NSG 6440 Final Mastery Assessment Primary Care of the
Family / Adult-Gerontology Primary Care Actual Exam
Spring 2026/2027 – Complete Questions and Detailed
Rationales – Pass Guaranteed – A+ Graded
Section 1: Health Maintenance, Screening & Prevention (Questions
1–20)
Q1: A healthy 58-year-old woman with no personal history of cancer asks which
screenings are backed by USPSTF Grade A evidence. Which recommendation fits that
criteria?
A. Annual screening mammography starting at age 40
B. Low-dose CT for lung cancer (she has no smoking history)
C. Colorectal cancer screening with colonoscopy every 10 years [CORRECT]
D. Serum CA-125 testing for ovarian cancer
Correct Answer: C
Rationale: The best answer is C because colorectal cancer screening for adults aged 50
to 75 is a USPSTF Grade A recommendation. Mammography (A) is Grade B for
average-risk women, lung cancer screening (B) only applies to adults with a 20
pack-year history, and ovarian cancer screening (D) has a Grade D recommendation
against routine use.
Q2: You are reviewing the immunization record of a 68-year-old man who received Tdap
at age 50. He has no chronic conditions. Which immunization is most appropriate to
administer today?
A. Pneumococcal polysaccharide vaccine (PPSV23) only
B. Tetanus and diphtheria toxoids (Td) booster
,C. Tetanus, diphtheria, and pertussis (Tdap) booster
D. Pneumococcal conjugate vaccine (PCV20) [CORRECT]
Correct Answer: D
Rationale: The best answer is D because all adults aged 65 and older should receive one
dose of PCV20 (or PCV15 followed by PPSV23). A Td or Tdap booster (B or C) is not due
until 10 years after the last tetanus-containing vaccine, and PPSV23 alone (A) is not the
preferred strategy per current ACIP guidelines.
Q3: A 45-year-old woman with a BMI of 32 and a family history of diabetes in her mother
asks about diabetes screening. Her blood pressure is 118/76 mmHg and she feels well.
What does the USPSTF recommend?
A. Screening only if she develops symptoms of hyperglycemia
B. Screening beginning now and repeating every 3 years [CORRECT]
C. Screening beginning at age 50 regardless of risk factors
D. Screening with HbA1c only; fasting glucose is not acceptable
Correct Answer: B
Rationale: The best answer is B because the USPSTF recommends screening for
prediabetes and type 2 diabetes in adults aged 35 to 70 who are overweight or obese,
with repeat screening every 3 years if results are normal. Waiting for symptoms (A)
misses the point of screening, age 50 (C) is incorrect, and either HbA1c or fasting
glucose (D) are acceptable screening tests.
Q4: A 19-year-old college student presents for a routine physical before starting school.
She received her childhood immunizations on schedule but has not had any vaccines
since age 12. Which vaccine is specifically recommended for her age group today?
A. Herpes zoster (Shingrix) vaccine
B. Meningococcal conjugate (MenACWY) booster [CORRECT]
C. Pneumococcal conjugate (PCV15) vaccine
D. Hepatitis A vaccine series
Correct Answer: B
Rationale: The best answer is B because adolescents should receive a booster dose of
MenACWY at age 16, and if missed, should receive it before college entry. Shingrix (A) is
for adults 50 and older, PCV15 (C) is for adults 65+ or those with risk factors, and
hepatitis A (D) is only for those with specific risk factors or upon request.
,Q5: During a well-child visit, the parents of a 12-month-old ask about the hepatitis A
vaccine. Which statement best reflects current CDC recommendations?
A. It is given only to children traveling internationally
B. It is administered as a 2-dose series starting at 12 months [CORRECT]
C. It is optional and not part of the routine childhood schedule
D. It is given as a 3-dose series along with hepatitis B
Correct Answer: B
Rationale: The best answer is B because the hepatitis A vaccine is routinely
recommended as a 2-dose series, with the first dose given at 12 through 23 months of
age. It is not just for travel (A), it is not optional (C), and it is a 2-dose series, not 3-dose
(D).
Q6: A 52-year-old man with a 30 pack-year smoking history quit smoking 2 years ago.
He is otherwise healthy. Which screening test should you recommend?
A. Annual chest X-ray
B. Low-dose CT scan of the chest [CORRECT]
C. Sputum cytology every 6 months
D. No screening needed since he quit smoking
Correct Answer: B
Rationale: The best answer is B because the USPSTF recommends annual low-dose CT
for lung cancer screening in adults aged 50 to 80 with a 20 pack-year or greater
smoking history who currently smoke or quit within the past 15 years. Chest X-ray (A)
and sputum cytology (C) are not recommended, and screening is still indicated (D) since
he quit only 2 years ago.
