Primary Care 5th ED Sample items
Chapter 001
1.A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1
ACO. What is part of this designation? Bonuses based on achievement of benchmarks
2. What was an important finding of the Advisory Board survey of 2014 about primary care preferences
of patients? Ease of access to care.
3. Which assessments of care providers are performed as part of the Value Based Purchasing initiative?
(Select all that apply.)
Appraising costs per case of care for Medicare patients
Assessing patients’ satisfaction with hospital care
Monitoring mortality rates of all patients with pneumonia
Chapter 002
1. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
Reduction of payments for patients readmitted within 30 days after discharge
2. According to Naylor’s transitional care model, which intervention has resulted in lower costs and
fewer re-hospitalizations in high-risk older patients?
Coordination of post-hospital care by advanced practice nurses
3. Which approaches are among those recommended by the Agency for Healthcare Research and
Quality to improve health literacy in patients? (Select all that apply.)
Empowering patients and families Correct
Repeating the instructions Correct
Supplementing teaching with visual aids Correct
Chapter 003
1. What is the purpose of Level II research?
To describe relationships among characteristics or variables
2. Which is the most appropriate research design for a Level III research study?
Experimental design
3.What is the purpose of clinical research trials in the spectrum of translational research?
Examination of safety and effectiveness of various interventions
Chapter 004
1. The provider learns that a patient is taking herbal supplements for a variety of reasons. What is
an important point to discuss with this patient about taking such supplements?
Many supplements lack clear clinical evidence of efficacy Correct
2. A patient takes glucosamine chondroitin to help control osteoarthritis pain. Which medications,
taken in conjunction with this medication, are of concern?
Blood-thinning agents Correct
3. Which dietary supplements have shown some effectiveness in reducing blood pressure in
patients with hypertension? (Select all that apply.)
CoQ10 Correct
Garlic extract Correct
L-arginine Correct
Test Bank - Chapter 005
,1. The chronic care model (CCM) was developed to manage patients with complicated chronic
conditions because the traditional acute care model could not provide efficient and cost-effective
chronic care.
did not meet longitudinal health care needs for this population. Correct
2. What are functions of patient registries in the chronic care model? (Select all that apply.)
Alerting providers to medication interactions Correct
Recommending routine screenings Correct
Reminding providers about immunizations Correct
Transmitting clinical data about patients Correct
3. Which are key components of the Patient-Centered Medical Home? (Select all that apply.)
Access to care Correct
Comprehensive care Correct
Coordination of care Correct
Test Bank - Chapter 006
1. A primary care provider administers the “Newest Vital Sign” health literacy test to a patient
newly diagnosed with a chronic disease. What information is gained by administering this test?
Ability to calculate data, along with general knowledge about health Correct
2. What is the main reason for using the REALM-SF instrument to evaluate health literacy?
It evaluates medical word recognition. Correct
3. A female patient who is from the Middle East schedules an appointment in a primary care office.
To provide culturally responsive care, what will the clinic personnel do when meeting this patient for the
first time?
Inquire about the patient’s beliefs about health and treatment Correct
Test Bank - Chapter 007
1. A patient expresses concern that she is at risk for breast cancer. To best assess the risk for this
patient, what is the best initial action?
Gather and record a three-generation pedigree Correct
2. A patient asks about direct-to-consumer (DTC) genetic testing. What will the provider tell the
patient?
Much of the information does not predict disease risk.
Test Bank - Chapter 008
1. What is an important part of patient care that can minimize the risk of a formal patient
complaint even when a mistake is made?
Maintaining effective patient communication Correct
2. What are some causes for failures or delays in diagnosing patients resulting in malpractice
claims? (Select all that apply.)
Failing to request appropriate consultations
Not acting on diagnostic test results
Test Bank - Chapter 009
1. Which behavior is most characteristic of early adolescence?
Arguing with parents and teachers
2. What is the initial sign of puberty in the adolescent male?
Testicular enlargement
3. A parent reports that an adolescent child does well in school but seems to consistently make
poor decisions about activities with friends. What will the practitioner recommend as an approach to
help the adolescent make better decisions?
Listening without making suggestions about choices
Test Bank - Chapter 010
, 1. Which is the most important factor limiting access to health care for sexual and gender
minorities?
Laws prohibiting full marriage equality
2. What is the medical diagnostic term used to identify transgender patients?
Gender dysphoria Correct
Test Bank - Chapter 011
1. A woman who is currently pregnant reports that she has had three previous pregnancies: twins
delivered at 35 weeks gestation (both living), one at 38 weeks gestation (living), and one miscarriage at
16 weeks gestation. How will this be recorded as her G/TPAL in her electronic medical record?
