MSN 624 Advanced Primary Care Core Exam verified with correct answers and
rationales /instant pdf
1. A 58-year-old patient presents with persistent blood pressure readings
averaging 148/92 mmHg over two separate visits. According to current
hypertension guidelines, the most appropriate diagnosis is:
A. Elevated blood pressure
B. Stage 1 hypertension
C. Stage 2 hypertension
D. Hypertensive emergency
Correct Answer: B
Rationale: Blood pressure of 130–139/80–89 mmHg is Stage 1 hypertension, while ≥140/90
mmHg is Stage 2 in some guidelines. Clinical management depends on the guideline followed
and patient risk profile, emphasizing confirmation with repeated measurements and overall
cardiovascular risk assessment.
2. Which laboratory test is most useful for diagnosing diabetes mellitus?
A. Hemoglobin A1C
B. Serum sodium
C. White blood cell count
D. Hemoglobin
Correct Answer: A
Rationale: Hemoglobin A1C reflects average blood glucose over approximately three months
and is widely used to diagnose and monitor diabetes.
3. Which lifestyle intervention provides the greatest reduction in cardiovascular
risk?
A. Smoking cessation
B. Daily vitamin supplementation
C. Increased caffeine intake
D. Limiting water intake
Correct Answer: A
,Rationale: Smoking cessation significantly reduces cardiovascular morbidity and mortality.
4. A patient presents with sudden crushing chest pain radiating to the left arm.
What is the priority action?
A. Activate emergency evaluation for possible acute coronary syndrome
B. Schedule routine follow-up in one week
C. Recommend rest at home only
D. Prescribe antibiotics
Correct Answer: A
Rationale: Acute coronary syndrome is a medical emergency requiring immediate evaluation.
5. Which lipid-lowering medication class is considered first-line therapy for most
patients with hyperlipidemia?
A. Statins
B. Antacids
C. Antihistamines
D. Corticosteroids
Correct Answer: A
Rationale: Statins reduce LDL cholesterol and lower cardiovascular risk.
6. Which patient is at greatest risk for developing chronic kidney disease?
A. Patient with diabetes and hypertension
B. Healthy 22-year-old athlete
C. Patient with seasonal allergies
D. Patient with tension headaches
Correct Answer: A
Rationale: Diabetes and hypertension are the leading causes of chronic kidney disease.
,7. Which screening test is recommended for colorectal cancer in average-risk
adults beginning at guideline-recommended ages?
A. Colorectal cancer screening using approved methods (e.g., stool-based testing or
colonoscopy)
B. Chest X-ray
C. Electroencephalogram
D. Bone scan
Correct Answer: A
Rationale: Multiple evidence-based screening options are recommended depending on patient
age, risk factors, and preferences.
8. Which vaccine is recommended annually for most adults?
A. Influenza vaccine
B. Rabies vaccine
C. Yellow fever vaccine
D. Cholera vaccine
Correct Answer: A
Rationale: Annual influenza vaccination reduces serious illness and complications.
9. Which physical examination finding is most consistent with heart failure?
A. Bilateral lower-extremity edema and pulmonary crackles
B. Dry skin only
C. Enlarged pupils
D. Ear pain
Correct Answer: A
Rationale: Fluid overload commonly produces edema and pulmonary congestion.
10. Which thyroid laboratory result is most consistent with primary
hypothyroidism?
, A. Elevated TSH with low free T4
B. Low TSH with elevated T4
C. Normal TSH with elevated calcium
D. Elevated sodium only
Correct Answer: A
Rationale: Primary hypothyroidism results in increased TSH due to reduced thyroid hormone
production.
11. Which symptom is most commonly associated with iron-deficiency anemia?
A. Fatigue
B. Polyuria
C. Hematuria
D. Jaundice
Correct Answer: A
Rationale: Fatigue results from decreased oxygen-carrying capacity.
12. Which medication class is commonly recommended as first-line treatment for
uncomplicated hypertension in many patients?
A. Thiazide-type diuretics
B. Antifungal medications
C. Antivirals
D. Opioids
Correct Answer: A
Rationale: Thiazide diuretics remain one of several recommended first-line antihypertensive
classes depending on patient characteristics.
