PRIMARY CARE ART AND SCIENCE OF
ADVANCED EXAM SCRIPT 2026 COMPLETE
QUESTIONS AND SOLUTIONS
◉ You suspect that Nikki has a gastroduodenal ulcer caused by
Helicobacter pylori and plan to treat her empirically. What
medications should you order?
1.
A proton pump inhibitor (omeprazole), tetracycline or amoxicillin,
and metronidazole (Flagyl).
2.
Bismuth subsalicylate (Pepto-Bismol) and omeprazole (Prilosec).
3.
Amoxicillin (Amoxil) and omeprazole (Prilosec).
4.
Clarithromycin (Biaxin) and metronidazole (Flagyl). Answer: A
proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and
metronidazole (Flagyl).
◉ An 83-year-old female presents to the urgent care clinic for
diarrhea. The patient was just discharged from the hospital 1 week
ago following treatment for pneumonia. The patient states she has
diarrhea, described as diffuse and watery, with mucus in it at times.
,She has approximately 10 episodes per day. What is the
recommended treatment for this patient?
1.
Fecal transplant.
2.
Intravenous (IV) metronidazole.
3.
Oral vancomycin.
4.
Gastrointestinal rest. Answer: Oral vancomycin.
◉ What is the most common bacterial cause of traveler's diarrhea?
1.
Escherichia coli.
2.
Campylobacter jejuni.
3.
Salmonella.
4.
Shigella. Answer: Escherichia coli.
,◉ A 7-year-old male presents with his mother to the urgent care
clinic complaining of abdominal pain. He started to complain of pain
prior to going to bed; however, it has gotten progressively worse and
is now preventing him from sleeping. He is nauseous but hasn't
vomited and didn't eat dinner due to the pain. The patient appears
pale and is complaining of right-sided abdominal pain. His vitals are
as follows: blood pressure 130/85, pulse 120, temperature 100.5°F,
pulse oximetry 98% on room air. On physical exam he is tender in
the right lower quadrant. His complete blood count (CBC) shows a
white blood cell count (WBC) of 17.0. What is the patient's likely
diagnosis?
1.
Appendicitis.
2.
Cholecystitis.
3.
Constipation.
4.
Gastroenteritis. Answer: Appendicitis.
◉ A 25-year-old male presents complaining of hematochezia. The
patient states he has noticed this for 2 days. He states there is a
streak of bright blood along his stool every time he has a bowel
movement. The patient has no pain with his bowel movements. He
admits to eating a poor diet. The patient has no abdominal pain,
nausea, or vomiting. On physical exam the patient has a positive
, fecal occult blood test but has no noticeable rectal bleeding or
lesions. What is the likely diagnosis?
1.
Internal hemorrhoid.
2.
External hemorrhoid.
3.
Bleeding peptic ulcer.
4.
Rectal fissure. Answer: Internal hemorrhoid.
◉ The screening guidelines for colon cancer recommend which of
the following for the general population?
1.
Colonoscopy starting at age 50.
2.
Colonoscopy starting at age 45.
3.
Fecal occult blood test (FOBT) and rectal exam starting at age 50.
4.
Fecal occult blood test (FOBT) and rectal exam starting at age 45.
Answer: Colonoscopy starting at age 50.
ADVANCED EXAM SCRIPT 2026 COMPLETE
QUESTIONS AND SOLUTIONS
◉ You suspect that Nikki has a gastroduodenal ulcer caused by
Helicobacter pylori and plan to treat her empirically. What
medications should you order?
1.
A proton pump inhibitor (omeprazole), tetracycline or amoxicillin,
and metronidazole (Flagyl).
2.
Bismuth subsalicylate (Pepto-Bismol) and omeprazole (Prilosec).
3.
Amoxicillin (Amoxil) and omeprazole (Prilosec).
4.
Clarithromycin (Biaxin) and metronidazole (Flagyl). Answer: A
proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and
metronidazole (Flagyl).
◉ An 83-year-old female presents to the urgent care clinic for
diarrhea. The patient was just discharged from the hospital 1 week
ago following treatment for pneumonia. The patient states she has
diarrhea, described as diffuse and watery, with mucus in it at times.
,She has approximately 10 episodes per day. What is the
recommended treatment for this patient?
1.
Fecal transplant.
2.
Intravenous (IV) metronidazole.
3.
Oral vancomycin.
4.
Gastrointestinal rest. Answer: Oral vancomycin.
◉ What is the most common bacterial cause of traveler's diarrhea?
1.
Escherichia coli.
2.
Campylobacter jejuni.
3.
Salmonella.
4.
Shigella. Answer: Escherichia coli.
,◉ A 7-year-old male presents with his mother to the urgent care
clinic complaining of abdominal pain. He started to complain of pain
prior to going to bed; however, it has gotten progressively worse and
is now preventing him from sleeping. He is nauseous but hasn't
vomited and didn't eat dinner due to the pain. The patient appears
pale and is complaining of right-sided abdominal pain. His vitals are
as follows: blood pressure 130/85, pulse 120, temperature 100.5°F,
pulse oximetry 98% on room air. On physical exam he is tender in
the right lower quadrant. His complete blood count (CBC) shows a
white blood cell count (WBC) of 17.0. What is the patient's likely
diagnosis?
1.
Appendicitis.
2.
Cholecystitis.
3.
Constipation.
4.
Gastroenteritis. Answer: Appendicitis.
◉ A 25-year-old male presents complaining of hematochezia. The
patient states he has noticed this for 2 days. He states there is a
streak of bright blood along his stool every time he has a bowel
movement. The patient has no pain with his bowel movements. He
admits to eating a poor diet. The patient has no abdominal pain,
nausea, or vomiting. On physical exam the patient has a positive
, fecal occult blood test but has no noticeable rectal bleeding or
lesions. What is the likely diagnosis?
1.
Internal hemorrhoid.
2.
External hemorrhoid.
3.
Bleeding peptic ulcer.
4.
Rectal fissure. Answer: Internal hemorrhoid.
◉ The screening guidelines for colon cancer recommend which of
the following for the general population?
1.
Colonoscopy starting at age 50.
2.
Colonoscopy starting at age 45.
3.
Fecal occult blood test (FOBT) and rectal exam starting at age 50.
4.
Fecal occult blood test (FOBT) and rectal exam starting at age 45.
Answer: Colonoscopy starting at age 50.
