UTA NURS 5337 Family Clinical Practice 1: Exam 1 - Questions
with Correct Answers
100 questions
1. A 50-year-old patient asks why her FNP recommends a statin based on the PREVENT
calculator rather than the older pooled cohort equations. The FNP explains that PREVENT:
A. Uses race as a primary variable
B. Only applies to people over 80
C. Does not use cholesterol values
D. Includes kidney function and estimates both ASCVD and heart failure risk without using race
Correct Answer: D. Includes kidney function and estimates both ASCVD and heart failure risk
without using race
Rationale: The AHA PREVENT equations, endorsed in the 2025 AHA/ACC hypertension guideline, add
eGFR, estimate total cardiovascular disease including heart failure, and remove race as a variable. The
older pooled cohort equations used race and tended to overestimate risk. PREVENT applies to adults 30
to 79 and does include cholesterol.
2. A healthy 45-year-old with no history of chickenpox and negative varicella IgG should receive:
A. One dose of zoster vaccine
B. Varicella immune globulin
C. No vaccine, because adults are immune
D. Two doses of varicella vaccine 4 to 8 weeks apart
Correct Answer: D. Two doses of varicella vaccine 4 to 8 weeks apart
Rationale: Non-immune adults need two doses of varicella vaccine 4 to 8 weeks apart. Zoster vaccines
prevent reactivation and are not a substitute in a seronegative person. Immune globulin is post-exposure
prophylaxis for high-risk patients, and many adults are not immune, which is why serology was checked.
3. A test with high sensitivity is most useful for:
A. Ruling in a disease when the result is positive
B. Determining disease prevalence
C. Ruling out a disease when the result is negative
D. Reducing false-positive results
Correct Answer: C. Ruling out a disease when the result is negative
Rationale: A highly sensitive test misses few true cases, so a negative result makes the disease unlikely
(SnNout). Ruling in disease with a positive result is the job of high specificity (SpPin). Prevalence is a
population measure, and false positives are reduced by specificity, not sensitivity.
,4. The best initial approach to assess fall risk in a 75-year-old is to:
A. Order a brain MRI
B. Prescribe vitamin D 50,000 units weekly to all older adults
C. Order a bone scan
D. Ask about prior falls and perform a timed up-and-go test
Correct Answer: D. Ask about prior falls and perform a timed up-and-go test
Rationale: Asking about falls in the past year and observing gait with the timed up-and-go identifies who
needs a multifactorial intervention. USPSTF recommends exercise interventions to prevent falls, but does
not recommend routine vitamin D for fall prevention in community-dwelling older adults. MRI and bone
scans are not screening tools for fall risk.
5. In a SOAP note, the Assessment section should contain:
A. The diagnosis or differential diagnoses with supporting reasoning
B. The vital signs and lab values
C. The patient's chief complaint in their own words
D. The medication refills ordered
Correct Answer: A. The diagnosis or differential diagnoses with supporting reasoning
Rationale: The Assessment synthesizes the subjective and objective data into a working diagnosis and
differentials. Vitals and labs go in Objective, and the chief complaint belongs in Subjective. Orders,
prescriptions, and education belong in the Plan.
6. A patient with diabetes asks why the FNP checks for albumin in the urine every year. The best
explanation is that:
A. It detects early diabetic kidney disease before the creatinine rises
B. It screens for bladder cancer
C. It replaces the need for an A1c
D. It diagnoses urinary tract infection
Correct Answer: A. It detects early diabetic kidney disease before the creatinine rises
Rationale: The urine albumin-to-creatinine ratio shows early glomerular damage when treatment (such as
an ACE inhibitor or SGLT2 inhibitor) can slow progression. It is not a bladder cancer or infection test.
Glycemic control is still monitored with A1c.
,7. The OLDCARTS mnemonic is used primarily to:
A. Grade the severity of a heart murmur
B. Structure the history of present illness
C. Calculate cardiovascular risk
D. Document a review of systems for billing
Correct Answer: B. Structure the history of present illness
Rationale: OLDCARTS covers onset, location, duration, character, aggravating and alleviating factors,
radiation, timing, and severity, which organizes the HPI. Murmurs are graded on a 1 to 6 scale, and
cardiovascular risk uses calculators such as PREVENT or the pooled cohort equations. The review of
systems is a separate head-to-toe symptom inventory.
8. A 40-year-old overweight adult with a BMI of 29 has never had diabetes testing. USPSTF
guidance is to:
A. Screen for prediabetes and type 2 diabetes now
B. Screen only if symptoms of polyuria develop
C. Begin screening at age 45 only
D. Screen only if a parent has diabetes
Correct Answer: A. Screen for prediabetes and type 2 diabetes now
Rationale: USPSTF recommends screening adults 35 to 70 who are overweight or obese, so this patient
qualifies now. Waiting for symptoms means diagnosis after complications may already be developing.
