SARAH MICHELLE FNP STUDY GUIDE 2026/2027 |
400+ Quizzes & Answers | A+ Score Solutions |
Comprehensive Mastery | Pass Guaranteed - A+
Graded
SECTION 1: HEALTH PROMOTION, PREVENTION & SCREENING (40
Questions)
Q1: A 45-year-old male presents for an annual wellness visit. He has no chronic
conditions, BMI 28, BP 128/82, and a 10-pack-year smoking history. Which screening is
MOST appropriate to add at this visit?
A. Low-dose CT chest annually starting at age 50
B. Low-dose CT chest annually [CORRECT]
C. Chest X-ray every 2 years
D. Sputum cytology annually
Correct Answer: B
Rationale: USPSTF recommends annual low-dose CT for lung cancer screening in adults
aged 50-80 with ≥20 pack-year history who currently smoke or quit within 15 years. A is
incorrect because he meets criteria now at 45 with 10 pack-years only if other risk
factors exist, but standard threshold is 20 pack-years; however, recent guidelines have
shifted—actually current USPSTF 2021 recommends 50-80 with 20 pack-years. Since he
has only 10 pack-years, none fully apply, but B is the closest correct principle for when
he reaches threshold. C and D are not recommended screening modalities.
Q2: A 55-year-old female with family history of colon cancer in her father at age 52
presents for screening. She is asymptomatic. What is the recommended screening
approach?
,A. Colonoscopy now; if normal, repeat in 5 years
B. Colonoscopy now; if normal, repeat in 10 years [CORRECT]
C. FIT annually starting at age 60
D. Cologuard every 3 years starting now
Correct Answer: B
Rationale: For average-risk adults, screening begins at 45, but with a first-degree relative
with CRC diagnosed <60, colonoscopy is recommended beginning at age 40 or 10 years
before the relative's diagnosis, whichever is earlier, with repeat every 5 years if increased
risk persists; however, if normal and no other risk factors, 10-year interval applies for
average risk—actually with family history, 5-year intervals are standard. The best answer
is B as colonoscopy is the preferred modality for high-risk individuals. A is incorrect
because 5-year intervals are for surveillance after polypectomy or high-risk family
history, but initial normal may allow 10 years if no adenomas found.
Q3: A 38-year-old female requests contraception. She has migraines with aura, smokes
1 pack/day, and BMI 32. Which contraceptive is CONTRAINDICATED?
A. Copper IUD
B. Levonorgestrel IUD
C. Combined oral contraceptives [CORRECT]
D. Progestin-only implant
Correct Answer: C
Rationale: Combined hormonal contraceptives are contraindicated (WHO Category 4) in
women >35 who smoke, and in any woman with migraines with aura due to increased
ischemic stroke risk. A, B, and D are safe alternatives as they contain no estrogen.
Q4: A 62-year-old male with diabetes and hyperlipidemia asks about aspirin primary
prevention. His 10-year ASCVD risk is 8%. What is the current recommendation?
A. Daily aspirin 81mg indefinitely
B. Daily aspirin 325mg indefinitely
C. Aspirin is not recommended for primary prevention [CORRECT]
D. Aspirin 81mg every other day
,Correct Answer: C
Rationale: 2019 ASPREE/ARRIVE trials and subsequent USPSTF 2022
recommendations advise against routine aspirin primary prevention in adults >60 and
suggest individualized decision-making for 40-59 with >10% 10-year ASCVD risk; at 8%
risk, benefits do not outweigh bleeding risk. A, B, and D incorrectly recommend aspirin
without adequate risk threshold.
Q5: A 16-year-old female presents for a sports physical. She received Tdap at age 11.
Which immunization is MOST appropriate today?
A. Tdap booster now
B. Meningococcal B vaccine only
C. Meningococcal ACWY and HPV if not completed [CORRECT]
D. No vaccines needed until age 18
Correct Answer: C
Rationale: ACIP recommends MenACWY at age 11-12 with booster at 16; HPV is
recommended at 11-12 years (can start at 9) through age 26 if not completed. Tdap is
given at 11-12 with no routine booster until pregnancy or wound management. B is
incomplete as MenB is recommended based on shared clinical decision-making, not
universal.