Q7: A 35-year-old woman presents for her annual exam. She has no family history of
breast cancer and is asymptomatic. According to the most current USPSTF
recommendation, at what age should biennial screening mammography begin for
average-risk women?
A. Age 40 [CORRECT]
B. Age 45
C. Age 50
D. Age 55
Correct Answer: A
, Rationale: The best answer is A because the USPSTF now recommends biennial
screening mammography for all average-risk women starting at age 40 and continuing
through age 74. Starting at 50 (C) was the older recommendation, and 45 (B) or 55 (D)
do not match current Grade B guidance.
Q8: A 70-year-old woman with osteoporosis (T-score -2.8) asks how often she should
have a follow-up DXA scan if her treatment remains unchanged. What do current
guidelines suggest?
A. Every 6 months to monitor response
B. Every 1 to 2 years [CORRECT]
C. Every 5 years since she is already on treatment
D. Only repeat if she has a new fracture
Correct Answer: B
Rationale: The best answer is B because for patients being monitored for osteoporosis
treatment response, DXA is typically repeated every 1 to 2 years to assess changes in
bone mineral density. Every 6 months (A) is too frequent, every 5 years (C) is too long
for active monitoring, and waiting for a fracture (D) defeats the purpose of monitoring.
Q9: A 16-year-old patient asks about HPV vaccination. She has not received any HPV
doses. Which statement is most accurate?
A. She is too old to start the series and will not benefit
B. She should receive a 2-dose series if started before age 15, but a 3-dose series if
started at age 15 or older [CORRECT]
C. HPV vaccine is only recommended for females
D. She needs only 1 dose since she is already sexually active
Correct Answer: B
Rationale: The best answer is B because the HPV vaccine schedule depends on the age
at initiation: those starting before age 15 need 2 doses, while those starting at age 15 or
older need 3 doses. She is not too old (A)—vaccination is recommended through age 26,
it is for all genders (C), and sexual activity (D) does not reduce the dose requirement.
Q10: A 42-year-old man with no chronic conditions asks about screening for abdominal
aortic aneurysm (AAA). He has never smoked. What is the USPSTF recommendation?
A. One-time ultrasound at age 45
B. One-time ultrasound at age 65
Family / Adult-Gerontology Primary Care Actual Exam
Spring 2026/2027 – Complete Questions and Detailed
Rationales – Pass Guaranteed – A+ Graded
Section 1: Health Maintenance, Screening & Prevention (Questions
1–20)
Q1: A healthy 58-year-old woman with no personal history of cancer asks which
screenings are backed by USPSTF Grade A evidence. Which recommendation fits that
criteria?
A. Annual screening mammography starting at age 40
B. Low-dose CT for lung cancer (she has no smoking history)
C. Colorectal cancer screening with colonoscopy every 10 years [CORRECT]
D. Serum CA-125 testing for ovarian cancer
Correct Answer: C
Rationale: The best answer is C because colorectal cancer screening for adults aged 50
to 75 is a USPSTF Grade A recommendation. Mammography (A) is Grade B for
average-risk women, lung cancer screening (B) only applies to adults with a 20
pack-year history, and ovarian cancer screening (D) has a Grade D recommendation
against routine use.
Q2: You are reviewing the immunization record of a 68-year-old man who received Tdap
at age 50. He has no chronic conditions. Which immunization is most appropriate to
administer today?
A. Pneumococcal polysaccharide vaccine (PPSV23) only
B. Tetanus and diphtheria toxoids (Td) booster
,C. Tetanus, diphtheria, and pertussis (Tdap) booster
D. Pneumococcal conjugate vaccine (PCV20) [CORRECT]
Correct Answer: D
Rationale: The best answer is D because all adults aged 65 and older should receive one
dose of PCV20 (or PCV15 followed by PPSV23). A Td or Tdap booster (B or C) is not due
until 10 years after the last tetanus-containing vaccine, and PPSV23 alone (A) is not the
preferred strategy per current ACIP guidelines.
Q3: A 45-year-old woman with a BMI of 32 and a family history of diabetes in her mother
asks about diabetes screening. Her blood pressure is 118/76 mmHg and she feels well.
What does the USPSTF recommend?
