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1. Question: A 68-year-old man with hypertension has a blood pressure of 152/88 mmHg at three separate office visits despite lifestyle modifications. What is the most appropriate next step?
2. Question: Which medication is generally recommended as a first-line treatment for uncomplicated primary hypertension?
3. Question: A 72-year-old woman reports dizziness when standing. Her seated BP is 138/76 mmHg and standing BP is 112/68 mmHg. What is the most likely diagnosis?
4. Question: Which lifestyle modification has the greatest average effect on lowering blood pressure in overweight adults?
5. Question: A patient has a fasting LDL-C of 205 mg/dL. According to current lipid management recommendations, the NP should:
6. Question: Which finding is most suggestive of heart failure?
7. Question: Which laboratory test is most helpful when evaluating suspected heart failure?
8. Question: A patient with atrial fibrillation has a CHA₂DS₂-VASc score indicating elevated stroke risk. What is the priority management consideration?
9. Question: A 65-year-old smoker presents with chronic cough and progressive dyspnea. Which diagnosis is most likely?
10. Question: Which test confirms persistent airflow obstruction in COPD?
11. Question: Which vaccine is recommended for adults aged 65 years and older to reduce the risk of pneumococcal disease?
12. Question: Which symptom is most characteristic of stable angina?
13. Question: Which medication is commonly prescribed for rapid relief of stable angina symptoms?
14. Question: An older adult presents with acute fever, productive cough, and focal crackles. What is the most likely diagnosis?
15. Question: What is the most important first step in evaluating dizziness in an older adult?
16. Question: Which medication class is associated with an increased risk of hyperkalemia?
17. Question: A patient taking warfarin develops black, tarry stools. What is the most appropriate action?
18. Question: Which intervention has the greatest impact on reducing cardiovascular risk in a patient who smokes?
19. Question: Which patient should be evaluated for secondary causes of hypertension?
20. Question: Which finding is most consistent with peripheral arterial disease (PAD)?
21. Question: Which bedside test is commonly used to screen for peripheral arterial disease?
22. Question: A patient with diabetes presents for preventive care. Which recommendation is most appropriate?
23. Question: Which medication is included in the AGS Beers Criteria as potentially inappropriate for many older adults because of its anticholinergic effects?
24. Question: A patient with asthma experiences symptoms twice per week but not daily. How should asthma control be assessed?
25. Question: During a Medicare Annual Wellness Visit, which screening is recommended to identify cognitive impairment?
26. Question: A 58-year-old man with type 2 diabetes and hypertension has a urine albumin-to-creatinine ratio of 120 mg/g. Which medication class provides both blood pressure control and kidney protection?
27. Question: A patient taking hydrochlorothiazide develops muscle cramps and fatigue. Which electrolyte abnormality is most likely?
28. Question: Which symptom most strongly suggests uncontrolled hypothyroidism?
29. Question: A 70-year-old woman with osteoporosis asks about fracture prevention. Which recommendation has the strongest evidence?
30. Question: A patient with atrial fibrillation reports sudden onset of unilateral weakness and slurred speech. What is the priority action?
31. Question: Which finding is most consistent with acute bacterial sinusitis rather than a viral upper respiratory infection?
32. Question: A patient with COPD receives smoking cessation counseling. Which intervention is associated with the highest quit rates?
33. Question: Which symptom is most concerning for giant cell arteritis?
34. Question: An older adult has recurrent falls. Which medication class commonly contributes to fall risk?
35. Question: Which laboratory test is most appropriate to monitor long-term glycemic control?
36. Question: A patient with stage 3 chronic kidney disease is prescribed an NSAID for chronic pain. What is the best response?
37. Question: A patient presents with sudden palpitations and a narrow-complex tachycardia at 170 bpm. If the patient is stable, which initial intervention is appropriate?
38. Question: Which finding suggests iron-deficiency anemia?
39. Question: Which recommendation best reduces the risk of osteoporosis-related fractures in older adults?
40. Question: A patient with GERD reports persistent symptoms despite lifestyle modifications and an adequate trial of acid-suppressive therapy. What is an appropriate next step?
41. Question: Which patient is at highest risk for abdominal aortic aneurysm?
42. Question: Which symptom is most typical of benign prostatic hyperplasia (BPH)?
43. Question: A patient taking a statin develops severe muscle pain and dark urine. What is the priority action?
44. Question: Which preventive service is recommended for most adults with hypertension?
45. Question: Which finding is most consistent with acute heart failure exacerbation?
46. Question: A patient with diabetes asks why annual dilated eye examinations are recommended.
47. Question: Which dietary pattern has strong evidence for reducing blood pressure?
48. Question: A patient presents with unilateral leg swelling after prolonged travel. Which diagnosis should be considered first?
49. Question: Which patient should receive counseling about reducing sodium intake?
50. Question: A 67-year-old patient asks how to lower cardiovascular risk. Which recommendation provides the greatest overall benefit?
