NURS 5337 CP-2 | Primary Care Exam | 71 Questions &
Answers with Rationales | Verified | Latest Update -
University of Texas, Arlington| 2026
1. Flank pain, CVA tenderness, fever, nausea, and vomiting are most likely associated with:
A. Cystitis B. Pyelonephritis C. Urethritis D. Nephrolithiasis
Correct Answer: B. Pyelonephritis
Rationale: Pyelonephritis is a bacterial infection of the kidney that commonly presents with
flank pain, costovertebral angle (CVA) tenderness, fever, nausea, and vomiting. Cystitis typically
causes dysuria, urinary frequency, and urgency without prominent systemic symptoms.
2. The straight leg maneuver can be used to diagnose:
A. Hip osteoarthritis B. Peripheral arterial disease C. Nerve root compression D. Deep vein
thrombosis
Correct Answer: C. Nerve root compression
Rationale: The straight leg raise test helps identify lumbar nerve root irritation or compression,
commonly associated with a herniated intervertebral disc and sciatica. Reproduction of radiating
pain down the leg during the maneuver supports nerve root involvement.
3. Which of the following is the most potent risk factor for lower extremity vascular occlusive
disease?
A. Obesity B. Cigarette smoking C. Sedentary lifestyle D. Family history of hypertension
Correct Answer: B. Cigarette smoking
Rationale: Cigarette smoking is a major modifiable risk factor for peripheral arterial disease
(PAD). It promotes endothelial dysfunction, inflammation, atherosclerotic plaque formation, and
arterial narrowing, reducing blood flow to the lower extremities.
4. A patient has been diagnosed with hepatitis B. The most common reported risk factor is:
A. Contaminated food consumption B. Unprotected sexual exposure C. Mosquito bites D.
Exposure to airborne droplets
Correct Answer: B. Unprotected sexual exposure
,Rationale: Hepatitis B virus (HBV) can be transmitted through infected blood and body fluids,
including through unprotected sexual contact. Other important transmission routes include
sharing contaminated needles and perinatal transmission. HBV is not transmitted through
contaminated food or mosquito bites.
5. Which of the following situations would require referral to a specialist for sinusitis?
A. Recurrent sinusitis B. Periorbital edema C. Sinusitis refractory to antibiotics D. All of the
above
Correct Answer: D. All of the above
Rationale: Recurrent sinusitis and persistent symptoms despite appropriate treatment may
require specialist evaluation. Periorbital edema is particularly concerning because it can indicate
an orbital complication. If accompanied by impaired eye movements, visual changes, proptosis,
or severe headache, urgent evaluation is necessary.
6. Your patient is a diabetic controlled on metformin and a sulfonylurea. The HbA1c is 6.1%,
and the patient presents with episodes of hypoglycemia. Which of the following is most
appropriate?
A. Increase the dose of metformin B. Increase the dose of the sulfonylurea C. Decrease the dose
of the sulfonylurea D. Add insulin therapy
Correct Answer: C. Decrease the dose of the sulfonylurea
Rationale: Sulfonylureas stimulate insulin secretion and can cause hypoglycemia. In a patient
with an HbA1c of 6.1% and recurrent hypoglycemic episodes, reducing the sulfonylurea dose or
discontinuing it, depending on the clinical circumstances, is appropriate. Treatment should be
individualized to prevent further hypoglycemia.
7. Which of the following is most likely to be observed in a patient with allergic rhinitis?
A. Persistent high fever and productive cough B. Exacerbation of symptoms after exposure to an
allergen C. Severe unilateral facial swelling D. Purulent nasal discharge with systemic toxicity
Correct Answer: B. Exacerbation of symptoms after exposure to an allergen
Rationale: Allergic rhinitis is an IgE-mediated inflammatory response to allergens such as
pollen, dust mites, or animal dander. Symptoms commonly include sneezing, nasal itching, clear
rhinorrhea, and nasal congestion that worsen after allergen exposure.
8. A 45-year-old man presents with otitis externa. What is the likely causative pathogen?
A. Streptococcus pneumoniae B. Pseudomonas aeruginosa C. Mycoplasma pneumoniae D.
Haemophilus influenzae
, Correct Answer: B. Pseudomonas aeruginosa
Rationale: Pseudomonas aeruginosa is one of the most common bacterial causes of acute otitis
externa, along with Staphylococcus aureus. Moisture and trauma to the external auditory canal
can disrupt its protective barrier and promote infection.
