FITZGERALD REVIEW QUESTIONS & VALID COMPLETE SOLUTIONS
PASSED LATEST VERSION QUESTIONS 1-50 WITh ANSWERS AND
DETAILED RATIONALES /GRADED A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
SECTION 1: PRIMARY CARE AND HEALTH PROMOTION (Questions 1-10)
**Question 1**
A 45-year-old asymptomatic woman with no cardiovascular risk factors presents for a routine physical
examination. According to USPSTF guidelines, when should screening for lipid disorders begin for this
patient?
A) Age 20
B) Age 35
C) Age 45
D) Age 50
**ANSWER:** C) Age 45
**RATIONALE:** The USPSTF recommends screening for lipid disorders in women beginning at age 45 if
they are at increased risk for coronary heart disease. For women without risk factors, screening may
begin at age 45-50. Men should begin screening at age 35 if at increased risk, or age 40-45 if not at
increased risk. This patient has no risk factors, so age 45-50 is appropriate.
---
**Question 2**
,A 68-year-old man with a 40-pack-year smoking history presents for evaluation. He quit smoking 5 years
ago. According to USPSTF guidelines, this patient should be screened for:
A) Abdominal aortic aneurysm one-time by ultrasound
B) Abdominal aortic aneurysm annually by ultrasound
C) Abdominal aortic aneurysm only if symptomatic
D) No AAA screening is recommended
**ANSWER:** A) Abdominal aortic aneurysm one-time by ultrasound
**RATIONALE:** The USPSTF recommends one-time screening for abdominal aortic aneurysm (AAA) by
ultrasonography in men aged 65-75 who have ever smoked (Grade B). This patient meets criteria: age 68
(within 65-75) and former smoker with 40-pack-year history. Women with smoking history do not benefit
from screening. Men without smoking history do not require screening.
---
**Question 3**
A 55-year-old woman has a blood pressure of 148/92 mmHg on two separate occasions. She has no
other medical conditions. According to JNC 8 guidelines, at what blood pressure threshold should
pharmacologic treatment be initiated?
A) 140/90 mmHg
B) 150/90 mmHg
C) 130/80 mmHg
D) 160/100 mmHg
**ANSWER:** B) 150/90 mmHg
,**RATIONALE:** JNC 8 guidelines recommend initiating pharmacologic treatment for hypertension in
adults aged 60 years or older at a systolic BP of 150 mmHg or higher or diastolic BP of 90 mmHg or
higher. For adults younger than 60 years, the threshold is 140/90 mmHg. This patient is 55 years old
(under 60), but the threshold is 140/90 for her age group. However, note that JNC 8 has been updated by
ACC/AHA 2017 which uses 130/80. For exam purposes, know both thresholds.
---
**Question 4**
A 30-year-old sexually active woman requests contraception. She has a history of migraine with visual
aura. Which contraceptive method is contraindicated?
A) Copper intrauterine device (IUD)
B) Levonorgestrel intrauterine device (IUD)
C) Combined oral contraceptives (estrogen-containing)
D) Etonogestrel implant (Nexplanon)
**ANSWER:** C) Combined oral contraceptives (estrogen-containing)
**RATIONALE:** Migraine with aura is an absolute contraindication to estrogen-containing
contraceptives (combined oral contraceptives, patch, ring) due to increased risk of ischemic stroke.
Progestin-only methods (IUDs, implant, DMPA, POP) are safe and appropriate for these patients. The
copper IUD is non-hormonal and also safe.
---
**Question 5**
A 72-year-old woman presents for a wellness visit. She has no history of falls. Which of the following is
the USPSTF recommendation regarding fall prevention interventions?
, A) Recommend vitamin D supplementation for all older adults
B) Recommend exercise or physical therapy to prevent falls
C) Recommend multifactorial assessment and intervention only for those with a history of falls
D) Do not recommend vitamin D supplementation for fall prevention
**ANSWER:** D) Do not recommend vitamin D supplementation for fall prevention
**RATIONALE:** The USPSTF recommends exercise interventions to prevent falls in community-dwelling
older adults at increased fall risk (Grade B). However, they recommend AGAINST vitamin D
supplementation for fall prevention (Grade D), finding insufficient evidence that vitamin D reduces falls.
They also recommend against multifactorial interventions for those without a fall history.
---
**Question 6**
A 50-year-old African American man with hypertension is started on monotherapy for blood pressure
control. According to JNC 8, which class of medication is recommended as first-line for this patient?
A) ACE inhibitor
B) Angiotensin receptor blocker (ARB)
C) Thiazide diuretic or calcium channel blocker (CCB)
D) Beta-blocker
**ANSWER:** C) Thiazide diuretic or calcium channel blocker (CCB)
**RATIONALE:** JNC 8 recommends that for the general non-Black population, initial antihypertensive
treatment should include a thiazide diuretic, CCB, ACE inhibitor, or ARB. However, for the Black
population (including African Americans), initial treatment should include a thiazide diuretic or CCB
because ACE inhibitors and ARBs are less effective as monotherapy in this population due to lower renin
levels.
