UTA NURS 5337 Family Clinical Practice 1: Practice Test 1
(Units 1-7) - Questions with Correct Answers
100 questions
1. Pneumococcal vaccination is now routinely recommended for all adults starting at age:
A. 50
B. 65
C. 40
D. 75
Correct Answer: A. 50
Rationale: In 2024, ACIP lowered the routine pneumococcal age from 65 to 50, using PCV20 or PCV21
alone or PCV15 followed by PPSV23. Age 65 was the old threshold. Ages 40 and 75 are not routine
starting points, although younger adults with risk conditions are vaccinated at any age.
2. Intimate partner violence screening is recommended by USPSTF for:
A. Only women presenting with injuries
B. All men over 65
C. Only pregnant adolescents
D. Women of reproductive age
Correct Answer: D. Women of reproductive age
Rationale: USPSTF recommends screening women of reproductive age for intimate partner violence and
referring those who screen positive to support services. Screening only those with injuries misses most
cases. There is no specific recommendation for men over 65, and pregnant adolescents are included but
not the only group.
3. An adult patient's positive PHQ-2 should be followed by:
A. Starting an SSRI immediately
B. Referring directly to inpatient psychiatry
C. Repeating the PHQ-2 in one year
D. Administering the PHQ-9 to assess severity
Correct Answer: D. Administering the PHQ-9 to assess severity
Rationale: The PHQ-2 is a sensitive first-step screen; a positive result needs the PHQ-9, which grades
severity and includes item 9 on self-harm thoughts. Starting medication before confirming the diagnosis is
premature. Inpatient referral is for imminent danger, and simply rescreening next year leaves a likely
depression untreated.
,4. Moderate-intensity physical activity guidelines for adults recommend:
A. At least 150 minutes per week plus muscle strengthening on 2 days
B. 30 minutes once per week
C. Strength training only
D. 300 minutes of vigorous activity daily
Correct Answer: A. At least 150 minutes per week plus muscle strengthening on 2 days
Rationale: The US Physical Activity Guidelines call for 150 to 300 minutes of moderate activity weekly, or
75 to 150 vigorous, plus muscle strengthening at least 2 days per week. Thirty minutes once a week is far
below target. Strength training alone misses aerobic benefit, and 300 vigorous minutes daily is unrealistic
and not the guideline.
5. A 30-year-old woman planning pregnancy has negative rubella immunity. She should be told
to:
A. Receive MMR during the first trimester
B. Receive MMR now and avoid pregnancy for 4 weeks
C. Avoid MMR permanently
D. Receive MMR only after age 40
Correct Answer: B. Receive MMR now and avoid pregnancy for 4 weeks
Rationale: MMR is a live vaccine, so it is given before conception with 4 weeks of contraception
afterward, or postpartum. Live vaccines are contraindicated during pregnancy. Avoiding it permanently
leaves her and a future fetus at risk of congenital rubella syndrome.
6. A patient asks the FNP to explain the difference between screening and diagnostic testing.
The best statement is:
A. Screening and diagnostic tests are the same
B. Diagnostic tests are always cheaper
C. Screening tests asymptomatic people; diagnostic tests evaluate symptoms or abnormal results
D. Screening is only for people with known disease
Correct Answer: C. Screening tests asymptomatic people; diagnostic tests evaluate
symptoms or abnormal results
Rationale: Screening looks for disease in people without symptoms, while diagnostic testing is ordered to
explain symptoms or confirm an abnormal screen. The distinction matters for guideline selection and for
coding. Costs vary, and people with known disease receive monitoring, not screening.
,7. A 55-year-old healthy adult asks about shingles prevention. The FNP explains the recurrent
zoster vaccine is given as:
A. One dose at age 60
B. One live-vaccine dose at age 65
C. Two doses, 2 to 6 months apart, starting at age 50
D. Three doses over 1 year starting at age 40
Correct Answer: C. Two doses, 2 to 6 months apart, starting at age 50
Rationale: Recombinant zoster vaccine (RZV) is a 2-dose series for immunocompetent adults 50 and
older, and it is over 90% effective. The older live vaccine was single-dose and is no longer available in the
US. There is no 3-dose series or start at 40 for healthy adults.
8. Which documentation element belongs in the Subjective section of a SOAP note?
A. Temperature 38.4 C
B. Crackles in the right lower lobe
C. The patient reports a 3-day history of productive cough
D. Chest x-ray shows a right lower lobe infiltrate
Correct Answer: C. The patient reports a 3-day history of productive cough
Rationale: The Subjective section records what the patient reports, such as symptom history. Vital signs,
examination findings, and imaging results are objective data. Mixing these sections makes the note harder
to follow and weakens clinical reasoning.