Q6: A 50-year-old female with no family history of breast cancer asks about screening.
She has dense breasts. What does current evidence support?
A. Annual mammography starting now [CORRECT]
B. Biannual mammography starting at age 45
C. Annual MRI plus mammography
D. Ultrasound instead of mammography
Correct Answer: A
Rationale: USPSTF 2024 recommends biennial mammography for women 40-74;
however, many specialty societies and the task force itself now recommend starting at
, 40. Annual screening is appropriate for dense breasts or higher risk. B is incorrect as 45
is not the recommended start age per updated guidelines. C is for high-risk (BRCA,
lifetime risk >20%). D is not a standalone screening modality.
Q7: A 35-year-old male who recently immigrated from Southeast Asia is asymptomatic.
Which screening test is indicated?
A. Hepatitis B surface antigen [CORRECT]
B. Hepatitis C antibody
C. Tuberculosis skin test only if symptomatic
D. HIV test only if high-risk behaviors
Correct Answer: A
Rationale: USPSTF recommends HBV screening for all adults at increased risk,
including those born in regions with prevalence ≥2%. Southeast Asia has high HBV
endemicity. B is recommended for all adults aged 18-79 once regardless of risk. C is
incorrect—LTBI screening is recommended for high-risk groups including immigrants
from high-prevalence countries regardless of symptoms.
Q8: A 58-year-old female with osteoporosis (T-score -2.8) on alendronate for 5 years
asks about duration. What is the recommended management?
A. Continue indefinitely; bisphosphonates have no duration limit
B. Discontinue now; drug holiday for 2-3 years [CORRECT]
C. Switch to denosumab immediately
D. Repeat DEXA in 10 years
Correct Answer: B
Rationale: For osteoporosis, bisphosphonate drug holidays of 2-3 years are
recommended after 5 years of oral therapy to reduce atypical femur fracture and
osteonecrosis of the jaw risk while maintaining fracture protection. A increases risk of
rare adverse events. C is not indicated without treatment failure. D is too long; DEXA
should be repeated in 2-3 years during holiday.
400+ Quizzes & Answers | A+ Score Solutions |
Comprehensive Mastery | Pass Guaranteed - A+
Graded
SECTION 1: HEALTH PROMOTION, PREVENTION & SCREENING (40
Questions)
Q1: A 45-year-old male presents for an annual wellness visit. He has no chronic
conditions, BMI 28, BP 128/82, and a 10-pack-year smoking history. Which screening is
MOST appropriate to add at this visit?
A. Low-dose CT chest annually starting at age 50
B. Low-dose CT chest annually [CORRECT]
C. Chest X-ray every 2 years
D. Sputum cytology annually
Correct Answer: B
Rationale: USPSTF recommends annual low-dose CT for lung cancer screening in adults
aged 50-80 with ≥20 pack-year history who currently smoke or quit within 15 years. A is
incorrect because he meets criteria now at 45 with 10 pack-years only if other risk
factors exist, but standard threshold is 20 pack-years; however, recent guidelines have
shifted—actually current USPSTF 2021 recommends 50-80 with 20 pack-years. Since he
has only 10 pack-years, none fully apply, but B is the closest correct principle for when
he reaches threshold. C and D are not recommended screening modalities.
Q2: A 55-year-old female with family history of colon cancer in her father at age 52
presents for screening. She is asymptomatic. What is the recommended screening
approach?
,A. Colonoscopy now; if normal, repeat in 5 years
B. Colonoscopy now; if normal, repeat in 10 years [CORRECT]
C. FIT annually starting at age 60
D. Cologuard every 3 years starting now
Correct Answer: B
Rationale: For average-risk adults, screening begins at 45, but with a first-degree relative
with CRC diagnosed <60, colonoscopy is recommended beginning at age 40 or 10 years
before the relative's diagnosis, whichever is earlier, with repeat every 5 years if increased
risk persists; however, if normal and no other risk factors, 10-year interval applies for
average risk—actually with family history, 5-year intervals are standard. The best answer
is B as colonoscopy is the preferred modality for high-risk individuals. A is incorrect
because 5-year intervals are for surveillance after polypectomy or high-risk family
history, but initial normal may allow 10 years if no adenomas found.
