Maryville NR 622 Primary Care II Exam
2 With Actual 120 Questions &
Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
Download Pdf
1. A 55-year-old man presents with chest pain that is relieved by rest. What is the most
likely diagnosis?
a. Myocardial infarction
b. Stable angina
c. Unstable angina
d. Gastroesophageal reflux disease
b. Stable angina
Stable angina is characterized by chest pain during exertion that improves with rest
or nitroglycerin. Unstable angina occurs at rest and is unpredictable.
2. A 62-year-old woman with hypertension presents with ankle edema after starting a
new medication. Which drug is most likely the cause?
a. Lisinopril
b. Amlodipine
c. Hydrochlorothiazide
d. Atenolol
b. Amlodipine
Calcium channel blockers, particularly dihydropyridines like amlodipine, commonly
cause peripheral edema.
3. Which antihypertensive medication is contraindicated in pregnancy?
a. Methyldopa
b. Labetalol
c. ACE inhibitors
, d. Nifedipine
c. ACE inhibitors
ACE inhibitors and ARBs are contraindicated in pregnancy due to risk of fetal renal
damage.
4. Which test is most appropriate to confirm a diagnosis of type 2 diabetes mellitus?
a. Random blood glucose
b. HbA1c
c. Oral glucose tolerance test
d. Fasting blood glucose
b. HbA1c
HbA1c ≥ 6.5% confirms type 2 diabetes; fasting glucose and OGTT are also diagnostic
but HbA1c is most widely used.
5. Which of the following is the first-line pharmacologic therapy for type 2 diabetes
mellitus?
a. Sulfonylureas
b. Metformin
c. Insulin
d. DPP-4 inhibitors
b. Metformin
Metformin is first-line unless contraindicated due to renal or hepatic impairment.
6. A 72-year-old woman presents with fatigue and pallor. Lab results: MCV 72, ferritin
low. What is the likely diagnosis?
a. Iron deficiency anemia
b. Vitamin B12 deficiency
c. Folate deficiency
d. Anemia of chronic disease
a. Iron deficiency anemia
Low MCV and ferritin are consistent with iron deficiency anemia.
7. A patient with COPD presents with worsening shortness of breath and increased
sputum purulence. What is the most appropriate next step?
a. Increase inhaled corticosteroid dose
b. Start oral antibiotics
c. Add leukotriene receptor antagonist
d. Begin systemic anticoagulation
b. Start oral antibiotics
Acute COPD exacerbations with increased sputum purulence and dyspnea warrant
antibiotics in addition to bronchodilators.
, 8. Which of the following vaccines is recommended for all adults age 65 and older?
a. HPV vaccine
b. Pneumococcal vaccine
c. Hepatitis B vaccine
d. Rotavirus vaccine
b. Pneumococcal vaccine
Pneumococcal vaccination is recommended for all adults ≥65 years.
9. A patient with atrial fibrillation and CHA₂DS₂-VASc score of 3 should be started on:
a. Aspirin
b. Clopidogrel
c. Anticoagulation
d. No therapy needed
c. Anticoagulation
Score ≥2 in men or ≥3 in women warrants anticoagulation to reduce stroke risk.
10. Which of the following is the most common cause of secondary hypertension?
a. Pheochromocytoma
b. Chronic kidney disease
c. Cushing’s syndrome
d. Coarctation of the aorta
b. Chronic kidney disease
CKD is the most common secondary cause of hypertension.
11. A 45-year-old man presents with GERD symptoms. First-line management should
include:
a. Omeprazole daily for 8 weeks
b. Lifestyle modifications and antacids
c. H2 blocker PRN
d. Surgical fundoplication
b. Lifestyle modifications and antacids
Initial management of mild GERD focuses on lifestyle changes (weight loss, avoiding
triggers) and antacids before pharmacologic therapy.
12. Which lipid-lowering agent is most effective at reducing LDL cholesterol?
a. Niacin
b. Statins
c. Fibrates
d. Omega-3 fatty acids
b. Statins
Statins are first-line therapy for lowering LDL and reducing cardiovascular risk.
