UTA NURS 5337 Family Clinical Practice 1: Exam 2 - Questions
with Correct Answers
100 questions
1. USPSTF recommends anxiety screening in adults under 65 using a tool such as:
A. CAGE
B. GAD-7
C. AUDIT-C
D. Mini-Cog
Correct Answer: B. GAD-7
Rationale: The GAD-7 is a validated anxiety screen and fits the 2023 USPSTF recommendation for
adults under 65. CAGE and AUDIT-C screen for alcohol misuse. The Mini-Cog is a brief dementia screen
and does not assess anxiety.
2. A 39-year-old female presents for an annual exam. HIV screening per USPSTF is
recommended:
A. Only if she reports injection drug use
B. Only during pregnancy
C. Only for men who have sex with men
D. At least once for all people aged 15 to 65
Correct Answer: D. At least once for all people aged 15 to 65
Rationale: USPSTF recommends HIV screening for everyone 15 to 65 at least once, with repeat testing
for those at increased risk, because many infections are undiagnosed. Risk-based testing alone misses
many cases. Pregnancy screening is a separate recommendation, not a limit on adult screening.
3. Which statement about the USPSTF letter grades is correct?
A. Grade C means the service should always be offered
B. Grade A and B services should be offered because net benefit is moderate to substantial
C. Grade D means evidence is insufficient
D. Grade I means the service is harmful
Correct Answer: B. Grade A and B services should be offered because net benefit is
moderate to substantial
Rationale: A and B grades indicate at least moderate certainty of moderate to substantial net benefit, so
clinicians should offer them. Grade C means offer selectively based on patient circumstances. Grade D
recommends against the service because harms outweigh benefits, while Grade I means evidence is
insufficient.
,4. A 70-year-old woman with normal cervical screening for the past 10 years asks if she still
needs Pap tests. The FNP explains:
A. Screening can stop after age 65 with adequate prior negative screening
B. She needs annual Pap tests for life
C. She needs a Pap test every 3 years until 80
D. She should switch to HPV testing every year
Correct Answer: A. Screening can stop after age 65 with adequate prior negative screening
Rationale: Women over 65 with adequate negative prior screening and no high-grade lesion history can
stop cervical screening because new cancers are rare. Lifelong annual testing adds harm without benefit.
There is no extension to 80, and annual HPV testing is not recommended.
5. A patient smokes 1 pack per day and says she is ready to quit in the next month. Following
the 5 A's, after Advise and Assess the FNP should next:
A. Arrange follow-up only after she relapses
B. Repeat advice at the next annual visit
C. Refer her to a cardiologist
D. Assist with a quit plan, pharmacotherapy, and a quit date
Correct Answer: D. Assist with a quit plan, pharmacotherapy, and a quit date
Rationale: The 5 A's are Ask, Advise, Assess readiness, Assist, and Arrange follow-up. Because she is
ready, the FNP should assist with a plan, medication, and a quit date, then arrange follow-up within the
first week or two. Delaying assistance or referral to cardiology wastes her readiness.
6. A patient with a BMI of 32 and no comorbidities asks about weight loss. The first-line
recommendation is:
A. Intensive, multicomponent behavioral intervention
B. Bariatric surgery referral
C. Phentermine for 2 years
D. A very low calorie diet of 500 kcal per day unsupervised
Correct Answer: A. Intensive, multicomponent behavioral intervention
Rationale: USPSTF recommends intensive behavioral programs (diet, activity, self-monitoring) for adults
with BMI 30 or more. Bariatric surgery is typically for BMI 40, or 35 with comorbidities. Phentermine is
approved only for short-term use, and an unsupervised 500 kcal diet is unsafe.
,7. A 35-year-old on chronic adalimumab therapy for Crohn's disease asks about shingles
vaccination. The FNP should know that:
A. Shingles vaccine is contraindicated in all immunosuppressed patients
B. She must wait until age 50
C. She should receive a live varicella vaccine instead
D. Recombinant zoster vaccine is recommended for immunocompromised adults age 19 and older
Correct Answer: D. Recombinant zoster vaccine is recommended for immunocompromised
adults age 19 and older
Rationale: Because the recombinant vaccine is not live, ACIP recommends it for adults 19 and older with
immunocompromise, who face higher zoster risk. Live vaccines are what are contraindicated in
immunosuppression, so the live varicella vaccine would be wrong. Waiting until 50 leaves a high-risk
patient unprotected.
8. A pre-participation sports exam for a 16-year-old reveals a systolic murmur that gets louder
with standing. The FNP should:
A. Clear the athlete because most murmurs are innocent
B. Repeat the exam next year
C. Restrict participation and refer for echocardiography to evaluate for hypertrophic cardiomyopathy
D. Order a chest x-ray only
Correct Answer: C. Restrict participation and refer for echocardiography to evaluate for
hypertrophic cardiomyopathy
Rationale: A murmur that increases with standing or Valsalva suggests dynamic outflow obstruction from
hypertrophic cardiomyopathy, a leading cause of sudden death in young athletes. Innocent murmurs
usually soften with standing. A chest x-ray will not diagnose it, and waiting a year risks a fatal event.
