NURS 6531 - Adult Primary Care Final Exam 2026/2027 – Edition
Questions With Verified Answers
Overview
NURS 6531 focuses on adult primary care: health promotion, disease prevention,
diagnosis/management of acute and chronic conditions, women’s/men’s health,
geriatrics, and evidence-based practice for NPs. ANCC A-GNP/FNP board
style. Correct answer in bold Green.
1. A 45yo with no CVD risk factors. USPSTF recommends screening for HTN
starting at:
A. Age 18, every 3-5 years if normal
B. Age 18, annually if BP 120-129/<80 or risk factors
C. Age 40, every year
D. Age 50, every 2 years
Rationale: USPSTF 2021: Screen adults ≥18. Annual if 120-129/<80 or risk. Every 3-
5yr if <120/80 + no risk.
2. A 67yo male, smoker, BP 150/92 on 3 readings. First-line antihypertensive per
JNC8?
A. Lisinopril
B. Amlodipine or HCTZ
C. Metoprolol
D. Losartan
Rationale: Age ≥60 goal <150/90. Non-black: thiazide, CCB, ACEi, ARB. Black:
thiazide or CCB.
3. A 55yo with DM, eGFR 58, urine ACR 45 mg/g. Best initial BP agent?
A. Amlodipine
B. HCTZ
C. Lisinopril
D. Atenolol
Rationale: DM + albuminuria: ACEi/ARB first-line for renal protection, regardless of
race.
4. A 50yo needs colorectal cancer screening, average risk. USPSTF recommends
start at:
A. 40
B. 45
C. 50
D. 55
Rationale: USPSTF 2021: Start CRC screening age 45-75. Options: FIT q1yr,
colonoscopy q10yr, etc.
5. A 65yo female, no history, never smoker. Lung cancer screening?
A. Annual LDCT
B. No screening indicated
C. CXR annually
D. Sputum cytology
, Rationale: USPSTF: LDCT age 50-80, 20 pack-year, current or quit ≤15yr. No risk = no
screen.
6. A 28yo female, BMI 32, presents for well exam. What cancer screening is
indicated now?
A. Mammogram
B. Pap test
C. Cervical cancer screening if due
D. Colonoscopy
Rationale: Age 21-29: Pap q3yr. 30-65: Pap q3yr or co-test q5yr or HPV q5yr. No
mammo or colon yet.
7. A 72yo male with DM, on metformin + glipizide, A1c 8.5%. Next best add?
A. More glipizide
B. SGLT2i or GLP-1 RA
C. Pioglitazone
D. DPP-4i
Rationale: ADA: If ASCVD/HF/CKD or need weight loss, add SGLT2i or GLP-1 RA with
CV benefit.
8. A 60yo with COPD, mMRC 2, 1 exacerbation last year not hospitalized. GOLD
group?
A. A
B. B
C. E
D. C
Rationale: GOLD ABE: B = mMRC ≥2 or CAT ≥10, 0-1 mod exacerbation. E = ≥2 or 1
hosp.
9. First-line therapy for GOLD B COPD?
A. SABA only
B. ICS/LABA
C. LAMA or LABA
D. Roflumilast
Rationale: GOLD B: LAMA or LABA. Not ICS unless eosinophils ≥300 or asthma
overlap.
10. A 68yo with atrial fibrillation, HTN, DM. CHA2DS2-VASc score and
anticoagulation?
A. 1, aspirin
B. 3, DOAC or warfarin
C. 2, no anticoagulation
D. 4, clopidogrel
Rationale: HTN=1, DM=1, age 65-74=1, female=1 → 3. Score ≥2 men, ≥3 women =
oral anticoag.
11. A 55yo with HFpEF, BP 148/88, eGFR 62. Best antihypertensive?
A. Metoprolol tartrate
B. Spironolactone
C. Diltiazem
D. Clonidine
Rationale: TOPCAT: MRA benefit in HFpEF. SGLT2i also now indicated.
