NURS 5433/ NURS5433 Midterm Exam
Family II (FNP 2) Review| UTA
(Latest 2026/2027 Update) | Graded A+
255 Verified Questions & Answers with Rationales
Section 1: Primary & Secondary Prevention
Q1: According to the 2026 CDC immunization schedule, which adult patient age 65 years or
older should receive the pneumococcal conjugate vaccine (PCV)?
A. Only those with chronic lung disease.
B. All adults age 65 and older. [CORRECT]
C. Only those who have never received a pneumococcal vaccine.
D. Adults who are immunocompromised only.
Correct Answer: B
Rationale: Current CDC guidelines recommend PCV15 or PCV20 for all adults age 65 and
older. If PCV15 is used, it should be followed by PPSV23 one year later. PCV20 alone is
sufficient and does not require PPSV23.
Board Pearl: PCV20 (Prevnar 20) covers serotypes included in PPSV23, simplifying the
schedule to a single dose for most seniors.
Q2: A 32-year-old pregnant patient at 34 weeks gestation asks about the RSV vaccine. What is
the most appropriate recommendation?
A. She is not eligible; only infants receive RSV prophylaxis.
B. She should receive the RSV vaccine (Abrysvo) between 32 -36 weeks gestation. [CORRECT]
C. She should wait until after delivery to receive the vaccine.
D. She should receive RSV immunoglobulin (Synagis) monthly.
Correct Answer: B
,Rationale: In 2026, the CDC recommends administration of the Pfizer RSV vaccine (Abrysvo)
to pregnant individuals during 32 through 36 weeks gestation to protect the newborn.
Board Pearl: Maternal RSV vaccination provides passive immunity to the infant for the first 6
months.
Q3: A 27-year-old woman presents for a well-woman exam. She has no risk factors for cervical
cancer. When should she begin cervical cancer screening?
A. Age 18
B. Age 21 [CORRECT]
C. Age 25
D. Age 30
Correct Answer: B
Rationale: USPSTF and ACS guidelines recommend starting cervical cancer screening at age
21, regardless of sexual history. Screening before age 21 is not recommended due to the high rate
of clearance of HPV in adolescents.
Board Pearl: "21 to 65" is the golden range for cervical cancer screening.
Q4: A 55-year-old patient presents for a physical. They have a 30-pack-year smoking history and
currently smoke. Which screening intervention is most appropriate?
A. Annual chest x-ray.
B. Low-dose computed tomography (LDCT) annually. [CORRECT]
C. Sputum cytology every year.
D. MRI of the chest.
Correct Answer: B
Rationale: USPSTF recommends annual screening for lung cancer with LDCT in adults aged 50
to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within
the past 15 years.
,Board Pearl: LDCT is the only recommended screening modality for lung cancer; CXR does not
reduce mortality.
Q5: A 45-year-old male with no known risk factors asks about cholesterol screening. What is the
appropriate action?
A. No screening needed until age 50.
B. Screen every 5 years. [CORRECT]
C. Screen every year.
D. Screen only if BMI is >30.
Correct Answer: B
Rationale: Men aged 45 to 65 and women aged 55 to 65 should have their lipids screened
periodically. For younger adults (men 20-45, women 20-55), screening is recommended if they
have risk factors (diabetes, HTN, smoking, family history). However, many guidelines suggest
checking at least once to establish a baseline.
Board Pearl: When in doubt, check a lipid panel at age 35-45 for men and 45-55 for women to
guide ASCVD risk calculation.
Q6: A 24-year-old female with a history of injection drug use is being screened for Hepatitis B.
Her HBsAg is positive. What does this indicate?
A. Immunity due to vaccination.
B. Acute or chronic Hepatitis B infection. [CORRECT]
C. Remote infection with immunity.
D. False positive.
Correct Answer: B
Rationale: A positive HBsAg indicates active infection, either acute or chronic. It means the
virus is currently present in the blood.
Board Pearl: HBsAg = Active; Anti-HBs = Immune (vaccine or recovery); Anti-HBc = Past or
current infection.
, Q7: Which patient is the best candidate for daily low-dose aspirin (81mg) for primary prevention
of cardiovascular disease?
A. A 60-year-old man with a 10% ASCVD risk and no bleeding risk. [CORRECT]
B. A 45-year-old woman with hypertension.
C. A 70-year-old man with diabetes.
D. A 50-year-old woman with a history of GI ulcers.
Correct Answer: A
Rationale: Current guidelines (2026) generally recommend against initiating aspirin for primary
prevention in adults over 60 due to bleeding risk. For adults 40-59 with a 10% or greater 10-year
CVD risk, the decision should be individualized.
Board Pearl: Aspirin is out for primary prevention in most >60 yo due to bleeding risk.
Q8: A 52-year-old female requests screening for colorectal cancer. She prefers a non-invasive
test. Which option is acceptable?
A. Flexible sigmoidoscopy every 5 years.
B. Fecal Immunochemical Test (FIT) annually. [CORRECT]
C. Colonoscopy every 2 years.
D. CT Colonography every 2 years.
Correct Answer: B
Rationale: FIT annually is a recommended screening option for average-risk adults aged 45 to
75. Colonoscopy is every 10 years; CT Colonography is every 5 years.
Board Pearl: FIT every year, FIT-DNA every 3 years, Colonoscopy every 10 years, Flex Sig
every 5 years (+ FIT).
