,South College NSG 5544 Exam 1 | Primary Care of Adults & Older
Adults (2026) Q&A
1. Which of the following best describes the primary purpose of a comprehensive health
history in primary care?
A) To establish a therapeutic nurse-patient relationship
B) To identify genetic predispositions to disease
C) To gather subjective data to guide clinical decision-making and identify health risks
D) To complete the required documentation for insurance reimbursement
Correct Answer: To gather subjective data to guide clinical decision-making and identify
health risks
Rationale: The comprehensive health history is the cornerstone of primary care, providing
subjective data that forms the basis for differential diagnosis, risk assessment, and
development of a patient-centered plan of care. While it may facilitate a therapeutic
relationship, its primary purpose is clinical decision-making.
2. A 72-year-old patient presents with decreased muscle mass and strength, which has
gradually worsened over the past year. This process is best described as:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: Atrophy
Rationale: Atrophy is the decrease in cell size, leading to tissue wasting. This is common in
aging (senile atrophy) or disuse. Hypertrophy is an increase in cell size, hyperplasia is an
increase in cell number, and metaplasia is the replacement of one cell type with another.
,3. A patient with chronic gastroesophageal reflux disease has an esophageal biopsy showing
replacement of the normal squamous epithelium with columnar epithelium. This change is
known as:
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another in response to chronic irritation. Barrett's esophagus, where squamous epithelium is
replaced by columnar epithelium, is a classic example. This adaptive change increases the
risk of adenocarcinoma.
4. A 58-year-old male with a 30-pack-year smoking history presents for a wellness visit. He
has no personal history of cancer, but his father was diagnosed with colorectal cancer at age
55. According to the USPSTF recommendations, when should screening for colorectal cancer
begin for this patient?
A) Age 45
B) Age 50
C) Age 40 or 10 years before the earliest diagnosis in the family
D) Age 45, but only if he has symptoms
Correct Answer: Age 40 or 10 years before the earliest diagnosis in the family
Rationale: For individuals with a first-degree relative diagnosed with colorectal cancer
before age 60, screening should begin at age 40 or 10 years before the earliest diagnosis in
the family, whichever is earlier. Age 45 is the general population start age.
, 5. A 55-year-old woman with a 10-year ASCVD risk score of 12%, LDL-C 160 mg/dL, and no
history of diabetes or coronary artery disease is being evaluated for primary prevention of
cardiovascular disease. What is the most appropriate pharmacologic intervention?
A) Initiate high-intensity statin therapy
B) Initiate moderate-intensity statin therapy
C) Initiate aspirin 81 mg daily
D) Lifestyle modification alone, recheck lipids in 6 months
Correct Answer: Initiate moderate-intensity statin therapy
Rationale: The USPSTF recommends initiating moderate-intensity statin therapy for adults
aged 40-75 years with one or more cardiovascular risk factors and a 10-year ASCVD risk of
10% or greater. High-intensity statin is typically reserved for those with clinical ASCVD or
very high risk.
6. According to the U.S. Preventive Services Task Force (USPSTF), at what age should routine
screening for colorectal cancer begin for average-risk adults?
A) Age 40
B) Age 45
C) Age 50
D) Age 55
Correct Answer: Age 45
Rationale: The USPSTF recommends that average-risk adults begin colorectal cancer
screening at age 45. This updated guideline reflects the increasing incidence of colorectal
cancer in younger populations and is a change from the previous recommendation of age
50.
Adults (2026) Q&A
1. Which of the following best describes the primary purpose of a comprehensive health
history in primary care?
A) To establish a therapeutic nurse-patient relationship
B) To identify genetic predispositions to disease
C) To gather subjective data to guide clinical decision-making and identify health risks
D) To complete the required documentation for insurance reimbursement
Correct Answer: To gather subjective data to guide clinical decision-making and identify
health risks
Rationale: The comprehensive health history is the cornerstone of primary care, providing
subjective data that forms the basis for differential diagnosis, risk assessment, and
development of a patient-centered plan of care. While it may facilitate a therapeutic
relationship, its primary purpose is clinical decision-making.
2. A 72-year-old patient presents with decreased muscle mass and strength, which has
gradually worsened over the past year. This process is best described as:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: Atrophy
Rationale: Atrophy is the decrease in cell size, leading to tissue wasting. This is common in
aging (senile atrophy) or disuse. Hypertrophy is an increase in cell size, hyperplasia is an
increase in cell number, and metaplasia is the replacement of one cell type with another.
,3. A patient with chronic gastroesophageal reflux disease has an esophageal biopsy showing
replacement of the normal squamous epithelium with columnar epithelium. This change is
known as:
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another in response to chronic irritation. Barrett's esophagus, where squamous epithelium is
replaced by columnar epithelium, is a classic example. This adaptive change increases the
risk of adenocarcinoma.
4. A 58-year-old male with a 30-pack-year smoking history presents for a wellness visit. He
has no personal history of cancer, but his father was diagnosed with colorectal cancer at age
55. According to the USPSTF recommendations, when should screening for colorectal cancer
begin for this patient?
A) Age 45
B) Age 50
C) Age 40 or 10 years before the earliest diagnosis in the family
D) Age 45, but only if he has symptoms
Correct Answer: Age 40 or 10 years before the earliest diagnosis in the family
Rationale: For individuals with a first-degree relative diagnosed with colorectal cancer
before age 60, screening should begin at age 40 or 10 years before the earliest diagnosis in
the family, whichever is earlier. Age 45 is the general population start age.
, 5. A 55-year-old woman with a 10-year ASCVD risk score of 12%, LDL-C 160 mg/dL, and no
history of diabetes or coronary artery disease is being evaluated for primary prevention of
cardiovascular disease. What is the most appropriate pharmacologic intervention?
A) Initiate high-intensity statin therapy
B) Initiate moderate-intensity statin therapy
C) Initiate aspirin 81 mg daily
D) Lifestyle modification alone, recheck lipids in 6 months
Correct Answer: Initiate moderate-intensity statin therapy
Rationale: The USPSTF recommends initiating moderate-intensity statin therapy for adults
aged 40-75 years with one or more cardiovascular risk factors and a 10-year ASCVD risk of
10% or greater. High-intensity statin is typically reserved for those with clinical ASCVD or
very high risk.
6. According to the U.S. Preventive Services Task Force (USPSTF), at what age should routine
screening for colorectal cancer begin for average-risk adults?
A) Age 40
B) Age 45
C) Age 50
D) Age 55
Correct Answer: Age 45
Rationale: The USPSTF recommends that average-risk adults begin colorectal cancer
screening at age 45. This updated guideline reflects the increasing incidence of colorectal
cancer in younger populations and is a change from the previous recommendation of age
50.