13. Which patient requires immediate evaluation?
A. Patient with sudden unilateral weakness and difficulty speaking
B. Patient with mild seasonal allergies
C. Patient with stable osteoarthritis
D. Patient requesting a refill of vitamins
rationales /instant pdf
1. A 58-year-old patient presents with persistent blood pressure readings
averaging 148/92 mmHg over two separate visits. According to current
hypertension guidelines, the most appropriate diagnosis is:
A. Elevated blood pressure
B. Stage 1 hypertension
C. Stage 2 hypertension
D. Hypertensive emergency
Correct Answer: B
Rationale: Blood pressure of 130–139/80–89 mmHg is Stage 1 hypertension, while ≥140/90
mmHg is Stage 2 in some guidelines. Clinical management depends on the guideline followed
and patient risk profile, emphasizing confirmation with repeated measurements and overall
cardiovascular risk assessment.
2. Which laboratory test is most useful for diagnosing diabetes mellitus?
A. Hemoglobin A1C
B. Serum sodium
C. White blood cell count
D. Hemoglobin
Correct Answer: A
Rationale: Hemoglobin A1C reflects average blood glucose over approximately three months
and is widely used to diagnose and monitor diabetes.
3. Which lifestyle intervention provides the greatest reduction in cardiovascular
risk?
A. Smoking cessation
B. Daily vitamin supplementation
C. Increased caffeine intake
D. Limiting water intake
Correct Answer: A
,Rationale: Smoking cessation significantly reduces cardiovascular morbidity and mortality.
4. A patient presents with sudden crushing chest pain radiating to the left arm.
What is the priority action?
A. Activate emergency evaluation for possible acute coronary syndrome
B. Schedule routine follow-up in one week
C. Recommend rest at home only
D. Prescribe antibiotics
Correct Answer: A
Rationale: Acute coronary syndrome is a medical emergency requiring immediate evaluation.
5. Which lipid-lowering medication class is considered first-line therapy for most
patients with hyperlipidemia?
A. Statins
B. Antacids
C. Antihistamines
D. Corticosteroids
Correct Answer: A
Rationale: Statins reduce LDL cholesterol and lower cardiovascular risk.
6. Which patient is at greatest risk for developing chronic kidney disease?
A. Patient with diabetes and hypertension
B. Healthy 22-year-old athlete
C. Patient with seasonal allergies
D. Patient with tension headaches
Correct Answer: A
Rationale: Diabetes and hypertension are the leading causes of chronic kidney disease.
,7. Which screening test is recommended for colorectal cancer in average-risk
adults beginning at guideline-recommended ages?
A. Colorectal cancer screening using approved methods (e.g., stool-based testing or
colonoscopy)
B. Chest X-ray
C. Electroencephalogram
D. Bone scan
Correct Answer: A
Rationale: Multiple evidence-based screening options are recommended depending on patient
age, risk factors, and preferences.
8. Which vaccine is recommended annually for most adults?
A. Influenza vaccine
B. Rabies vaccine
C. Yellow fever vaccine
D. Cholera vaccine
Correct Answer: A
Rationale: Annual influenza vaccination reduces serious illness and complications.
9. Which physical examination finding is most consistent with heart failure?
A. Bilateral lower-extremity edema and pulmonary crackles
B. Dry skin only
C. Enlarged pupils
D. Ear pain
Correct Answer: A
Rationale: Fluid overload commonly produces edema and pulmonary congestion.
10. Which thyroid laboratory result is most consistent with primary
hypothyroidism?
, A. Elevated TSH with low free T4
B. Low TSH with elevated T4
C. Normal TSH with elevated calcium
D. Elevated sodium only
Correct Answer: A
Rationale: Primary hypothyroidism results in increased TSH due to reduced thyroid hormone
production.
11. Which symptom is most commonly associated with iron-deficiency anemia?
A. Fatigue
B. Polyuria
C. Hematuria
D. Jaundice
Correct Answer: A
Rationale: Fatigue results from decreased oxygen-carrying capacity.
12. Which medication class is commonly recommended as first-line treatment for
uncomplicated hypertension in many patients?
A. Thiazide-type diuretics
B. Antifungal medications
C. Antivirals
D. Opioids
Correct Answer: A
Rationale: Thiazide diuretics remain one of several recommended first-line antihypertensive
classes depending on patient characteristics.
13. Which patient requires immediate evaluation?
A. Patient with sudden unilateral weakness and difficulty speaking
B. Patient with mild seasonal allergies
C. Patient with stable osteoarthritis
D. Patient requesting a refill of vitamins
