NURS 5432 FAMILY I MIDTERM EXAM UTA 2026/2027 |
Modules 1-6 Questions with Complete Solutions | Family
Nurse Practitioner | Pass Guaranteed - A+ Graded
Part I: Foundations of Family Practice & Health Promotion
Q1: A 42-year-old patient asks about lung cancer screening. They have a 25-pack-year
smoking history, currently smoke 1 pack per day, and are otherwise healthy. According
to current USPSTF guidelines, which recommendation applies?
A. Annual low-dose CT is recommended starting now regardless of quit date intent
B. Annual low-dose CT is recommended if they are between 50-80 years old and
currently smoke or quit within the past 15 years [CORRECT]
C. Chest X-ray annually is the preferred screening modality for this patient
D. Screening is not recommended until they accumulate 30 pack-years
Correct Answer: B
Rationale: USPSTF Grade B recommendation advises annual LDCT for adults 50-80 with
≥20 pack-years who currently smoke or quit within 15 years. Option A misses the age
requirement; C is incorrect as chest X-ray is not recommended for lung cancer
screening; D incorrectly raises the pack-year threshold.
Q2: During a well-woman visit, a 35-year-old with no family history of breast cancer asks
when she should start mammography. Based on current USPSTF guidelines, you advise:
A. Begin annual mammography now at age 35 due to her request
,B. Start biennial screening mammography at age 40 [CORRECT]
C. Wait until age 45 for annual mammograms as recommended for average-risk women
D. Begin mammography at age 50, as earlier screening causes more harm than benefit
Correct Answer: B
Rationale: Updated 2024 USPSTF recommendations advise biennial screening
mammography starting at age 40 for average-risk women. Option A is too aggressive
without risk factors; C reflects outdated guidance; D contradicts current evidence
supporting earlier screening initiation.
Q3: A 58-year-old patient with BMI 31 and prediabetes asks about diabetes prevention
strategies. Which intervention has the strongest evidence-based support for preventing
progression to type 2 diabetes?
A. Initiating metformin 850mg daily as primary prevention
B. Intensive lifestyle modification with 5-7% weight loss and 150 minutes physical
activity weekly [CORRECT]
C. Starting a GLP-1 receptor agonist for weight management
D. Adopting a ketogenic diet under medical supervision
Correct Answer: B
Rationale: The Diabetes Prevention Program showed lifestyle intervention reduced
diabetes incidence by 58% versus 31% with metformin. While metformin (A) is indicated
for very high-risk patients, intensive lifestyle modification remains first-line. GLP-1
,agonists (C) are not first-line for prediabetes; ketogenic diets (D) lack long-term
diabetes prevention evidence.
Q4: You're conducting a family assessment using the Calgary Family Assessment
Model. Which element represents the "structural" dimension of family functioning?
A. How the family manages conflict resolution during crises
B. The family's internal transactional patterns and external boundaries [CORRECT]
C. The emotional climate and quality of relationships between members
D. The family's ability to adapt to stressors using internal and external resources
Correct Answer: B
Rationale: The structural dimension examines family composition, rank order,
subsystems, and boundaries. Option A describes the functional dimension
(instrumental); C describes the functional dimension (expressive); D describes family
resilience rather than structure.
Q5: A 28-year-old patient with depression mentions financial stress affecting
medication adherence. Which screening tool best assesses social determinants of
health in primary care?
A. PHQ-9 for depression severity monitoring
B. PRAPARE (Protocol for Responding to and Assessing Patient Assets, Risks, and
Experiences) [CORRECT]
C. GAD-7 for anxiety assessment
, D. Morisky Medication Adherence Scale
Correct Answer: B
Rationale: PRAPARE specifically screens for social determinants including housing,
food security, employment, and transportation. PHQ-9 (A) and GAD-7 (C) assess mental
health symptoms, not social determinants. The Morisky scale (D) measures adherence
behavior, not underlying social barriers.
Q6: During a motivational interviewing session, a patient ambivalent about smoking
cessation says, "I know smoking is bad, but it helps my stress." Which response
demonstrates the "reflection" technique?
A. "You should quit because smoking causes lung cancer and heart disease"
B. "It sounds like you're concerned about your health but worry about losing a stress
management tool" [CORRECT]
C. "Have you considered nicotine replacement therapy to help with cravings?"
D. "On a scale of 1-10, how ready are you to quit smoking?"
Correct Answer: B
Rationale: This double-sided reflection acknowledges both the patient's awareness of
health risks and their concern about stress management, highlighting ambivalence
without judgment. Option A is confrontational; C jumps to solutions prematurely; D uses
the readiness ruler technique rather than reflection.
