ITE TEST BANK REALISTIC PRACTICE
QUESTIONS, ACCURATE ANSWERS,
EXAM-READY SOLUTIONS UPDATED
2026 GRADED A+
,1
A 67-year-old male sees you for a Medicare annual wellness visit. He tells you
that his best friend had a stroke and he asks about his risk for stroke. He has no
history of stroke, TIA, or neurologic symptoms. He has a family history of
cardiovascular disease in his father, who had a myocardial infarction at age 65
and died from a thrombotic stroke at age 71. The patient exercises regularly and
has a BMI of 27 kg/m2. His only current medical condition is hyperlipidemia,
and his cholesterol level is at goal on rosuvastatin (Crestor), 10 mg daily. He
also takes aspirin, 81 mg daily. His blood pressure is 125/78 mm Hg.
Based on U.S. Preventive Services Task Force guidelines, which one of the
following would be most appropriate at this time?
A) No additional testing for stroke risk
B) Auscultation for carotid bruits
C) Carotid duplex ultrasonography
D) Magnetic resonance angiography
E) CT angiography of the carotid art - CORRECT ANSWER -A. Carotid
artery disease affects extracranial carotid arteries and is caused by
atherosclerosis. This patient is asymptomatic and has no history of an ischemic
stroke, neurologic symptoms referable to the carotid arteries such as amaurosis
fugax, or TIA. He has risk factors for cardiovascular disease (age, male sex,
hyperlipidemia), but the U.S. Preventive Services Task Force recommends
against specific screening for asymptomatic carotid artery stenosis (D
recommendation), which has a low prevalence in the general adult population.
Stroke is a leading cause of disability and death in the United States, but
asymptomatic carotid artery stenosis causes a relatively small proportion of
strokes. Auscultation of the carotid arteries for bruits has been found to have
,poor accuracy for detecting carotid stenosis and is not a reasonable screening
approach. Appropriate modalities for detecting carotid stenosis include carotid
duplex ultrasonography, magnetic resonance angiography, and computed
tomography, but these are not recommended for screening asymptomatic
patients.
Ref: Final Recommendation Statement: Screening for Asymptomatic Carotid
Artery Stenosis. US Preventive Services Task Force, 2021.
2
A 28-year-old female presents for evaluation of nasal congestion, sneezing,
watery eyes, and postnasal drip. This has been an intermittent issue for her
every spring and she would like to manage it more effectively.
Which one of the following treatments has been shown to be the most effective
and best tolerated first-line therapy for this patient's condition?
A) A leukotriene receptor antagonist
B) Intranasal corticosteroid monotherapy
C) Intranasal corticosteroids plus an oral antihistamine
D) Inhaled corticosteroids
E) Annual triamcinolone injections - CORRECT ANSWER -B. This patient
has seasonal allergic rhinitis. A joint guideline statement from the American
Academy of Allergy, Asthma, and Immunology/American College of Allergy,
Asthma, and Immunology Joint Task Force on Practice Parameters recommends
that monotherapy with intranasal corticosteroids should be prescribed initially
in patients 12 years of age rather than combined treatment with oral
antihistamines because data has not shown an additional benefit to adding the
, antihistamine. Higher patient adherence and tolerance and fewer side effects
were seen with the monotherapy regimen. High-quality evidence indicates that
intranasal corticosteroids were more effective than leukotriene receptor
antagonists. Inhaled corticosteroids and triamcinolone injections are not
appropriate first-line options for the treatment of seasonal allergic rhinitis.
Ref: Hauk L: Treatment of seasonal allergic rhinitis: A guideline from the
AAAAI/ACAAI Joint Task Force on Practice Parameters. Am Fam Physician
2018;97(11):756-757.
3
A 68-year-old female presents with a 2-month history of watery diarrhea. She
has not had any blood or pus in her stools, and the stools are not oily. She has
not had any history of fever, chills, or weight loss, and has not traveled recently.
She smokes one pack of cigarettes per day. Her medications include ibuprofen,
sertraline (Zoloft), and pantoprazole (Protonix). A CBC, metabolic panel, C-
reactive protein level, IgA anti-tissue transglutaminase level, total IgA level,
and stool guaiac test are all normal.
Which one of the following tests would be most likely to yield a diagnosis?
