PRAC 6531
PRAC 6531 Adult-Gerontology Primary Care
Practicum: Comprehensive 200-Question Board-
Style Examination with Evidence-Based
Rationales Covering Health Maintenance,
Common Acute Presentations, Chronic Disease
Management, and Pharmacologic Interventions
Across the Adult Lifespan
================================================================================
DOCUMENT IDENTIFICATION
================================================================================
COURSE CODE: PRAC 6531
COURSE TITLE: Primary Care of Adults Across the Lifespan Practicum
EXAM TYPE: Comprehensive Summative Examination
TOTAL QUESTIONS: 200
DOCUMENT VERSION: v1.0
EFFECTIVE DATE: September 04, 2026
DOCUMENT CODE: PRAC-6531-EXAM-2026-200Q-FINAL
EXAMINATION PERIOD: Fall 2026
TARGET AUDIENCE: Advanced Practice Registered Nurse (APRN) Students
================================================================================
EXAMINATION SPECIFICATIONS
================================================================================
QUESTION TYPES:
┌─────────────────────────────────────────────────────────────────────────┐
│ • Multiple Choice (Single Answer) │
, PRAC 6531
│ • Select-All-That-Apply (SATA)
│ • True/False
│ • Case-Based / Scenario-Based
└─────────────────────────────────────────────────────────────────────────┘
CONTENT DOMAINS & QUESTION DISTRIBUTION:
┌─────────────────────────────────────────────────────────────────────────┐
│ SECTION 1: Preventive Health & Health Maintenance (40 Q) │
│ SECTION 2: Common Acute Conditions (40 Q) │
│ SECTION 3: Chronic Disease Management (60 Q) │
│ SECTION 4: Geriatric Syndromes & Special Populations (20 Q) │
│ SECTION 5: Pharmacotherapeutics & Prescribing (20 Q) │
│ SECTION 6: Professional Issues & Clinical Reasoning (20 Q) │
└─────────────────────────────────────────────────────────────────────────┘
================================================================================
ANSWER FORMAT SPECIFICATIONS
================================================================================
BLUE = QUESTION (Complete exam question with options)
RED = ANSWER (Correct answer with letter and full text)
PURPLE = RATIONALE (Detailed explanation with incorrect option analysis)
================================================================================
COPYRIGHT & PROPRIETARY NOTICE
================================================================================
© 2026 PRAC 6531 – Primary Care of Adults Across the Lifespan Practicum
All Rights Reserved.
This examination is for educational purposes only and is intended for
, PRAC 6531
use by students enrolled in PRAC 6531. Reproduction, distribution, or
unauthorized use of this material is strictly prohibited.
================================================================================
PRAC 6531 – Primary Care of Adults Across the Lifespan Practicum
Comprehensive Examination
SECTION 1: PREVENTIVE HEALTH & HEALTH MAINTENANCE (Questions 1-40)
QUESTION 1:
A 55-year-old asymptomatic man with no cardiac history presents for a physical examination. His
blood pressure is 128/82 mmHg. According to USPSTF guidelines, when should you next screen him
for hypertension?
A. In 1 year
B. In 2 years
C. In 3 years
D. In 5 years
ANSWER:
B. In 2 years
RATIONALE:
The USPSTF recommends annual screening for adults aged 40 years or older or those at increased
risk for hypertension. However, if blood pressure is less than 130/85 mmHg, screening every 2 years
is acceptable. This patient is 55 years old with blood pressure 128/82 mmHg (elevated but not in the
hypertensive range). Annual screening would be appropriate for those with blood pressure 130-
139/85-89 mmHg or those with other risk factors. Screening every 3 years is recommended for
adults aged 18-39 with normal blood pressure and no risk factors .
QUESTION 2:
A 68-year-old woman with a 30-pack-year smoking history quit smoking 10 years ago. She has no
respiratory symptoms. When should you next screen for lung cancer with low-dose CT (LDCT)?
A. Not needed because she quit more than 5 years ago
B. Annually until age 75
C. One-time screen at age 70
D. Every 2 years until age 80
ANSWER:
B. Annually until age 75
, PRAC 6531
RATIONALE:
The USPSTF recommends annual LDCT screening for lung cancer in adults aged 50-80 years with a
20+ pack-year smoking history who currently smoke or have quit within the past 15 years. This
patient quit within 15 years (10 years ago), so screening should continue annually until age 75.
