NSG 300 FINAL EXAM: NURSE
PRACTITIONERS IN PRIMARY CARE.
QUESTIONS AND ANSWERS
1. A 55-year-old male with a history of hypertension presents with a blood pressure of 155/95
mmHg. He is currently on Lisinopril 20mg daily. According to JNC 8 and ACC/AHA guidelines,
what is the next appropriate step in management?
A. Increase Lisinopril to 40mg daily
B. Switch Lisinopril to Losartan
C. Add a Calcium Channel Blocker (CCB) or Thiazide diuretic
D. Continue current dose and recheck in 6 months
Answer: C
Conceptual Explanation: If the blood pressure goal is not reached within one month of
treatment, the clinician should increase the dose of the initial drug or add a second drug
from one of the recommended classes (Thiazide, CCB, ACEI, or ARB).
,2. Which of the following is considered a first-line treatment for an adult patient diagnosed
with Community-Acquired Pneumonia (CAP) with no comorbidities and no recent antibiotic
use?
A. Levofloxacin
B. Ciprofloxacin
C. Amoxicillin or Doxycycline
D. Vancomycin
Answer: C
Conceptual Explanation: Current ATS/IDSA guidelines recommend high-dose Amoxicillin
or Doxycycline as monotherapy for healthy outpatients without comorbidities.
3. A 65-year-old female presents for a routine check-up. Her TSH is 8.2 mIU/L (Normal: 0.4–
4.0) and her Free T4 is within the normal range. She reports mild fatigue. What is the most
likely diagnosis?
A. Overt Hypothyroidism
B. Subclinical Hypothyroidism
C. Secondary Hypothyroidism
D. Grave’s Disease
Answer: B
, Conceptual Explanation: Subclinical hypothyroidism is characterized by an elevated TSH
with a normal Free T4 level.
4. In the management of Type 2 Diabetes, Metformin is contraindicated in patients with
which of the following conditions?
A. Body Mass Index (BMI) greater than 35
B. Hypertension
C. History of gestational diabetes
D. Glomerular Filtration Rate (eGFR) less than 30 mL/min/1.73m²
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with severe renal
impairment (eGFR < 30) due to the increased risk of lactic acidosis.
5. Which physical examination maneuver is most specific for diagnosing an Anterior Cruciate
Ligament (ACL) tear?
A. McMurray Test
B. Phalen Test
C. Lachman Test
D. Empty Can Test
Answer: C
PRACTITIONERS IN PRIMARY CARE.
QUESTIONS AND ANSWERS
1. A 55-year-old male with a history of hypertension presents with a blood pressure of 155/95
mmHg. He is currently on Lisinopril 20mg daily. According to JNC 8 and ACC/AHA guidelines,
what is the next appropriate step in management?
A. Increase Lisinopril to 40mg daily
B. Switch Lisinopril to Losartan
C. Add a Calcium Channel Blocker (CCB) or Thiazide diuretic
D. Continue current dose and recheck in 6 months
Answer: C
Conceptual Explanation: If the blood pressure goal is not reached within one month of
treatment, the clinician should increase the dose of the initial drug or add a second drug
from one of the recommended classes (Thiazide, CCB, ACEI, or ARB).
,2. Which of the following is considered a first-line treatment for an adult patient diagnosed
with Community-Acquired Pneumonia (CAP) with no comorbidities and no recent antibiotic
use?
A. Levofloxacin
B. Ciprofloxacin
C. Amoxicillin or Doxycycline
D. Vancomycin
Answer: C
Conceptual Explanation: Current ATS/IDSA guidelines recommend high-dose Amoxicillin
or Doxycycline as monotherapy for healthy outpatients without comorbidities.
3. A 65-year-old female presents for a routine check-up. Her TSH is 8.2 mIU/L (Normal: 0.4–
4.0) and her Free T4 is within the normal range. She reports mild fatigue. What is the most
likely diagnosis?
A. Overt Hypothyroidism
B. Subclinical Hypothyroidism
C. Secondary Hypothyroidism
D. Grave’s Disease
Answer: B
, Conceptual Explanation: Subclinical hypothyroidism is characterized by an elevated TSH
with a normal Free T4 level.
4. In the management of Type 2 Diabetes, Metformin is contraindicated in patients with
which of the following conditions?
A. Body Mass Index (BMI) greater than 35
B. Hypertension
C. History of gestational diabetes
D. Glomerular Filtration Rate (eGFR) less than 30 mL/min/1.73m²
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with severe renal
impairment (eGFR < 30) due to the increased risk of lactic acidosis.
5. Which physical examination maneuver is most specific for diagnosing an Anterior Cruciate
Ligament (ACL) tear?
A. McMurray Test
B. Phalen Test
C. Lachman Test
D. Empty Can Test
Answer: C
