Maryville NR 620 Primary Care I Exam
2 With Actual 120 Questions &
Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
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Maryville NR 620 Primary Care I – Exam 2
1. A 45-year-old woman presents with fatigue and pallor. Labs reveal microcytic,
hypochromic anemia. What is the most likely cause?
a. Vitamin B12 deficiency
b. Folic acid deficiency
c. Iron deficiency
d. Aplastic anemia
Rationale: Iron deficiency is the most common cause of microcytic, hypochromic
anemia due to decreased hemoglobin production.
2. A 22-year-old college student presents with sore throat, fever, and posterior cervical
lymphadenopathy. Which test is most appropriate?
a. Rapid strep test
b. Monospot test
c. Throat culture
d. CBC only
Rationale: Mononucleosis is suspected; the Monospot test detects heterophile
antibodies.
3. Which medication is first-line therapy for hypertension in a patient with diabetes?
a. Thiazide diuretic
b. Calcium channel blocker
c. ACE inhibitor
, d. Beta-blocker
Rationale: ACE inhibitors are preferred in diabetics because they protect renal
function.
4. A 30-year-old woman presents with dysuria, frequency, and urgency. Urine dipstick
shows leukocyte esterase and nitrites. What is the best treatment?
a. Trimethoprim-sulfamethoxazole
b. Ciprofloxacin
c. Nitrofurantoin for 7 days
d. Amoxicillin
Rationale: TMP-SMX is first-line therapy for uncomplicated cystitis unless
resistance rates are high.
5. A patient with asthma uses albuterol more than twice weekly. What is the next step
in management?
a. Increase albuterol use
b. Start an inhaled corticosteroid
c. Add theophylline
d. Add leukotriene inhibitor
Rationale: Inhaled corticosteroids are added when asthma symptoms occur more
than 2 days per week.
6. Which murmur is associated with rheumatic fever?
a. Aortic stenosis
b. Aortic regurgitation
c. Mitral stenosis
d. Mitral valve prolapse
Rationale: Rheumatic fever classically leads to mitral stenosis due to valvular
scarring.
7. A 65-year-old male presents with unilateral temporal headache and jaw claudication.
ESR is elevated. What is the most appropriate next step?
a. CT scan of the head
b. Start prednisone immediately
c. Temporal artery biopsy first
d. MRI brain
Rationale: Temporal arteritis requires immediate steroids to prevent vision loss.
8. Which vaccine is recommended for adults aged 65 and older?
a. Varicella vaccine
b. Pneumococcal vaccine
c. Hepatitis A vaccine
d. MMR vaccine
, Rationale: Pneumococcal vaccination is recommended for adults ≥65 years to
reduce pneumonia risk.
9. A patient with COPD has an FEV1/FVC ratio <70%. What medication is first-line for
symptom control?
a. Inhaled corticosteroids
b. Short-acting bronchodilator
c. Long-acting beta agonist
d. Systemic corticosteroids
Rationale: Short-acting bronchodilators (albuterol or ipratropium) are first-line for
COPD symptom relief.
10. Which of the following is the hallmark finding in gout?
a. Joint warmth and redness
b. Negatively birefringent urate crystals
c. Joint space narrowing
d. Positive ANA
Rationale: Polarized microscopy showing negatively birefringent monosodium
urate crystals confirms gout.
11. A 40-year-old woman presents with fatigue, weight gain, and constipation. Exam
shows dry skin and bradycardia. Labs reveal elevated TSH and low free T4. What is
the most likely diagnosis?
a. Hyperthyroidism
b. Subclinical hypothyroidism
c. Primary hypothyroidism
d. Secondary hypothyroidism
Rationale: Elevated TSH with low T4 indicates primary hypothyroidism, most
commonly due to Hashimoto’s thyroiditis.
12. Which lipid-lowering medication is contraindicated in pregnancy?
a. Bile acid sequestrants
b. Statins
c. Ezetimibe
d. Fish oil
Rationale: Statins are teratogenic and should not be used during pregnancy.