Family history adds risk but is not required, and age 45 is not the threshold in this recommendation.
9. Hypertension with a heart rate of 110 and tremor in a thin patient warrants checking:
A. Hemoglobin A1c
B. Lipid panel
C. Uric acid
D. TSH
Correct Answer: D. TSH
Rationale: Hyperthyroidism causes systolic hypertension, tachycardia, tremor and weight loss and is a
reversible secondary cause. A1c, lipids and uric acid matter for cardiovascular risk but do not explain this
picture. A beta blocker may help symptoms while the thyroid workup proceeds.
, 10. A patient with hypertension drinks 4 beers nightly. The recommendation is to limit alcohol
to:
A. No alcohol limit as long as BP is treated
B. 5 drinks per day
C. No more than 2 drinks per day for men and 1 for women
D. Only weekend binge drinking
Correct Answer: C. No more than 2 drinks per day for men and 1 for women
Rationale: Heavy alcohol use raises BP and blunts medication effects, so men should limit to 2 drinks
and women to 1 daily, or less. Treated BP does not cancel the harm. Binge drinking also raises BP and
cardiovascular risk.
11. A borderline-risk 52-year-old is undecided about a statin. Which test can help reclassify risk?
A. Exercise stress test
B. Coronary artery calcium score
C. Resting ECG
D. Carotid intima-media thickness
Correct Answer: B. Coronary artery calcium score
Rationale: A CAC score of zero supports deferring a statin in many patients, while a score of 100 or more
favors treatment. Stress testing evaluates symptoms rather than refining risk in asymptomatic people.
ECG has low value for this decision, and carotid IMT is no longer recommended.
12. A 58-year-old with hypertension and type 2 diabetes has a urine albumin-to-creatinine ratio
of 120 mg/g. The preferred antihypertensive is:
A. A thiazide diuretic alone
B. An ACE inhibitor or ARB
C. Amlodipine alone
D. Metoprolol
Correct Answer: B. An ACE inhibitor or ARB
Rationale: With albuminuria, an ACE inhibitor or ARB lowers intraglomerular pressure and slows
nephropathy progression. Thiazides and amlodipine lower BP but lack this renoprotective effect, so they
are add-ons. Metoprolol is not preferred unless another indication exists.
with Correct Answers
100 questions
1. A 50-year-old patient asks why her FNP recommends a statin based on the PREVENT
calculator rather than the older pooled cohort equations. The FNP explains that PREVENT:
A. Uses race as a primary variable
B. Only applies to people over 80
C. Does not use cholesterol values
D. Includes kidney function and estimates both ASCVD and heart failure risk without using race
Correct Answer: D. Includes kidney function and estimates both ASCVD and heart failure risk
without using race
Rationale: The AHA PREVENT equations, endorsed in the 2025 AHA/ACC hypertension guideline, add
eGFR, estimate total cardiovascular disease including heart failure, and remove race as a variable. The
older pooled cohort equations used race and tended to overestimate risk. PREVENT applies to adults 30
to 79 and does include cholesterol.
2. A healthy 45-year-old with no history of chickenpox and negative varicella IgG should receive:
A. One dose of zoster vaccine
B. Varicella immune globulin
C. No vaccine, because adults are immune
D. Two doses of varicella vaccine 4 to 8 weeks apart
Correct Answer: D. Two doses of varicella vaccine 4 to 8 weeks apart
Rationale: Non-immune adults need two doses of varicella vaccine 4 to 8 weeks apart. Zoster vaccines
prevent reactivation and are not a substitute in a seronegative person. Immune globulin is post-exposure
prophylaxis for high-risk patients, and many adults are not immune, which is why serology was checked.
3. A test with high sensitivity is most useful for:
A. Ruling in a disease when the result is positive
B. Determining disease prevalence
C. Ruling out a disease when the result is negative
D. Reducing false-positive results
Correct Answer: C. Ruling out a disease when the result is negative
Rationale: A highly sensitive test misses few true cases, so a negative result makes the disease unlikely
(SnNout). Ruling in disease with a positive result is the job of high specificity (SpPin). Prevalence is a
population measure, and false positives are reduced by specificity, not sensitivity.
,4. The best initial approach to assess fall risk in a 75-year-old is to:
A. Order a brain MRI
B. Prescribe vitamin D 50,000 units weekly to all older adults
C. Order a bone scan
D. Ask about prior falls and perform a timed up-and-go test
Correct Answer: D. Ask about prior falls and perform a timed up-and-go test
Rationale: Asking about falls in the past year and observing gait with the timed up-and-go identifies who
needs a multifactorial intervention. USPSTF recommends exercise interventions to prevent falls, but does
not recommend routine vitamin D for fall prevention in community-dwelling older adults. MRI and bone
scans are not screening tools for fall risk.
