Nurse Practitioners in Primary Care I Practice
Exam 2026 Practice Questions & Study Guide |
Complete Exam-Style Questions with Correct
Detailed Answers & Rationales (Reliable
Answers)
1.
A 47-year-old adult with no personal or family history of
colorectal cancer presents for a preventive visit. Which
screening recommendation is most appropriate for an average-
risk patient?
A. Begin screening at age 55
B. Begin screening only after symptoms develop
C. Begin screening at age 45
D. Begin screening at age 50 only if the patient has a history of
smoking
Rationale: The recommended starting age for colorectal cancer
screening in average-risk adults is 45 years. Screening can be
performed using several accepted strategies, including stool-
based testing and direct visualization tests such as colonoscopy.
Beginning at age 45 reflects the increased recognition of
colorectal cancer occurring in younger adults. Screening should
,be individualized according to risk factors, prior results, family
history, and the specific screening modality selected.
2.
A patient has a blood pressure of 152/94 mmHg during an
office visit but reports normal readings at home. What is the
most appropriate next step before diagnosing sustained
hypertension when clinically appropriate?
A. Immediately diagnose stage 2 hypertension based on the
single reading
B. Obtain additional out-of-office or repeated blood pressure
measurements
C. Tell the patient to stop all physical activity
D. Start two antihypertensive medications without further
assessment
Rationale: A single elevated office measurement does not
always establish persistent hypertension. Repeated
standardized measurements and, when appropriate, home or
ambulatory blood pressure monitoring can help distinguish
sustained hypertension from white-coat hypertension.
Confirming the blood pressure pattern is important because
treatment decisions should be based on reliable measurements
rather than an isolated abnormal value.
,3.
A patient with type 2 diabetes has an A1C of 9.1% despite
adherence to metformin and lifestyle interventions. Which
principle should guide the next management decision?
A. Continue metformin alone for another year
B. Stop metformin automatically
C. Treat the A1C value without considering comorbidities
D. Select additional therapy based on glycemic needs,
comorbidities, risks, preferences, and treatment goals
Rationale: Diabetes treatment should be individualized rather
than based solely on the A1C value. Cardiovascular disease,
chronic kidney disease, heart failure, obesity, hypoglycemia risk,
cost, route of administration, adverse effects, and patient
preferences can influence medication selection. When glycemic
targets are not achieved with initial therapy, intensification
should occur in a timely manner while maintaining appropriate
foundational therapy when tolerated and not contraindicated.
4.
A patient reports unilateral calf swelling, warmth, and
tenderness that began yesterday. Which diagnosis should
receive immediate consideration?
, A. Osteoarthritis
B. Cellulitis only
C. Deep vein thrombosis
D. Chronic venous insufficiency
Rationale: New unilateral leg swelling, warmth, and tenderness
are concerning for deep vein thrombosis, particularly when
accompanied by relevant risk factors such as recent
immobilization, surgery, cancer, or previous venous
thromboembolism. Clinical assessment should determine the
patient's pretest probability and whether diagnostic testing is
indicated. DVT is clinically important because thrombus
embolization can result in pulmonary embolism.
5.
A patient with asthma uses a rescue inhaler several times each
week and awakens at night because of wheezing. What does
this pattern most strongly indicate?
A. Adequately controlled asthma
B. A need to discontinue all inhaled therapy
C. Inadequate asthma control requiring reassessment and
treatment adjustment
D. That the patient has COPD rather than asthma
Exam 2026 Practice Questions & Study Guide |
Complete Exam-Style Questions with Correct
Detailed Answers & Rationales (Reliable
Answers)
1.
A 47-year-old adult with no personal or family history of
colorectal cancer presents for a preventive visit. Which
screening recommendation is most appropriate for an average-
risk patient?
A. Begin screening at age 55
B. Begin screening only after symptoms develop
C. Begin screening at age 45
D. Begin screening at age 50 only if the patient has a history of
smoking
Rationale: The recommended starting age for colorectal cancer
screening in average-risk adults is 45 years. Screening can be
performed using several accepted strategies, including stool-
based testing and direct visualization tests such as colonoscopy.
Beginning at age 45 reflects the increased recognition of
colorectal cancer occurring in younger adults. Screening should
,be individualized according to risk factors, prior results, family
history, and the specific screening modality selected.
2.
A patient has a blood pressure of 152/94 mmHg during an
office visit but reports normal readings at home. What is the
most appropriate next step before diagnosing sustained
hypertension when clinically appropriate?
A. Immediately diagnose stage 2 hypertension based on the
single reading
B. Obtain additional out-of-office or repeated blood pressure
measurements
C. Tell the patient to stop all physical activity
D. Start two antihypertensive medications without further
assessment
Rationale: A single elevated office measurement does not
always establish persistent hypertension. Repeated
standardized measurements and, when appropriate, home or
ambulatory blood pressure monitoring can help distinguish
sustained hypertension from white-coat hypertension.
Confirming the blood pressure pattern is important because
treatment decisions should be based on reliable measurements
rather than an isolated abnormal value.
,3.
A patient with type 2 diabetes has an A1C of 9.1% despite
adherence to metformin and lifestyle interventions. Which
principle should guide the next management decision?
A. Continue metformin alone for another year
B. Stop metformin automatically
C. Treat the A1C value without considering comorbidities
D. Select additional therapy based on glycemic needs,
comorbidities, risks, preferences, and treatment goals
Rationale: Diabetes treatment should be individualized rather
than based solely on the A1C value. Cardiovascular disease,
chronic kidney disease, heart failure, obesity, hypoglycemia risk,
cost, route of administration, adverse effects, and patient
preferences can influence medication selection. When glycemic
targets are not achieved with initial therapy, intensification
should occur in a timely manner while maintaining appropriate
foundational therapy when tolerated and not contraindicated.
4.
A patient reports unilateral calf swelling, warmth, and
tenderness that began yesterday. Which diagnosis should
receive immediate consideration?
, A. Osteoarthritis
B. Cellulitis only
C. Deep vein thrombosis
D. Chronic venous insufficiency
Rationale: New unilateral leg swelling, warmth, and tenderness
are concerning for deep vein thrombosis, particularly when
accompanied by relevant risk factors such as recent
immobilization, surgery, cancer, or previous venous
thromboembolism. Clinical assessment should determine the
patient's pretest probability and whether diagnostic testing is
indicated. DVT is clinically important because thrombus
embolization can result in pulmonary embolism.
5.
A patient with asthma uses a rescue inhaler several times each
week and awakens at night because of wheezing. What does
this pattern most strongly indicate?
A. Adequately controlled asthma
B. A need to discontinue all inhaled therapy
C. Inadequate asthma control requiring reassessment and
treatment adjustment
D. That the patient has COPD rather than asthma
