NURS 6551 MIDTERM EXAM 1 – WEEK 6 Actual Exam
| Foundations of Advanced Primary Care, Women's
Health, & Clinical Reasoning – Complete Q&A – Pass
Guaranteed - A+ Graded
Section 1 – Foundations of Advanced Primary Care
Q1: A 52-year-old woman presents for her annual well-woman visit and asks when she
should start mammography screening. According to current USPSTF recommendations,
what is the most accurate counseling point?
A. Begin shared decision-making about mammography at age 50 and start routine
biennial screening by age 55
B. Start biennial screening mammography at age 40 and continue through age 74
[CORRECT]
C. Begin annual mammography at age 45 and continue for life
D. Routine mammography is no longer recommended for average-risk women
Correct Answer: B
Rationale: The USPSTF now recommends that all average-risk women begin biennial
screening mammography at age 40, a shift from previous guidance, and continue
through age 74. This reflects updated modeling showing mortality benefit when
screening starts earlier.
Q2: During a health maintenance visit, a 68-year-old man asks which adult vaccines he
needs. He had Tdap ten years ago and received Prevnar 20 last year. He has never had
shingles. Which vaccine is indicated now?
A. Pneumococcal polysaccharide vaccine (PPSV23)
B. Tetanus and diphtheria booster (Td) only
C. Recombinant zoster vaccine (Shingrix) [CORRECT]
D. Live zoster vaccine (Zostavax)
Correct Answer: C
,Rationale: Shingrix is recommended for all adults aged 50 and older regardless of prior
shingles or varicella history, given as a two-dose series. Zostavax is no longer available
in the United States, and he already has adequate pneumococcal coverage with Prevnar
20.
Q3: A 45-year-old patient with a 30 pack-year smoking history currently smokes one
pack per day and is interested in lung cancer screening. According to USPSTF
guidelines, which screening test is appropriate?
A. Annual chest X-ray
B. Annual low-dose computed tomography (LDCT) [CORRECT]
C. Sputum cytology every 6 months
D. Bronchoscopy every 2 years
Correct Answer: B
Rationale: Annual low-dose CT is recommended for adults aged 50 to 80 with a 20
pack-year or greater smoking history who currently smoke or have quit within the past
15 years. Chest X-ray has not been shown to reduce mortality in lung cancer screening.
Q4: A nurse practitioner is counseling a 35-year-old woman about folic acid
supplementation. Which statement reflects evidence-based preconception health
promotion?
A. All women of reproductive potential should take 400 mcg of folic acid daily
[CORRECT]
B. Folic acid is only necessary once a pregnancy is confirmed
C. Women with a normal diet do not need folic acid supplementation
D. Folic acid should be started at 800 mcg only after the first prenatal visit
Correct Answer: A
Rationale: Because neural tube defects develop in the first weeks of pregnancy—often
before a woman knows she is pregnant—all women capable of becoming pregnant
should consume 400 mcg of folic acid daily. Waiting until pregnancy is confirmed
misses the critical window.
Q5: A patient with low health literacy is newly diagnosed with type 2 diabetes. Which
teaching strategy best supports patient understanding and retention?
A. Provide a detailed pamphlet written at a college reading level
B. Use the teach-back method to confirm understanding [CORRECT]
, C. Focus exclusively on pathophysiology to build knowledge
D. Ask the patient to sign an informed consent form for education
Correct Answer: B
Rationale: The teach-back method—asking patients to explain in their own words what
they need to know or do—is the most reliable way to confirm comprehension, especially
when health literacy is limited. It is a cornerstone of patient-centered primary care.
Q6: Which USPSTF Grade A recommendation applies to asymptomatic adults aged 45
to 75?
A. Screening for thyroid dysfunction
B. Screening for colorectal cancer [CORRECT]
C. Screening for carotid artery stenosis with ultrasound
D. Screening for chronic obstructive pulmonary disease
Correct Answer: B
Rationale: Colorectal cancer screening is a Grade A recommendation for adults aged 45
to 75, with multiple acceptable modalities including stool-based tests, colonoscopy, and
CT colonography. The other options are either Grade D or have insufficient evidence for
routine screening.
Q7: A 24-year-old graduate student presents for a new patient visit. She has no chronic
conditions and takes no medications. Which preventive service is the highest priority at
this visit?
A. Bone mineral density testing
B. Screening for cervical cancer with cytology [CORRECT]
C. Coronary artery calcium scoring
D. Abdominal aortic aneurysm ultrasound
Correct Answer: B
Rationale: Cervical cancer screening with cytology alone every three years is
recommended starting at age 21, making it appropriate for this patient. The other
screening tests are either not indicated at this age or reserved for specific risk
populations.
Q8: A nurse practitioner is practicing in a state with full practice authority. Which activity
falls within the NP's independent scope?