Screening should be discontinued once an individual has not smoked for 15 years or reaches age 80.
Since this patient quit only 10 years ago, she remains eligible for annual screening .
QUESTION 3:
Which immunization is universally recommended for all adults aged 65 years and older regardless of
prior vaccination status?
A. Pneumococcal polysaccharide vaccine (PPSV23) only
B. Pneumococcal conjugate vaccine (PCV20) as a single dose
C. Both PCV13 and PPSV23 one year apart
D. PCV13 followed by PPSV23 at least 8 weeks later
ANSWER:
B. Pneumococcal conjugate vaccine (PCV20) as a single dose
RATIONALE:
The ACIP now recommends either PCV20 alone or PCV15 followed by PPSV23 for all adults aged 65
years and older. PCV20 as a single dose is the simpler option and is universally recommended
regardless of prior pneumococcal vaccination status. PCV13 is no longer recommended as the sole
option. PCV15 followed by PPSV23 is an alternative strategy, but PCV20 as a single dose is the
preferred option for many patients due to its simplicity and broader serotype coverage .
QUESTION 4:
A 66-year-old woman with no osteoporosis risk factors asks about calcium and vitamin D
supplementation. According to the NIH, what is the recommended daily calcium intake for this
patient?
A. 800 mg/day from diet only
B. 1200 mg/day from diet and supplements combined
C. 1500 mg/day regardless of dietary intake
D. Only vitamin D is needed after age 70
ANSWER:
B. 1200 mg/day from diet and supplements combined
RATIONALE:
The NIH recommends 1200 mg/day of calcium for women over age 50 and men over age 70. Dietary
sources are preferred, but supplements can help fill gaps when dietary intake is insufficient. High-
dose supplements (more than 1500 mg/day) may increase the risk of kidney stones and possibly
cardiovascular disease. The recommendation is 1200 mg/day combined from dietary sources and
supplements, not from supplements alone .
PRAC 6531 Adult-Gerontology Primary Care
Practicum: Comprehensive 200-Question Board-
Style Examination with Evidence-Based
Rationales Covering Health Maintenance,
Common Acute Presentations, Chronic Disease
Management, and Pharmacologic Interventions
Across the Adult Lifespan
================================================================================
DOCUMENT IDENTIFICATION
================================================================================
COURSE CODE: PRAC 6531
COURSE TITLE: Primary Care of Adults Across the Lifespan Practicum
EXAM TYPE: Comprehensive Summative Examination
TOTAL QUESTIONS: 200
DOCUMENT VERSION: v1.0
EFFECTIVE DATE: September 04, 2026
DOCUMENT CODE: PRAC-6531-EXAM-2026-200Q-FINAL
EXAMINATION PERIOD: Fall 2026
TARGET AUDIENCE: Advanced Practice Registered Nurse (APRN) Students
================================================================================
EXAMINATION SPECIFICATIONS
================================================================================
QUESTION TYPES:
┌─────────────────────────────────────────────────────────────────────────┐
│ • Multiple Choice (Single Answer) │
, PRAC 6531
│ • Select-All-That-Apply (SATA)
│ • True/False
│ • Case-Based / Scenario-Based
└─────────────────────────────────────────────────────────────────────────┘
CONTENT DOMAINS & QUESTION DISTRIBUTION:
┌─────────────────────────────────────────────────────────────────────────┐
│ SECTION 1: Preventive Health & Health Maintenance (40 Q) │
│ SECTION 2: Common Acute Conditions (40 Q) │
│ SECTION 3: Chronic Disease Management (60 Q) │
│ SECTION 4: Geriatric Syndromes & Special Populations (20 Q) │
│ SECTION 5: Pharmacotherapeutics & Prescribing (20 Q) │
│ SECTION 6: Professional Issues & Clinical Reasoning (20 Q) │
└─────────────────────────────────────────────────────────────────────────┘
================================================================================
ANSWER FORMAT SPECIFICATIONS
================================================================================
BLUE = QUESTION (Complete exam question with options)
RED = ANSWER (Correct answer with letter and full text)
PURPLE = RATIONALE (Detailed explanation with incorrect option analysis)
================================================================================
COPYRIGHT & PROPRIETARY NOTICE
================================================================================
© 2026 PRAC 6531 – Primary Care of Adults Across the Lifespan Practicum
All Rights Reserved.