5. In a SOAP note, the Assessment section should contain:
A. The diagnosis or differential diagnoses with supporting reasoning
B. The vital signs and lab values
C. The patient's chief complaint in their own words
D. The medication refills ordered
Correct Answer: A. The diagnosis or differential diagnoses with supporting reasoning
Rationale: The Assessment synthesizes the subjective and objective data into a working diagnosis and
differentials. Vitals and labs go in Objective, and the chief complaint belongs in Subjective. Orders,
prescriptions, and education belong in the Plan.
6. A patient with diabetes asks why the FNP checks for albumin in the urine every year. The best
explanation is that:
A. It detects early diabetic kidney disease before the creatinine rises
B. It screens for bladder cancer
C. It replaces the need for an A1c
D. It diagnoses urinary tract infection
Correct Answer: A. It detects early diabetic kidney disease before the creatinine rises
Rationale: The urine albumin-to-creatinine ratio shows early glomerular damage when treatment (such as
an ACE inhibitor or SGLT2 inhibitor) can slow progression. It is not a bladder cancer or infection test.
Glycemic control is still monitored with A1c.
,7. The OLDCARTS mnemonic is used primarily to:
A. Grade the severity of a heart murmur
B. Structure the history of present illness
C. Calculate cardiovascular risk
D. Document a review of systems for billing
Correct Answer: B. Structure the history of present illness
Rationale: OLDCARTS covers onset, location, duration, character, aggravating and alleviating factors,
radiation, timing, and severity, which organizes the HPI. Murmurs are graded on a 1 to 6 scale, and
cardiovascular risk uses calculators such as PREVENT or the pooled cohort equations. The review of
systems is a separate head-to-toe symptom inventory.
8. A 40-year-old overweight adult with a BMI of 29 has never had diabetes testing. USPSTF
guidance is to:
A. Screen for prediabetes and type 2 diabetes now
B. Screen only if symptoms of polyuria develop
C. Begin screening at age 45 only
D. Screen only if a parent has diabetes
Correct Answer: A. Screen for prediabetes and type 2 diabetes now
Rationale: USPSTF recommends screening adults 35 to 70 who are overweight or obese, so this patient
qualifies now. Waiting for symptoms means diagnosis after complications may already be developing.
Family history adds risk but is not required, and age 45 is not the threshold in this recommendation.
9. Hypertension with a heart rate of 110 and tremor in a thin patient warrants checking:
A. Hemoglobin A1c
B. Lipid panel
C. Uric acid
D. TSH
Correct Answer: D. TSH
Rationale: Hyperthyroidism causes systolic hypertension, tachycardia, tremor and weight loss and is a
reversible secondary cause. A1c, lipids and uric acid matter for cardiovascular risk but do not explain this
picture. A beta blocker may help symptoms while the thyroid workup proceeds.
, 10. A patient with hypertension drinks 4 beers nightly. The recommendation is to limit alcohol
to:
A. No alcohol limit as long as BP is treated
B. 5 drinks per day
C. No more than 2 drinks per day for men and 1 for women
D. Only weekend binge drinking
Correct Answer: C. No more than 2 drinks per day for men and 1 for women
Rationale: Heavy alcohol use raises BP and blunts medication effects, so men should limit to 2 drinks
and women to 1 daily, or less. Treated BP does not cancel the harm. Binge drinking also raises BP and
cardiovascular risk.
11. A borderline-risk 52-year-old is undecided about a statin. Which test can help reclassify risk?
A. Exercise stress test
B. Coronary artery calcium score
C. Resting ECG
D. Carotid intima-media thickness
Correct Answer: B. Coronary artery calcium score
Rationale: A CAC score of zero supports deferring a statin in many patients, while a score of 100 or more
favors treatment. Stress testing evaluates symptoms rather than refining risk in asymptomatic people.
ECG has low value for this decision, and carotid IMT is no longer recommended.
12. A 58-year-old with hypertension and type 2 diabetes has a urine albumin-to-creatinine ratio
of 120 mg/g. The preferred antihypertensive is:
A. A thiazide diuretic alone
B. An ACE inhibitor or ARB
C. Amlodipine alone
D. Metoprolol
Correct Answer: B. An ACE inhibitor or ARB
Rationale: With albuminuria, an ACE inhibitor or ARB lowers intraglomerular pressure and slows
nephropathy progression. Thiazides and amlodipine lower BP but lack this renoprotective effect, so they
are add-ons. Metoprolol is not preferred unless another indication exists.