13. A 55-year-old man presents with sudden onset severe chest pain radiating to his
back. BP is unequal in both arms. What is the most likely diagnosis?
a. Myocardial infarction
b. Pulmonary embolism
c. Aortic dissection
d. Pericarditis
2 With Actual 120 Questions &
Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
Download Pdf
Maryville NR 620 Primary Care I – Exam 2
1. A 45-year-old woman presents with fatigue and pallor. Labs reveal microcytic,
hypochromic anemia. What is the most likely cause?
a. Vitamin B12 deficiency
b. Folic acid deficiency
c. Iron deficiency
d. Aplastic anemia
Rationale: Iron deficiency is the most common cause of microcytic, hypochromic
anemia due to decreased hemoglobin production.
2. A 22-year-old college student presents with sore throat, fever, and posterior cervical
lymphadenopathy. Which test is most appropriate?
a. Rapid strep test
b. Monospot test
c. Throat culture
d. CBC only
Rationale: Mononucleosis is suspected; the Monospot test detects heterophile
antibodies.
3. Which medication is first-line therapy for hypertension in a patient with diabetes?
a. Thiazide diuretic
b. Calcium channel blocker
c. ACE inhibitor
, d. Beta-blocker
Rationale: ACE inhibitors are preferred in diabetics because they protect renal
function.
4. A 30-year-old woman presents with dysuria, frequency, and urgency. Urine dipstick
shows leukocyte esterase and nitrites. What is the best treatment?
a. Trimethoprim-sulfamethoxazole
b. Ciprofloxacin
c. Nitrofurantoin for 7 days
d. Amoxicillin
Rationale: TMP-SMX is first-line therapy for uncomplicated cystitis unless
resistance rates are high.
5. A patient with asthma uses albuterol more than twice weekly. What is the next step
in management?
a. Increase albuterol use
b. Start an inhaled corticosteroid
c. Add theophylline
d. Add leukotriene inhibitor
Rationale: Inhaled corticosteroids are added when asthma symptoms occur more
than 2 days per week.
6. Which murmur is associated with rheumatic fever?
a. Aortic stenosis
b. Aortic regurgitation
c. Mitral stenosis
d. Mitral valve prolapse
Rationale: Rheumatic fever classically leads to mitral stenosis due to valvular
scarring.
7. A 65-year-old male presents with unilateral temporal headache and jaw claudication.
ESR is elevated. What is the most appropriate next step?
a. CT scan of the head
b. Start prednisone immediately
c. Temporal artery biopsy first
d. MRI brain
Rationale: Temporal arteritis requires immediate steroids to prevent vision loss.
8. Which vaccine is recommended for adults aged 65 and older?
a. Varicella vaccine
b. Pneumococcal vaccine
c. Hepatitis A vaccine
d. MMR vaccine
, Rationale: Pneumococcal vaccination is recommended for adults ≥65 years to
reduce pneumonia risk.
9. A patient with COPD has an FEV1/FVC ratio <70%. What medication is first-line for
symptom control?
a. Inhaled corticosteroids
b. Short-acting bronchodilator
c. Long-acting beta agonist
d. Systemic corticosteroids
Rationale: Short-acting bronchodilators (albuterol or ipratropium) are first-line for
COPD symptom relief.
10. Which of the following is the hallmark finding in gout?
a. Joint warmth and redness
b. Negatively birefringent urate crystals
c. Joint space narrowing
d. Positive ANA
Rationale: Polarized microscopy showing negatively birefringent monosodium
urate crystals confirms gout.
11. A 40-year-old woman presents with fatigue, weight gain, and constipation. Exam
shows dry skin and bradycardia. Labs reveal elevated TSH and low free T4. What is
the most likely diagnosis?
a. Hyperthyroidism
b. Subclinical hypothyroidism
c. Primary hypothyroidism
d. Secondary hypothyroidism
Rationale: Elevated TSH with low T4 indicates primary hypothyroidism, most
commonly due to Hashimoto’s thyroiditis.
12. Which lipid-lowering medication is contraindicated in pregnancy?
a. Bile acid sequestrants
b. Statins
c. Ezetimibe
d. Fish oil
Rationale: Statins are teratogenic and should not be used during pregnancy.
13. A 55-year-old man presents with sudden onset severe chest pain radiating to his
back. BP is unequal in both arms. What is the most likely diagnosis?
a. Myocardial infarction
b. Pulmonary embolism
c. Aortic dissection
d. Pericarditis