9. Mary is a 26-year-old banker who was told that her blood pressure was high. Since then, her
blood pressure readings have been 144/86, 140/82, and 148/88 mmHg. She has no pertinent past
medical history except low back pain for one year following a car crash. Medications: vitamin
once daily and Aleve, two tablets every morning and evening, for low back pain. Her family
history is significant for both parents and a brother with hypertension. She does not smoke and
drinks only socially. She jogs two miles five days a week. Renal tests are normal. Today's blood
pressure is 144/84 mmHg, heart rate is 74 beats/min, and BMI is 23. What would you
recommend for her blood pressure?
A. Begin hydrochlorothiazide 12.5 mg daily B. Recommend lifestyle modifications and assess
for medication-related hypertension C. Begin immediate combination therapy with three
antihypertensive medications D. Reassure her that no further evaluation is necessary
Correct Answer: B. Recommend lifestyle modifications and assess for medication-related
hypertension
Rationale: Mary is a young adult with repeatedly elevated blood pressure and regular use of
naproxen (Aleve), an NSAID that can increase blood pressure and interfere with blood pressure
control. Confirming hypertension with home or ambulatory monitoring, reviewing NSAID use,
and recommending sodium reduction and other lifestyle measures are appropriate initial steps.
Medication may be indicated if hypertension is confirmed, depending on her overall
cardiovascular risk and the applicable guideline. Starting hydrochlorothiazide immediately is not
necessarily the best first step in this clinical scenario.
10. Erectile dysfunction is a complex phenomenon with a variety of causes. The most
predominant cause is:
A. Vascular B. Infectious C. Dermatological D. Gastrointestinal
Correct Answer: A. Vascular
Rationale: Vascular dysfunction is a leading cause of erectile dysfunction, particularly in older
men and those with diabetes, hypertension, dyslipidemia, or smoking history. Impaired arterial
blood flow or dysfunction of the vascular mechanisms needed to maintain an erection can result
in erectile difficulties.
11. Using the ASCVD Risk Calculator, the 10-year risk for atherosclerotic cardiovascular
disease is calculated for which of the following age groups using the traditional pooled cohort
equations?
Answers with Rationales | Verified | Latest Update -
University of Texas, Arlington| 2026
1. Flank pain, CVA tenderness, fever, nausea, and vomiting are most likely associated with:
A. Cystitis B. Pyelonephritis C. Urethritis D. Nephrolithiasis
Correct Answer: B. Pyelonephritis
Rationale: Pyelonephritis is a bacterial infection of the kidney that commonly presents with
flank pain, costovertebral angle (CVA) tenderness, fever, nausea, and vomiting. Cystitis typically
causes dysuria, urinary frequency, and urgency without prominent systemic symptoms.
2. The straight leg maneuver can be used to diagnose:
A. Hip osteoarthritis B. Peripheral arterial disease C. Nerve root compression D. Deep vein
thrombosis
Correct Answer: C. Nerve root compression
Rationale: The straight leg raise test helps identify lumbar nerve root irritation or compression,
commonly associated with a herniated intervertebral disc and sciatica. Reproduction of radiating
pain down the leg during the maneuver supports nerve root involvement.
3. Which of the following is the most potent risk factor for lower extremity vascular occlusive
disease?
A. Obesity B. Cigarette smoking C. Sedentary lifestyle D. Family history of hypertension
Correct Answer: B. Cigarette smoking
Rationale: Cigarette smoking is a major modifiable risk factor for peripheral arterial disease
(PAD). It promotes endothelial dysfunction, inflammation, atherosclerotic plaque formation, and
arterial narrowing, reducing blood flow to the lower extremities.
4. A patient has been diagnosed with hepatitis B. The most common reported risk factor is:
A. Contaminated food consumption B. Unprotected sexual exposure C. Mosquito bites D.
Exposure to airborne droplets
Correct Answer: B. Unprotected sexual exposure
,Rationale: Hepatitis B virus (HBV) can be transmitted through infected blood and body fluids,
including through unprotected sexual contact. Other important transmission routes include
sharing contaminated needles and perinatal transmission. HBV is not transmitted through
contaminated food or mosquito bites.
