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Test Bank - Primary Care, Interprofessional Collaborative Practice, 6th Edition (Buttaro, 2021) Chapter 1-228 | All Chapters
- Which of the following best describes the purpose of the SOAP note format in primary care documentation? A. Ensures patient billing is accurate B. Organizes clinical reasoning and decision-making C. Facilitates interdisciplinary meetings D. Summarizes insurance requirements SOAP (Subjective, Objective, Assessment, Plan) organizes clinical reasoning to guide decision-making and continuity of care.
- Which strategy is most effective in reducing medication errors in elderly patients? A. Using generic names only B. Performing medication reconciliation at every visit C. Writing prescriptions in cursive D. Advising patients to avoid herbal remedies Medication reconciliation ensures updated, accurate lists of medications to avoid duplications or interactions.
- In managing chronic diseases, which approach is foundational in the patient-centered medical home model? A. Physician-directed care
B. Shared decision-making with the patient C. Annual physical exams only D. Passive follow-up care Shared decision-making improves adherence, satisfaction, and outcomes through active patient involvement.
- What is the first step in clinical reasoning when evaluating a new symptom? A. Order diagnostic tests B. Take a detailed history C. Prescribe treatment D. Review old records A detailed history guides hypothesis generation and focused assessment.
- Which patient group should receive the shingles (zoster) vaccine according to CDC guidelines? A. Anyone over age 30 B. Adults with chronic pain C. Adults 50 years and older regardless of prior infection D. Children under 12 CDC recommends recombinant zoster vaccine for adults aged 50 and older to prevent shingles.
- A female patient presents with fatigue, weight gain, and cold intolerance. What is the most appropriate initial diagnostic test? A. CBC B. TSH C. ESR
D. 1 month DSM-5 criteria require at least 2 weeks of symptoms for major depressive disorder. 10.Which lab result is most indicative of a urinary tract infection in a symptomatic patient? A. Negative nitrites B. Positive leukocyte esterase C. Low specific gravity D. Negative blood Leukocyte esterase indicates white cells in urine, suggesting infection. 11.What is the most appropriate management for asymptomatic bacteriuria in a non-pregnant woman? A. Treat with antibiotics B. Do not treat C. Order imaging studies D. Refer to urology Asymptomatic bacteriuria does not require treatment in non-pregnant women unless they are undergoing urologic procedures. 12.A 55-year-old male smoker with no symptoms asks about lung cancer screening. What should the provider recommend? A. No screening unless symptoms develop B. Annual low-dose CT scan if 30-pack-year history C. Chest x-ray every two years
D. Pulmonary function test Annual low-dose CT screening is recommended for patients aged 50– 80 with a 20+ pack-year history who currently smoke or quit within the last 15 years. 13.Which of the following medications should be avoided in patients with heart failure? A. ACE inhibitors B. Beta-blockers C. NSAIDs D. Loop diuretics NSAIDs can cause fluid retention and worsen heart failure symptoms. 14.What is the most common cause of chronic cough in non-smokers? A. Asthma B. GERD C. Post-nasal drip syndrome D. COPD Post-nasal drip (upper airway cough syndrome) is the most common cause of chronic cough in non-smokers. 15.A patient with new onset atrial fibrillation and a CHADS2 score of 2 should receive: A. No treatment B. Aspirin only C. Oral anticoagulation D. Calcium supplements
19.Which class of antibiotics is most appropriate for treating community- acquired pneumonia in a healthy adult? A. Penicillin B. Macrolides C. Cephalosporins D. Aminoglycosides Macrolides (e.g., azithromycin) cover typical and atypical pathogens in uncomplicated pneumonia. 20.Which lab value indicates poor glycemic control in a diabetic patient? A. Hemoglobin 13. B. Hemoglobin A1C of 9.2% C. Fasting glucose of 88 D. Potassium 4. An A1C >7% generally indicates poor glycemic control in most diabetic patients. 21.Which condition is considered an emergency requiring immediate referral in primary care? A. Otitis media B. Retinal detachment C. Sinusitis D. Conjunctivitis Retinal detachment is an ophthalmologic emergency with risk of permanent vision loss.
22.Which lifestyle change most effectively reduces blood pressure? A. Reducing caffeine B. Weight loss C. Increasing dairy intake D. Avoiding shellfish Weight loss has the most significant impact on lowering blood pressure among lifestyle changes. 23.What is the recommended first-line pharmacologic therapy for generalized anxiety disorder (GAD)? A. Benzodiazepines B. SSRIs C. Beta-blockers D. Antipsychotics SSRIs are considered first-line pharmacologic treatment for GAD. 24.A patient reports a mole that has changed shape and color. What is the next step? A. Reassure and monitor B. Perform excisional biopsy C. Prescribe corticosteroids D. Start antibiotics Changing shape and color raise concern for melanoma, requiring biopsy. 25.What is the recommended age to begin colorectal cancer screening in average-risk adults? A. 40
Rebound tenderness at McBurney’s point is a hallmark sign of appendicitis. 29.In a diabetic patient with proteinuria, which class of medication is renal protective? A. Calcium channel blockers B. ACE inhibitors C. Thiazide diuretics D. Beta-blockers ACE inhibitors reduce proteinuria and delay progression of diabetic nephropathy. 30.What is the best screening tool for cognitive impairment in the elderly? A. Beck Depression Inventory B. Mini-Cog C. PHQ- 9 D. Trail Making Test Mini-Cog is a brief, validated tool for detecting dementia in older adults. 31.Which vaccine is recommended during every pregnancy regardless of prior immunization history? A. Hepatitis B B. Tdap C. HPV D. Influenza (live) Tdap is recommended during each pregnancy to protect the newborn from pertussis.