9. The FNP generating a differential diagnosis for fatigue should first:
A. List every possible diagnosis in alphabetical order
B. Consider the most common and the most dangerous causes that fit the findings
C. Order a full body CT
D. Assume a psychiatric cause
Correct Answer: B. Consider the most common and the most dangerous causes that fit the
findings
Rationale: Good diagnostic reasoning prioritizes conditions that are likely (such as anemia,
hypothyroidism, depression, sleep disorders) and conditions that cannot be missed (such as malignancy).
Unranked lists do not guide workup. Broad imaging without direction leads to incidental findings, and
anchoring on a psychiatric cause risks missing organic disease.
, 10. A 58-year-old with LDL 150 mg/dL, hypertension, and a 10-year ASCVD risk of 12% has no
cardiovascular disease. The USPSTF recommendation is to:
A. Recheck lipids in 5 years without treatment
B. Start a moderate-intensity statin
C. Prescribe daily aspirin instead of a statin
D. Order a stress test before deciding
Correct Answer: B. Start a moderate-intensity statin
Rationale: USPSTF recommends a statin for adults 40 to 75 with one or more risk factors and a 10-year
risk of 10% or more (Grade B). Aspirin for primary prevention is no longer routinely recommended at 60
and older and has a narrow benefit window before that. A stress test in an asymptomatic patient does not
guide statin initiation.
11. A pregnant patient at 30 weeks asks about whooping cough protection for her baby. The FNP
recommends:
A. Tdap only if she has never had it
B. Tdap now, during this pregnancy
C. Tdap after delivery instead
D. Waiting until the infant is 2 months old
Correct Answer: B. Tdap now, during this pregnancy
Rationale: Tdap is recommended during every pregnancy, ideally at 27 to 36 weeks, so maternal
antibodies cross the placenta and protect the infant before the first DTaP dose. Prior Tdap does not
exempt her because antibody levels fall. Postpartum dosing protects the newborn far less, and waiting
leaves the infant vulnerable during the highest-risk months.
12. A patient asks why influenza vaccine is needed every year. The best explanation is that:
A. The vaccine contains live virus that is cleared
B. Circulating strains change and vaccine-induced immunity wanes
C. Annual vaccine boosts tetanus protection too
D. One dose provides lifelong immunity but is repeated for paperwork
Correct Answer: B. Circulating strains change and vaccine-induced immunity wanes
Rationale: Antigenic drift changes the dominant strains, so the vaccine is reformulated each season and
antibody levels also decline over months. Most injectable flu vaccines are inactivated, not live. Influenza
vaccine provides no tetanus protection and does not give lifelong immunity.
(Units 1-7) - Questions with Correct Answers
100 questions
1. Pneumococcal vaccination is now routinely recommended for all adults starting at age:
A. 50
B. 65
C. 40
D. 75
Correct Answer: A. 50
Rationale: In 2024, ACIP lowered the routine pneumococcal age from 65 to 50, using PCV20 or PCV21
alone or PCV15 followed by PPSV23. Age 65 was the old threshold. Ages 40 and 75 are not routine
starting points, although younger adults with risk conditions are vaccinated at any age.
2. Intimate partner violence screening is recommended by USPSTF for:
A. Only women presenting with injuries
B. All men over 65
C. Only pregnant adolescents
D. Women of reproductive age
Correct Answer: D. Women of reproductive age
Rationale: USPSTF recommends screening women of reproductive age for intimate partner violence and
referring those who screen positive to support services. Screening only those with injuries misses most
cases. There is no specific recommendation for men over 65, and pregnant adolescents are included but
not the only group.
3. An adult patient's positive PHQ-2 should be followed by:
A. Starting an SSRI immediately
B. Referring directly to inpatient psychiatry
C. Repeating the PHQ-2 in one year
D. Administering the PHQ-9 to assess severity
Correct Answer: D. Administering the PHQ-9 to assess severity
Rationale: The PHQ-2 is a sensitive first-step screen; a positive result needs the PHQ-9, which grades
severity and includes item 9 on self-harm thoughts. Starting medication before confirming the diagnosis is
premature. Inpatient referral is for imminent danger, and simply rescreening next year leaves a likely
depression untreated.
,4. Moderate-intensity physical activity guidelines for adults recommend:
A. At least 150 minutes per week plus muscle strengthening on 2 days
B. 30 minutes once per week
C. Strength training only
D. 300 minutes of vigorous activity daily
Correct Answer: A. At least 150 minutes per week plus muscle strengthening on 2 days
Rationale: The US Physical Activity Guidelines call for 150 to 300 minutes of moderate activity weekly, or
75 to 150 vigorous, plus muscle strengthening at least 2 days per week. Thirty minutes once a week is far
below target. Strength training alone misses aerobic benefit, and 300 vigorous minutes daily is unrealistic
and not the guideline.
