Primary Care The Art and Science of Advanced Practice
Nursing
An Interprofessional Approach, 6th Edition — Study Guide
150 Practice Questions with Answers & Rationales
Combined Q&A Format
This guide has questions created for self-study and exam preparation, covering core primary care topics addressed
in Dunphy, Winland-Brown, Porter, and Thomas's Primary Care: The Art and Science of Advanced Practice
Nursing (6th ed.) — health assessment, dermatology, HEENT, respiratory, cardiovascular, GI, GU/renal,
musculoskeletal, endocrine, neurological, psychiatric/behavioral health, women's health, men's health, pediatric,
and geriatric primary care.
Health Assessment & Primary Care Foundations
1. The primary care provider's approach that emphasizes continuous, comprehensive, coordinated care across the
lifespan is best described as:
A. Episodic care
B. The primary care model (first-contact, longitudinal, comprehensive, coordinated care)
C. Tertiary care only
D. Emergency triage
Correct Answer: B
Rationale: Primary care is defined by first-contact access, continuity over time, comprehensiveness, and coordination of
care across settings and providers.
2. An interprofessional approach to primary care primarily emphasizes:
A. The NP working independently without consultation
B. Collaborative practice among multiple disciplines to optimize patient outcomes
C. Referring all complex patients to specialists immediately
D. Limiting communication between providers
Correct Answer: B
Rationale: Interprofessional collaborative practice draws on the expertise of multiple disciplines (medicine, nursing,
pharmacy, social work, etc.) to provide comprehensive, patient-centered care.
3. When taking a health history, the mnemonic OLDCARTS is commonly used to characterize which aspect of the
visit?
A. Past medical history
B. The chief complaint/symptom analysis
C. Family history
, D. Review of systems only
Correct Answer: B
Rationale: OLDCARTS (Onset, Location, Duration, Character, Aggravating/Alleviating factors, Radiation, Timing,
Severity) is a structured approach to characterizing a presenting symptom.
4. Which of the following best reflects a patient-centered approach to primary care decision-making?
A. The provider makes all decisions without patient input
B. Shared decision-making that incorporates patient values, preferences, and evidence
C. Following a rigid protocol regardless of patient circumstances
D. Deferring entirely to family decisions
Correct Answer: B
Rationale: Patient-centered, shared decision-making integrates the best evidence with the individual patient's values and
preferences.
5. The 'review of systems' portion of a health history differs from the history of present illness (HPI) in that it:
A. Focuses only on the chief complaint in depth
B. Is a systematic inquiry into symptoms across body systems, not necessarily related to the chief complaint
C. Is only performed during physical exam
D. Replaces the need for a physical exam
Correct Answer: B
Rationale: The ROS is a structured symptom inventory across body systems, complementing but distinct from the
focused HPI of the presenting problem.
6. Evidence-based practice in primary care integrates which three components?
A. Provider preference, cost, and convenience only
B. Best available research evidence, clinical expertise, and patient values/preferences
C. Only the most recent clinical trial results
D. Insurance coverage alone
Correct Answer: B
Rationale: EBP is defined as the integration of best research evidence, clinical expertise, and patient values to guide
clinical decision-making.
7. When screening an asymptomatic adult for a condition, the provider should primarily consider USPSTF
recommendations because they are based on:
A. Expert opinion alone
B. Systematic review of evidence regarding benefits and harms of screening
C. Cost to the healthcare system only
D. Patient preference exclusively
Correct Answer: B
Rationale: The U.S. Preventive Services Task Force issues evidence-graded recommendations based on systematic
reviews of screening benefits versus harms.
8. A 'Grade A' USPSTF recommendation indicates:
A. The service should not be offered
B. High certainty that the net benefit is substantial; the service should be offered
C. Insufficient evidence to make a recommendation
D. The service is only for symptomatic patients
Correct Answer: B
Rationale: Grade A recommendations reflect high certainty of substantial net benefit, indicating providers should
offer/provide the service.
9. Motivational interviewing, often used in primary care to support behavior change, is best characterized by:
A. Directly telling patients what to do
B. A collaborative, patient-centered communication style that explores and resolves ambivalence about change
C. Confronting patients about poor choices
, D. Avoiding discussion of behavior change altogether
Correct Answer: B
Rationale: Motivational interviewing is a collaborative conversation style that strengthens a patient's own motivation
for change by exploring ambivalence, rather than direct confrontation.