Family II (FNP 2) Review| UTA
(Latest 2026/2027 Update) | Graded A+
255 Verified Questions & Answers with Rationales
Section 1: Primary & Secondary Prevention
Q1: According to the 2026 CDC immunization schedule, which adult patient age 65 years or
older should receive the pneumococcal conjugate vaccine (PCV)?
A. Only those with chronic lung disease.
B. All adults age 65 and older. [CORRECT]
C. Only those who have never received a pneumococcal vaccine.
D. Adults who are immunocompromised only.
Correct Answer: B
Rationale: Current CDC guidelines recommend PCV15 or PCV20 for all adults age 65 and
older. If PCV15 is used, it should be followed by PPSV23 one year later. PCV20 alone is
sufficient and does not require PPSV23.
Board Pearl: PCV20 (Prevnar 20) covers serotypes included in PPSV23, simplifying the
schedule to a single dose for most seniors.
Q2: A 32-year-old pregnant patient at 34 weeks gestation asks about the RSV vaccine. What is
the most appropriate recommendation?
A. She is not eligible; only infants receive RSV prophylaxis.
B. She should receive the RSV vaccine (Abrysvo) between 32 -36 weeks gestation. [CORRECT]
C. She should wait until after delivery to receive the vaccine.
D. She should receive RSV immunoglobulin (Synagis) monthly.
Correct Answer: B
,Rationale: In 2026, the CDC recommends administration of the Pfizer RSV vaccine (Abrysvo)
to pregnant individuals during 32 through 36 weeks gestation to protect the newborn.
Board Pearl: Maternal RSV vaccination provides passive immunity to the infant for the first 6
months.
Q3: A 27-year-old woman presents for a well-woman exam. She has no risk factors for cervical
cancer. When should she begin cervical cancer screening?
A. Age 18
B. Age 21 [CORRECT]
C. Age 25
D. Age 30
Correct Answer: B
Rationale: USPSTF and ACS guidelines recommend starting cervical cancer screening at age
21, regardless of sexual history. Screening before age 21 is not recommended due to the high rate
of clearance of HPV in adolescents.
Board Pearl: "21 to 65" is the golden range for cervical cancer screening.
Q4: A 55-year-old patient presents for a physical. They have a 30-pack-year smoking history and
currently smoke. Which screening intervention is most appropriate?
A. Annual chest x-ray.
B. Low-dose computed tomography (LDCT) annually. [CORRECT]
C. Sputum cytology every year.
D. MRI of the chest.
Correct Answer: B
Rationale: USPSTF recommends annual screening for lung cancer with LDCT in adults aged 50
to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within
the past 15 years.
,Board Pearl: LDCT is the only recommended screening modality for lung cancer; CXR does not
reduce mortality.
Q5: A 45-year-old male with no known risk factors asks about cholesterol screening. What is the
appropriate action?
A. No screening needed until age 50.
B. Screen every 5 years. [CORRECT]
C. Screen every year.
D. Screen only if BMI is >30.
Correct Answer: B
Rationale: Men aged 45 to 65 and women aged 55 to 65 should have their lipids screened
periodically. For younger adults (men 20-45, women 20-55), screening is recommended if they
have risk factors (diabetes, HTN, smoking, family history). However, many guidelines suggest
checking at least once to establish a baseline.
Board Pearl: When in doubt, check a lipid panel at age 35-45 for men and 45-55 for women to
guide ASCVD risk calculation.
Q6: A 24-year-old female with a history of injection drug use is being screened for Hepatitis B.
Her HBsAg is positive. What does this indicate?
A. Immunity due to vaccination.
B. Acute or chronic Hepatitis B infection. [CORRECT]
C. Remote infection with immunity.
D. False positive.
Correct Answer: B
Rationale: A positive HBsAg indicates active infection, either acute or chronic. It means the
virus is currently present in the blood.
Board Pearl: HBsAg = Active; Anti-HBs = Immune (vaccine or recovery); Anti-HBc = Past or
current infection.
, Q7: Which patient is the best candidate for daily low-dose aspirin (81mg) for primary prevention
of cardiovascular disease?
A. A 60-year-old man with a 10% ASCVD risk and no bleeding risk. [CORRECT]
B. A 45-year-old woman with hypertension.
C. A 70-year-old man with diabetes.
D. A 50-year-old woman with a history of GI ulcers.
Correct Answer: A
Rationale: Current guidelines (2026) generally recommend against initiating aspirin for primary
prevention in adults over 60 due to bleeding risk. For adults 40-59 with a 10% or greater 10-year
CVD risk, the decision should be individualized.
Board Pearl: Aspirin is out for primary prevention in most >60 yo due to bleeding risk.
Q8: A 52-year-old female requests screening for colorectal cancer. She prefers a non-invasive
test. Which option is acceptable?
A. Flexible sigmoidoscopy every 5 years.
B. Fecal Immunochemical Test (FIT) annually. [CORRECT]
C. Colonoscopy every 2 years.
D. CT Colonography every 2 years.
Correct Answer: B
Rationale: FIT annually is a recommended screening option for average-risk adults aged 45 to
75. Colonoscopy is every 10 years; CT Colonography is every 5 years.
Board Pearl: FIT every year, FIT-DNA every 3 years, Colonoscopy every 10 years, Flex Sig
every 5 years (+ FIT).
