NR577 / NR 577 Primary Care Management of
Adolescents and Adults Final Exam Review (Latest
2026/2027) – Study Guide & Practice Questions |
FNP Focus
Section 1: Preventive Care & Complex Chronic Disease
Q1: A healthy 55-year-old female with a 20-pack-year smoking history (quit 5 years ago)
presents for a routine physical. She has no personal or strong family history of cancer.
According to USPSTF guidelines, what is the most appropriate recommendation for
lung cancer screening?
A) Annual low-dose CT scan (LDCT) is recommended.
B) Annual chest x-ray is recommended.
C) Screening is not recommended at this time.
D) A one-time LDCT is sufficient.
Correct Answer: A
Rationale: The USPSTF recommends annual screening for lung cancer with LDCT in
adults aged 50 to 80 years who have a 20 pack-year smoking history and currently
smoke or have quit within the past 15 years. This patient meets all criteria (age 55, 20
pack-year, quit within 15 years). Chest x-ray (B) is not recommended. Screening is
indicated (C is wrong). Screening is annual, not one-time (D).
Q2: A 38-year-old male with obesity (BMI 32), hypertension (controlled on lisinopril),
and pre-diabetes (A1c 6.0%) presents wanting to lose weight. He has tried diet and
exercise without success. What is the most appropriate initial pharmacologic
intervention?
A) Orlistat (Xenical)
,B) Phentermine-topiramate (Qsymia)
C) Liraglutide (Saxenda) or Semaglutide (Wegovy)
D) Recommend bariatric surgery evaluation.
Correct Answer: C
Rationale: For this patient with obesity and pre-diabetes, a GLP-1 receptor agonist
(liraglutide or semaglutide) is an excellent first-line pharmacologic choice. These agents
are FDA-approved for chronic weight management and have the added benefit of
improving glycemic control and reducing cardiovascular risk. Orlistat (A) has modest
efficacy and significant GI side effects. Phentermine-topiramate (B) is effective but is a
controlled substance (phentermine) and topiramate has significant side effects
(teratogenicity, cognitive); it may be used but GLP-1 RAs are often preferred, especially
with pre-diabetes. Bariatric surgery (D) may be considered if BMI were ≥40 (or ≥35 with
comorbidity), but pharmacotherapy is the appropriate next step.
Q3: A 45-year-old woman with well-controlled hypertension presents for her annual
physical. Her BP today is 128/78 mmHg on lisinopril 10 mg daily. She has no other
comorbidities. According to JNC 8 guidelines, what is the most appropriate BP goal and
management?
A) Target BP <130/80 mmHg; increase lisinopril dose.
B) Target BP <140/90 mmHg; continue current dose.
C) Target BP <150/90 mmHg; continue current dose.
D) Target BP <130/80 mmHg; add amlodipine.
Correct Answer: B
Rationale: JNC 8 recommends a BP target <140/90 mmHg for adults <60 years with
uncomplicated hypertension. Her current BP of 128/78 mmHg is at goal. There is no
need to intensify therapy (A, D) as she is already at target. While some guidelines
, (AHA/ACC) suggest <130/80, JNC 8 remains the primary guideline referenced for
straightforward HTN management in primary care.
Q4: (Multiple Select) A 52-year-old male with diabetes (A1c 7.5%), hypertension, and
dyslipidemia presents for diabetes management. According to ADA 2024 standards,
which of the following are appropriate components of his diabetes care?
A) Check A1c every 6 months
B) Prescribe a SGLT2 inhibitor or GLP-1 RA with proven cardiovascular benefit
C) Target BP <130/80 mmHg
D) Statin therapy regardless of LDL level
E) Annual foot exam
F) Screen for depression using a validated tool
Correct Answers: B, C, D, E, F
Rationale: All are appropriate except A1c every 6 months (A) - ADA recommends every
3 months if not at goal or if therapy has changed. For patients with ASCVD risk factors
(this patient), a SGLT2i or GLP-1 RA (B) is recommended. BP target <130/80 (C) is
appropriate for most adults with diabetes. Statin therapy (D) is indicated for all diabetics
≥40 years regardless of LDL. Annual foot exam (E) and depression screening (F) are
standard diabetes care components.
Q5: A 29-year-old sexually active female presents for a routine visit. She has no history
of cervical dysplasia. According to USPSTF guidelines, when should cervical cancer
screening begin and with which test?
