NURS 5434 FINAL EXAM / NURS 5434 FAMILY NURSE PRACTITIONER III
(FAMILY III) FINAL EXAM UNIVERSITY OT TEXAS AT ARLINGTON
2026/2027 COMPLETE ACCURATE EXAM
1. A 52-year-old patient with no significant cardiovascular history presents for
an annual primary care visit and asks which preventive services should be
prioritized. The patient has normal vital signs, no tobacco use, and no
concerning symptoms. Which approach best reflects the role of the family
nurse practitioner in preventive care?
A. Order every available screening test to maximize early detection
regardless of evidence
B. Base screening primarily on patient preference without considering age
or risk
C. Use evidence-based recommendations while incorporating age,
individual risk factors, benefits, harms, and shared decision-making
D. Limit preventive services to immunizations because asymptomatic
patients do not require additional screening
Answer: C
2. A 67-year-old man who smoked one pack per day for 25 years but quit 10
years ago asks about abdominal aortic aneurysm screening. He has never
previously undergone screening and has no abdominal symptoms. Which
screening approach is most appropriate?
A. Offer a one-time abdominal ultrasound based on his age and history of
tobacco exposure
B. Perform abdominal CT annually beginning at age 70
C. Screen only if an abdominal bruit is detected
D. Routine screening is indicated only for women older than 65 years
Answer: A
3. A 45-year-old average-risk patient asks when colorectal cancer screening
should begin. The patient has no personal history of inflammatory bowel
disease, colorectal polyps, or colorectal cancer and no first-degree relative
with colorectal cancer. Which response is most appropriate?
pg. 1
, A. Screening should wait until age 60 unless symptoms develop
B. Screening should begin at age 40 for all average-risk adults
C. Screening is unnecessary if the patient has no gastrointestinal symptoms
D. Screening should begin at age 45 using an age-appropriate
recommended screening strategy
Answer: D
4. A 58-year-old patient with an average risk of colorectal cancer prefers
colonoscopy rather than stool-based testing. The patient asks how
frequently a normal screening colonoscopy is generally repeated. Which
interval is appropriate?
A. Every 2 years
B. Every 10 years
C. Every 3 years
D. Every 5 years
Answer: B
5. A 52-year-old woman asks whether she should perform routine breast self-
examinations as a formal cancer-screening strategy. She has no breast
symptoms and no high-risk genetic history. Which counseling is most
appropriate?
A. Breast self-examination should replace mammography
B. Breast self-examination should be performed every month and is
mandatory for all women
C. Routine formal breast self-examination is not recommended as a
screening strategy, although patients should be familiar with their breasts
and report changes
D. Breast self-examination is recommended only after age 65
Answer: C
6. A 42-year-old woman with average breast cancer risk asks about
mammography. She has no breast symptoms and no known genetic
predisposition. Which approach best reflects contemporary preventive
care?
pg. 2
, A. Discuss age-appropriate mammographic screening using shared decision-
making and current evidence-based recommendations
B. Delay all mammography until age 55
C. Order breast MRI as the routine first-line screening test
D. Recommend screening only after a palpable breast mass develops
Answer: A
7. A 38-year-old woman asks about cervical cancer screening. She has an
intact cervix, no history of cervical cancer, and average risk. Which
statement is most accurate?
A. Screening should occur annually with cytology beginning at age 18
B. Screening should stop at age 40 regardless of previous results
C. Screening should be performed only when symptoms such as abnormal
bleeding occur
D. Cervical cancer screening should follow an age-appropriate evidence-
based interval using an accepted screening modality
Answer: D
8. A 55-year-old woman asks whether a routine pelvic examination is
necessary every year even when she has no symptoms. Which response is
most appropriate?
A. An annual pelvic examination is mandatory for every asymptomatic
woman
B. The need for pelvic examination should be based on symptoms,
preventive needs, and individual risk rather than automatically performing
it as a cancer-screening test
C. Pelvic examination is never appropriate after menopause
D. Pelvic examination should always be replaced by abdominal CT
Answer: B
9. A 68-year-old man asks whether PSA testing should automatically be
performed every year. He has no urinary symptoms and no strong family
history of prostate cancer. Which approach is most appropriate?
A. Explain potential benefits and harms and use shared decision-making
pg. 3
, rather than automatically screening every asymptomatic man
B. PSA screening is mandatory annually for all men beginning at age 40
C. PSA testing should be performed only when urinary retention occurs
D. PSA testing is never appropriate under any circumstance
Answer: A
10. A 60-year-old woman with no previous osteoporosis diagnosis asks whether
she should undergo bone mineral density screening. Which factor most
strongly supports routine screening at this age?
A. Any history of seasonal allergies
B. A history of uncomplicated appendectomy
C. Being a woman older than the recommended screening threshold for
osteoporosis
D. Having a normal body mass index
Answer: C
11. A 67-year-old woman has never received pneumococcal vaccination and
asks which current conjugate vaccine strategy can provide broad protection.
Which approach is appropriate for an adult who is eligible for PCV20?
A. Give PPSV23 every year for five consecutive years
B. Give only the influenza vaccine
C. Delay pneumococcal vaccination until age 80
D. Administer PCV20 according to current adult pneumococcal
recommendations
Answer: D
12. A 66-year-old patient presents in October and asks when the influenza
vaccine should be received. The patient has no contraindication to
vaccination. Which recommendation is appropriate?
