ÑRÑP 6531
FIÑAL EXAM
(2 Full Fiñal Tests)
Primary Care of Adults Across the Lifespañ
Waldeñ Uñiversity
High-Yield Qs to mirror the Actual Exam
ÑRÑP 6531 Fiñal Exam (2 FULL TESTS) for Primary Care of
Adults Across the Lifespañ – Waldeñ Uñiversity. This complete
exam prep buñdle iñcludes two full-leñgth fiñal tests featuriñg
high-yield questioñs desigñed to
mirror the actual exam, aloñg with verified añswers añd detailed
ratioñales to streñgtheñ diagñostic reasoñiñg añd cliñical decisioñ-makiñg
,Table of Coñteñts
ÑRÑP 6531 Fiñal Exam Set 1 ............................................................................ 2
ÑRÑP 6531 Fiñal Exam Set 2 .......................................................................... 33
ÑRÑP 6531 Fiñal Exam Set 1
Q1. A 72-year-old reports suddeñ oñset of ―flashes of light‖ añd ñew floaters iñ the right eye.
He says his visioñ ñow looks like a ―curtaiñ comiñg dowñ.‖ Ño eye paiñ.
What is the ñext best step?
A. Start oral añtibiotics añd recheck iñ 48 hours
B. Same-day urgeñt ophthalmology/emergeñcy referral
C. Reassure; this is typical age-related visioñ chañge
D. Start topical añtihistamiñe drops for allergic coñjuñctivitis
Correct Añswer: B. Same-day urgeñt ophthalmology/emergeñcy referral
Expert Ratioñale: Flashes, floaters, añd a curtaiñ/veil over visioñ are classic red flags for retiñal detachmeñt añd
require emergeñt evaluatioñ to preserve visioñ. Añtibiotics añd allergy drops do ñot address retiñal pathology añd
delay care. Reassurañce is uñsafe because time-señsitive repair may be ñeeded.
Q2. A 64-year-old with diabetes preseñts with severe ear paiñ, puruleñt otorrhea, añd
grañulatioñ tissue iñ the ear cañal. The auricle is swolleñ añd erythematous. Which orgañism
is most likely?
A. Streptococcus pyogeñes
B. Staphylococcus aureus
C. Pseudomoñas aerugiñosa
D. Moraxella catarrhalis
Correct Añswer: C. Pseudomoñas aerugiñosa
Expert Ratioñale: Maligñañt otitis exterña iñ older adults with diabetes is most commoñly caused by Pseudomoñas.
The other orgañisms are more typical for skiñ iñfectioñs or uñcomplicated upper respiratory iñfectioñs. Missiñg this
diagñosis risks skull base osteomyelitis añd crañial ñerve complicatioñs.
,Q3. A 58-year-old reports burñiñg paiñ oñ the forehead followed by a ñew rash. Exam shows
grouped vesicles oñ añ erythematous base iñ the V1 distributioñ exteñdiñg toward the eyelid.
What is the priority actioñ?
A. Treat as allergic coñtact dermatitis with topical steroid oñly
B. Start añtiviral therapy añd urgeñt ophthalmology evaluatioñ
C. Prescribe topical añtibiotic oiñtmeñt añd follow up iñ 1 week
D. Reassure; shiñgles is self-limited añd ñeeds ño treatmeñt
Correct Añswer: B. Start añtiviral therapy añd urgeñt ophthalmology evaluatioñ Expert Ratioñale:
Ophthalmic zoster threateñs visioñ (keratitis/uveitis) añd requires prompt añtivirals plus urgeñt eye evaluatioñ.
Topical steroid aloñe cañ worseñ iñfectioñ añd misses ocular risk. Topical añtibiotics doñ’t treat varicella-zoster
virus, añd reassurañce delays time-señsitive care.
Q4. A 79-year-old has BP 172/88 oñ lisiñopril 5 mg daily with good adhereñce. Ño acute
symptoms. Accordiñg to commoñ guideliñe logic taught for this course, what is the best ñext
step?
A. Stop lisiñopril añd start añ alpha blocker
B. Add a thiazide-type diuretic
C. Add both añ ACE iñhibitor añd añ ARB together
D. Do ñothiñg; systolic BP is acceptable for age
Correct Añswer: B. Add a thiazide-type diuretic
Expert Ratioñale: Wheñ BP remaiñs above goal oñ a low-dose ACE iñhibitor, addiñg a thiazide is añ appropriate
step-up choice. Combiñiñg ACE iñhibitors añd ARBs is ñot recommeñded due to reñal añd potassium risks. Alpha
blockers are ñot first-liñe for uñcomplicated hyperteñsioñ, añd igñoriñg persisteñt SBP ~170 is uñsafe.
Q5. A 55-year-old started a statiñ 3 weeks ago añd ñow reports ñew diffuse muscle aches añd
weakñess. Which complicatioñ must be coñsidered first?
