Newest NURS 5432 Advanced Primary Care Nursing: Comprehensive Final
Examination with Detailed Rationales (2026 Edition)
1. A 52-year-old woman presents for a routine health visit. Which screening test
is recommended for average-risk colorectal cancer screening?
A. Annual chest X-ray
B. Colon cancer screening beginning at age 45 for average-risk adults
C. PSA test
D. Pelvic ultrasound every year
Answer: B
Rationale: Average-risk adults should begin colorectal cancer screening at age 45 using an
appropriate screening strategy.
2. A 3-month-old infant presents for a well-child examination. Which
developmental milestone is expected?
A. Walking independently
B. Rolling from front to back
C. Speaking in two-word sentences
D. Drawing circles
Answer: B
Rationale: Many infants begin rolling around this age, although the exact timing varies.
3. Which patient requires immediate evaluation?
A. Adult with seasonal allergies
B. Child with fever and petechial rash
C. Adult with mild tension headache
D. Teen with acne
Answer: B
Rationale: Fever with petechiae may indicate meningococcal disease or another serious infection
requiring urgent assessment.
,4. Which laboratory value is most useful for monitoring long-term glycemic
control?
A. Serum sodium
B. Hemoglobin A1c
C. White blood cell count
D. Platelet count
Answer: B
Rationale: HbA1c reflects average glucose levels over approximately 2–3 months.
5. Which vaccine is routinely recommended during every pregnancy?
A. HPV
B. Tdap (during each pregnancy at the recommended gestational window)
C. MMR
D. Varicella
Answer: B
Rationale: Tdap is recommended during each pregnancy to help protect the newborn from
pertussis.
6. Which symptom is most consistent with uncomplicated acute cystitis?
A. Dysuria and urinary frequency
B. Productive cough
C. Chest pain
D. Blurred vision
Answer: A
Rationale: Dysuria, frequency, and urgency are common symptoms of acute cystitis.
7. A patient has a blood pressure of 146/92 mmHg on two appropriately
measured visits. Which diagnosis is most appropriate?
,A. Normal blood pressure
B. Hypertension
C. Hypotension
D. Orthostatic hypotension
Answer: B
Rationale: Persistent blood pressure readings ≥130/80 mmHg generally meet criteria for
hypertension when confirmed appropriately.
8. Which physical examination finding is most concerning in a patient with
shortness of breath?
A. Clear lung sounds
B. Cyanosis
C. Normal respiratory rate
D. Warm skin
Answer: B
Rationale: Cyanosis suggests inadequate oxygenation and requires urgent evaluation.
9. Which lipid value is generally considered desirable?
A. LDL 190 mg/dL
B. LDL 95 mg/dL
C. LDL 170 mg/dL
D. LDL 210 mg/dL
Answer: B
Rationale: Lower LDL cholesterol is associated with reduced cardiovascular risk for many
patients.
10. Which statement best reflects evidence-based practice?
A. Relying only on personal experience
B. Integrating current evidence, clinical expertise, and patient preferences
C. Following tradition only
D. Using internet searches without appraisal
, Answer: B
Rationale: Evidence-based practice combines the best available evidence with clinical expertise
and patient values.
11. A patient with asthma reports nighttime symptoms three times per week.
What does this suggest?
A. Well-controlled asthma
B. Poorly controlled asthma requiring reassessment
C. Resolved asthma
D. No treatment needed
Answer: B
Rationale: Frequent nighttime symptoms suggest suboptimal asthma control.
12. Which lifestyle modification is most effective for lowering blood pressure?
A. Smoking more
B. Increasing sodium intake
C. Regular physical activity and a heart-healthy eating pattern
D. Avoiding fruits and vegetables
Answer: C
Rationale: Exercise and healthy dietary patterns can significantly reduce blood pressure.
13. Which finding is most characteristic of iron deficiency anemia?
A. Fatigue and pallor
B. Bradycardia only
C. Hypertension
D. Hyperglycemia
Answer: A
Rationale: Fatigue and pallor are common manifestations of anemia.