A) Clostridioides (Clostridium) difficile toxin
B) Colonoscopy
C) Fecal calprotectin
D) A stool culture
E) Stool examination for ova and parasites - CORRECT ANSWER -B. In
patients with chronic nonbloody diarrhea, the differential diagnosis includes
microscopic (lymphocytic or collagenous) colitis. The mucosa appears normal
QUESTIONS, ACCURATE ANSWERS,
EXAM-READY SOLUTIONS UPDATED
2026 GRADED A+
,1
A 67-year-old male sees you for a Medicare annual wellness visit. He tells you
that his best friend had a stroke and he asks about his risk for stroke. He has no
history of stroke, TIA, or neurologic symptoms. He has a family history of
cardiovascular disease in his father, who had a myocardial infarction at age 65
and died from a thrombotic stroke at age 71. The patient exercises regularly and
has a BMI of 27 kg/m2. His only current medical condition is hyperlipidemia,
and his cholesterol level is at goal on rosuvastatin (Crestor), 10 mg daily. He
also takes aspirin, 81 mg daily. His blood pressure is 125/78 mm Hg.
Based on U.S. Preventive Services Task Force guidelines, which one of the
following would be most appropriate at this time?
A) No additional testing for stroke risk
B) Auscultation for carotid bruits
C) Carotid duplex ultrasonography
D) Magnetic resonance angiography
E) CT angiography of the carotid art - CORRECT ANSWER -A. Carotid
artery disease affects extracranial carotid arteries and is caused by
atherosclerosis. This patient is asymptomatic and has no history of an ischemic
stroke, neurologic symptoms referable to the carotid arteries such as amaurosis
fugax, or TIA. He has risk factors for cardiovascular disease (age, male sex,
hyperlipidemia), but the U.S. Preventive Services Task Force recommends
against specific screening for asymptomatic carotid artery stenosis (D
recommendation), which has a low prevalence in the general adult population.
Stroke is a leading cause of disability and death in the United States, but
asymptomatic carotid artery stenosis causes a relatively small proportion of
strokes. Auscultation of the carotid arteries for bruits has been found to have
,poor accuracy for detecting carotid stenosis and is not a reasonable screening
approach. Appropriate modalities for detecting carotid stenosis include carotid
duplex ultrasonography, magnetic resonance angiography, and computed
tomography, but these are not recommended for screening asymptomatic
patients.
Ref: Final Recommendation Statement: Screening for Asymptomatic Carotid
Artery Stenosis. US Preventive Services Task Force, 2021.
2
A 28-year-old female presents for evaluation of nasal congestion, sneezing,
watery eyes, and postnasal drip. This has been an intermittent issue for her
every spring and she would like to manage it more effectively.
Which one of the following treatments has been shown to be the most effective
and best tolerated first-line therapy for this patient's condition?
A) A leukotriene receptor antagonist
B) Intranasal corticosteroid monotherapy
C) Intranasal corticosteroids plus an oral antihistamine
D) Inhaled corticosteroids
E) Annual triamcinolone injections - CORRECT ANSWER -B. This patient
has seasonal allergic rhinitis. A joint guideline statement from the American
Academy of Allergy, Asthma, and Immunology/American College of Allergy,
Asthma, and Immunology Joint Task Force on Practice Parameters recommends
that monotherapy with intranasal corticosteroids should be prescribed initially
in patients 12 years of age rather than combined treatment with oral
antihistamines because data has not shown an additional benefit to adding the
, antihistamine. Higher patient adherence and tolerance and fewer side effects
were seen with the monotherapy regimen. High-quality evidence indicates that
intranasal corticosteroids were more effective than leukotriene receptor
antagonists. Inhaled corticosteroids and triamcinolone injections are not
appropriate first-line options for the treatment of seasonal allergic rhinitis.
Ref: Hauk L: Treatment of seasonal allergic rhinitis: A guideline from the
AAAAI/ACAAI Joint Task Force on Practice Parameters. Am Fam Physician
2018;97(11):756-757.
3
A 68-year-old female presents with a 2-month history of watery diarrhea. She
has not had any blood or pus in her stools, and the stools are not oily. She has
not had any history of fever, chills, or weight loss, and has not traveled recently.
She smokes one pack of cigarettes per day. Her medications include ibuprofen,
sertraline (Zoloft), and pantoprazole (Protonix). A CBC, metabolic panel, C-
reactive protein level, IgA anti-tissue transglutaminase level, total IgA level,
and stool guaiac test are all normal.
Which one of the following tests would be most likely to yield a diagnosis?
A) Clostridioides (Clostridium) difficile toxin
B) Colonoscopy
C) Fecal calprotectin
D) A stool culture
E) Stool examination for ova and parasites - CORRECT ANSWER -B. In
patients with chronic nonbloody diarrhea, the differential diagnosis includes
microscopic (lymphocytic or collagenous) colitis. The mucosa appears normal
