Primary Care Interprofessional Collaborative Practice 6th
Edition questions and answers (over 100 questions and
answers)
Topic 1: Health Promotion & Disease Prevention
1. A 55-year-old asymptomatic patient with no significant medical history presents for an annual
physical. According to the USPSTF guidelines, which screening should the provider prioritize?
a. Annual lipid panel
b. Colonoscopy every 5 years
c. One-time screening for abdominal aortic aneurysm
d. PSA screening for prostate cancer
Answer: c. One-time screening for abdominal aortic aneurysm
Rationale: The USPSTF recommends one-time screening for abdominal aortic aneurysm with
ultrasonography in men aged 65-75 who have ever smoked. While the patient is 55, if risk factors are
present, this is a key consideration. Lipid screening is recommended every 5 years for low-risk patients,
not annually.
2. A 45-year-old woman with a body mass index (BMI) of 32 kg/m² presents for a wellness visit. She has
no other comorbidities. What is the most appropriate intervention?
a. Refer for bariatric surgery consultation
b. Prescribe orlistat for weight loss
c. Offer intensive behavioral counseling interventions
d. Advise that no intervention is needed until BMI exceeds 35
Answer: c. Offer intensive behavioral counseling interventions
Rationale: The USPSTF recommends intensive, multicomponent behavioral counseling for adults with a
BMI of 30 or higher. Pharmacotherapy and surgery are considered when behavioral interventions fail or
with comorbidities.
,3. A 68-year-old female patient has a 30-pack-year smoking history and quit 10 years ago. She has no
cardiovascular or respiratory symptoms. Which screening should be offered?
a. Annual chest x-ray
b. Low-dose computed tomography (LDCT) annually
c. Spirometry every 2 years
d. No screening is indicated
Answer: b. Low-dose computed tomography (LDCT) annually
Rationale: USPSTF criteria for lung cancer screening: age 50-80, 20+ pack-year history, currently smoke or
quit within 15 years. This patient meets criteria and should undergo annual LDCT.
4. A sexually active 22-year-old woman requests contraception. She has no contraindications to any
method. According to the USPSTF, which service should be provided at this visit?
a. Chlamydia screening
b. HIV screening
c. Both chlamydia and HIV screening
d. Neither screening is indicated at this visit
Answer: c. Both chlamydia and HIV screening
Rationale: The USPSTF recommends chlamydia screening for all sexually active women aged 24 and
younger, and HIV screening for all individuals aged 15-65 regardless of risk.
5. A 50-year-old African American male with a history of hypertension presents for a physical. Which
additional screening is most important based on his demographic profile?
a. Vitamin D deficiency
b. Hepatitis C
,c. Type 2 diabetes
d. Osteoporosis
Answer: c. Type 2 diabetes
Rationale: The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 40-70
who are overweight or obese. African American ethnicity is a risk factor for diabetes.
Topic 2: Chronic Disease Management
6. A 65-year-old patient with type 2 diabetes has a blood pressure of 142/88 mm Hg on two separate
visits. She is already on metformin 1000 mg twice daily. What is the next most appropriate step?
a. Add a statin
b. Initiate an ACE inhibitor or ARB
c. Recommend a low-sodium diet and recheck in 3 months
d. Increase metformin to 2000 mg twice daily
Answer: b. Initiate an ACE inhibitor or ARB
Rationale: For patients with diabetes and blood pressure ≥140/90, pharmacotherapy is indicated. ACE
inhibitors or ARBs are first-line due to renoprotective effects.
7. A 72-year-old patient with heart failure with reduced ejection fraction (HFrEF) presents with
worsening dyspnea and 3+ pitting edema. He is on lisinopril, carvedilol, and furosemide. What is the
most appropriate next step?
a. Increase carvedilol dose
b. Add spironolactone
c. Increase furosemide dose
d. Discontinue lisinopril
, Answer: c. Increase furosemide dose
Rationale: Worsening volume overload in HFrEF requires diuretic adjustment first to manage symptoms.
Guideline-directed medical therapy (GDMT) should be optimized once euvolemia is achieved.
8. A patient with COPD has an FEV1 of 55% predicted, with frequent exacerbations (2 in the past year).
According to GOLD guidelines, which maintenance regimen is most appropriate?
a. Short-acting beta-agonist (SABA) as needed only
b. Long-acting beta-agonist (LABA) alone
c. LABA + long-acting muscarinic antagonist (LAMA)
d. Inhaled corticosteroid (ICS) alone
Answer: c. LABA + LAMA
Rationale: GOLD Group E (exacerbation-prone) patients benefit from LABA+LAMA dual bronchodilation.
ICS is added if eosinophils are elevated or with asthma features.
9. A 60-year-old patient with stage 3 chronic kidney disease (eGFR 45 mL/min) has a potassium level of
5.6 mEq/L. He takes lisinopril 20 mg daily. What is the most appropriate action?
a. Continue lisinopril and add furosemide
b. Discontinue lisinopril and repeat potassium in 1 week
c. Increase lisinopril to 40 mg daily
d. Add spironolactone
Answer: b. Discontinue lisinopril and repeat potassium in 1 week
Rationale: ACE inhibitors can cause hyperkalemia in CKD. With potassium >5.5, the ACE inhibitor should
be held or reduced. Spironolactone would worsen hyperkalemia.
10. A patient with rheumatoid arthritis on methotrexate presents with a dry cough and dyspnea on
exertion. What is the most likely diagnosis?
