Actual 2026 with Detailed Rationales | 100% Verified |
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SECTION 1: Primary Care Across the Lifespan
(Questions 1–15)
Q1: A 4-year-old child is brought to the clinic for a well-child visit. The parent reports
the child can hop on one foot, speak in complete sentences, and dress
independently. Which developmental milestone is most consistent with this age?
A. 2-year-old milestones
B. 3-year-old milestones
C. 4-year-old milestones [CORRECT]
D. 5-year-old milestones
Correct Answer: C
Rationale: Correct because by age 4, children typically demonstrate hopping on one
foot, use complete sentences with complex grammar, and achieve independent
dressing skills.
Q2: A 65-year-old patient presents for an annual physical. According to USPSTF
guidelines, which screening is recommended for this age group?
A. Routine PSA testing for all men
B. Colorectal cancer screening and annual influenza vaccination [CORRECT]
C. Routine chest x-ray for lung cancer screening
D. Bone density screening only for women with fractures
Correct Answer: B
Rationale: Correct because USPSTF recommends colorectal cancer screening for
adults aged 45–75 and annual influenza vaccination for all adults, including those 65
and older.
Q3: An adolescent patient (16 years old) presents with concerns about acne. Which
topical medication is first-line for mild comedonal acne?
,A. Oral isotretinoin
B. Topical retinoid (tretinoin) [CORRECT]
C. Oral tetracycline
D. Topical corticosteroid
Correct Answer: B
Rationale: Correct because topical retinoids are first-line for comedonal acne as they
normalize follicular keratinization, prevent microcomedone formation, and have
anti-inflammatory properties.
Q4: A 72-year-old patient reports difficulty hearing high-pitched sounds and following
conversations in noisy environments. Which type of hearing loss is most likely?
A. Conductive hearing loss
B. Sensorineural (presbycusis) [CORRECT]
C. Mixed hearing loss
D. Central auditory processing disorder
Correct Answer: B
Rationale: Correct because presbycusis is age-related sensorineural hearing loss
characterized by bilateral high-frequency hearing loss and difficulty with speech
discrimination in noisy environments.
Q5: A pregnant patient at 28 weeks gestation asks about recommended vaccines
during pregnancy. Which vaccine is routinely recommended?
A. MMR (measles, mumps, rubella)
B. Tdap (tetanus, diphtheria, pertussis) [CORRECT]
C. Varicella vaccine
D. HPV vaccine
Correct Answer: B
Rationale: Correct because Tdap is recommended during each pregnancy between
27–36 weeks gestation to provide passive immunity against pertussis to the
newborn; live vaccines (MMR, varicella) are contraindicated.
Q6: A 45-year-old patient with no chronic conditions presents for a wellness visit.
Which blood pressure classification applies to a reading of 138/88 mmHg?
A. Normal
B. Elevated
C. Stage 1 hypertension [CORRECT]
D. Stage 2 hypertension
Correct Answer: C
, Rationale: Correct because according to ACC/AHA guidelines, systolic 130–139 or
diastolic 80–89 mmHg defines stage 1 hypertension, requiring lifestyle modification
and reassessment.
Q7: An infant at the 2-month well-child visit receives routine immunizations. Which
vaccine is NOT part of the standard 2-month schedule?
A. DTaP
B. IPV
C. MMR [CORRECT]
D. Hib
Correct Answer: C
Rationale: Correct because MMR is administered at 12–15 months of age, not at 2
months; the 2-month schedule includes DTaP, IPV, Hib, PCV, and rotavirus.
Q8: A 55-year-old patient with a 30-pack-year smoking history asks about lung
cancer screening. Which USPSTF recommendation applies?
A. Annual chest x-ray
B. Annual low-dose CT scan for adults aged 50–80 with ≥20 pack-year history
[CORRECT]
C. Screening is not recommended for any smoker
D. Sputum cytology every 6 months
Correct Answer: B
Rationale: Correct because USPSTF recommends annual lung cancer screening with
low-dose CT for adults aged 50–80 with a ≥20 pack-year history who currently
smoke or quit within the past 15 years.
Q9: A geriatric patient reports frequent falls at home. Which assessment tool is most
appropriate for evaluating fall risk in primary care?
A. Mini-Mental State Examination (MMSE)
B. Timed Up and Go (TUG) test [CORRECT]
C. Geriatric Depression Scale (GDS)
D. Activities of Daily Living (ADL) assessment
Correct Answer: B
Rationale: Correct because the TUG test is a validated, quick screening tool that
assesses mobility, balance, and fall risk in older adults; completion in >12 seconds
indicates increased fall risk.