32.In a case of suspected hypothyroidism, which lab abnormality is expected? A. High TSH, low T B. High TSH, low free T C. Low TSH, high T D. Normal TSH, low free T Primary hypothyroidism presents with elevated TSH and low free T4. 33.A 72-year-old woman with osteoporosis is started on bisphosphonates. What is the most common side effect? A. Hyperkalemia B. Gastroesophageal irritation C. Vision changes D. Constipation Bisphosphonates can cause esophageal irritation; take with water and stay upright. 34.Which patient is most appropriate to start on low-dose aspirin for primary prevention? A. 40-year-old female with no comorbidities B. 60-year-old with well-controlled asthma C. 55-year-old male with 10-year CVD risk >10% D. 25-year-old athlete Aspirin may be used in adults 40–70 years old with high cardiovascular risk, if benefits outweigh risks. 35.What is the most appropriate test to confirm H. pylori infection in a patient with no recent antibiotic use?
Short-acting beta agonists (e.g., albuterol) are used for quick asthma relief. 39.What is the first-line treatment for acute otitis media in a child? A. Azithromycin B. Amoxicillin C. Ciprofloxacin D. Clindamycin Amoxicillin is the first-line antibiotic for uncomplicated acute otitis media. 40.A patient presents with a painless breast mass. What is the most appropriate initial test? A. MRI B. Mammogram C. Fine-needle aspiration D. Chest x-ray Mammography is the first imaging test for evaluating a breast mass in most adults. 41.What test is used to monitor warfarin therapy? A. aPTT B. INR C. Anti-Xa level D. Platelet count INR is used to monitor therapeutic levels of warfarin. 42.A patient with GERD fails lifestyle modification. What is the next best step? A. H2 blocker
B. Proton pump inhibitor C. Antibiotic therapy D. Antacid as needed PPIs are more effective than H2 blockers for GERD symptom control. 43.What is the most important counseling point when starting metformin? A. Risk of weight gain B. Risk of lactic acidosis in renal impairment C. Avoid dairy D. Risk of severe hypoglycemia Metformin should be used with caution in patients with renal impairment due to risk of lactic acidosis. 44.What should be monitored regularly in patients on long-term corticosteroids? A. TSH B. Bone mineral density C. AST/ALT D. Serum amylase Long-term corticosteroids can lead to osteoporosis; monitor bone density. 45.In a smoker with a persistent cough and weight loss, what is the next best step? A. Trial of antibiotics B. Chest X-ray C. Peak flow monitoring
49.Which medication is contraindicated in pregnancy? A. Penicillin B. Acetaminophen C. ACE inhibitors D. Ceftriaxone ACE inhibitors are teratogenic and should be avoided in pregnancy. 50.A patient presents with acute monoarticular joint swelling and pain. What is the most likely diagnosis? A. Osteoarthritis B. Rheumatoid arthritis C. Gout D. Lupus Acute, painful, swollen joints—especially in the big toe—are classic for gout. 51.Which of the following statements is true regarding statin therapy in patients with diabetes? A. Statins are only recommended after age 60 B. Statins should be avoided in patients with hypertension C. Statins are recommended in diabetic patients aged 40–75 regardless of LDL level D. Statins are used only for secondary prevention Guidelines recommend statins for primary prevention in patients with diabetes aged 40–75 years, even with normal LDL.
52.Which clinical feature is most suggestive of bacterial sinusitis rather than viral? A. Nasal congestion for 3 days B. Symptoms persisting beyond 10 days without improvement C. Clear nasal discharge D. Sneezing Prolonged duration of symptoms >10 days without improvement suggests bacterial etiology. 53.What is the best test to confirm a diagnosis of type 2 diabetes mellitus? A. Fasting glucose of 110 B. Random glucose of 180 C. Hemoglobin A1C ≥ 6.5% D. Urine glucose A1C ≥6.5% is one of the diagnostic criteria for type 2 diabetes. 54.Which vitamin deficiency is most associated with chronic alcohol use? A. Vitamin A B. Vitamin D C. Thiamine (B1) D. Folate Thiamine deficiency can lead to Wernicke’s encephalopathy in alcohol- dependent patients. 55.A woman has a painless ulcer on her vulva and a positive RPR test. What is the diagnosis? A. Herpes simplex virus
D. Diabetes mellitus Live vaccines are contraindicated during pregnancy. 59.Which of the following symptoms is characteristic of generalized anxiety disorder? A. Sudden onset panic B. Hallucinations C. Excessive worry lasting >6 months D. Compulsive behaviors GAD is marked by chronic, excessive worry lasting more than 6 months. 60.What is the most common bacterial cause of pharyngitis in children? A. Haemophilus influenzae B. Staphylococcus aureus C. Group A Streptococcus D. Neisseria gonorrhoeae Group A Streptococcus is the primary bacterial cause of pharyngitis. 61.Which lab result would you expect in a patient with anemia of chronic disease? A. High MCV B. Low ferritin C. Low serum iron with normal or high ferritin D. High reticulocyte count In anemia of chronic disease, iron is sequestered, so serum iron is low but ferritin is normal/high.
62.Which of the following is most effective in preventing progression of diabetic retinopathy? A. Annual ophthalmology referral B. Vitamin supplements C. Tight glycemic control D. Avoiding alcohol Tight glycemic control significantly reduces the risk and progression of diabetic retinopathy. 63.Which of the following is an appropriate non-pharmacologic treatment for insomnia? A. Late night exercise B. Cognitive behavioral therapy C. Alcohol use before bed D. Afternoon naps CBT for insomnia is considered first-line therapy and more effective than medications. 64.What symptom would raise concern for prostate cancer in a man with BPH? A. Weak stream B. Hematuria C. Nocturia D. Urgency Hematuria in the setting of BPH may suggest malignancy and should be evaluated.
