Test bank HOLLIER Clinical Guidelines in Primary
Care 4th Edition /StudyGuide Plus Rationales 2025
Q&A | Instant Download PDF
,Practice Exam: Hollier’s Clinical Guidelines in Primary Care, 4th Ed.
1. A patient with newly diagnosed hypertension is started on
hydrochlorothiazide. Which lab should be monitored?
a) Liver function tests
b) Serum electrolytes
c) Thyroid panel
d) Hemoglobin A1c
Thiazide diuretics can cause electrolyte disturbances, especially
hypokalemia and hyponatremia, so electrolytes must be monitored.
2. A 45-year-old male presents with sudden unilateral vision loss described as
a curtain falling. Likely diagnosis?
a) Macular degeneration
b) Central retinal artery occlusion
c) Retinal detachment
d) Optic neuritis
A “curtain” or “shade” effect is classic for retinal detachment.
3. Which of the following antibiotics is first-line for a healthy adult with
community-acquired pneumonia?
a) Amoxicillin-clavulanate
b) Azithromycin
c) Ciprofloxacin
d) Clindamycin
Macrolides like azithromycin are appropriate first-line treatment for healthy
patients with no comorbidities or recent antibiotic use.
,4. The recommended age to begin colorectal cancer screening for average-risk
adults is:
a) 40
b) 45
c) 50
d) 55
Most guidelines still recommend starting screening at age 50 for average-
risk patients, though some updated guidelines suggest 45.
5. A patient with suspected temporal arteritis should be prescribed which
medication immediately?
a) NSAIDs
b) Low-dose aspirin
c) High-dose prednisone
d) Methotrexate
Immediate high-dose corticosteroids are needed to prevent vision loss in
temporal arteritis.
6. The most sensitive physical exam finding for appendicitis is:
a) Rovsing’s sign
b) Psoas sign
c) Rebound tenderness
d) McBurney’s point tenderness
McBurney’s point tenderness is the most reliable sign of appendicitis on
exam.
, 7. A patient with type 2 diabetes and a BP of 145/92 mmHg should be started
on:
a) Beta-blocker
b) Thiazide diuretic
c) ACE inhibitor
d) Calcium channel blocker
ACE inhibitors provide renal protection in diabetics with hypertension.
8. A common finding in psoriasis is:
a) Nikolsky’s sign
b) Silvery scales on plaques
c) Honey-colored crusts
d) Herald patch
Psoriasis presents with well-demarcated plaques and silvery scales.
9. Which murmur is associated with a mid-systolic click?
a) Aortic stenosis
b) Mitral regurgitation
c) Tricuspid regurgitation
d) Mitral valve prolapse
Mitral valve prolapse classically produces a mid-systolic click.
10.A child with a barking cough and stridor likely has:
a) Epiglottitis
b) Croup
c) Asthma
Care 4th Edition /StudyGuide Plus Rationales 2025
Q&A | Instant Download PDF
,Practice Exam: Hollier’s Clinical Guidelines in Primary Care, 4th Ed.
1. A patient with newly diagnosed hypertension is started on
hydrochlorothiazide. Which lab should be monitored?
a) Liver function tests
b) Serum electrolytes
c) Thyroid panel
d) Hemoglobin A1c
Thiazide diuretics can cause electrolyte disturbances, especially
hypokalemia and hyponatremia, so electrolytes must be monitored.
2. A 45-year-old male presents with sudden unilateral vision loss described as
a curtain falling. Likely diagnosis?
a) Macular degeneration
b) Central retinal artery occlusion
c) Retinal detachment
d) Optic neuritis
A “curtain” or “shade” effect is classic for retinal detachment.
3. Which of the following antibiotics is first-line for a healthy adult with
community-acquired pneumonia?
a) Amoxicillin-clavulanate
b) Azithromycin
c) Ciprofloxacin
d) Clindamycin
Macrolides like azithromycin are appropriate first-line treatment for healthy
patients with no comorbidities or recent antibiotic use.
,4. The recommended age to begin colorectal cancer screening for average-risk
adults is:
a) 40
b) 45
c) 50
d) 55
Most guidelines still recommend starting screening at age 50 for average-
risk patients, though some updated guidelines suggest 45.
5. A patient with suspected temporal arteritis should be prescribed which
medication immediately?
a) NSAIDs
b) Low-dose aspirin
c) High-dose prednisone
d) Methotrexate
Immediate high-dose corticosteroids are needed to prevent vision loss in
temporal arteritis.
6. The most sensitive physical exam finding for appendicitis is:
a) Rovsing’s sign
b) Psoas sign
c) Rebound tenderness
d) McBurney’s point tenderness
McBurney’s point tenderness is the most reliable sign of appendicitis on
exam.
, 7. A patient with type 2 diabetes and a BP of 145/92 mmHg should be started
on:
a) Beta-blocker
b) Thiazide diuretic
c) ACE inhibitor
d) Calcium channel blocker
ACE inhibitors provide renal protection in diabetics with hypertension.
8. A common finding in psoriasis is:
a) Nikolsky’s sign
b) Silvery scales on plaques
c) Honey-colored crusts
d) Herald patch
Psoriasis presents with well-demarcated plaques and silvery scales.
9. Which murmur is associated with a mid-systolic click?
a) Aortic stenosis
b) Mitral regurgitation
c) Tricuspid regurgitation
d) Mitral valve prolapse
Mitral valve prolapse classically produces a mid-systolic click.
10.A child with a barking cough and stridor likely has:
a) Epiglottitis
b) Croup
c) Asthma