Modules 1-6 Questions with Complete Solutions | Family
Nurse Practitioner | Pass Guaranteed - A+ Graded
Part I: Foundations of Family Practice & Health Promotion
Q1: A 42-year-old patient asks about lung cancer screening. They have a 25-pack-year
smoking history, currently smoke 1 pack per day, and are otherwise healthy. According
to current USPSTF guidelines, which recommendation applies?
A. Annual low-dose CT is recommended starting now regardless of quit date intent
B. Annual low-dose CT is recommended if they are between 50-80 years old and
currently smoke or quit within the past 15 years [CORRECT]
C. Chest X-ray annually is the preferred screening modality for this patient
D. Screening is not recommended until they accumulate 30 pack-years
Correct Answer: B
Rationale: USPSTF Grade B recommendation advises annual LDCT for adults 50-80 with
≥20 pack-years who currently smoke or quit within 15 years. Option A misses the age
requirement; C is incorrect as chest X-ray is not recommended for lung cancer
screening; D incorrectly raises the pack-year threshold.
Q2: During a well-woman visit, a 35-year-old with no family history of breast cancer asks
when she should start mammography. Based on current USPSTF guidelines, you advise:
A. Begin annual mammography now at age 35 due to her request
,B. Start biennial screening mammography at age 40 [CORRECT]
C. Wait until age 45 for annual mammograms as recommended for average-risk women
D. Begin mammography at age 50, as earlier screening causes more harm than benefit
Correct Answer: B
Rationale: Updated 2024 USPSTF recommendations advise biennial screening
mammography starting at age 40 for average-risk women. Option A is too aggressive
without risk factors; C reflects outdated guidance; D contradicts current evidence
supporting earlier screening initiation.
Q3: A 58-year-old patient with BMI 31 and prediabetes asks about diabetes prevention
strategies. Which intervention has the strongest evidence-based support for preventing
progression to type 2 diabetes?
A. Initiating metformin 850mg daily as primary prevention
B. Intensive lifestyle modification with 5-7% weight loss and 150 minutes physical
activity weekly [CORRECT]
C. Starting a GLP-1 receptor agonist for weight management
D. Adopting a ketogenic diet under medical supervision
Correct Answer: B
Rationale: The Diabetes Prevention Program showed lifestyle intervention reduced
diabetes incidence by 58% versus 31% with metformin. While metformin (A) is indicated
for very high-risk patients, intensive lifestyle modification remains first-line. GLP-1
,agonists (C) are not first-line for prediabetes; ketogenic diets (D) lack long-term
diabetes prevention evidence.
Q4: You're conducting a family assessment using the Calgary Family Assessment
Model. Which element represents the "structural" dimension of family functioning?
A. How the family manages conflict resolution during crises
B. The family's internal transactional patterns and external boundaries [CORRECT]
C. The emotional climate and quality of relationships between members
D. The family's ability to adapt to stressors using internal and external resources
Correct Answer: B
Rationale: The structural dimension examines family composition, rank order,
subsystems, and boundaries. Option A describes the functional dimension
(instrumental); C describes the functional dimension (expressive); D describes family
resilience rather than structure.
Q5: A 28-year-old patient with depression mentions financial stress affecting
medication adherence. Which screening tool best assesses social determinants of
health in primary care?
A. PHQ-9 for depression severity monitoring
B. PRAPARE (Protocol for Responding to and Assessing Patient Assets, Risks, and
Experiences) [CORRECT]
C. GAD-7 for anxiety assessment
, D. Morisky Medication Adherence Scale
Correct Answer: B
Rationale: PRAPARE specifically screens for social determinants including housing,
food security, employment, and transportation. PHQ-9 (A) and GAD-7 (C) assess mental
health symptoms, not social determinants. The Morisky scale (D) measures adherence
behavior, not underlying social barriers.
Q6: During a motivational interviewing session, a patient ambivalent about smoking
cessation says, "I know smoking is bad, but it helps my stress." Which response
demonstrates the "reflection" technique?
A. "You should quit because smoking causes lung cancer and heart disease"
B. "It sounds like you're concerned about your health but worry about losing a stress
management tool" [CORRECT]
C. "Have you considered nicotine replacement therapy to help with cravings?"
D. "On a scale of 1-10, how ready are you to quit smoking?"
Correct Answer: B
Rationale: This double-sided reflection acknowledges both the patient's awareness of
health risks and their concern about stress management, highlighting ambivalence
without judgment. Option A is confrontational; C jumps to solutions prematurely; D uses
the readiness ruler technique rather than reflection.