G4P:1113
2. A pregnant woman who is overweight has no previous history of hypertension or diabetes. Her
initial screening exam reveals a blood pressure of 140/90 and a fasting blood glucose of 128 mg/dL.
What will the practitioner do?
Monitor blood pressure and fasting blood glucose closely
3. A pregnant woman reports not having had any vaccinations as a child but requests vaccines
during her pregnancy. Which vaccines may be given? (Select all that apply.)
HPV Correct
Inactivated influenza Correct
Tdap Correct
Test Bank - Chapter 012
1. The mother of a 3-day-old newborn reports that her infant nurses every 4 hours during the day
and sleeps 6 hours at night. What will the provider recommend?
Awakening the baby every 3 hours to nurse
2. An infant who has just begun nursing develops hyperbilirubinemia. What will the provider tell
the mother?
To use a breast pump to increase her milk supply
3. A mother who has been breastfeeding her infant for several weeks develops a fever, breast
warmth, and breast tenderness. What will the provider recommend?
Warm packs and increased frequency of nursing
Test Bank - Chapter 013
1. When prescribing medications to an 80-year-old patient, the provider will
consult the Beers list to help identify potentially problematic drugs. Correct
2. An 80-year-old woman who lives alone is noted to have a recent weight loss of 5 pounds. She
appears somewhat confused, according to her daughter, who is concerned that she is developing
dementia. The provider learns that the woman still drives, volunteers at the local hospital, and attends a
book club with several friends once a month. What is the initial step in evaluating this patient?
Obtain a CBC, serum electrolytes, BUN, and glucose Correct
3. The practitioner is establishing a plan for routine health maintenance for a new female client
who is 80 years old. The client has never smoked and has been in good health. What will the practitioner
include in routine care for this patient? (Select all that apply.)
Pneumovax vaccine if not previously given Correct
Yearly influenza vaccine Correct
Test Bank - Chapter 014
1. When should palliative care be initiated by a primary care provider?
As part of routine health maintenance Correct
2. When using the “Five Wishes” approach to documenting patient preferences for end-of-life care,
the provider will document which types of preferences? (Select all that apply.)
How much information to give various family members Correct
Chapter 001
1.A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1
ACO. What is part of this designation? Bonuses based on achievement of benchmarks
2. What was an important finding of the Advisory Board survey of 2014 about primary care preferences
of patients? Ease of access to care.
3. Which assessments of care providers are performed as part of the Value Based Purchasing initiative?
(Select all that apply.)
Appraising costs per case of care for Medicare patients
Assessing patients’ satisfaction with hospital care
Monitoring mortality rates of all patients with pneumonia
Chapter 002
1. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
Reduction of payments for patients readmitted within 30 days after discharge
2. According to Naylor’s transitional care model, which intervention has resulted in lower costs and
fewer re-hospitalizations in high-risk older patients?
Coordination of post-hospital care by advanced practice nurses
3. Which approaches are among those recommended by the Agency for Healthcare Research and
Quality to improve health literacy in patients? (Select all that apply.)
Empowering patients and families Correct
Repeating the instructions Correct
Supplementing teaching with visual aids Correct
Chapter 003
1. What is the purpose of Level II research?
To describe relationships among characteristics or variables
2. Which is the most appropriate research design for a Level III research study?
Experimental design
3.What is the purpose of clinical research trials in the spectrum of translational research?
Examination of safety and effectiveness of various interventions
Chapter 004
1. The provider learns that a patient is taking herbal supplements for a variety of reasons. What is
an important point to discuss with this patient about taking such supplements?
Many supplements lack clear clinical evidence of efficacy Correct
2. A patient takes glucosamine chondroitin to help control osteoarthritis pain. Which medications,
taken in conjunction with this medication, are of concern?
Blood-thinning agents Correct
3. Which dietary supplements have shown some effectiveness in reducing blood pressure in
patients with hypertension? (Select all that apply.)
CoQ10 Correct
Garlic extract Correct
L-arginine Correct
Test Bank - Chapter 005
,1. The chronic care model (CCM) was developed to manage patients with complicated chronic
conditions because the traditional acute care model could not provide efficient and cost-effective
chronic care.
did not meet longitudinal health care needs for this population. Correct
2. What are functions of patient registries in the chronic care model? (Select all that apply.)
Alerting providers to medication interactions Correct
Recommending routine screenings Correct
Reminding providers about immunizations Correct
Transmitting clinical data about patients Correct
3. Which are key components of the Patient-Centered Medical Home? (Select all that apply.)
Access to care Correct
Comprehensive care Correct
Coordination of care Correct
Test Bank - Chapter 006
1. A primary care provider administers the “Newest Vital Sign” health literacy test to a patient
newly diagnosed with a chronic disease. What information is gained by administering this test?
