It depends what you mean by primitive, I guess. Theoretically you could get really small (function definition + function application) and build everything else from this two. Now, functions like + or car could be defined in such a minimal language (in fact Alonzo Church,the originator of lambda calculus and the granddad of functional programming did just that with numbers and the elementary arithmetic operations: wikipedia can probably tell you more precise information about this
http://en.wikipedia.org/wiki/Church_numerals), but your interpreter/compiler will be very very slow and impractical (and heaven knows we need not give more ammo to the people who say lisp is *nice* but it doesn't have libraries and frameworks and the fluff. they'll say lisp is *nice* but it doesn't even have numbers and addition

). So, you'll have to draw the line somewhere and say that some functions and identifiers are gonna be recognized as "special" and treat them that way. So, numbers, strings, booleans, +, -, *, /, %, strlen,strcat or what have you will be efficiently implemented, but transparent to the programmer. You could of course extend this to any function, regardless of complexity (or how primitive it really is). In a lisp geared toward programming games for example, you could have primitives like create-rendering-context or draw-polygon-with-texture etc.