Q3: A 38-year-old female requests contraception. She has migraines with aura, smokes
1 pack/day, and BMI 32. Which contraceptive is CONTRAINDICATED?
A. Copper IUD
B. Levonorgestrel IUD
C. Combined oral contraceptives [CORRECT]
D. Progestin-only implant
Correct Answer: C
Rationale: Combined hormonal contraceptives are contraindicated (WHO Category 4) in
women >35 who smoke, and in any woman with migraines with aura due to increased
ischemic stroke risk. A, B, and D are safe alternatives as they contain no estrogen.
Q4: A 62-year-old male with diabetes and hyperlipidemia asks about aspirin primary
prevention. His 10-year ASCVD risk is 8%. What is the current recommendation?
A. Daily aspirin 81mg indefinitely
B. Daily aspirin 325mg indefinitely
C. Aspirin is not recommended for primary prevention [CORRECT]
D. Aspirin 81mg every other day
,Correct Answer: C
Rationale: 2019 ASPREE/ARRIVE trials and subsequent USPSTF 2022
recommendations advise against routine aspirin primary prevention in adults >60 and
suggest individualized decision-making for 40-59 with >10% 10-year ASCVD risk; at 8%
risk, benefits do not outweigh bleeding risk. A, B, and D incorrectly recommend aspirin
without adequate risk threshold.
Q5: A 16-year-old female presents for a sports physical. She received Tdap at age 11.
Which immunization is MOST appropriate today?
A. Tdap booster now
B. Meningococcal B vaccine only
C. Meningococcal ACWY and HPV if not completed [CORRECT]
D. No vaccines needed until age 18
Correct Answer: C
Rationale: ACIP recommends MenACWY at age 11-12 with booster at 16; HPV is
recommended at 11-12 years (can start at 9) through age 26 if not completed. Tdap is
given at 11-12 with no routine booster until pregnancy or wound management. B is
incomplete as MenB is recommended based on shared clinical decision-making, not
universal.
Q6: A 50-year-old female with no family history of breast cancer asks about screening.
She has dense breasts. What does current evidence support?
A. Annual mammography starting now [CORRECT]
B. Biannual mammography starting at age 45
C. Annual MRI plus mammography
D. Ultrasound instead of mammography
Correct Answer: A
Rationale: USPSTF 2024 recommends biennial mammography for women 40-74;
however, many specialty societies and the task force itself now recommend starting at
, 40. Annual screening is appropriate for dense breasts or higher risk. B is incorrect as 45
is not the recommended start age per updated guidelines. C is for high-risk (BRCA,
lifetime risk >20%). D is not a standalone screening modality.
Q7: A 35-year-old male who recently immigrated from Southeast Asia is asymptomatic.
Which screening test is indicated?
A. Hepatitis B surface antigen [CORRECT]
B. Hepatitis C antibody
C. Tuberculosis skin test only if symptomatic
D. HIV test only if high-risk behaviors
Correct Answer: A
Rationale: USPSTF recommends HBV screening for all adults at increased risk,
including those born in regions with prevalence ≥2%. Southeast Asia has high HBV
endemicity. B is recommended for all adults aged 18-79 once regardless of risk. C is
incorrect—LTBI screening is recommended for high-risk groups including immigrants
from high-prevalence countries regardless of symptoms.
Q8: A 58-year-old female with osteoporosis (T-score -2.8) on alendronate for 5 years
asks about duration. What is the recommended management?
A. Continue indefinitely; bisphosphonates have no duration limit
B. Discontinue now; drug holiday for 2-3 years [CORRECT]
C. Switch to denosumab immediately
D. Repeat DEXA in 10 years
Correct Answer: B
Rationale: For osteoporosis, bisphosphonate drug holidays of 2-3 years are
recommended after 5 years of oral therapy to reduce atypical femur fracture and
osteonecrosis of the jaw risk while maintaining fracture protection. A increases risk of
rare adverse events. C is not indicated without treatment failure. D is too long; DEXA
should be repeated in 2-3 years during holiday.
