2026–2027 | LATEST COMPREHENSIVE PRACTICE EXAM QUESTIONS
AND VERIFIED ANSWERS | DETAILED RATIONALES | HIGH-YIELD
FAMILY MEDICINE CERTIFICATION PREP STUDY GUIDE
A 42-YEAR-OLD ASIAN MALE PRESENTS FOR FOLLOW-UP OF ELEVATED BLOOD PRESSURE. HE
HAS NO ADDITIONAL CHRONIC MEDICAL PROBLEMS AND IS OTHERWISE ASYMPTOMATIC. AN
EXAMINATION IS SIGNIFICANT FOR A BLOOD PRESSURE OF 162/95 MM HG BUT IS OTHERWISE
UNREMARKABLE.
LABORATORY FINDINGS UNREMARKABLE
URINE MICROALBUMIN NEGATIVE
ACCORDING TO THE AMERICAN COLLEGE OF CARDIOLOGY/AMERICAN HEART ASSOCIATION
2017 GUIDELINES, WHICH ONE OF THE FOLLOWING WOULD BE THE MOST APPROPRIATE
MEDICATION TO INITIATE AT THIS TIME?
A) CLONIDINE (CATAPRES), 0.1 MG TWICE DAILY
B) HYDRALAZINE, 25 MG THREE TIMES DAILY
C) LISINOPRIL/HYDROCHLOROTHIAZIDE (ZESTORETIC), 10/12.5 MG DAILY
D) METOPROLOL TARTRATE (LOPRESSOR), 25 MG TWICE DAILY
E) TRIAMTERENE (DYRENIUM), 50 MG DAILY
ANSWER: C
THIS PATIENT HAS HYPERTENSION AND ACCORDING TO BOTH JNC 8 AND AMERICAN COLLEGE
OF CARDIOLOGY/AMERICAN HEART ASSOCIATION 2017 GUIDELINES, ANTIHYPERTENSIVE
TREATMENT SHOULD BE INITIATED. FOR THE GENERAL NON-AFRICAN-AMERICAN POPULATION,
MONOTHERAPY WITH AN ACE INHIBITOR, AN ANGIOTENSIN RECEPTOR BLOCKER, A CALCIUM
CHANNEL BLOCKER, OR A THIAZIDE DIURETIC WOULD BE APPROPRIATE FOR INITIAL
MANAGEMENT. IT IS ALSO APPROPRIATE TO INITIATE COMBINATION ANTIHYPERTENSIVE
THERAPY AS AN INITIAL MANAGEMENT STRATEGY, ALTHOUGH PATIENTS SHOULD NOT TAKE AN
ACE INHIBITOR AND AN ANGIOTENSIN RECEPTOR BLOCKER SIMULTANEOUSLY. STUDIES HAVE
SHOWN THAT BLOOD PRESSURE CONTROL IS ACHIEVED FASTER WITH THE INITIATION OF
COMBINATION THERAPY COMPARED TO MONOTHERAPY, WITHOUT AN INCREASE IN
MORBIDITY. LISINOPRIL/HYDROCHLOROTHIAZIDE WOULD BE AN APPROPRIATE CHOICE IN THIS
, PATIENT. -BLOCKERS, VASODILATORS, -BLOCKERS, AND POTASSIUM-SPARING DIURETICS ARE
NOT RECOMMENDED AS INITIAL CHOICES FOR THE TREATMENT OF HYPERTENSION.
DURING ROUNDS AT THE NURSING HOME, YOU ARE INFORMED THAT THERE ARE TWO
RESIDENTS ON THE UNIT WITH LABORATORY-CONFIRMED INFLUENZA. ACCORDING TO CDC
GUIDELINES, WHO SHOULD RECEIVE CHEMOPROPHYLAXIS FOR INFLUENZA?
A) ONLY SYMPTOMATIC RESIDENTS ON THE SAME UNIT
B) ONLY SYMPTOMATIC RESIDENTS IN THE ENTIRE FACILITY
C) ALL ASYMPTOMATIC RESIDENTS ON THE SAME UNIT
D) ALL RESIDENTS OF THE FACILITY REGARDLESS OF SYMPTOMS
E) ALL STAFF REGARDLESS OF SYMPTOMS
ANSWER: C
IN LONG-TERM CARE FACILITIES, AN INFLUENZA OUTBREAK IS DEFINED AS TWO LABORATORY-
CONFIRMED CASES OF INFLUENZA
WITHIN 72 HOURS IN PATIENTS ON THE SAME UNIT. THE CDC RECOMMENDS
CHEMOPROPHYLAXIS FOR ALL ASYMPTOMATIC RESIDENTS OF THE AFFECTED UNIT. ANY
RESIDENT EXHIBITING SYMPTOMS OF INFLUENZA SHOULD BE TREATED FOR INFLUENZA AND
NOT GIVEN CHEMOPROPHYLAXIS DOSING. CHEMOPROPHYLAXIS IS NOT RECOMMENDED FOR
RESIDENTS OF OTHER UNITS UNLESS THERE ARE TWO LABORATORY-CONFIRMED CASES IN
THOSE UNITS. FACILITY STAFF OF THE AFFECTED UNIT CAN BE CONSIDERED FOR
CHEMOPROPHYLAXIS IF THEY HAVE NOT BEEN VACCINATED OR IF THEY HAD A RECENT
VACCINATION, BUT CHEMOPROPHYLAXIS IS NOT RECOMMENDED FOR ALL STAFF IN THE ENTIRE
FACILITY.
A 24-YEAR-OLD FEMALE PRESENTS WITH A 2-DAY HISTORY OF MILD TO MODERATE PELVIC PAIN.
SHE HAS HAD TWO MALE SEX PARTNERS IN THE LAST 6 MONTHS AND USES ORAL
CONTRACEPTIVES AND SOMETIMES CONDOMS.