NUNP 6565 Synthesis in Advanced
Nursing Practice of Patients in Primary
Care Settings
Midterm Exam Review
(Questions & Solutions)
2025
©2025
, 1. Case: A 56‑year‑old man with type 2 diabetes, hypertension, and
hyperlipidemia presents for a comprehensive primary care visit. His
laboratory values, blood pressure readings, and lifestyle factors are
reviewed.
Question: Which approach best synthesizes the evidence‑based
guidelines into an individualized care plan for this patient?
a) Prescribe medications according to standard protocols without
considering lifestyle factors.
b) Develop a care plan that integrates pharmacotherapy, lifestyle
modification (diet/exercise), and periodic monitoring, with active patient
engagement.
c) Focus solely on aggressive pharmacologic management.
d) Provide a pamphlet about diabetes without a tailored plan.
Correct ANS: b) Develop a care plan that integrates pharmacotherapy,
lifestyle modification (diet/exercise), and periodic monitoring, with active
patient engagement.
Rationale: Synthesis of advanced nursing practice involves integrating
clinical guidelines with patient-specific factors—such as comorbidities,
lifestyle, and readiness for change—to create an individualized,
comprehensive plan.
---
2. Case: A 42‑year‑old woman presents with depressive symptoms,
chronic pain, and poorly controlled hypertension. Her care requires a
blend of physical and mental health strategies.
Question: Which integrated management strategy best synthesizes
care for this patient?
a) Refer her exclusively for psychiatric treatment.
b) Initiate treatment with an antidepressant and ignore pain
management.
c) Combine pharmacologic management of hypertension and depression
©2025
,with a referral to behavioral health services and incorporate pain
management, emphasizing interprofessional collaboration.
d) Advise self‑management only.
Correct ANS: c) Combine pharmacologic management of
hypertension and depression with a referral to behavioral health services
and incorporate pain management, emphasizing interprofessional
collaboration.
Rationale: Synthesis in primary care requires an integrated, holistic
strategy that addresses both mental and physical health;
interprofessional care and the combination of tailored pharmacotherapy
with therapy for pain and behavioral issues are essential.
---
3. Case: A 63‑year‑old patient with multiple chronic conditions
(diabetes, heart failure, and chronic kidney disease) presents for routine
follow‑up. Laboratory data, imaging reports, and current medications are
available.
Question: In synthesizing this patient’s complex data, what is the most
effective strategy?
a) Rely strictly on previous medication regimens.
b) Disregard patient preferences and focus solely on numerical targets.
c) Integrate current clinical data with patient history, preferences, and
evidence‑based guidelines to adjust treatment goals and optimize care.
d) Refer immediately to a specialist without synthesizing available data.
Correct ANS: c) Integrate current clinical data with patient history,
preferences, and evidence‑based guidelines to adjust treatment goals
and optimize care.
Rationale: The essence of synthesis in advanced nursing is to merge
diverse information (labs, imaging, medical history, patient goals) into a
coherent, adaptable care plan that reflects best‑practice guidelines and
individual needs.
©2025
, ---
4. Case: A primary care clinic seeks to improve chronic disease
management through telehealth. A 58‑year‑old woman with heart failure
is enrolled in a remote monitoring program.
Question: Which factor is most critical in synthesizing telehealth into
her management plan?
a) Limiting communication to periodic phone calls.
b) Utilizing remote monitoring devices that integrate with electronic
health records (EHRs) to track vital signs and symptoms, enabling timely
interventions.
c) Replacing all in‑person visits with automated messages.
d) Ignoring patient concerns expressed via digital platforms.
Correct ANS: b) Utilizing remote monitoring devices that integrate
with electronic health records (EHRs) to track vital signs and symptoms,
enabling timely interventions.
Rationale: Effective synthesis of telehealth in primary care involves
leveraging technology to offer continuous monitoring, integrating data
with the EHR, and using that information to inform clinical decisions and
maintain patient engagement.
---
5. Case: A 47‑year‑old woman is due for cervical cancer screening. She
has a history of a prior abnormal Pap smear that was managed
conservatively.
Question: Which synthesis strategy aligns with current screening
guidelines in primary care?
a) Arrange for an annual Pap smear exclusively.
b) Defer screening because of her previous abnormal result.
c) Implement co‑testing with a Pap smear and high‑risk human
papillomavirus (HPV) testing every 5 years, considering her history and
age.
d) Immediately proceed to colposcopy without repeat screening.