Ability to calculate data, along with general knowledge about health Correct
2. What is the main reason for using the REALM-SF instrument to evaluate health literacy?
It evaluates medical word recognition. Correct
3. A female patient who is from the Middle East schedules an appointment in a primary care office.
To provide culturally responsive care, what will the clinic personnel do when meeting this patient for the
first time?
Inquire about the patient’s beliefs about health and treatment Correct
Test Bank - Chapter 007
1. A patient expresses concern that she is at risk for breast cancer. To best assess the risk for this
patient, what is the best initial action?
Gather and record a three-generation pedigree Correct
2. A patient asks about direct-to-consumer (DTC) genetic testing. What will the provider tell the
patient?
Much of the information does not predict disease risk.
Test Bank - Chapter 008
1. What is an important part of patient care that can minimize the risk of a formal patient
complaint even when a mistake is made?
Maintaining effective patient communication Correct
2. What are some causes for failures or delays in diagnosing patients resulting in malpractice
claims? (Select all that apply.)
Failing to request appropriate consultations
Not acting on diagnostic test results
Test Bank - Chapter 009
1. Which behavior is most characteristic of early adolescence?
Arguing with parents and teachers
2. What is the initial sign of puberty in the adolescent male?
Testicular enlargement
3. A parent reports that an adolescent child does well in school but seems to consistently make
poor decisions about activities with friends. What will the practitioner recommend as an approach to
help the adolescent make better decisions?
Listening without making suggestions about choices
Test Bank - Chapter 010
, 1. Which is the most important factor limiting access to health care for sexual and gender
minorities?
Laws prohibiting full marriage equality
2. What is the medical diagnostic term used to identify transgender patients?
Gender dysphoria Correct
Test Bank - Chapter 011
1. A woman who is currently pregnant reports that she has had three previous pregnancies: twins
delivered at 35 weeks gestation (both living), one at 38 weeks gestation (living), and one miscarriage at
16 weeks gestation. How will this be recorded as her G/TPAL in her electronic medical record?
G4P:1113
2. A pregnant woman who is overweight has no previous history of hypertension or diabetes. Her
initial screening exam reveals a blood pressure of 140/90 and a fasting blood glucose of 128 mg/dL.
What will the practitioner do?
Monitor blood pressure and fasting blood glucose closely
3. A pregnant woman reports not having had any vaccinations as a child but requests vaccines
during her pregnancy. Which vaccines may be given? (Select all that apply.)
HPV Correct
Inactivated influenza Correct
Tdap Correct
Test Bank - Chapter 012
1. The mother of a 3-day-old newborn reports that her infant nurses every 4 hours during the day
and sleeps 6 hours at night. What will the provider recommend?
Awakening the baby every 3 hours to nurse
2. An infant who has just begun nursing develops hyperbilirubinemia. What will the provider tell
the mother?
To use a breast pump to increase her milk supply
3. A mother who has been breastfeeding her infant for several weeks develops a fever, breast
warmth, and breast tenderness. What will the provider recommend?
Warm packs and increased frequency of nursing
Test Bank - Chapter 013
1. When prescribing medications to an 80-year-old patient, the provider will
consult the Beers list to help identify potentially problematic drugs. Correct
2. An 80-year-old woman who lives alone is noted to have a recent weight loss of 5 pounds. She
appears somewhat confused, according to her daughter, who is concerned that she is developing
dementia. The provider learns that the woman still drives, volunteers at the local hospital, and attends a
book club with several friends once a month. What is the initial step in evaluating this patient?
Obtain a CBC, serum electrolytes, BUN, and glucose Correct
3. The practitioner is establishing a plan for routine health maintenance for a new female client
who is 80 years old. The client has never smoked and has been in good health. What will the practitioner
include in routine care for this patient? (Select all that apply.)
Pneumovax vaccine if not previously given Correct
Yearly influenza vaccine Correct
Test Bank - Chapter 014
1. When should palliative care be initiated by a primary care provider?
As part of routine health maintenance Correct
2. When using the “Five Wishes” approach to documenting patient preferences for end-of-life care,
the provider will document which types of preferences? (Select all that apply.)
How much information to give various family members Correct