A. Influenza vaccine is needed only once after age 65
B. Influenza vaccination should be received annually, ideally before
influenza activity becomes widespread
C. Influenza vaccination should be delayed until the patient develops
respiratory symptoms
pg. 4
(FAMILY III) FINAL EXAM UNIVERSITY OT TEXAS AT ARLINGTON
2026/2027 COMPLETE ACCURATE EXAM
1. A 52-year-old patient with no significant cardiovascular history presents for
an annual primary care visit and asks which preventive services should be
prioritized. The patient has normal vital signs, no tobacco use, and no
concerning symptoms. Which approach best reflects the role of the family
nurse practitioner in preventive care?
A. Order every available screening test to maximize early detection
regardless of evidence
B. Base screening primarily on patient preference without considering age
or risk
C. Use evidence-based recommendations while incorporating age,
individual risk factors, benefits, harms, and shared decision-making
D. Limit preventive services to immunizations because asymptomatic
patients do not require additional screening
Answer: C
2. A 67-year-old man who smoked one pack per day for 25 years but quit 10
years ago asks about abdominal aortic aneurysm screening. He has never
previously undergone screening and has no abdominal symptoms. Which
screening approach is most appropriate?
A. Offer a one-time abdominal ultrasound based on his age and history of
tobacco exposure
B. Perform abdominal CT annually beginning at age 70
C. Screen only if an abdominal bruit is detected
D. Routine screening is indicated only for women older than 65 years
Answer: A
3. A 45-year-old average-risk patient asks when colorectal cancer screening
should begin. The patient has no personal history of inflammatory bowel
disease, colorectal polyps, or colorectal cancer and no first-degree relative
with colorectal cancer. Which response is most appropriate?
pg. 1
, A. Screening should wait until age 60 unless symptoms develop
B. Screening should begin at age 40 for all average-risk adults
C. Screening is unnecessary if the patient has no gastrointestinal symptoms
D. Screening should begin at age 45 using an age-appropriate
recommended screening strategy
Answer: D
4. A 58-year-old patient with an average risk of colorectal cancer prefers
colonoscopy rather than stool-based testing. The patient asks how
frequently a normal screening colonoscopy is generally repeated. Which
interval is appropriate?
A. Every 2 years
B. Every 10 years
C. Every 3 years
D. Every 5 years
Answer: B
5. A 52-year-old woman asks whether she should perform routine breast self-
examinations as a formal cancer-screening strategy. She has no breast
symptoms and no high-risk genetic history. Which counseling is most
appropriate?
A. Breast self-examination should replace mammography
B. Breast self-examination should be performed every month and is
mandatory for all women
C. Routine formal breast self-examination is not recommended as a
screening strategy, although patients should be familiar with their breasts
and report changes
D. Breast self-examination is recommended only after age 65
Answer: C
6. A 42-year-old woman with average breast cancer risk asks about
mammography. She has no breast symptoms and no known genetic
predisposition. Which approach best reflects contemporary preventive
care?
pg. 2
, A. Discuss age-appropriate mammographic screening using shared decision-
making and current evidence-based recommendations
B. Delay all mammography until age 55
C. Order breast MRI as the routine first-line screening test
D. Recommend screening only after a palpable breast mass develops
Answer: A
7. A 38-year-old woman asks about cervical cancer screening. She has an
intact cervix, no history of cervical cancer, and average risk. Which
statement is most accurate?
A. Screening should occur annually with cytology beginning at age 18
B. Screening should stop at age 40 regardless of previous results
C. Screening should be performed only when symptoms such as abnormal
bleeding occur
D. Cervical cancer screening should follow an age-appropriate evidence-
based interval using an accepted screening modality
Answer: D
8. A 55-year-old woman asks whether a routine pelvic examination is
necessary every year even when she has no symptoms. Which response is
most appropriate?
A. An annual pelvic examination is mandatory for every asymptomatic
woman
B. The need for pelvic examination should be based on symptoms,
preventive needs, and individual risk rather than automatically performing
it as a cancer-screening test
C. Pelvic examination is never appropriate after menopause
D. Pelvic examination should always be replaced by abdominal CT
Answer: B
9. A 68-year-old man asks whether PSA testing should automatically be
performed every year. He has no urinary symptoms and no strong family
history of prostate cancer. Which approach is most appropriate?
A. Explain potential benefits and harms and use shared decision-making
pg. 3
, rather than automatically screening every asymptomatic man
B. PSA screening is mandatory annually for all men beginning at age 40
C. PSA testing should be performed only when urinary retention occurs
D. PSA testing is never appropriate under any circumstance
Answer: A
10. A 60-year-old woman with no previous osteoporosis diagnosis asks whether
she should undergo bone mineral density screening. Which factor most
strongly supports routine screening at this age?
A. Any history of seasonal allergies
B. A history of uncomplicated appendectomy
C. Being a woman older than the recommended screening threshold for
osteoporosis
D. Having a normal body mass index
Answer: C
11. A 67-year-old woman has never received pneumococcal vaccination and
asks which current conjugate vaccine strategy can provide broad protection.
Which approach is appropriate for an adult who is eligible for PCV20?
A. Give PPSV23 every year for five consecutive years
B. Give only the influenza vaccine
C. Delay pneumococcal vaccination until age 80
D. Administer PCV20 according to current adult pneumococcal
recommendations
Answer: D
12. A 66-year-old patient presents in October and asks when the influenza
vaccine should be received. The patient has no contraindication to
vaccination. Which recommendation is appropriate?
A. Influenza vaccine is needed only once after age 65
B. Influenza vaccination should be received annually, ideally before
influenza activity becomes widespread
C. Influenza vaccination should be delayed until the patient develops
respiratory symptoms
pg. 4