PASSED LATEST VERSION QUESTIONS 1-50 WITh ANSWERS AND
DETAILED RATIONALES /GRADED A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
SECTION 1: PRIMARY CARE AND HEALTH PROMOTION (Questions 1-10)
**Question 1**
A 45-year-old asymptomatic woman with no cardiovascular risk factors presents for a routine physical
examination. According to USPSTF guidelines, when should screening for lipid disorders begin for this
patient?
A) Age 20
B) Age 35
C) Age 45
D) Age 50
**ANSWER:** C) Age 45
**RATIONALE:** The USPSTF recommends screening for lipid disorders in women beginning at age 45 if
they are at increased risk for coronary heart disease. For women without risk factors, screening may
begin at age 45-50. Men should begin screening at age 35 if at increased risk, or age 40-45 if not at
increased risk. This patient has no risk factors, so age 45-50 is appropriate.
---
**Question 2**
,A 68-year-old man with a 40-pack-year smoking history presents for evaluation. He quit smoking 5 years
ago. According to USPSTF guidelines, this patient should be screened for:
A) Abdominal aortic aneurysm one-time by ultrasound
B) Abdominal aortic aneurysm annually by ultrasound
C) Abdominal aortic aneurysm only if symptomatic
D) No AAA screening is recommended
**ANSWER:** A) Abdominal aortic aneurysm one-time by ultrasound
**RATIONALE:** The USPSTF recommends one-time screening for abdominal aortic aneurysm (AAA) by
ultrasonography in men aged 65-75 who have ever smoked (Grade B). This patient meets criteria: age 68
(within 65-75) and former smoker with 40-pack-year history. Women with smoking history do not benefit
from screening. Men without smoking history do not require screening.
---
**Question 3**
A 55-year-old woman has a blood pressure of 148/92 mmHg on two separate occasions. She has no
other medical conditions. According to JNC 8 guidelines, at what blood pressure threshold should
pharmacologic treatment be initiated?
A) 140/90 mmHg
B) 150/90 mmHg
C) 130/80 mmHg
D) 160/100 mmHg
**ANSWER:** B) 150/90 mmHg
,**RATIONALE:** JNC 8 guidelines recommend initiating pharmacologic treatment for hypertension in
adults aged 60 years or older at a systolic BP of 150 mmHg or higher or diastolic BP of 90 mmHg or
higher. For adults younger than 60 years, the threshold is 140/90 mmHg. This patient is 55 years old
(under 60), but the threshold is 140/90 for her age group. However, note that JNC 8 has been updated by
ACC/AHA 2017 which uses 130/80. For exam purposes, know both thresholds.
---
**Question 4**
A 30-year-old sexually active woman requests contraception. She has a history of migraine with visual
aura. Which contraceptive method is contraindicated?
A) Copper intrauterine device (IUD)
B) Levonorgestrel intrauterine device (IUD)
C) Combined oral contraceptives (estrogen-containing)
D) Etonogestrel implant (Nexplanon)
**ANSWER:** C) Combined oral contraceptives (estrogen-containing)
**RATIONALE:** Migraine with aura is an absolute contraindication to estrogen-containing
contraceptives (combined oral contraceptives, patch, ring) due to increased risk of ischemic stroke.
Progestin-only methods (IUDs, implant, DMPA, POP) are safe and appropriate for these patients. The
copper IUD is non-hormonal and also safe.
---
**Question 5**
A 72-year-old woman presents for a wellness visit. She has no history of falls. Which of the following is
the USPSTF recommendation regarding fall prevention interventions?
, A) Recommend vitamin D supplementation for all older adults
B) Recommend exercise or physical therapy to prevent falls
C) Recommend multifactorial assessment and intervention only for those with a history of falls
D) Do not recommend vitamin D supplementation for fall prevention
**ANSWER:** D) Do not recommend vitamin D supplementation for fall prevention
**RATIONALE:** The USPSTF recommends exercise interventions to prevent falls in community-dwelling
older adults at increased fall risk (Grade B). However, they recommend AGAINST vitamin D
supplementation for fall prevention (Grade D), finding insufficient evidence that vitamin D reduces falls.
They also recommend against multifactorial interventions for those without a fall history.
---
**Question 6**
A 50-year-old African American man with hypertension is started on monotherapy for blood pressure
control. According to JNC 8, which class of medication is recommended as first-line for this patient?
A) ACE inhibitor
B) Angiotensin receptor blocker (ARB)
C) Thiazide diuretic or calcium channel blocker (CCB)
D) Beta-blocker
**ANSWER:** C) Thiazide diuretic or calcium channel blocker (CCB)
**RATIONALE:** JNC 8 recommends that for the general non-Black population, initial antihypertensive
treatment should include a thiazide diuretic, CCB, ACE inhibitor, or ARB. However, for the Black
population (including African Americans), initial treatment should include a thiazide diuretic or CCB
because ACE inhibitors and ARBs are less effective as monotherapy in this population due to lower renin
levels.