10. The concept of 'cultural humility' in primary care differs from 'cultural competence' primarily in that cultural
humility emphasizes:
A. Mastering all facts about every culture
B. An ongoing process of self-reflection and openness to learning from the patient, rather than achieving fixed
'competence'
C. Applying one standardized approach to all patients
D. Avoiding discussion of cultural factors entirely
Correct Answer: B
Rationale: Cultural humility emphasizes lifelong self-reflection and learning, recognizing that providers cannot achieve
complete 'competence' in every culture, and centers the patient's own expertise about their experience.
Dermatology in Primary Care
11. A well-demarcated, erythematous, scaly plaque on the extensor surfaces of the elbows and knees is most
characteristic of:
A. Atopic dermatitis
B. Psoriasis
C. Tinea corporis
D. Contact dermatitis
Correct Answer: B
Rationale: Psoriasis classically presents as well-demarcated erythematous plaques with silvery scale on extensor
surfaces (elbows, knees, scalp).
12. Atopic dermatitis (eczema) in infants classically presents on which body areas?
A. Extensor surfaces only
B. Face and extensor surfaces in infants, flexural areas in older children
C. Only the trunk
D. Only the scalp
Correct Answer: B
Rationale: Infantile atopic dermatitis typically affects the face and extensor surfaces, while the distribution shifts to
flexural areas (antecubital, popliteal fossae) in older children.
13. A KOH (potassium hydroxide) preparation is used to diagnose which category of skin condition?
A. Bacterial infections
B. Fungal infections (e.g., tinea, candidiasis)
C. Viral infections
D. Autoimmune skin conditions
Correct Answer: B
Rationale: KOH prep dissolves keratin, allowing visualization of fungal hyphae/spores under microscopy to confirm
dermatophyte or yeast infections.
14. The ABCDE criteria used to evaluate a pigmented skin lesion for possible melanoma include Asymmetry, Border
irregularity, Color variation, Diameter greater than 6mm, and:
A. Elevation only
B. Evolution/change over time
C. Erythema
D. Exudate
Correct Answer: B
Nursing
An Interprofessional Approach, 6th Edition — Study Guide
150 Practice Questions with Answers & Rationales
Combined Q&A Format
This guide has questions created for self-study and exam preparation, covering core primary care topics addressed
in Dunphy, Winland-Brown, Porter, and Thomas's Primary Care: The Art and Science of Advanced Practice
Nursing (6th ed.) — health assessment, dermatology, HEENT, respiratory, cardiovascular, GI, GU/renal,
musculoskeletal, endocrine, neurological, psychiatric/behavioral health, women's health, men's health, pediatric,
and geriatric primary care.
Health Assessment & Primary Care Foundations
1. The primary care provider's approach that emphasizes continuous, comprehensive, coordinated care across the
lifespan is best described as:
A. Episodic care
B. The primary care model (first-contact, longitudinal, comprehensive, coordinated care)
C. Tertiary care only
D. Emergency triage
Correct Answer: B
Rationale: Primary care is defined by first-contact access, continuity over time, comprehensiveness, and coordination of
care across settings and providers.
2. An interprofessional approach to primary care primarily emphasizes:
A. The NP working independently without consultation
B. Collaborative practice among multiple disciplines to optimize patient outcomes
C. Referring all complex patients to specialists immediately
D. Limiting communication between providers
Correct Answer: B
Rationale: Interprofessional collaborative practice draws on the expertise of multiple disciplines (medicine, nursing,
pharmacy, social work, etc.) to provide comprehensive, patient-centered care.
3. When taking a health history, the mnemonic OLDCARTS is commonly used to characterize which aspect of the
visit?
A. Past medical history
B. The chief complaint/symptom analysis
C. Family history
, D. Review of systems only
Correct Answer: B
Rationale: OLDCARTS (Onset, Location, Duration, Character, Aggravating/Alleviating factors, Radiation, Timing,
Severity) is a structured approach to characterizing a presenting symptom.
4. Which of the following best reflects a patient-centered approach to primary care decision-making?
A. The provider makes all decisions without patient input
B. Shared decision-making that incorporates patient values, preferences, and evidence
C. Following a rigid protocol regardless of patient circumstances
D. Deferring entirely to family decisions
Correct Answer: B
Rationale: Patient-centered, shared decision-making integrates the best evidence with the individual patient's values and
preferences.
