Family Nurse Practitioner Quiz: Primary Care IQ Test

1. Which of the following is the first-line treatment for uncomplicated hypertension in most adults?

ACE inhibitor

Beta-blocker

Calcium channel blocker

Diuretic

2. A 45-year-old patient presents with persistent fatigue and weight gain. Which thyroid test should you order first?

Free T3 level

TSH level

Thyroid antibodies

Free T4 level

3. What is the recommended initial systolic blood pressure goal for most adults with hypertension?

Less than 130 mmHg

Less than 140 mmHg

Less than 150 mmHg

Less than 160 mmHg

4. A patient on metformin reports new-onset diarrhea and abdominal cramping. What is your next step?

Discontinue metformin immediately

Assess GI symptoms and consider dose reduction or alternative formulation

Increase metformin dose to improve tolerance

Refer to gastroenterology

5. Which finding is most consistent with diabetic nephropathy?

Hypertension and microalbuminuria

Hematuria and proteinuria

Hyperkalemia and metabolic alkalosis

Normal creatinine with elevated BUN

6. A 60-year-old with COPD reports increased dyspnea. Which vital sign finding warrants urgent evaluation?

Oxygen saturation 92%

Heart rate 95 bpm

Oxygen saturation 88%

Respiratory rate 18 breaths/min

7. Which medication class is contraindicated in patients with asthma or COPD?

ACE inhibitors

Non-selective beta-blockers

Calcium channel blockers

Statins

8. A patient presents with chest pain, diaphoresis, and dyspnea. What is the priority action?

Perform a comprehensive history

Obtain a 12-lead ECG and cardiac biomarkers immediately

Order a chest X-ray

Prescribe antacids

9. Which of the following best describes the pathophysiology of Type 2 diabetes?

Autoimmune destruction of pancreatic beta cells

Insulin resistance and relative insulin deficiency

Absolute insulin deficiency from the onset

Excessive glucagon production

10. A patient on lisinopril develops a persistent dry cough. What is the most appropriate action?

Continue lisinopril; cough will resolve

Switch to an ARB or alternative antihypertensive

Add a cough suppressant

Increase lisinopril dose

Submit

12. True or False: A hemoglobin A1c of 6.5% or higher is diagnostic for diabetes mellitus.

True

False

13. Which physical examination finding is most specific for heart failure with reduced ejection fraction?

Peripheral edema

Crackles on lung auscultation

S3 gallop

Tachycardia

14. A patient presents with elevated LDL cholesterol. What is the most important lifestyle modification to recommend first?

Eliminate all dietary fat

Increase physical activity and reduce saturated fat intake

Start statin therapy immediately

Reduce sodium intake