CMN 574 EXAM 3: ADVANCED
PRIMARY CARE NURSING QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE. JUST
RELEASED
1. A 45-year-old patient presents with a fasting plasma glucose of 128 mg/dL on two separate
occasions. According to the ADA guidelines, what is the most appropriate next step in
management?
A. Diagnose Type 2 Diabetes and begin lifestyle modification counseling.
B. Initiate Metformin 500mg BID immediately.
C. Perform an Oral Glucose Tolerance Test (OGTT) to confirm.
D. Repeat the fasting glucose in 6 months.
Answer: A
Conceptual Explanation: A fasting plasma glucose (FPG) ≥ 126 mg/dL on two separate
occasions is diagnostic for Diabetes Mellitus. Lifestyle modification is the first-line
intervention alongside or preceding pharmacotherapy.
2. Which thyroid laboratory pattern is most consistent with subclinical hypothyroidism?
A. Low TSH, Low Free T4
,B. High TSH, Low Free T4
C. Low TSH, Normal Free T4
D. High TSH, Normal Free T4
Answer: D
Conceptual Explanation: Subclinical hypothyroidism is defined by an elevated TSH level
in the presence of a normal Free T4 level.
3. A patient with GERD reports recent unintentional weight loss and difficulty swallowing
solid foods. What is the priority intervention?
A. Refer for an urgent Upper Endoscopy (EGD).
B. Increase the PPI dose to twice daily.
C. Order a Barium Swallow study.
D. Switch from a PPI to an H2 blocker.
Answer: A
Conceptual Explanation: Dysphagia and weight loss are ‘alarm symptoms’ for GERD that
necessitate an EGD to rule out malignancy or Barrett’s esophagus.
4. In a patient with microcytic anemia, which lab finding best differentiates Iron Deficiency
Anemia from Thalassemia Trait?
A. Mean Corpuscular Volume (MCV)
B. Red Cell Distribution Width (RDW)
, C. Hemoglobin level
D. Total Iron Binding Capacity (TIBC)
Answer: B
Conceptual Explanation: RDW is typically increased in Iron Deficiency Anemia (reflecting
varying sizes of RBCs as iron stores deplete) but remains normal in Thalassemia Trait
(where RBCs are uniformly small).
5. A patient’s Hepatitis B serology shows: HBsAg negative, anti-HBc positive, and anti-HBs
positive. How should the NP interpret these results?
A. Susceptible to infection
B. Immune due to vaccination
C. Chronic Hepatitis B infection
D. Immune due to natural infection
Answer: D
Conceptual Explanation: Anti-HBc (core antibody) indicates a previous or current
infection. If anti-HBs is also positive and HBsAg is negative, the patient is immune due to
recovery from natural infection.
6. Which medication for BPH is most likely to cause orthostatic hypotension during the initial
dosing phase?
A. Terazosin
PRIMARY CARE NURSING QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE. JUST
RELEASED
1. A 45-year-old patient presents with a fasting plasma glucose of 128 mg/dL on two separate
occasions. According to the ADA guidelines, what is the most appropriate next step in
management?
A. Diagnose Type 2 Diabetes and begin lifestyle modification counseling.
B. Initiate Metformin 500mg BID immediately.
C. Perform an Oral Glucose Tolerance Test (OGTT) to confirm.
D. Repeat the fasting glucose in 6 months.
Answer: A
Conceptual Explanation: A fasting plasma glucose (FPG) ≥ 126 mg/dL on two separate
occasions is diagnostic for Diabetes Mellitus. Lifestyle modification is the first-line
intervention alongside or preceding pharmacotherapy.
2. Which thyroid laboratory pattern is most consistent with subclinical hypothyroidism?
A. Low TSH, Low Free T4
,B. High TSH, Low Free T4
C. Low TSH, Normal Free T4
D. High TSH, Normal Free T4
Answer: D
Conceptual Explanation: Subclinical hypothyroidism is defined by an elevated TSH level
in the presence of a normal Free T4 level.
3. A patient with GERD reports recent unintentional weight loss and difficulty swallowing
solid foods. What is the priority intervention?
A. Refer for an urgent Upper Endoscopy (EGD).
B. Increase the PPI dose to twice daily.
C. Order a Barium Swallow study.
D. Switch from a PPI to an H2 blocker.
Answer: A
Conceptual Explanation: Dysphagia and weight loss are ‘alarm symptoms’ for GERD that
necessitate an EGD to rule out malignancy or Barrett’s esophagus.
4. In a patient with microcytic anemia, which lab finding best differentiates Iron Deficiency
Anemia from Thalassemia Trait?
A. Mean Corpuscular Volume (MCV)
B. Red Cell Distribution Width (RDW)
, C. Hemoglobin level
D. Total Iron Binding Capacity (TIBC)
Answer: B
Conceptual Explanation: RDW is typically increased in Iron Deficiency Anemia (reflecting
varying sizes of RBCs as iron stores deplete) but remains normal in Thalassemia Trait
(where RBCs are uniformly small).
5. A patient’s Hepatitis B serology shows: HBsAg negative, anti-HBc positive, and anti-HBs
positive. How should the NP interpret these results?
A. Susceptible to infection
B. Immune due to vaccination
C. Chronic Hepatitis B infection
D. Immune due to natural infection
Answer: D
Conceptual Explanation: Anti-HBc (core antibody) indicates a previous or current
infection. If anti-HBs is also positive and HBsAg is negative, the patient is immune due to
recovery from natural infection.
6. Which medication for BPH is most likely to cause orthostatic hypotension during the initial
dosing phase?
A. Terazosin