9. Which regimen is considered high-intensity statin therapy?
A. Atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg
B. Simvastatin 10 mg
C. Pravastatin 20 mg
D. Atorvastatin 10 mg
Correct Answer: A. Atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg
Rationale: High-intensity statins lower LDL by 50% or more; only atorvastatin 40 to 80 and rosuvastatin
20 to 40 reach that. Simvastatin 10, pravastatin 20 and atorvastatin 10 are low or moderate intensity.
Simvastatin 80 is avoided due to myopathy risk.
, 10. A patient on rosuvastatin asks about the new diabetes risk. The FNP explains that:
A. Statins modestly raise the chance of diabetes, but the cardiovascular benefit outweighs this risk
B. Statins cure diabetes
C. Statins should be stopped if A1c rises at all
D. Diabetes risk is only with simvastatin
Correct Answer: A. Statins modestly raise the chance of diabetes, but the cardiovascular
benefit outweighs this risk
Rationale: Statins slightly increase incident diabetes, mostly in patients already near the threshold, but
they prevent far more cardiovascular events. Stopping them for a small A1c rise forfeits that benefit. The
effect is a class effect and is somewhat greater with high-intensity statins.
11. A patient has BP 190/120 with no headache, chest pain, vision change, or neurologic deficits.
This is best termed:
A. Hypertensive emergency
B. Severe asymptomatic hypertension
C. Malignant hypertension with encephalopathy
D. Pre-eclampsia
Correct Answer: B. Severe asymptomatic hypertension
Rationale: Without acute target-organ damage, very high BP is severe hypertension (urgency), managed
by restarting or adjusting oral agents and close follow-up rather than rapid lowering. Emergency requires
organ damage such as stroke, MI, encephalopathy or kidney injury. Pre-eclampsia applies only to
pregnancy after 20 weeks.
12. Statins are contraindicated in which patient?
A. A woman who is pregnant
B. A patient with stable chronic kidney disease
C. A patient over 75 with ASCVD
D. A patient with controlled diabetes
Correct Answer: A. A woman who is pregnant
Rationale: Statins have traditionally been avoided in pregnancy and breastfeeding; in 2021 the FDA
removed the broad contraindication, but most patients should stop them when pregnancy is planned or
confirmed, except some very high-risk patients. CKD, older age with ASCVD and diabetes are indications,
not contraindications. This makes the pregnant patient the best answer.
with Correct Answers
100 questions
1. USPSTF recommends anxiety screening in adults under 65 using a tool such as:
A. CAGE
B. GAD-7
C. AUDIT-C
D. Mini-Cog
Correct Answer: B. GAD-7
Rationale: The GAD-7 is a validated anxiety screen and fits the 2023 USPSTF recommendation for
adults under 65. CAGE and AUDIT-C screen for alcohol misuse. The Mini-Cog is a brief dementia screen
and does not assess anxiety.
2. A 39-year-old female presents for an annual exam. HIV screening per USPSTF is
recommended:
A. Only if she reports injection drug use
B. Only during pregnancy
C. Only for men who have sex with men
D. At least once for all people aged 15 to 65
Correct Answer: D. At least once for all people aged 15 to 65
Rationale: USPSTF recommends HIV screening for everyone 15 to 65 at least once, with repeat testing
for those at increased risk, because many infections are undiagnosed. Risk-based testing alone misses
many cases. Pregnancy screening is a separate recommendation, not a limit on adult screening.
3. Which statement about the USPSTF letter grades is correct?
A. Grade C means the service should always be offered
B. Grade A and B services should be offered because net benefit is moderate to substantial
C. Grade D means evidence is insufficient
D. Grade I means the service is harmful
Correct Answer: B. Grade A and B services should be offered because net benefit is
moderate to substantial
Rationale: A and B grades indicate at least moderate certainty of moderate to substantial net benefit, so
clinicians should offer them. Grade C means offer selectively based on patient circumstances. Grade D
recommends against the service because harms outweigh benefits, while Grade I means evidence is
insufficient.
,4. A 70-year-old woman with normal cervical screening for the past 10 years asks if she still
needs Pap tests. The FNP explains:
A. Screening can stop after age 65 with adequate prior negative screening
B. She needs annual Pap tests for life
C. She needs a Pap test every 3 years until 80
D. She should switch to HPV testing every year
Correct Answer: A. Screening can stop after age 65 with adequate prior negative screening
Rationale: Women over 65 with adequate negative prior screening and no high-grade lesion history can
stop cervical screening because new cancers are rare. Lifelong annual testing adds harm without benefit.
There is no extension to 80, and annual HPV testing is not recommended.