This examination is for educational purposes only and is intended for
, PRAC 6531
use by students enrolled in PRAC 6531. Reproduction, distribution, or
unauthorized use of this material is strictly prohibited.
================================================================================
PRAC 6531 – Primary Care of Adults Across the Lifespan Practicum
Comprehensive Examination
SECTION 1: PREVENTIVE HEALTH & HEALTH MAINTENANCE (Questions 1-40)
QUESTION 1:
A 55-year-old asymptomatic man with no cardiac history presents for a physical examination. His
blood pressure is 128/82 mmHg. According to USPSTF guidelines, when should you next screen him
for hypertension?
A. In 1 year
B. In 2 years
C. In 3 years
D. In 5 years
ANSWER:
B. In 2 years
RATIONALE:
The USPSTF recommends annual screening for adults aged 40 years or older or those at increased
risk for hypertension. However, if blood pressure is less than 130/85 mmHg, screening every 2 years
is acceptable. This patient is 55 years old with blood pressure 128/82 mmHg (elevated but not in the
hypertensive range). Annual screening would be appropriate for those with blood pressure 130-
139/85-89 mmHg or those with other risk factors. Screening every 3 years is recommended for
adults aged 18-39 with normal blood pressure and no risk factors .
QUESTION 2:
A 68-year-old woman with a 30-pack-year smoking history quit smoking 10 years ago. She has no
respiratory symptoms. When should you next screen for lung cancer with low-dose CT (LDCT)?
A. Not needed because she quit more than 5 years ago
B. Annually until age 75
C. One-time screen at age 70
D. Every 2 years until age 80
ANSWER:
B. Annually until age 75
, PRAC 6531
RATIONALE:
The USPSTF recommends annual LDCT screening for lung cancer in adults aged 50-80 years with a
20+ pack-year smoking history who currently smoke or have quit within the past 15 years. This
patient quit within 15 years (10 years ago), so screening should continue annually until age 75.
Screening should be discontinued once an individual has not smoked for 15 years or reaches age 80.
Since this patient quit only 10 years ago, she remains eligible for annual screening .
QUESTION 3:
Which immunization is universally recommended for all adults aged 65 years and older regardless of
prior vaccination status?
A. Pneumococcal polysaccharide vaccine (PPSV23) only
B. Pneumococcal conjugate vaccine (PCV20) as a single dose
C. Both PCV13 and PPSV23 one year apart
D. PCV13 followed by PPSV23 at least 8 weeks later
ANSWER:
B. Pneumococcal conjugate vaccine (PCV20) as a single dose
RATIONALE:
The ACIP now recommends either PCV20 alone or PCV15 followed by PPSV23 for all adults aged 65
years and older. PCV20 as a single dose is the simpler option and is universally recommended
regardless of prior pneumococcal vaccination status. PCV13 is no longer recommended as the sole
option. PCV15 followed by PPSV23 is an alternative strategy, but PCV20 as a single dose is the
preferred option for many patients due to its simplicity and broader serotype coverage .
QUESTION 4:
A 66-year-old woman with no osteoporosis risk factors asks about calcium and vitamin D
supplementation. According to the NIH, what is the recommended daily calcium intake for this
patient?
A. 800 mg/day from diet only
B. 1200 mg/day from diet and supplements combined
C. 1500 mg/day regardless of dietary intake
D. Only vitamin D is needed after age 70
ANSWER:
B. 1200 mg/day from diet and supplements combined
RATIONALE:
The NIH recommends 1200 mg/day of calcium for women over age 50 and men over age 70. Dietary
sources are preferred, but supplements can help fill gaps when dietary intake is insufficient. High-
dose supplements (more than 1500 mg/day) may increase the risk of kidney stones and possibly
cardiovascular disease. The recommendation is 1200 mg/day combined from dietary sources and
supplements, not from supplements alone .
