaluation commonly includes clinical examination and age-appropriate diagnostic imaging, with further testing guided by findings.
A 70-year-old with hypertension reports dizziness when standing. Supine blood pressure is 142/78 mm Hg and, after standing for three minutes, is 116/68 mm Hg with symptoms. What is the best initial clinical response?
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Correct answer: AA symptomatic postural blood-pressure drop warrants assessment for medication effects, volume depletion, and other causes. Review the medication list and hydration, consider appropriate management changes, and address safety and fall prevention rather than reflexively intensifying blood-pressure treatment.
A 64-year-old has a screening fecal immunochemical test that is positive and feels well. What is the appropriate next step?
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Correct answer: BA positive fecal immunochemical test requires diagnostic follow-up, typically colonoscopy, even when the patient has no symptoms. Repeating the screening test does not replace evaluation of the positive result.
A 70-year-old has a new normocytic anemia on routine testing. The patient is hemodynamically stable and reports no visible bleeding. What is a useful initial step in evaluating the anemia?
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Correct answer: BAnemia evaluation begins by confirming and characterizing the abnormality, including red-cell indices and often a reticulocyte count, followed by a focused history, examination, and targeted testing. Empiric iron may be inappropriate without evidence of iron deficiency, and invasive testing is not automatically the first step.
How to use this practice test
Access is free. The published bank contains 50 questions; each practice session presents up to 20 random questions and displays results afterward. Use a session to identify which clinical decisions need more work, then revisit the reasoning behind missed answers, such as evaluating orthostatic symptoms or following up an abnormal screening result.
Preparation tips
- For orthostatic dizziness, compare supine and standing measurements with symptoms, and consider medication effects and immediate fall risk when choosing a response.
- Distinguish screening from diagnostic evaluation: a new persistent breast lump or cervical node calls for assessment even when routine screening is not due.
- Practice follow-up planning for abnormal screening results, including the need to evaluate a positive fecal immunochemical test.
- For new anemia, organize an initial evaluation around the blood-count pattern, relevant history, and evidence of blood loss.
- For exertional dyspnea, rehearse focused history and examination questions that help separate cardiopulmonary causes and determine urgency.