NURS 6531 ADVANCED PRACTICE
PRIMARY CARE EXAM 3 QUESTIONS
AND VERIFIED ANSWERS| GRADE
A+|WALDEN UNIVERSITY
1. A 68-year-old patient with a history of hypertension presents for a routine visit. The blood
pressure is 154/92 mmHg. According to JNC 8 guidelines, what is the target blood pressure for
this patient?
A. <130/80 mmHg
B. <140/90 mmHg
C. <120/80 mmHg
D. <150/90 mmHg
Answer: D
Conceptual Explanation: For patients aged 60 years or older without diabetes or chronic
kidney disease, JNC 8 guidelines recommend a target blood pressure of less than 150/90
mmHg.
2. Which of the following physical examination findings is most characteristic of Heberden’s
nodes in a patient with Osteoarthritis?
A. Bony enlargement of the proximal interphalangeal (PIP) joints
,B. Ulnar deviation of the metacarpophalangeal (MCP) joints
C. Bony enlargement of the distal interphalangeal (DIP) joints
D. Soft tissue swelling of the wrist joints
Answer: C
Conceptual Explanation: Heberden’s nodes are bony enlargements specifically located at
the distal interphalangeal (DIP) joints, characteristic of osteoarthritis.
3. A 45-year-old male complains of sudden, severe pain in his right great toe that began
overnight. His serum uric acid level is 9.0 mg/dL. Which medication is the first-line treatment
for an acute flare of gout?
A. Colchicine
B. Allopurinol
C. Febuxostat
D. Probenecid
Answer: A
Conceptual Explanation: Colchicine, NSAIDs, or corticosteroids are first-line for acute
gout flares. Allopurinol is used for long-term urate-lowering therapy but should not be
initiated during an acute attack.
, 4. A patient with COPD presents with a FEV1/FVC ratio of 0.65 and an FEV1 of 45% predicted.
According to the GOLD criteria, how is this severity classified?
A. GOLD 1: Mild
B. GOLD 2: Moderate
C. GOLD 3: Severe
D. GOLD 4: Very Severe
Answer: C
Conceptual Explanation: GOLD 3 (Severe) is defined by an FEV1 between 30% and 49%
of the predicted value in patients with a FEV1/FVC ratio < 0.70.
5. Which screening test is the most appropriate for a 55-year-old patient with a 30-pack-year
history of smoking who currently smokes?
A. Low-dose computed tomography (LDCT) annually
B. Sputum cytology every 6 months
C. Chest X-ray annually
D. Pulmonary function tests (PFTs) annually
Answer: A
Conceptual Explanation: USPSTF recommends annual screening for lung cancer with
LDCT in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently
smoke or have quit within the past 15 years.
PRIMARY CARE EXAM 3 QUESTIONS
AND VERIFIED ANSWERS| GRADE
A+|WALDEN UNIVERSITY
1. A 68-year-old patient with a history of hypertension presents for a routine visit. The blood
pressure is 154/92 mmHg. According to JNC 8 guidelines, what is the target blood pressure for
this patient?
A. <130/80 mmHg
B. <140/90 mmHg
C. <120/80 mmHg
D. <150/90 mmHg
Answer: D
Conceptual Explanation: For patients aged 60 years or older without diabetes or chronic
kidney disease, JNC 8 guidelines recommend a target blood pressure of less than 150/90
mmHg.
2. Which of the following physical examination findings is most characteristic of Heberden’s
nodes in a patient with Osteoarthritis?
A. Bony enlargement of the proximal interphalangeal (PIP) joints
,B. Ulnar deviation of the metacarpophalangeal (MCP) joints
C. Bony enlargement of the distal interphalangeal (DIP) joints
D. Soft tissue swelling of the wrist joints
Answer: C
Conceptual Explanation: Heberden’s nodes are bony enlargements specifically located at
the distal interphalangeal (DIP) joints, characteristic of osteoarthritis.
3. A 45-year-old male complains of sudden, severe pain in his right great toe that began
overnight. His serum uric acid level is 9.0 mg/dL. Which medication is the first-line treatment
for an acute flare of gout?
A. Colchicine
B. Allopurinol
C. Febuxostat
D. Probenecid
Answer: A
Conceptual Explanation: Colchicine, NSAIDs, or corticosteroids are first-line for acute
gout flares. Allopurinol is used for long-term urate-lowering therapy but should not be
initiated during an acute attack.
, 4. A patient with COPD presents with a FEV1/FVC ratio of 0.65 and an FEV1 of 45% predicted.
According to the GOLD criteria, how is this severity classified?
A. GOLD 1: Mild
B. GOLD 2: Moderate
C. GOLD 3: Severe
D. GOLD 4: Very Severe
Answer: C
Conceptual Explanation: GOLD 3 (Severe) is defined by an FEV1 between 30% and 49%
of the predicted value in patients with a FEV1/FVC ratio < 0.70.
5. Which screening test is the most appropriate for a 55-year-old patient with a 30-pack-year
history of smoking who currently smokes?
A. Low-dose computed tomography (LDCT) annually
B. Sputum cytology every 6 months
C. Chest X-ray annually
D. Pulmonary function tests (PFTs) annually
Answer: A
Conceptual Explanation: USPSTF recommends annual screening for lung cancer with
LDCT in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently
smoke or have quit within the past 15 years.