A. Screening only if she develops symptoms of hyperglycemia
B. Screening beginning now and repeating every 3 years [CORRECT]
C. Screening beginning at age 50 regardless of risk factors
D. Screening with HbA1c only; fasting glucose is not acceptable
Correct Answer: B
Rationale: The best answer is B because the USPSTF recommends screening for
prediabetes and type 2 diabetes in adults aged 35 to 70 who are overweight or obese,
with repeat screening every 3 years if results are normal. Waiting for symptoms (A)
misses the point of screening, age 50 (C) is incorrect, and either HbA1c or fasting
glucose (D) are acceptable screening tests.
Q4: A 19-year-old college student presents for a routine physical before starting school.
She received her childhood immunizations on schedule but has not had any vaccines
since age 12. Which vaccine is specifically recommended for her age group today?
A. Herpes zoster (Shingrix) vaccine
B. Meningococcal conjugate (MenACWY) booster [CORRECT]
C. Pneumococcal conjugate (PCV15) vaccine
D. Hepatitis A vaccine series
Correct Answer: B
Rationale: The best answer is B because adolescents should receive a booster dose of
MenACWY at age 16, and if missed, should receive it before college entry. Shingrix (A) is
for adults 50 and older, PCV15 (C) is for adults 65+ or those with risk factors, and
hepatitis A (D) is only for those with specific risk factors or upon request.
,Q5: During a well-child visit, the parents of a 12-month-old ask about the hepatitis A
vaccine. Which statement best reflects current CDC recommendations?
A. It is given only to children traveling internationally
B. It is administered as a 2-dose series starting at 12 months [CORRECT]
C. It is optional and not part of the routine childhood schedule
D. It is given as a 3-dose series along with hepatitis B
Correct Answer: B
Rationale: The best answer is B because the hepatitis A vaccine is routinely
recommended as a 2-dose series, with the first dose given at 12 through 23 months of
age. It is not just for travel (A), it is not optional (C), and it is a 2-dose series, not 3-dose
(D).
Q6: A 52-year-old man with a 30 pack-year smoking history quit smoking 2 years ago.
He is otherwise healthy. Which screening test should you recommend?
A. Annual chest X-ray
B. Low-dose CT scan of the chest [CORRECT]
C. Sputum cytology every 6 months
D. No screening needed since he quit smoking
Correct Answer: B
Rationale: The best answer is B because the USPSTF recommends annual low-dose CT
for lung cancer screening in adults aged 50 to 80 with a 20 pack-year or greater
smoking history who currently smoke or quit within the past 15 years. Chest X-ray (A)
and sputum cytology (C) are not recommended, and screening is still indicated (D) since
he quit only 2 years ago.
Q7: A 35-year-old woman presents for her annual exam. She has no family history of
breast cancer and is asymptomatic. According to the most current USPSTF
recommendation, at what age should biennial screening mammography begin for
average-risk women?
A. Age 40 [CORRECT]
B. Age 45
C. Age 50
D. Age 55
Correct Answer: A
, Rationale: The best answer is A because the USPSTF now recommends biennial
screening mammography for all average-risk women starting at age 40 and continuing
through age 74. Starting at 50 (C) was the older recommendation, and 45 (B) or 55 (D)
do not match current Grade B guidance.
Q8: A 70-year-old woman with osteoporosis (T-score -2.8) asks how often she should
have a follow-up DXA scan if her treatment remains unchanged. What do current
guidelines suggest?
A. Every 6 months to monitor response
B. Every 1 to 2 years [CORRECT]
C. Every 5 years since she is already on treatment
D. Only repeat if she has a new fracture
Correct Answer: B
Rationale: The best answer is B because for patients being monitored for osteoporosis
treatment response, DXA is typically repeated every 1 to 2 years to assess changes in
bone mineral density. Every 6 months (A) is too frequent, every 5 years (C) is too long
for active monitoring, and waiting for a fracture (D) defeats the purpose of monitoring.
Q9: A 16-year-old patient asks about HPV vaccination. She has not received any HPV
doses. Which statement is most accurate?
A. She is too old to start the series and will not benefit
B. She should receive a 2-dose series if started before age 15, but a 3-dose series if
started at age 15 or older [CORRECT]
C. HPV vaccine is only recommended for females
D. She needs only 1 dose since she is already sexually active
Correct Answer: B
Rationale: The best answer is B because the HPV vaccine schedule depends on the age
at initiation: those starting before age 15 need 2 doses, while those starting at age 15 or
older need 3 doses. She is not too old (A)—vaccination is recommended through age 26,
it is for all genders (C), and sexual activity (D) does not reduce the dose requirement.
Q10: A 42-year-old man with no chronic conditions asks about screening for abdominal
aortic aneurysm (AAA). He has never smoked. What is the USPSTF recommendation?
A. One-time ultrasound at age 45
B. One-time ultrasound at age 65
