Monthly updates are rollups meaning they are cumulative. https://redmondmag.com/articles/2018/06/13/windows-server-2008-sp2-update-model-change.aspx https://www.zdnet.com/article/microsoft-to-move-to-monthly-patch-rollups-for-windows-7-8-1-as-of-october-2016/ So the May updates should include whatever you missed from the April updates.
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