2 With Actual 120 Questions &
Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
Download Pdf
1. A 55-year-old man presents with chest pain that is relieved by rest. What is the most
likely diagnosis?
a. Myocardial infarction
b. Stable angina
c. Unstable angina
d. Gastroesophageal reflux disease
b. Stable angina
Stable angina is characterized by chest pain during exertion that improves with rest
or nitroglycerin. Unstable angina occurs at rest and is unpredictable.
2. A 62-year-old woman with hypertension presents with ankle edema after starting a
new medication. Which drug is most likely the cause?
a. Lisinopril
b. Amlodipine
c. Hydrochlorothiazide
d. Atenolol
b. Amlodipine
Calcium channel blockers, particularly dihydropyridines like amlodipine, commonly
cause peripheral edema.
3. Which antihypertensive medication is contraindicated in pregnancy?
a. Methyldopa
b. Labetalol
c. ACE inhibitors
, d. Nifedipine
c. ACE inhibitors
ACE inhibitors and ARBs are contraindicated in pregnancy due to risk of fetal renal
damage.
4. Which test is most appropriate to confirm a diagnosis of type 2 diabetes mellitus?
a. Random blood glucose
b. HbA1c
c. Oral glucose tolerance test
d. Fasting blood glucose
b. HbA1c
HbA1c ≥ 6.5% confirms type 2 diabetes; fasting glucose and OGTT are also diagnostic
but HbA1c is most widely used.
5. Which of the following is the first-line pharmacologic therapy for type 2 diabetes
mellitus?
a. Sulfonylureas
b. Metformin
c. Insulin
d. DPP-4 inhibitors
b. Metformin
Metformin is first-line unless contraindicated due to renal or hepatic impairment.
6. A 72-year-old woman presents with fatigue and pallor. Lab results: MCV 72, ferritin
low. What is the likely diagnosis?
a. Iron deficiency anemia
b. Vitamin B12 deficiency
c. Folate deficiency
d. Anemia of chronic disease
a. Iron deficiency anemia
Low MCV and ferritin are consistent with iron deficiency anemia.
7. A patient with COPD presents with worsening shortness of breath and increased
sputum purulence. What is the most appropriate next step?
a. Increase inhaled corticosteroid dose
b. Start oral antibiotics
c. Add leukotriene receptor antagonist
d. Begin systemic anticoagulation
b. Start oral antibiotics
Acute COPD exacerbations with increased sputum purulence and dyspnea warrant
antibiotics in addition to bronchodilators.
, 8. Which of the following vaccines is recommended for all adults age 65 and older?
a. HPV vaccine
b. Pneumococcal vaccine
c. Hepatitis B vaccine
d. Rotavirus vaccine
b. Pneumococcal vaccine
Pneumococcal vaccination is recommended for all adults ≥65 years.
9. A patient with atrial fibrillation and CHA₂DS₂-VASc score of 3 should be started on:
a. Aspirin
b. Clopidogrel
c. Anticoagulation
d. No therapy needed
c. Anticoagulation
Score ≥2 in men or ≥3 in women warrants anticoagulation to reduce stroke risk.
10. Which of the following is the most common cause of secondary hypertension?
a. Pheochromocytoma
b. Chronic kidney disease
c. Cushing’s syndrome
d. Coarctation of the aorta
b. Chronic kidney disease
CKD is the most common secondary cause of hypertension.
11. A 45-year-old man presents with GERD symptoms. First-line management should
include:
a. Omeprazole daily for 8 weeks
b. Lifestyle modifications and antacids
c. H2 blocker PRN
d. Surgical fundoplication
b. Lifestyle modifications and antacids
Initial management of mild GERD focuses on lifestyle changes (weight loss, avoiding
triggers) and antacids before pharmacologic therapy.
12. Which lipid-lowering agent is most effective at reducing LDL cholesterol?
a. Niacin
b. Statins
c. Fibrates
d. Omega-3 fatty acids
b. Statins
Statins are first-line therapy for lowering LDL and reducing cardiovascular risk.