5. A patient smokes 1 pack per day and says she is ready to quit in the next month. Following
the 5 A's, after Advise and Assess the FNP should next:
A. Arrange follow-up only after she relapses
B. Repeat advice at the next annual visit
C. Refer her to a cardiologist
D. Assist with a quit plan, pharmacotherapy, and a quit date
Correct Answer: D. Assist with a quit plan, pharmacotherapy, and a quit date
Rationale: The 5 A's are Ask, Advise, Assess readiness, Assist, and Arrange follow-up. Because she is
ready, the FNP should assist with a plan, medication, and a quit date, then arrange follow-up within the
first week or two. Delaying assistance or referral to cardiology wastes her readiness.
6. A patient with a BMI of 32 and no comorbidities asks about weight loss. The first-line
recommendation is:
A. Intensive, multicomponent behavioral intervention
B. Bariatric surgery referral
C. Phentermine for 2 years
D. A very low calorie diet of 500 kcal per day unsupervised
Correct Answer: A. Intensive, multicomponent behavioral intervention
Rationale: USPSTF recommends intensive behavioral programs (diet, activity, self-monitoring) for adults
with BMI 30 or more. Bariatric surgery is typically for BMI 40, or 35 with comorbidities. Phentermine is
approved only for short-term use, and an unsupervised 500 kcal diet is unsafe.
,7. A 35-year-old on chronic adalimumab therapy for Crohn's disease asks about shingles
vaccination. The FNP should know that:
A. Shingles vaccine is contraindicated in all immunosuppressed patients
B. She must wait until age 50
C. She should receive a live varicella vaccine instead
D. Recombinant zoster vaccine is recommended for immunocompromised adults age 19 and older
Correct Answer: D. Recombinant zoster vaccine is recommended for immunocompromised
adults age 19 and older
Rationale: Because the recombinant vaccine is not live, ACIP recommends it for adults 19 and older with
immunocompromise, who face higher zoster risk. Live vaccines are what are contraindicated in
immunosuppression, so the live varicella vaccine would be wrong. Waiting until 50 leaves a high-risk
patient unprotected.
8. A pre-participation sports exam for a 16-year-old reveals a systolic murmur that gets louder
with standing. The FNP should:
A. Clear the athlete because most murmurs are innocent
B. Repeat the exam next year
C. Restrict participation and refer for echocardiography to evaluate for hypertrophic cardiomyopathy
D. Order a chest x-ray only
Correct Answer: C. Restrict participation and refer for echocardiography to evaluate for
hypertrophic cardiomyopathy
Rationale: A murmur that increases with standing or Valsalva suggests dynamic outflow obstruction from
hypertrophic cardiomyopathy, a leading cause of sudden death in young athletes. Innocent murmurs
usually soften with standing. A chest x-ray will not diagnose it, and waiting a year risks a fatal event.
9. Which regimen is considered high-intensity statin therapy?
A. Atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg
B. Simvastatin 10 mg
C. Pravastatin 20 mg
D. Atorvastatin 10 mg
Correct Answer: A. Atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg
Rationale: High-intensity statins lower LDL by 50% or more; only atorvastatin 40 to 80 and rosuvastatin
20 to 40 reach that. Simvastatin 10, pravastatin 20 and atorvastatin 10 are low or moderate intensity.
Simvastatin 80 is avoided due to myopathy risk.
, 10. A patient on rosuvastatin asks about the new diabetes risk. The FNP explains that:
A. Statins modestly raise the chance of diabetes, but the cardiovascular benefit outweighs this risk
B. Statins cure diabetes
C. Statins should be stopped if A1c rises at all
D. Diabetes risk is only with simvastatin
Correct Answer: A. Statins modestly raise the chance of diabetes, but the cardiovascular
benefit outweighs this risk
Rationale: Statins slightly increase incident diabetes, mostly in patients already near the threshold, but
they prevent far more cardiovascular events. Stopping them for a small A1c rise forfeits that benefit. The
effect is a class effect and is somewhat greater with high-intensity statins.
11. A patient has BP 190/120 with no headache, chest pain, vision change, or neurologic deficits.
This is best termed:
A. Hypertensive emergency
B. Severe asymptomatic hypertension
C. Malignant hypertension with encephalopathy
D. Pre-eclampsia
Correct Answer: B. Severe asymptomatic hypertension
Rationale: Without acute target-organ damage, very high BP is severe hypertension (urgency), managed
by restarting or adjusting oral agents and close follow-up rather than rapid lowering. Emergency requires
organ damage such as stroke, MI, encephalopathy or kidney injury. Pre-eclampsia applies only to
pregnancy after 20 weeks.
12. Statins are contraindicated in which patient?
A. A woman who is pregnant
B. A patient with stable chronic kidney disease
C. A patient over 75 with ASCVD
D. A patient with controlled diabetes
Correct Answer: A. A woman who is pregnant
Rationale: Statins have traditionally been avoided in pregnancy and breastfeeding; in 2021 the FDA
removed the broad contraindication, but most patients should stop them when pregnancy is planned or
confirmed, except some very high-risk patients. CKD, older age with ASCVD and diabetes are indications,
not contraindications. This makes the pregnant patient the best answer.
