NSG 555 EXAM 3 (WILKES) NEWEST 2026 ACTUAL
EXAM TEST BANK| NURSE PRACTITIONERS IN
PRIMARY CARE I EXAM 3 REVIEW WITH COMPLETE 250
REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
1. A 58-year-old male with hypertension reports substernal chest
pressure when walking uphill that resolves with rest. His ECG is
normal. The most appropriate next step is:
A) Coronary angiography
B) Stress testing (exercise treadmill or nuclear)
C) Prescribe nitroglycerin and discharge
D) Repeat ECG in 1 hour
Correct Answer: B) Stress testing (exercise treadmill or nuclear)
Rationale: Classic stable angina requires risk stratification. A
normal resting ECG does not rule out CAD. Stress testing assesses
for inducible ischemia and guides further management.
2. A 72-year-old female has a new murmur, mid-systolic click,
and late systolic murmur at the apex. These findings suggest:
1
, A) Aortic stenosis
B) Mitral stenosis
C) Mitral valve prolapse
D) Hypertrophic cardiomyopathy
Correct Answer: C) Mitral valve prolapse
Rationale: Mid-systolic click followed by a late systolic murmur
at the apex is classic for mitral valve prolapse, often benign but
may progress to regurgitation.
3. Which antihypertensive is preferred in a diabetic patient with
albuminuria?
A) Hydrochlorothiazide
B) Metoprolol
C) Lisinopril (ACE inhibitor)
D) Amlodipine
Correct Answer: C) Lisinopril (ACE inhibitor)
Rationale: ACE inhibitors and ARBs reduce intraglomerular
pressure and slow the progression of diabetic nephropathy,
making them first-line in diabetics with albuminuria.
2
,4. A 45-year-old presents with leg pain while walking that
resolves within 2 minutes of rest. Ankle-brachial index (ABI) is
0.70. This indicates:
A) Venous insufficiency
B) Peripheral artery disease (PAD)
C) Spinal stenosis
D) Diabetic neuropathy
Correct Answer: B) Peripheral artery disease (PAD)
Rationale: An ABI <0.90 confirms PAD. Classic claudication is
reproducible muscle pain with exercise relieved by rest,
distinguishing it from neurogenic claudication.
5. A 62-year-old with heart failure with reduced ejection
fraction (HFrEF) is on lisinopril, metoprolol, and furosemide. He
remains symptomatic (NYHA class III). The NP should consider
adding:
A) Digoxin
B) Spironolactone
3
, C) Hydralazine
D) Ivabradine
Correct Answer: B) Spironolactone
Rationale: Guideline-directed therapy for HFrEF (EF ≤35%,
NYHA II–IV) includes a mineralocorticoid receptor antagonist
(spironolactone or eplerenone) added to an ACE inhibitor and
beta-blocker.
6. Which ECG finding is most specific for pericarditis?
A) ST elevation in a single coronary distribution
B) Deep Q waves
C) Diffuse concave ST elevation with PR depression
D) Prolonged QT interval
Correct Answer: C) Diffuse concave ST elevation with PR
depression
Rationale: Pericarditis causes diffuse, concave (scooped) ST
elevation and PR segment depression across most leads, unlike
the regional, convex ST elevation of MI.
4
EXAM TEST BANK| NURSE PRACTITIONERS IN
PRIMARY CARE I EXAM 3 REVIEW WITH COMPLETE 250
REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
1. A 58-year-old male with hypertension reports substernal chest
pressure when walking uphill that resolves with rest. His ECG is
normal. The most appropriate next step is:
A) Coronary angiography
B) Stress testing (exercise treadmill or nuclear)
C) Prescribe nitroglycerin and discharge
D) Repeat ECG in 1 hour
Correct Answer: B) Stress testing (exercise treadmill or nuclear)
Rationale: Classic stable angina requires risk stratification. A
normal resting ECG does not rule out CAD. Stress testing assesses
for inducible ischemia and guides further management.
2. A 72-year-old female has a new murmur, mid-systolic click,
and late systolic murmur at the apex. These findings suggest:
1
, A) Aortic stenosis
B) Mitral stenosis
C) Mitral valve prolapse
D) Hypertrophic cardiomyopathy
Correct Answer: C) Mitral valve prolapse
Rationale: Mid-systolic click followed by a late systolic murmur
at the apex is classic for mitral valve prolapse, often benign but
may progress to regurgitation.
3. Which antihypertensive is preferred in a diabetic patient with
albuminuria?
A) Hydrochlorothiazide
B) Metoprolol
C) Lisinopril (ACE inhibitor)
D) Amlodipine
Correct Answer: C) Lisinopril (ACE inhibitor)
Rationale: ACE inhibitors and ARBs reduce intraglomerular
pressure and slow the progression of diabetic nephropathy,
making them first-line in diabetics with albuminuria.
2
,4. A 45-year-old presents with leg pain while walking that
resolves within 2 minutes of rest. Ankle-brachial index (ABI) is
0.70. This indicates:
A) Venous insufficiency
B) Peripheral artery disease (PAD)
C) Spinal stenosis
D) Diabetic neuropathy
Correct Answer: B) Peripheral artery disease (PAD)
Rationale: An ABI <0.90 confirms PAD. Classic claudication is
reproducible muscle pain with exercise relieved by rest,
distinguishing it from neurogenic claudication.
5. A 62-year-old with heart failure with reduced ejection
fraction (HFrEF) is on lisinopril, metoprolol, and furosemide. He
remains symptomatic (NYHA class III). The NP should consider
adding:
A) Digoxin
B) Spironolactone
3
, C) Hydralazine
D) Ivabradine
Correct Answer: B) Spironolactone
Rationale: Guideline-directed therapy for HFrEF (EF ≤35%,
NYHA II–IV) includes a mineralocorticoid receptor antagonist
(spironolactone or eplerenone) added to an ACE inhibitor and
beta-blocker.
6. Which ECG finding is most specific for pericarditis?
A) ST elevation in a single coronary distribution
B) Deep Q waves
C) Diffuse concave ST elevation with PR depression
D) Prolonged QT interval
Correct Answer: C) Diffuse concave ST elevation with PR
depression
Rationale: Pericarditis causes diffuse, concave (scooped) ST
elevation and PR segment depression across most leads, unlike
the regional, convex ST elevation of MI.
4
