FNP654 | FNP654 Family Primary Care II Final
Exam v2 | Questions with Correct Answers and
Expert Explanation for Each Question | Grand
Canyon University
1. A 65-year-old patient with a history of COPD presents with increased dyspnea and
productive cough. Which of the following is the most appropriate first-line antibiotic if
a bacterial exacerbation is suspected?
A. Amoxicillin-clavulanate
B. Ciprofloxacin
C. Nitrofurantoin
D. Metronidazole
Correct Answer: A
Expert Explanation: Amoxicillin-clavulanate is a preferred first-line agent for COPD
exacerbations as it covers common pathogens like H. influenzae and S. pneumoniae.
It provides broader coverage than simple amoxicillin against beta-lactamase-
producing organisms. Macrolides or tetracyclines are also alternatives depending on
local resistance patterns.
2. Which screening tool is most appropriate for identifying alcohol use disorder in a
primary care setting?
A. AUDIT-C
,B. GAD-7
C. PHQ-9
D. MMSE
Correct Answer: A
Expert Explanation: The AUDIT-C is a shortened version of the Alcohol Use
Disorders Identification Test specifically designed for rapid screening. It consists of
three questions regarding frequency and quantity of alcohol consumption. A high
score indicates a need for a more detailed assessment of the patient’s drinking
habits.
3. A 4-year-old child presents for a well-child visit. Which of the following vaccines are
typically administered at this age?
A. MMR, Varicella, DTaP, and IPV
B. HepB, Hib, and PCV13
C. HPV and Meningococcal
D. Rotavirus and DTaP
Correct Answer: A
Expert Explanation: Children aged 4 to 6 years require booster doses of MMR,
Varicella, DTaP, and Inactivated Poliovirus (IPV). These vaccines ensure continued
,immunity before the child enters the school environment. The annual influenza
vaccine is also recommended for this age group.
4. An 82-year-old female presents with new-onset confusion and urinary urgency.
What is the most likely diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Urinary tract infection
D. Normal pressure hydrocephalus
Correct Answer: C
Expert Explanation: In elderly patients, acute confusion or delirium is a frequent
presenting symptom of a urinary tract infection. Unlike dementia, delirium has a
rapid onset and is often reversible once the underlying infection is treated. A
urinalysis and culture should be obtained to confirm the diagnosis.
5. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-year-old
patient without diabetes or chronic kidney disease?
A. < 130/80 mmHg
B. < 140/90 mmHg
C. < 120/70 mmHg
, D. < 150/90 mmHg
Correct Answer: D
Expert Explanation: For patients aged 60 years or older without diabetes or CKD,
the JNC 8 goal is less than 150/90 mmHg. This higher threshold was established
based on evidence regarding the balance of treatment benefits versus risks in older
adults. If the patient has diabetes or CKD, the target drops to less than 140/90
mmHg.
6. Which of the following is a classic physical exam finding in a patient with a meniscus
tear?
A. Lachman test positivity
B. Anterior drawer test positivity
C. Valgus stress test positivity
D. McMurray test positivity
Correct Answer: D
Expert Explanation: The McMurray test involves rotating the knee with internal
and external rotation to elicit a click or pain indicative of a meniscus tear. In
contrast, the Lachman and Anterior Drawer tests evaluate the integrity of the
Anterior Cruciate Ligament (ACL). The Valgus stress test assesses the Medial
Collateral Ligament (MCL).
Exam v2 | Questions with Correct Answers and
Expert Explanation for Each Question | Grand
Canyon University
1. A 65-year-old patient with a history of COPD presents with increased dyspnea and
productive cough. Which of the following is the most appropriate first-line antibiotic if
a bacterial exacerbation is suspected?
A. Amoxicillin-clavulanate
B. Ciprofloxacin
C. Nitrofurantoin
D. Metronidazole
Correct Answer: A
Expert Explanation: Amoxicillin-clavulanate is a preferred first-line agent for COPD
exacerbations as it covers common pathogens like H. influenzae and S. pneumoniae.
It provides broader coverage than simple amoxicillin against beta-lactamase-
producing organisms. Macrolides or tetracyclines are also alternatives depending on
local resistance patterns.
2. Which screening tool is most appropriate for identifying alcohol use disorder in a
primary care setting?
A. AUDIT-C
,B. GAD-7
C. PHQ-9
D. MMSE
Correct Answer: A
Expert Explanation: The AUDIT-C is a shortened version of the Alcohol Use
Disorders Identification Test specifically designed for rapid screening. It consists of
three questions regarding frequency and quantity of alcohol consumption. A high
score indicates a need for a more detailed assessment of the patient’s drinking
habits.
3. A 4-year-old child presents for a well-child visit. Which of the following vaccines are
typically administered at this age?
A. MMR, Varicella, DTaP, and IPV
B. HepB, Hib, and PCV13
C. HPV and Meningococcal
D. Rotavirus and DTaP
Correct Answer: A
Expert Explanation: Children aged 4 to 6 years require booster doses of MMR,
Varicella, DTaP, and Inactivated Poliovirus (IPV). These vaccines ensure continued
,immunity before the child enters the school environment. The annual influenza
vaccine is also recommended for this age group.
4. An 82-year-old female presents with new-onset confusion and urinary urgency.
What is the most likely diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Urinary tract infection
D. Normal pressure hydrocephalus
Correct Answer: C
Expert Explanation: In elderly patients, acute confusion or delirium is a frequent
presenting symptom of a urinary tract infection. Unlike dementia, delirium has a
rapid onset and is often reversible once the underlying infection is treated. A
urinalysis and culture should be obtained to confirm the diagnosis.
5. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-year-old
patient without diabetes or chronic kidney disease?
A. < 130/80 mmHg
B. < 140/90 mmHg
C. < 120/70 mmHg
, D. < 150/90 mmHg
Correct Answer: D
Expert Explanation: For patients aged 60 years or older without diabetes or CKD,
the JNC 8 goal is less than 150/90 mmHg. This higher threshold was established
based on evidence regarding the balance of treatment benefits versus risks in older
adults. If the patient has diabetes or CKD, the target drops to less than 140/90
mmHg.
6. Which of the following is a classic physical exam finding in a patient with a meniscus
tear?
A. Lachman test positivity
B. Anterior drawer test positivity
C. Valgus stress test positivity
D. McMurray test positivity
Correct Answer: D
Expert Explanation: The McMurray test involves rotating the knee with internal
and external rotation to elicit a click or pain indicative of a meniscus tear. In
contrast, the Lachman and Anterior Drawer tests evaluate the integrity of the
Anterior Cruciate Ligament (ACL). The Valgus stress test assesses the Medial
Collateral Ligament (MCL).