A) Begin now with Pap test alone every 3 years
B) Begin now with HPV test alone every 5 years
C) Begin at age 30 with co-testing (Pap + HPV) every 5 years
D) Begin at age 21 with Pap test alone every 3 years
Correct Answer: D
Adolescents and Adults Final Exam Review (Latest
2026/2027) – Study Guide & Practice Questions |
FNP Focus
Section 1: Preventive Care & Complex Chronic Disease
Q1: A healthy 55-year-old female with a 20-pack-year smoking history (quit 5 years ago)
presents for a routine physical. She has no personal or strong family history of cancer.
According to USPSTF guidelines, what is the most appropriate recommendation for
lung cancer screening?
A) Annual low-dose CT scan (LDCT) is recommended.
B) Annual chest x-ray is recommended.
C) Screening is not recommended at this time.
D) A one-time LDCT is sufficient.
Correct Answer: A
Rationale: The USPSTF recommends annual screening for lung cancer with LDCT in
adults aged 50 to 80 years who have a 20 pack-year smoking history and currently
smoke or have quit within the past 15 years. This patient meets all criteria (age 55, 20
pack-year, quit within 15 years). Chest x-ray (B) is not recommended. Screening is
indicated (C is wrong). Screening is annual, not one-time (D).
Q2: A 38-year-old male with obesity (BMI 32), hypertension (controlled on lisinopril),
and pre-diabetes (A1c 6.0%) presents wanting to lose weight. He has tried diet and
exercise without success. What is the most appropriate initial pharmacologic
intervention?
A) Orlistat (Xenical)
,B) Phentermine-topiramate (Qsymia)
C) Liraglutide (Saxenda) or Semaglutide (Wegovy)
D) Recommend bariatric surgery evaluation.
Correct Answer: C
Rationale: For this patient with obesity and pre-diabetes, a GLP-1 receptor agonist
(liraglutide or semaglutide) is an excellent first-line pharmacologic choice. These agents
are FDA-approved for chronic weight management and have the added benefit of
improving glycemic control and reducing cardiovascular risk. Orlistat (A) has modest
efficacy and significant GI side effects. Phentermine-topiramate (B) is effective but is a
controlled substance (phentermine) and topiramate has significant side effects
(teratogenicity, cognitive); it may be used but GLP-1 RAs are often preferred, especially
with pre-diabetes. Bariatric surgery (D) may be considered if BMI were ≥40 (or ≥35 with
comorbidity), but pharmacotherapy is the appropriate next step.
Q3: A 45-year-old woman with well-controlled hypertension presents for her annual
physical. Her BP today is 128/78 mmHg on lisinopril 10 mg daily. She has no other
comorbidities. According to JNC 8 guidelines, what is the most appropriate BP goal and
management?
A) Target BP <130/80 mmHg; increase lisinopril dose.
B) Target BP <140/90 mmHg; continue current dose.
C) Target BP <150/90 mmHg; continue current dose.
D) Target BP <130/80 mmHg; add amlodipine.
Correct Answer: B
Rationale: JNC 8 recommends a BP target <140/90 mmHg for adults <60 years with
uncomplicated hypertension. Her current BP of 128/78 mmHg is at goal. There is no
need to intensify therapy (A, D) as she is already at target. While some guidelines
, (AHA/ACC) suggest <130/80, JNC 8 remains the primary guideline referenced for
straightforward HTN management in primary care.
Q4: (Multiple Select) A 52-year-old male with diabetes (A1c 7.5%), hypertension, and
dyslipidemia presents for diabetes management. According to ADA 2024 standards,
which of the following are appropriate components of his diabetes care?
A) Check A1c every 6 months
B) Prescribe a SGLT2 inhibitor or GLP-1 RA with proven cardiovascular benefit
C) Target BP <130/80 mmHg
D) Statin therapy regardless of LDL level
E) Annual foot exam
F) Screen for depression using a validated tool
Correct Answers: B, C, D, E, F
Rationale: All are appropriate except A1c every 6 months (A) - ADA recommends every
3 months if not at goal or if therapy has changed. For patients with ASCVD risk factors
(this patient), a SGLT2i or GLP-1 RA (B) is recommended. BP target <130/80 (C) is
appropriate for most adults with diabetes. Statin therapy (D) is indicated for all diabetics
≥40 years regardless of LDL. Annual foot exam (E) and depression screening (F) are
standard diabetes care components.
Q5: A 29-year-old sexually active female presents for a routine visit. She has no history
of cervical dysplasia. According to USPSTF guidelines, when should cervical cancer
screening begin and with which test?
A) Begin now with Pap test alone every 3 years
B) Begin now with HPV test alone every 5 years
C) Begin at age 30 with co-testing (Pap + HPV) every 5 years
D) Begin at age 21 with Pap test alone every 3 years
Correct Answer: D