Examination with Detailed Rationales (2026 Edition)
1. A 52-year-old woman presents for a routine health visit. Which screening test
is recommended for average-risk colorectal cancer screening?
A. Annual chest X-ray
B. Colon cancer screening beginning at age 45 for average-risk adults
C. PSA test
D. Pelvic ultrasound every year
Answer: B
Rationale: Average-risk adults should begin colorectal cancer screening at age 45 using an
appropriate screening strategy.
2. A 3-month-old infant presents for a well-child examination. Which
developmental milestone is expected?
A. Walking independently
B. Rolling from front to back
C. Speaking in two-word sentences
D. Drawing circles
Answer: B
Rationale: Many infants begin rolling around this age, although the exact timing varies.
3. Which patient requires immediate evaluation?
A. Adult with seasonal allergies
B. Child with fever and petechial rash
C. Adult with mild tension headache
D. Teen with acne
Answer: B
Rationale: Fever with petechiae may indicate meningococcal disease or another serious infection
requiring urgent assessment.
,4. Which laboratory value is most useful for monitoring long-term glycemic
control?
A. Serum sodium
B. Hemoglobin A1c
C. White blood cell count
D. Platelet count
Answer: B
Rationale: HbA1c reflects average glucose levels over approximately 2–3 months.
5. Which vaccine is routinely recommended during every pregnancy?
A. HPV
B. Tdap (during each pregnancy at the recommended gestational window)
C. MMR
D. Varicella
Answer: B
Rationale: Tdap is recommended during each pregnancy to help protect the newborn from
pertussis.
6. Which symptom is most consistent with uncomplicated acute cystitis?
A. Dysuria and urinary frequency
B. Productive cough
C. Chest pain
D. Blurred vision
Answer: A
Rationale: Dysuria, frequency, and urgency are common symptoms of acute cystitis.
7. A patient has a blood pressure of 146/92 mmHg on two appropriately
measured visits. Which diagnosis is most appropriate?
,A. Normal blood pressure
B. Hypertension
C. Hypotension
D. Orthostatic hypotension
Answer: B
Rationale: Persistent blood pressure readings ≥130/80 mmHg generally meet criteria for
hypertension when confirmed appropriately.
8. Which physical examination finding is most concerning in a patient with
shortness of breath?
A. Clear lung sounds
B. Cyanosis
C. Normal respiratory rate
D. Warm skin
Answer: B
Rationale: Cyanosis suggests inadequate oxygenation and requires urgent evaluation.
9. Which lipid value is generally considered desirable?
A. LDL 190 mg/dL
B. LDL 95 mg/dL
C. LDL 170 mg/dL
D. LDL 210 mg/dL
Answer: B
Rationale: Lower LDL cholesterol is associated with reduced cardiovascular risk for many
patients.
10. Which statement best reflects evidence-based practice?
A. Relying only on personal experience
B. Integrating current evidence, clinical expertise, and patient preferences
C. Following tradition only
D. Using internet searches without appraisal
, Answer: B
Rationale: Evidence-based practice combines the best available evidence with clinical expertise
and patient values.
11. A patient with asthma reports nighttime symptoms three times per week.
What does this suggest?
A. Well-controlled asthma
B. Poorly controlled asthma requiring reassessment
C. Resolved asthma
D. No treatment needed
Answer: B
Rationale: Frequent nighttime symptoms suggest suboptimal asthma control.
12. Which lifestyle modification is most effective for lowering blood pressure?
A. Smoking more
B. Increasing sodium intake
C. Regular physical activity and a heart-healthy eating pattern
D. Avoiding fruits and vegetables
Answer: C
Rationale: Exercise and healthy dietary patterns can significantly reduce blood pressure.
13. Which finding is most characteristic of iron deficiency anemia?
A. Fatigue and pallor
B. Bradycardia only
C. Hypertension
D. Hyperglycemia
Answer: A
Rationale: Fatigue and pallor are common manifestations of anemia.