5. Which of the following situations would require referral to a specialist for sinusitis?
A. Recurrent sinusitis B. Periorbital edema C. Sinusitis refractory to antibiotics D. All of the
above
Correct Answer: D. All of the above
Rationale: Recurrent sinusitis and persistent symptoms despite appropriate treatment may
require specialist evaluation. Periorbital edema is particularly concerning because it can indicate
an orbital complication. If accompanied by impaired eye movements, visual changes, proptosis,
or severe headache, urgent evaluation is necessary.
6. Your patient is a diabetic controlled on metformin and a sulfonylurea. The HbA1c is 6.1%,
and the patient presents with episodes of hypoglycemia. Which of the following is most
appropriate?
A. Increase the dose of metformin B. Increase the dose of the sulfonylurea C. Decrease the dose
of the sulfonylurea D. Add insulin therapy
Correct Answer: C. Decrease the dose of the sulfonylurea
Rationale: Sulfonylureas stimulate insulin secretion and can cause hypoglycemia. In a patient
with an HbA1c of 6.1% and recurrent hypoglycemic episodes, reducing the sulfonylurea dose or
discontinuing it, depending on the clinical circumstances, is appropriate. Treatment should be
individualized to prevent further hypoglycemia.
7. Which of the following is most likely to be observed in a patient with allergic rhinitis?
A. Persistent high fever and productive cough B. Exacerbation of symptoms after exposure to an
allergen C. Severe unilateral facial swelling D. Purulent nasal discharge with systemic toxicity
Correct Answer: B. Exacerbation of symptoms after exposure to an allergen
Rationale: Allergic rhinitis is an IgE-mediated inflammatory response to allergens such as
pollen, dust mites, or animal dander. Symptoms commonly include sneezing, nasal itching, clear
rhinorrhea, and nasal congestion that worsen after allergen exposure.
8. A 45-year-old man presents with otitis externa. What is the likely causative pathogen?
A. Streptococcus pneumoniae B. Pseudomonas aeruginosa C. Mycoplasma pneumoniae D.
Haemophilus influenzae
, Correct Answer: B. Pseudomonas aeruginosa
Rationale: Pseudomonas aeruginosa is one of the most common bacterial causes of acute otitis
externa, along with Staphylococcus aureus. Moisture and trauma to the external auditory canal
can disrupt its protective barrier and promote infection.
9. Mary is a 26-year-old banker who was told that her blood pressure was high. Since then, her
blood pressure readings have been 144/86, 140/82, and 148/88 mmHg. She has no pertinent past
medical history except low back pain for one year following a car crash. Medications: vitamin
once daily and Aleve, two tablets every morning and evening, for low back pain. Her family
history is significant for both parents and a brother with hypertension. She does not smoke and
drinks only socially. She jogs two miles five days a week. Renal tests are normal. Today's blood
pressure is 144/84 mmHg, heart rate is 74 beats/min, and BMI is 23. What would you
recommend for her blood pressure?
A. Begin hydrochlorothiazide 12.5 mg daily B. Recommend lifestyle modifications and assess
for medication-related hypertension C. Begin immediate combination therapy with three
antihypertensive medications D. Reassure her that no further evaluation is necessary
Correct Answer: B. Recommend lifestyle modifications and assess for medication-related
hypertension
Rationale: Mary is a young adult with repeatedly elevated blood pressure and regular use of
naproxen (Aleve), an NSAID that can increase blood pressure and interfere with blood pressure
control. Confirming hypertension with home or ambulatory monitoring, reviewing NSAID use,
and recommending sodium reduction and other lifestyle measures are appropriate initial steps.
Medication may be indicated if hypertension is confirmed, depending on her overall
cardiovascular risk and the applicable guideline. Starting hydrochlorothiazide immediately is not
necessarily the best first step in this clinical scenario.
10. Erectile dysfunction is a complex phenomenon with a variety of causes. The most
predominant cause is:
A. Vascular B. Infectious C. Dermatological D. Gastrointestinal
Correct Answer: A. Vascular
Rationale: Vascular dysfunction is a leading cause of erectile dysfunction, particularly in older
men and those with diabetes, hypertension, dyslipidemia, or smoking history. Impaired arterial
blood flow or dysfunction of the vascular mechanisms needed to maintain an erection can result
in erectile difficulties.
11. Using the ASCVD Risk Calculator, the 10-year risk for atherosclerotic cardiovascular
disease is calculated for which of the following age groups using the traditional pooled cohort
equations?