A. Ordering diagnostic tests and initiating evidence-based treatment plans [CORRECT]
| Foundations of Advanced Primary Care, Women's
Health, & Clinical Reasoning – Complete Q&A – Pass
Guaranteed - A+ Graded
Section 1 – Foundations of Advanced Primary Care
Q1: A 52-year-old woman presents for her annual well-woman visit and asks when she
should start mammography screening. According to current USPSTF recommendations,
what is the most accurate counseling point?
A. Begin shared decision-making about mammography at age 50 and start routine
biennial screening by age 55
B. Start biennial screening mammography at age 40 and continue through age 74
[CORRECT]
C. Begin annual mammography at age 45 and continue for life
D. Routine mammography is no longer recommended for average-risk women
Correct Answer: B
Rationale: The USPSTF now recommends that all average-risk women begin biennial
screening mammography at age 40, a shift from previous guidance, and continue
through age 74. This reflects updated modeling showing mortality benefit when
screening starts earlier.
Q2: During a health maintenance visit, a 68-year-old man asks which adult vaccines he
needs. He had Tdap ten years ago and received Prevnar 20 last year. He has never had
shingles. Which vaccine is indicated now?
A. Pneumococcal polysaccharide vaccine (PPSV23)
B. Tetanus and diphtheria booster (Td) only
C. Recombinant zoster vaccine (Shingrix) [CORRECT]
D. Live zoster vaccine (Zostavax)
Correct Answer: C
,Rationale: Shingrix is recommended for all adults aged 50 and older regardless of prior
shingles or varicella history, given as a two-dose series. Zostavax is no longer available
in the United States, and he already has adequate pneumococcal coverage with Prevnar
20.
Q3: A 45-year-old patient with a 30 pack-year smoking history currently smokes one
pack per day and is interested in lung cancer screening. According to USPSTF
guidelines, which screening test is appropriate?
A. Annual chest X-ray
B. Annual low-dose computed tomography (LDCT) [CORRECT]
C. Sputum cytology every 6 months
D. Bronchoscopy every 2 years
Correct Answer: B
Rationale: Annual low-dose CT is recommended for adults aged 50 to 80 with a 20
pack-year or greater smoking history who currently smoke or have quit within the past
15 years. Chest X-ray has not been shown to reduce mortality in lung cancer screening.
Q4: A nurse practitioner is counseling a 35-year-old woman about folic acid
supplementation. Which statement reflects evidence-based preconception health
promotion?
A. All women of reproductive potential should take 400 mcg of folic acid daily
[CORRECT]
B. Folic acid is only necessary once a pregnancy is confirmed
C. Women with a normal diet do not need folic acid supplementation
D. Folic acid should be started at 800 mcg only after the first prenatal visit
Correct Answer: A
Rationale: Because neural tube defects develop in the first weeks of pregnancy—often
before a woman knows she is pregnant—all women capable of becoming pregnant
should consume 400 mcg of folic acid daily. Waiting until pregnancy is confirmed
misses the critical window.
Q5: A patient with low health literacy is newly diagnosed with type 2 diabetes. Which
teaching strategy best supports patient understanding and retention?
A. Provide a detailed pamphlet written at a college reading level
B. Use the teach-back method to confirm understanding [CORRECT]
, C. Focus exclusively on pathophysiology to build knowledge
D. Ask the patient to sign an informed consent form for education
Correct Answer: B
Rationale: The teach-back method—asking patients to explain in their own words what
they need to know or do—is the most reliable way to confirm comprehension, especially
when health literacy is limited. It is a cornerstone of patient-centered primary care.
Q6: Which USPSTF Grade A recommendation applies to asymptomatic adults aged 45
to 75?
A. Screening for thyroid dysfunction
B. Screening for colorectal cancer [CORRECT]
C. Screening for carotid artery stenosis with ultrasound
D. Screening for chronic obstructive pulmonary disease
Correct Answer: B
Rationale: Colorectal cancer screening is a Grade A recommendation for adults aged 45
to 75, with multiple acceptable modalities including stool-based tests, colonoscopy, and
CT colonography. The other options are either Grade D or have insufficient evidence for
routine screening.
Q7: A 24-year-old graduate student presents for a new patient visit. She has no chronic
conditions and takes no medications. Which preventive service is the highest priority at
this visit?
A. Bone mineral density testing
B. Screening for cervical cancer with cytology [CORRECT]
C. Coronary artery calcium scoring
D. Abdominal aortic aneurysm ultrasound
Correct Answer: B
Rationale: Cervical cancer screening with cytology alone every three years is
recommended starting at age 21, making it appropriate for this patient. The other
screening tests are either not indicated at this age or reserved for specific risk
populations.
Q8: A nurse practitioner is practicing in a state with full practice authority. Which activity
falls within the NP's independent scope?
A. Ordering diagnostic tests and initiating evidence-based treatment plans [CORRECT]