©2025
Nursing Practice of Patients in Primary
Care Settings
Midterm Exam Review
(Questions & Solutions)
2025
©2025
, 1. Case: A 56‑year‑old man with type 2 diabetes, hypertension, and
hyperlipidemia presents for a comprehensive primary care visit. His
laboratory values, blood pressure readings, and lifestyle factors are
reviewed.
Question: Which approach best synthesizes the evidence‑based
guidelines into an individualized care plan for this patient?
a) Prescribe medications according to standard protocols without
considering lifestyle factors.
b) Develop a care plan that integrates pharmacotherapy, lifestyle
modification (diet/exercise), and periodic monitoring, with active patient
engagement.
c) Focus solely on aggressive pharmacologic management.
d) Provide a pamphlet about diabetes without a tailored plan.
Correct ANS: b) Develop a care plan that integrates pharmacotherapy,
lifestyle modification (diet/exercise), and periodic monitoring, with active
patient engagement.
Rationale: Synthesis of advanced nursing practice involves integrating
clinical guidelines with patient-specific factors—such as comorbidities,
lifestyle, and readiness for change—to create an individualized,
comprehensive plan.
---
2. Case: A 42‑year‑old woman presents with depressive symptoms,
chronic pain, and poorly controlled hypertension. Her care requires a
blend of physical and mental health strategies.
Question: Which integrated management strategy best synthesizes
care for this patient?
a) Refer her exclusively for psychiatric treatment.
b) Initiate treatment with an antidepressant and ignore pain
management.
c) Combine pharmacologic management of hypertension and depression
©2025
,with a referral to behavioral health services and incorporate pain
management, emphasizing interprofessional collaboration.
d) Advise self‑management only.
Correct ANS: c) Combine pharmacologic management of
hypertension and depression with a referral to behavioral health services
and incorporate pain management, emphasizing interprofessional
collaboration.
Rationale: Synthesis in primary care requires an integrated, holistic
strategy that addresses both mental and physical health;
interprofessional care and the combination of tailored pharmacotherapy
with therapy for pain and behavioral issues are essential.
---
3. Case: A 63‑year‑old patient with multiple chronic conditions
(diabetes, heart failure, and chronic kidney disease) presents for routine
follow‑up. Laboratory data, imaging reports, and current medications are
available.
Question: In synthesizing this patient’s complex data, what is the most
effective strategy?
a) Rely strictly on previous medication regimens.
b) Disregard patient preferences and focus solely on numerical targets.
c) Integrate current clinical data with patient history, preferences, and
evidence‑based guidelines to adjust treatment goals and optimize care.
d) Refer immediately to a specialist without synthesizing available data.
Correct ANS: c) Integrate current clinical data with patient history,
preferences, and evidence‑based guidelines to adjust treatment goals
and optimize care.
Rationale: The essence of synthesis in advanced nursing is to merge
diverse information (labs, imaging, medical history, patient goals) into a
coherent, adaptable care plan that reflects best‑practice guidelines and
individual needs.
©2025
, ---
4. Case: A primary care clinic seeks to improve chronic disease
management through telehealth. A 58‑year‑old woman with heart failure
is enrolled in a remote monitoring program.
Question: Which factor is most critical in synthesizing telehealth into
her management plan?
a) Limiting communication to periodic phone calls.
b) Utilizing remote monitoring devices that integrate with electronic
health records (EHRs) to track vital signs and symptoms, enabling timely
interventions.
c) Replacing all in‑person visits with automated messages.
d) Ignoring patient concerns expressed via digital platforms.
Correct ANS: b) Utilizing remote monitoring devices that integrate
with electronic health records (EHRs) to track vital signs and symptoms,
enabling timely interventions.
Rationale: Effective synthesis of telehealth in primary care involves
leveraging technology to offer continuous monitoring, integrating data
with the EHR, and using that information to inform clinical decisions and
maintain patient engagement.
---
5. Case: A 47‑year‑old woman is due for cervical cancer screening. She
has a history of a prior abnormal Pap smear that was managed
conservatively.
Question: Which synthesis strategy aligns with current screening
guidelines in primary care?
a) Arrange for an annual Pap smear exclusively.
b) Defer screening because of her previous abnormal result.
c) Implement co‑testing with a Pap smear and high‑risk human
papillomavirus (HPV) testing every 5 years, considering her history and
age.
d) Immediately proceed to colposcopy without repeat screening.
©2025