Edition questions and answers (over 100 questions and
answers)
Topic 1: Health Promotion & Disease Prevention
1. A 55-year-old asymptomatic patient with no significant medical history presents for an annual
physical. According to the USPSTF guidelines, which screening should the provider prioritize?
a. Annual lipid panel
b. Colonoscopy every 5 years
c. One-time screening for abdominal aortic aneurysm
d. PSA screening for prostate cancer
Answer: c. One-time screening for abdominal aortic aneurysm
Rationale: The USPSTF recommends one-time screening for abdominal aortic aneurysm with
ultrasonography in men aged 65-75 who have ever smoked. While the patient is 55, if risk factors are
present, this is a key consideration. Lipid screening is recommended every 5 years for low-risk patients,
not annually.
2. A 45-year-old woman with a body mass index (BMI) of 32 kg/m² presents for a wellness visit. She has
no other comorbidities. What is the most appropriate intervention?
a. Refer for bariatric surgery consultation
b. Prescribe orlistat for weight loss
c. Offer intensive behavioral counseling interventions
d. Advise that no intervention is needed until BMI exceeds 35
Answer: c. Offer intensive behavioral counseling interventions
Rationale: The USPSTF recommends intensive, multicomponent behavioral counseling for adults with a
BMI of 30 or higher. Pharmacotherapy and surgery are considered when behavioral interventions fail or
with comorbidities.
,3. A 68-year-old female patient has a 30-pack-year smoking history and quit 10 years ago. She has no
cardiovascular or respiratory symptoms. Which screening should be offered?
a. Annual chest x-ray
b. Low-dose computed tomography (LDCT) annually
c. Spirometry every 2 years
d. No screening is indicated
Answer: b. Low-dose computed tomography (LDCT) annually
Rationale: USPSTF criteria for lung cancer screening: age 50-80, 20+ pack-year history, currently smoke or
quit within 15 years. This patient meets criteria and should undergo annual LDCT.
4. A sexually active 22-year-old woman requests contraception. She has no contraindications to any
method. According to the USPSTF, which service should be provided at this visit?
a. Chlamydia screening
b. HIV screening
c. Both chlamydia and HIV screening
d. Neither screening is indicated at this visit
Answer: c. Both chlamydia and HIV screening
Rationale: The USPSTF recommends chlamydia screening for all sexually active women aged 24 and
younger, and HIV screening for all individuals aged 15-65 regardless of risk.
5. A 50-year-old African American male with a history of hypertension presents for a physical. Which
additional screening is most important based on his demographic profile?
a. Vitamin D deficiency
b. Hepatitis C
,c. Type 2 diabetes
d. Osteoporosis
Answer: c. Type 2 diabetes
Rationale: The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 40-70
who are overweight or obese. African American ethnicity is a risk factor for diabetes.
Topic 2: Chronic Disease Management
6. A 65-year-old patient with type 2 diabetes has a blood pressure of 142/88 mm Hg on two separate
visits. She is already on metformin 1000 mg twice daily. What is the next most appropriate step?
a. Add a statin
b. Initiate an ACE inhibitor or ARB
c. Recommend a low-sodium diet and recheck in 3 months
d. Increase metformin to 2000 mg twice daily
Answer: b. Initiate an ACE inhibitor or ARB
Rationale: For patients with diabetes and blood pressure ≥140/90, pharmacotherapy is indicated. ACE
inhibitors or ARBs are first-line due to renoprotective effects.
7. A 72-year-old patient with heart failure with reduced ejection fraction (HFrEF) presents with
worsening dyspnea and 3+ pitting edema. He is on lisinopril, carvedilol, and furosemide. What is the
most appropriate next step?
a. Increase carvedilol dose
b. Add spironolactone
c. Increase furosemide dose
d. Discontinue lisinopril
, Answer: c. Increase furosemide dose
Rationale: Worsening volume overload in HFrEF requires diuretic adjustment first to manage symptoms.
Guideline-directed medical therapy (GDMT) should be optimized once euvolemia is achieved.
8. A patient with COPD has an FEV1 of 55% predicted, with frequent exacerbations (2 in the past year).
According to GOLD guidelines, which maintenance regimen is most appropriate?
a. Short-acting beta-agonist (SABA) as needed only
b. Long-acting beta-agonist (LABA) alone
c. LABA + long-acting muscarinic antagonist (LAMA)
d. Inhaled corticosteroid (ICS) alone
Answer: c. LABA + LAMA
Rationale: GOLD Group E (exacerbation-prone) patients benefit from LABA+LAMA dual bronchodilation.
ICS is added if eosinophils are elevated or with asthma features.
9. A 60-year-old patient with stage 3 chronic kidney disease (eGFR 45 mL/min) has a potassium level of
5.6 mEq/L. He takes lisinopril 20 mg daily. What is the most appropriate action?
a. Continue lisinopril and add furosemide
b. Discontinue lisinopril and repeat potassium in 1 week
c. Increase lisinopril to 40 mg daily
d. Add spironolactone
Answer: b. Discontinue lisinopril and repeat potassium in 1 week
Rationale: ACE inhibitors can cause hyperkalemia in CKD. With potassium >5.5, the ACE inhibitor should
be held or reduced. Spironolactone would worsen hyperkalemia.
10. A patient with rheumatoid arthritis on methotrexate presents with a dry cough and dyspnea on
exertion. What is the most likely diagnosis?