5. The 'review of systems' portion of a health history differs from the history of present illness (HPI) in that it:
A. Focuses only on the chief complaint in depth
B. Is a systematic inquiry into symptoms across body systems, not necessarily related to the chief complaint
C. Is only performed during physical exam
D. Replaces the need for a physical exam
Correct Answer: B
Rationale: The ROS is a structured symptom inventory across body systems, complementing but distinct from the
focused HPI of the presenting problem.
6. Evidence-based practice in primary care integrates which three components?
A. Provider preference, cost, and convenience only
B. Best available research evidence, clinical expertise, and patient values/preferences
C. Only the most recent clinical trial results
D. Insurance coverage alone
Correct Answer: B
Rationale: EBP is defined as the integration of best research evidence, clinical expertise, and patient values to guide
clinical decision-making.
7. When screening an asymptomatic adult for a condition, the provider should primarily consider USPSTF
recommendations because they are based on:
A. Expert opinion alone
B. Systematic review of evidence regarding benefits and harms of screening
C. Cost to the healthcare system only
D. Patient preference exclusively
Correct Answer: B
Rationale: The U.S. Preventive Services Task Force issues evidence-graded recommendations based on systematic
reviews of screening benefits versus harms.
8. A 'Grade A' USPSTF recommendation indicates:
A. The service should not be offered
B. High certainty that the net benefit is substantial; the service should be offered
C. Insufficient evidence to make a recommendation
D. The service is only for symptomatic patients
Correct Answer: B
Rationale: Grade A recommendations reflect high certainty of substantial net benefit, indicating providers should
offer/provide the service.
9. Motivational interviewing, often used in primary care to support behavior change, is best characterized by:
A. Directly telling patients what to do
B. A collaborative, patient-centered communication style that explores and resolves ambivalence about change
C. Confronting patients about poor choices
, D. Avoiding discussion of behavior change altogether
Correct Answer: B
Rationale: Motivational interviewing is a collaborative conversation style that strengthens a patient's own motivation
for change by exploring ambivalence, rather than direct confrontation.
10. The concept of 'cultural humility' in primary care differs from 'cultural competence' primarily in that cultural
humility emphasizes:
A. Mastering all facts about every culture
B. An ongoing process of self-reflection and openness to learning from the patient, rather than achieving fixed
'competence'
C. Applying one standardized approach to all patients
D. Avoiding discussion of cultural factors entirely
Correct Answer: B
Rationale: Cultural humility emphasizes lifelong self-reflection and learning, recognizing that providers cannot achieve
complete 'competence' in every culture, and centers the patient's own expertise about their experience.
Dermatology in Primary Care
11. A well-demarcated, erythematous, scaly plaque on the extensor surfaces of the elbows and knees is most
characteristic of:
A. Atopic dermatitis
B. Psoriasis
C. Tinea corporis
D. Contact dermatitis
Correct Answer: B
Rationale: Psoriasis classically presents as well-demarcated erythematous plaques with silvery scale on extensor
surfaces (elbows, knees, scalp).
12. Atopic dermatitis (eczema) in infants classically presents on which body areas?
A. Extensor surfaces only
B. Face and extensor surfaces in infants, flexural areas in older children
C. Only the trunk
D. Only the scalp
Correct Answer: B
Rationale: Infantile atopic dermatitis typically affects the face and extensor surfaces, while the distribution shifts to
flexural areas (antecubital, popliteal fossae) in older children.
13. A KOH (potassium hydroxide) preparation is used to diagnose which category of skin condition?
A. Bacterial infections
B. Fungal infections (e.g., tinea, candidiasis)
C. Viral infections
D. Autoimmune skin conditions
Correct Answer: B
Rationale: KOH prep dissolves keratin, allowing visualization of fungal hyphae/spores under microscopy to confirm
dermatophyte or yeast infections.
14. The ABCDE criteria used to evaluate a pigmented skin lesion for possible melanoma include Asymmetry, Border
irregularity, Color variation, Diameter greater than 6mm, and:
A. Elevation only
B. Evolution/change over time
C. Erythema
D. Exudate
Correct Answer: B
