COMPLETE ACTUAL EXAM Real Questions –
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Keeping Patients Well: Health Promotion & Disease Prevention Across the Lifespan
Q1: An otherwise healthy 25-year-old female presents for a routine well-visit. She is
sexually active with one partner and uses an intrauterine device for contraception.
Based on current USPSTF guidelines, what cervical cancer screening recommendation
should the FNP provide?
A. She does not need screening until age 30.
B. She should have a Pap smear alone every 3 years. [CORRECT]
C. She needs both a Pap smear and HPV testing today.
D. She only needs screening if she develops symptoms of abnormal vaginal bleeding.
Correct Answer: B
Rationale: This choice is correct because current USPSTF guidelines recommend
cervical cancer screening with cytology (Pap smear) alone every 3 years for women
aged 21 to 29, as co-testing isn't recommended for this younger age group.
Q2: A 55-year-old patient with a 30-pack-year smoking history asks about lung cancer
screening. He quit smoking 6 months ago. What is the FNP's best response?
A. "Because you quit smoking, you no longer qualify for screening."
B. "You need to wait at least 5 years after quitting before you are eligible for screening."
C. "You qualify for an annual low-dose CT scan because of your age and smoking
history." [CORRECT]
D. "We will start with a baseline chest X-ray and see if anything looks suspicious."
Correct Answer: C
Rationale: The best answer is offering the low-dose CT scan because USPSTF
guidelines recommend annual screening for adults aged 50 to 80 who have a 20
pack-year history and currently smoke or have quit within the past 15 years.
Q3: A 42-year-old woman with no family history of breast cancer and average risk asks
when she should start getting mammograms. What does the current USPSTF guideline
state?
A. Starting at age 40, every 2 years [CORRECT]
B. Starting at age 50, every year
,C. Starting at age 35, every year
D. Starting at age 45, every 2 years
Correct Answer: A
Rationale: This matches what we teach in MN580 for that clinical scenario, as the
recent 2024 USPSTF update lowered the starting age for biennial mammograms to 40
for women at average risk.
Q4: A 48-year-old male is in the office for a physical. He has no family history of
colorectal cancer and no personal history of polyps. Which screening option is
appropriate to offer him today?
A. Colonoscopy every 10 years
B. Annual fecal immunochemical test (FIT) [CORRECT]
C. Flexible sigmoidoscopy every 5 years
D. CT colonography every 2 years
Correct Answer: B
Rationale: That aligns with the standard of primary care for a patient presenting with
average risk, as the USPSTF recommends starting colorectal screening at age 45, and
a non-invasive option like annual FIT is completely appropriate to offer alongside
colonoscopy.
Q5: A 67-year-old patient with poorly controlled diabetes and chronic kidney disease is
in for a check-up. She received the pneumococcal conjugate vaccine (PCV20) at age
65. Does she need the pneumococcal polysaccharide vaccine (PPSV23) today?
A. Yes, she needs PPSV23 today because of her chronic conditions.
B. No, she is already fully vaccinated with PCV20 and does not need PPSV23.
[CORRECT]
C. Yes, but only if her creatinine clearance drops below 30.
D. No, PPSV23 is only given to patients under 65.
Correct Answer: B
Rationale: The best answer is that she is done with her pneumococcal series, because
current CDC guidelines state that if a patient receives PCV20 at age 65 or older, they do
not need PPSV23 regardless of their comorbidities.
Q6: A 60-year-old patient is unsure if he ever had the shingles vaccine. What is the
standard recommendation for the recombinant zoster vaccine (Shingrix) in this age
group?
A. It is only recommended for patients who have already had an outbreak of shingles.
B. It is a live vaccine given as a single dose.
C. It is recommended as a 2-dose series for adults 50 years and older. [CORRECT]
D. It is contraindicated in anyone over 60 due to the risk of Guillain-Barré syndrome.
Correct Answer: C
, Rationale: This choice is correct because current immunization guidelines strongly
recommend the recombinant, non-live Shingrix vaccine as a two-dose series for all
adults over 50 to prevent herpes zoster and postherpetic neuralgia.
Q7: A 28-year-old female is currently 28 weeks pregnant with her first child. She has not
received any vaccines during this pregnancy. Which vaccine is explicitly recommended
at this stage of pregnancy?
A. Tdap (Tetanus, diphtheria, pertussis) [CORRECT]
B. MMR (Measles, mumps, rubella)
C. HPV (Human papillomavirus)
D. Varicella
Correct Answer: A
Rationale: That aligns with the standard of primary care for obstetrics, as the Tdap
vaccine is recommended during the third trimester (preferably between 27 and 36
weeks) to pass protective pertussis antibodies to the newborn.
Q8: A 35-year-old patient has a BMI of 32 kg/m² and no other cardiometabolic risk
factors. What is the most appropriate initial intervention for weight management?
A. Refer immediately for bariatric surgery evaluation.
B. Prescribe a GLP-1 receptor agonist.
C. Prescribe intensive lifestyle interventions focusing on diet, physical activity, and
behavioral changes. [CORRECT]
D. Reassure the patient that a BMI of 32 is considered healthy and requires no
intervention.
Correct Answer: C
Rationale: This matches what we teach in MN580 for that clinical scenario because
first-line therapy for obesity without severe comorbidities is always intensive lifestyle
modification, reserving medications and surgery for when lifestyle changes fail or risk
factors are high.
Q9: During a well-visit, a 40-year-old patient admits to drinking a 6-pack of beer every
weekend and smoking a half-pack of cigarettes daily. What is the best initial behavioral
intervention?
A. Prescribe nicotine replacement therapy and naltrexone immediately.
B. Use the 5 A's framework to provide a brief intervention for both tobacco and alcohol
use. [CORRECT]
C. Refer the patient to an inpatient rehabilitation center.
D. Tell the patient they must quit cold turkey before returning to the clinic.
Correct Answer: B