CURRENT MEDICAL DIAGNOSIS AND
TREATMENT 2026
65TH EDITION
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
1
Reference
Ch. 1 — Disease Prevention & Health Promotion — Adult
Immunizations. accessmedicine.mhmedical.com
Stem
A 72-year-old man with well-controlled COPD and type 2
diabetes presents for routine care in October. He received an
influenza vaccine last January, had pneumococcal vaccination 8
,years ago, and never received zoster vaccination. Which
immunization intervention is the highest priority today?
A. Administer influenza vaccine now.
B. Give recombinant zoster vaccine today.
C. Repeat pneumococcal polysaccharide vaccine (PPSV23)
today.
D. Give Tdap today.
Correct answer: A
Rationale — Correct (A)
Annual influenza vaccination is time-sensitive and
recommended every fall/winter for older adults and those with
COPD/diabetes to reduce morbidity. CMDT emphasizes
seasonal influenza as the immediate, high-yield preventive
action in October. accessmedicine.mhmedical.com
Rationale — Incorrect
B. Zoster vaccination is recommended for older adults but is not
more urgent than current seasonal influenza in October; it can
be scheduled.
C. Routine repeat PPSV23 timing depends on prior vaccine type
and interval; an automatic repeat at 8 years is not universally
recommended without reviewing prior vaccine series.
D. Tdap is given once in adulthood then Td/Tdap boosters per
schedule; it is not the highest priority unless indicated by
wound/booster needs.
,Teaching point
Administer annual influenza vaccine promptly each season for
older adults with chronic disease.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
accessmedicine.mhmedical.com
2
Reference
Ch. 1 — Disease Prevention & Health Promotion —
Hypertension screening & diagnosis.
accessmedicine.mhmedical.com
Stem
A 48-year-old woman has an office blood pressure of 148/92
mm Hg on two separate visits one week apart, each measured
by a single office reading. She is otherwise asymptomatic. What
is the most appropriate next step to confirm the diagnosis?
A. Start ACE inhibitor therapy now.
B. Obtain ambulatory (24-hour) or home blood pressure
monitoring.
C. Order basic metabolic panel and begin lifestyle counseling
only.
D. Repeat a third office blood pressure reading today and if
elevated, diagnose hypertension.
, Correct answer: B
Rationale — Correct (B)
CMDT stresses confirming persistent hypertension with out-of-
office measurements (ambulatory or standardized home BP
monitoring) to avoid white-coat hypertension and guide
therapy. This step precedes chronic pharmacologic treatment in
most ambulatory patients. accessmedicine.mhmedical.com
Rationale — Incorrect
A. Immediate pharmacotherapy may be indicated for very high
BP or end-organ damage, but confirmation with out-of-office
measurements is preferred for an asymptomatic patient.
C. Metabolic panel and lifestyle counseling are appropriate but
do not replace the recommended confirmatory
ambulatory/home BP monitoring.
D. A third office reading can help but is inferior to validated
ambulatory/home monitoring for diagnosis per CMDT guidance.
Teaching point
Confirm new hypertension with validated out-of-office BP
(ambulatory or home) before chronic drug therapy.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
accessmedicine.mhmedical.com
3
TREATMENT 2026
65TH EDITION
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
1
Reference
Ch. 1 — Disease Prevention & Health Promotion — Adult
Immunizations. accessmedicine.mhmedical.com
Stem
A 72-year-old man with well-controlled COPD and type 2
diabetes presents for routine care in October. He received an
influenza vaccine last January, had pneumococcal vaccination 8
,years ago, and never received zoster vaccination. Which
immunization intervention is the highest priority today?
A. Administer influenza vaccine now.
B. Give recombinant zoster vaccine today.
C. Repeat pneumococcal polysaccharide vaccine (PPSV23)
today.
D. Give Tdap today.
Correct answer: A
Rationale — Correct (A)
Annual influenza vaccination is time-sensitive and
recommended every fall/winter for older adults and those with
COPD/diabetes to reduce morbidity. CMDT emphasizes
seasonal influenza as the immediate, high-yield preventive
action in October. accessmedicine.mhmedical.com
Rationale — Incorrect
B. Zoster vaccination is recommended for older adults but is not
more urgent than current seasonal influenza in October; it can
be scheduled.
C. Routine repeat PPSV23 timing depends on prior vaccine type
and interval; an automatic repeat at 8 years is not universally
recommended without reviewing prior vaccine series.
D. Tdap is given once in adulthood then Td/Tdap boosters per
schedule; it is not the highest priority unless indicated by
wound/booster needs.
,Teaching point
Administer annual influenza vaccine promptly each season for
older adults with chronic disease.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
accessmedicine.mhmedical.com
2
Reference
Ch. 1 — Disease Prevention & Health Promotion —
Hypertension screening & diagnosis.
accessmedicine.mhmedical.com
Stem
A 48-year-old woman has an office blood pressure of 148/92
mm Hg on two separate visits one week apart, each measured
by a single office reading. She is otherwise asymptomatic. What
is the most appropriate next step to confirm the diagnosis?
A. Start ACE inhibitor therapy now.
B. Obtain ambulatory (24-hour) or home blood pressure
monitoring.
C. Order basic metabolic panel and begin lifestyle counseling
only.
D. Repeat a third office blood pressure reading today and if
elevated, diagnose hypertension.
, Correct answer: B
Rationale — Correct (B)
CMDT stresses confirming persistent hypertension with out-of-
office measurements (ambulatory or standardized home BP
monitoring) to avoid white-coat hypertension and guide
therapy. This step precedes chronic pharmacologic treatment in
most ambulatory patients. accessmedicine.mhmedical.com
Rationale — Incorrect
A. Immediate pharmacotherapy may be indicated for very high
BP or end-organ damage, but confirmation with out-of-office
measurements is preferred for an asymptomatic patient.
C. Metabolic panel and lifestyle counseling are appropriate but
do not replace the recommended confirmatory
ambulatory/home BP monitoring.
D. A third office reading can help but is inferior to validated
ambulatory/home monitoring for diagnosis per CMDT guidance.
Teaching point
Confirm new hypertension with validated out-of-office BP
(ambulatory or home) before chronic drug therapy.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
accessmedicine.mhmedical.com
3