51. Question: A 74-year-old woman with hypertension has a clinic blood pressure of 164/92 mmHg, but home blood pressure readings average 126/78 mmHg. What is the most likely explanation?
52. Question: Which physical examination finding is most suggestive of aortic stenosis?
53. Question: A 66-year-old man with COPD presents with increased sputum volume, purulence, and worsening dyspnea. What is the most likely diagnosis?
54. Question: Which patient should be evaluated for obstructive sleep apnea?
55. Question: A patient with diabetes has an HbA1c of 9.4%. Which statement is most accurate?
56. Question: A 72-year-old woman reports new urinary urgency and dysuria without vaginal symptoms. Which diagnosis is most likely?
57. Question: Which lifestyle intervention is recommended for patients with prediabetes?
58. Question: A patient has bilateral pitting edema, elevated jugular venous pressure, and hepatomegaly. Which condition is most likely?
59. Question: Which medication is most likely to increase the risk of hypoglycemia?
60. Question: A patient taking levothyroxine reports taking the medication with breakfast and coffee each morning. What counseling is appropriate?
61. Question: Which symptom is most concerning for acute coronary syndrome?
62. Question: Which vaccine is routinely recommended each year for adults, especially older adults and those with chronic disease?
63. Question: A patient with chronic kidney disease has an eGFR of 38 mL/min/1.73 m². What is an important management consideration?
64. Question: A 68-year-old patient complains of calf pain after walking two blocks that resolves with rest. Which diagnosis is most likely?
65. Question: Which physical examination maneuver helps assess volume status in suspected heart failure?
66. Question: A patient reports heartburn, dysphagia, and unintentional weight loss. What is the most appropriate next step?
67. Question: Which factor most strongly increases the risk of stroke in atrial fibrillation?
68. Question: A patient develops persistent cough after starting lisinopril. What is the most likely explanation?
69. Question: Which patient should receive counseling regarding fall prevention?
70. Question: Which finding is most consistent with bacterial community-acquired pneumonia?
71. Question: Which laboratory value should be monitored after initiating an ACE inhibitor?
72. Question: Which recommendation is appropriate for reducing cardiovascular risk in a patient with hyperlipidemia?
73. Question: A patient presents with acute unilateral facial droop involving the forehead and inability to close one eye. Which diagnosis is most likely?
74. Question: Which statement about shared decision-making is most accurate?
75. Question: A 69-year-old patient asks how to maintain healthy aging. Which recommendation is most appropriate?
76. Question: A 69-year-old woman with hypertension and diabetes presents for follow-up. Her BP is 148/86 mmHg despite adherence to two antihypertensive medications. What is the most appropriate next step?
77. Question: Which patient is most likely to benefit from statin therapy for primary prevention after a clinician–patient risk discussion?
78. Question: A patient with COPD asks which intervention most slows disease progression. What is the best answer?
79. Question: Which symptom is most concerning for acute decompensated heart failure?
80. Question: A patient with type 2 diabetes reports numbness and burning pain in both feet. Which complication is most likely?
81. Question: Which lifestyle recommendation is most appropriate for a patient with hyperlipidemia?
82. Question: A 72-year-old patient reports increasing forgetfulness. What is the best initial approach?
83. Question: Which patient is at greatest risk for falls?
84. Question: A patient develops facial swelling shortly after starting an ACE inhibitor. What is the priority action?
85. Question: Which preventive recommendation is appropriate for reducing influenza-related complications in older adults?
86. Question: A patient with chronic kidney disease asks why NSAIDs should be avoided. What is the best explanation?
87. Question: A patient presents with sudden pleuritic chest pain and shortness of breath after prolonged immobility. Which diagnosis should be considered urgently?
88. Question: Which examination finding is most consistent with dehydration?
89. Question: A patient with asthma reports nighttime symptoms three nights per week despite prescribed therapy. What does this suggest?
90. Question: Which patient should receive counseling about home blood pressure monitoring?
91. Question: A patient with diabetes and hypertension asks why kidney function is monitored regularly. What is the best response?
92. Question: Which symptom most strongly suggests transient ischemic attack (TIA)?
93. Question: Which recommendation best reduces medication-related adverse events in older adults?
94. Question: A patient with suspected obstructive sleep apnea asks why treatment is important. Which response is most accurate?
95. Question: Which counseling point is appropriate when prescribing a statin?
96. Question: Which patient is most likely to require urgent evaluation?
97. Question: Which factor contributes most to successful management of chronic disease?
98. Question: An older adult asks how to reduce the risk of future falls. Which recommendation is most appropriate?
99. Question: A patient asks why preventive screenings continue even when they feel well. What is the best response?
100. Question: A newly graduated Family Nurse Practitioner asks what principle should guide clinical decision-making in primary care. Which response is best? Bottom of Form