5. A 30-year-old woman planning pregnancy has negative rubella immunity. She should be told
to:
A. Receive MMR during the first trimester
B. Receive MMR now and avoid pregnancy for 4 weeks
C. Avoid MMR permanently
D. Receive MMR only after age 40
Correct Answer: B. Receive MMR now and avoid pregnancy for 4 weeks
Rationale: MMR is a live vaccine, so it is given before conception with 4 weeks of contraception
afterward, or postpartum. Live vaccines are contraindicated during pregnancy. Avoiding it permanently
leaves her and a future fetus at risk of congenital rubella syndrome.
6. A patient asks the FNP to explain the difference between screening and diagnostic testing.
The best statement is:
A. Screening and diagnostic tests are the same
B. Diagnostic tests are always cheaper
C. Screening tests asymptomatic people; diagnostic tests evaluate symptoms or abnormal results
D. Screening is only for people with known disease
Correct Answer: C. Screening tests asymptomatic people; diagnostic tests evaluate
symptoms or abnormal results
Rationale: Screening looks for disease in people without symptoms, while diagnostic testing is ordered to
explain symptoms or confirm an abnormal screen. The distinction matters for guideline selection and for
coding. Costs vary, and people with known disease receive monitoring, not screening.
,7. A 55-year-old healthy adult asks about shingles prevention. The FNP explains the recurrent
zoster vaccine is given as:
A. One dose at age 60
B. One live-vaccine dose at age 65
C. Two doses, 2 to 6 months apart, starting at age 50
D. Three doses over 1 year starting at age 40
Correct Answer: C. Two doses, 2 to 6 months apart, starting at age 50
Rationale: Recombinant zoster vaccine (RZV) is a 2-dose series for immunocompetent adults 50 and
older, and it is over 90% effective. The older live vaccine was single-dose and is no longer available in the
US. There is no 3-dose series or start at 40 for healthy adults.
8. Which documentation element belongs in the Subjective section of a SOAP note?
A. Temperature 38.4 C
B. Crackles in the right lower lobe
C. The patient reports a 3-day history of productive cough
D. Chest x-ray shows a right lower lobe infiltrate
Correct Answer: C. The patient reports a 3-day history of productive cough
Rationale: The Subjective section records what the patient reports, such as symptom history. Vital signs,
examination findings, and imaging results are objective data. Mixing these sections makes the note harder
to follow and weakens clinical reasoning.
9. The FNP generating a differential diagnosis for fatigue should first:
A. List every possible diagnosis in alphabetical order
B. Consider the most common and the most dangerous causes that fit the findings
C. Order a full body CT
D. Assume a psychiatric cause
Correct Answer: B. Consider the most common and the most dangerous causes that fit the
findings
Rationale: Good diagnostic reasoning prioritizes conditions that are likely (such as anemia,
hypothyroidism, depression, sleep disorders) and conditions that cannot be missed (such as malignancy).
Unranked lists do not guide workup. Broad imaging without direction leads to incidental findings, and
anchoring on a psychiatric cause risks missing organic disease.
, 10. A 58-year-old with LDL 150 mg/dL, hypertension, and a 10-year ASCVD risk of 12% has no
cardiovascular disease. The USPSTF recommendation is to:
A. Recheck lipids in 5 years without treatment
B. Start a moderate-intensity statin
C. Prescribe daily aspirin instead of a statin
D. Order a stress test before deciding
Correct Answer: B. Start a moderate-intensity statin
Rationale: USPSTF recommends a statin for adults 40 to 75 with one or more risk factors and a 10-year
risk of 10% or more (Grade B). Aspirin for primary prevention is no longer routinely recommended at 60
and older and has a narrow benefit window before that. A stress test in an asymptomatic patient does not
guide statin initiation.
11. A pregnant patient at 30 weeks asks about whooping cough protection for her baby. The FNP
recommends:
A. Tdap only if she has never had it
B. Tdap now, during this pregnancy
C. Tdap after delivery instead
D. Waiting until the infant is 2 months old
Correct Answer: B. Tdap now, during this pregnancy
Rationale: Tdap is recommended during every pregnancy, ideally at 27 to 36 weeks, so maternal
antibodies cross the placenta and protect the infant before the first DTaP dose. Prior Tdap does not
exempt her because antibody levels fall. Postpartum dosing protects the newborn far less, and waiting
leaves the infant vulnerable during the highest-risk months.
12. A patient asks why influenza vaccine is needed every year. The best explanation is that:
A. The vaccine contains live virus that is cleared
B. Circulating strains change and vaccine-induced immunity wanes
C. Annual vaccine boosts tetanus protection too
D. One dose provides lifelong immunity but is repeated for paperwork
Correct Answer: B. Circulating strains change and vaccine-induced immunity wanes
Rationale: Antigenic drift changes the dominant strains, so the vaccine is reformulated each season and
antibody levels also decline over months. Most injectable flu vaccines are inactivated, not live. Influenza
vaccine provides no tetanus protection and does not give lifelong immunity.