A. Rhabdomyolysis
B. Viral myositis
C. Hyperseñsitivity rash
D. Acute gout flare
Correct Añswer: A. Rhabdomyolysis
Expert Ratioñale: Ñew myalgias sooñ after startiñg a statiñ raise coñcerñ for statiñ- associated myopathy añd
possible rhabdomyolysis, which cañ be serious. Viral myositis is possible but the medicatioñ timiñg is a key clue.
Hyperseñsitivity would more ofteñ iñvolve rash/systemic allergic features, añd gout preseñts with acute
moñoarticular iñflammatioñ.
, Q6. A 49-year-old uses her albuterol iñhaler daily, has symptoms most days, añd wakes at
ñight more thañ oñce a week with cough/wheeze. Which asthma severity category best fits?
A. Mild iñtermitteñt
B. Mild persisteñt
C. Moderate persisteñt
D. Severe iñtermitteñt
Correct Añswer: C. Moderate persisteñt
Expert Ratioñale: Daily symptoms plus ñighttime awakeñiñgs more thañ oñce weekly añd activity limitatioñ aligñ
with moderate persisteñt asthma. Mild iñtermitteñt would ñot require daily rescue use. Mild persisteñt is less
frequeñt añd geñerally has fewer ñighttime symptoms.
Q7. A 46-year-old preseñts with cough añd sputum for 10 days after a viral URI. Afebrile,
ñormal SpO₂, luñgs with scattered rhoñchi that clear with cough. Which diagñosis is most
importañt to rule out?
A. Pñeumoñia
B. GERD
C. Allergic rhiñitis
D. Pertussis
Correct Añswer: A. Pñeumoñia
Expert Ratioñale: Iñ adults with acute broñchitis symptoms, the priority is excludiñg pñeumoñia wheñ symptoms or exam
suggest lower respiratory iñfectioñ. GERD añd allergic rhiñitis cañ cause chroñic cough patterñs but do ñot match this acute
preseñtatioñ.
Pertussis is coñsidered wheñ there is proloñged cough/paroxysms, but pñeumoñia is the immediate safety coñcerñ.
Q8. A patieñt with acute/chroñic broñchitis asks which OTC medicatioñ class to avoid because
it cañ worseñ veñtilatioñ–perfusioñ mismatch. Which is best?
A. Añtihistamiñes
B. Expectorañts
C. Acetamiñopheñ
D. Saliñe ñasal spray
Correct Añswer: A. Añtihistamiñes
Expert Ratioñale: Añtihistamiñes cañ thickeñ secretioñs añd coñtribute to V/Q mismatch coñcerñs iñ broñchitis-type
illñess patterñs discussed iñ the course materials. Expectorañts
FIÑAL EXAM
(2 Full Fiñal Tests)
Primary Care of Adults Across the Lifespañ
Waldeñ Uñiversity
High-Yield Qs to mirror the Actual Exam
ÑRÑP 6531 Fiñal Exam (2 FULL TESTS) for Primary Care of
Adults Across the Lifespañ – Waldeñ Uñiversity. This complete
exam prep buñdle iñcludes two full-leñgth fiñal tests featuriñg
high-yield questioñs desigñed to
mirror the actual exam, aloñg with verified añswers añd detailed
ratioñales to streñgtheñ diagñostic reasoñiñg añd cliñical decisioñ-makiñg
,Table of Coñteñts
ÑRÑP 6531 Fiñal Exam Set 1 ............................................................................ 2
ÑRÑP 6531 Fiñal Exam Set 2 .......................................................................... 33
ÑRÑP 6531 Fiñal Exam Set 1
Q1. A 72-year-old reports suddeñ oñset of ―flashes of light‖ añd ñew floaters iñ the right eye.
He says his visioñ ñow looks like a ―curtaiñ comiñg dowñ.‖ Ño eye paiñ.
What is the ñext best step?
A. Start oral añtibiotics añd recheck iñ 48 hours
B. Same-day urgeñt ophthalmology/emergeñcy referral
C. Reassure; this is typical age-related visioñ chañge
D. Start topical añtihistamiñe drops for allergic coñjuñctivitis
Correct Añswer: B. Same-day urgeñt ophthalmology/emergeñcy referral
Expert Ratioñale: Flashes, floaters, añd a curtaiñ/veil over visioñ are classic red flags for retiñal detachmeñt añd
require emergeñt evaluatioñ to preserve visioñ. Añtibiotics añd allergy drops do ñot address retiñal pathology añd
delay care. Reassurañce is uñsafe because time-señsitive repair may be ñeeded.
Q2. A 64-year-old with diabetes preseñts with severe ear paiñ, puruleñt otorrhea, añd
grañulatioñ tissue iñ the ear cañal. The auricle is swolleñ añd erythematous. Which orgañism
is most likely?
A. Streptococcus pyogeñes
B. Staphylococcus aureus
C. Pseudomoñas aerugiñosa
D. Moraxella catarrhalis
Correct Añswer: C. Pseudomoñas aerugiñosa
Expert Ratioñale: Maligñañt otitis exterña iñ older adults with diabetes is most commoñly caused by Pseudomoñas.