Questions With Verified Answers
Overview
NURS 6531 focuses on adult primary care: health promotion, disease prevention,
diagnosis/management of acute and chronic conditions, women’s/men’s health,
geriatrics, and evidence-based practice for NPs. ANCC A-GNP/FNP board
style. Correct answer in bold Green.
1. A 45yo with no CVD risk factors. USPSTF recommends screening for HTN
starting at:
A. Age 18, every 3-5 years if normal
B. Age 18, annually if BP 120-129/<80 or risk factors
C. Age 40, every year
D. Age 50, every 2 years
Rationale: USPSTF 2021: Screen adults ≥18. Annual if 120-129/<80 or risk. Every 3-
5yr if <120/80 + no risk.
2. A 67yo male, smoker, BP 150/92 on 3 readings. First-line antihypertensive per
JNC8?
A. Lisinopril
B. Amlodipine or HCTZ
C. Metoprolol
D. Losartan
Rationale: Age ≥60 goal <150/90. Non-black: thiazide, CCB, ACEi, ARB. Black:
thiazide or CCB.
3. A 55yo with DM, eGFR 58, urine ACR 45 mg/g. Best initial BP agent?
A. Amlodipine
B. HCTZ
C. Lisinopril
D. Atenolol
Rationale: DM + albuminuria: ACEi/ARB first-line for renal protection, regardless of
race.
4. A 50yo needs colorectal cancer screening, average risk. USPSTF recommends
start at:
A. 40
B. 45
C. 50
D. 55
Rationale: USPSTF 2021: Start CRC screening age 45-75. Options: FIT q1yr,
colonoscopy q10yr, etc.
5. A 65yo female, no history, never smoker. Lung cancer screening?
A. Annual LDCT
B. No screening indicated
C. CXR annually
D. Sputum cytology
, Rationale: USPSTF: LDCT age 50-80, 20 pack-year, current or quit ≤15yr. No risk = no
screen.
6. A 28yo female, BMI 32, presents for well exam. What cancer screening is
indicated now?
A. Mammogram
B. Pap test
C. Cervical cancer screening if due
D. Colonoscopy
Rationale: Age 21-29: Pap q3yr. 30-65: Pap q3yr or co-test q5yr or HPV q5yr. No
mammo or colon yet.
7. A 72yo male with DM, on metformin + glipizide, A1c 8.5%. Next best add?
A. More glipizide
B. SGLT2i or GLP-1 RA
C. Pioglitazone
D. DPP-4i
Rationale: ADA: If ASCVD/HF/CKD or need weight loss, add SGLT2i or GLP-1 RA with
CV benefit.
8. A 60yo with COPD, mMRC 2, 1 exacerbation last year not hospitalized. GOLD
group?
A. A
B. B
C. E
D. C
Rationale: GOLD ABE: B = mMRC ≥2 or CAT ≥10, 0-1 mod exacerbation. E = ≥2 or 1
hosp.
9. First-line therapy for GOLD B COPD?
A. SABA only
B. ICS/LABA
C. LAMA or LABA
D. Roflumilast
Rationale: GOLD B: LAMA or LABA. Not ICS unless eosinophils ≥300 or asthma
overlap.
10. A 68yo with atrial fibrillation, HTN, DM. CHA2DS2-VASc score and
anticoagulation?
A. 1, aspirin
B. 3, DOAC or warfarin
C. 2, no anticoagulation
D. 4, clopidogrel
Rationale: HTN=1, DM=1, age 65-74=1, female=1 → 3. Score ≥2 men, ≥3 women =
oral anticoag.
11. A 55yo with HFpEF, BP 148/88, eGFR 62. Best antihypertensive?
A. Metoprolol tartrate
B. Spironolactone
C. Diltiazem
D. Clonidine
Rationale: TOPCAT: MRA benefit in HFpEF. SGLT2i also now indicated.