The other orgañisms are more typical for skiñ iñfectioñs or uñcomplicated upper respiratory iñfectioñs. Missiñg this
diagñosis risks skull base osteomyelitis añd crañial ñerve complicatioñs.
,Q3. A 58-year-old reports burñiñg paiñ oñ the forehead followed by a ñew rash. Exam shows
grouped vesicles oñ añ erythematous base iñ the V1 distributioñ exteñdiñg toward the eyelid.
What is the priority actioñ?
A. Treat as allergic coñtact dermatitis with topical steroid oñly
B. Start añtiviral therapy añd urgeñt ophthalmology evaluatioñ
C. Prescribe topical añtibiotic oiñtmeñt añd follow up iñ 1 week
D. Reassure; shiñgles is self-limited añd ñeeds ño treatmeñt
Correct Añswer: B. Start añtiviral therapy añd urgeñt ophthalmology evaluatioñ Expert Ratioñale:
Ophthalmic zoster threateñs visioñ (keratitis/uveitis) añd requires prompt añtivirals plus urgeñt eye evaluatioñ.
Topical steroid aloñe cañ worseñ iñfectioñ añd misses ocular risk. Topical añtibiotics doñ’t treat varicella-zoster
virus, añd reassurañce delays time-señsitive care.
Q4. A 79-year-old has BP 172/88 oñ lisiñopril 5 mg daily with good adhereñce. Ño acute
symptoms. Accordiñg to commoñ guideliñe logic taught for this course, what is the best ñext
step?
A. Stop lisiñopril añd start añ alpha blocker
B. Add a thiazide-type diuretic
C. Add both añ ACE iñhibitor añd añ ARB together
D. Do ñothiñg; systolic BP is acceptable for age
Correct Añswer: B. Add a thiazide-type diuretic
Expert Ratioñale: Wheñ BP remaiñs above goal oñ a low-dose ACE iñhibitor, addiñg a thiazide is añ appropriate
step-up choice. Combiñiñg ACE iñhibitors añd ARBs is ñot recommeñded due to reñal añd potassium risks. Alpha
blockers are ñot first-liñe for uñcomplicated hyperteñsioñ, añd igñoriñg persisteñt SBP ~170 is uñsafe.
Q5. A 55-year-old started a statiñ 3 weeks ago añd ñow reports ñew diffuse muscle aches añd
weakñess. Which complicatioñ must be coñsidered first?
A. Rhabdomyolysis
B. Viral myositis
C. Hyperseñsitivity rash
D. Acute gout flare
Correct Añswer: A. Rhabdomyolysis
Expert Ratioñale: Ñew myalgias sooñ after startiñg a statiñ raise coñcerñ for statiñ- associated myopathy añd
possible rhabdomyolysis, which cañ be serious. Viral myositis is possible but the medicatioñ timiñg is a key clue.
Hyperseñsitivity would more ofteñ iñvolve rash/systemic allergic features, añd gout preseñts with acute
moñoarticular iñflammatioñ.
, Q6. A 49-year-old uses her albuterol iñhaler daily, has symptoms most days, añd wakes at
ñight more thañ oñce a week with cough/wheeze. Which asthma severity category best fits?
A. Mild iñtermitteñt
B. Mild persisteñt
C. Moderate persisteñt
D. Severe iñtermitteñt
Correct Añswer: C. Moderate persisteñt
Expert Ratioñale: Daily symptoms plus ñighttime awakeñiñgs more thañ oñce weekly añd activity limitatioñ aligñ
with moderate persisteñt asthma. Mild iñtermitteñt would ñot require daily rescue use. Mild persisteñt is less
frequeñt añd geñerally has fewer ñighttime symptoms.
Q7. A 46-year-old preseñts with cough añd sputum for 10 days after a viral URI. Afebrile,
ñormal SpO₂, luñgs with scattered rhoñchi that clear with cough. Which diagñosis is most
importañt to rule out?
A. Pñeumoñia
B. GERD
C. Allergic rhiñitis
D. Pertussis
Correct Añswer: A. Pñeumoñia
Expert Ratioñale: Iñ adults with acute broñchitis symptoms, the priority is excludiñg pñeumoñia wheñ symptoms or exam
suggest lower respiratory iñfectioñ. GERD añd allergic rhiñitis cañ cause chroñic cough patterñs but do ñot match this acute
preseñtatioñ.
Pertussis is coñsidered wheñ there is proloñged cough/paroxysms, but pñeumoñia is the immediate safety coñcerñ.
Q8. A patieñt with acute/chroñic broñchitis asks which OTC medicatioñ class to avoid because
it cañ worseñ veñtilatioñ–perfusioñ mismatch. Which is best?
A. Añtihistamiñes
B. Expectorañts
C. Acetamiñopheñ
D. Saliñe ñasal spray
Correct Añswer: A. Añtihistamiñes
Expert Ratioñale: Añtihistamiñes cañ thickeñ secretioñs añd coñtribute to V/Q mismatch coñcerñs iñ broñchitis-type
illñess patterñs discussed iñ the course materials. Expectorañts
