NSG 554 Exam 3 V2 | NSG 554 Nurse
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG554 Exam 3 2026)
1. A 45-year-old male patient presents with symptoms of productive cough, fever, and
dyspnea. On physical examination, you note dullness to percussion and increased tactile
fremitus on the right lower lobe. Which of the following is the most likely diagnosis?
A. Community-Acquired Pneumonia
B. Acute Bronchitis
C. Pleural Effusion
D. Pneumothorax
Answer: A
Rationale: Community-acquired pneumonia typically presents with clinical signs of
consolidation, such as increased tactile fremitus and dullness to percussion. In contrast,
pleural effusions would show decreased tactile fremitus due to fluid separating the lung
from the chest wall. The presence of a productive cough and fever further supports an
infectious process within the lung parenchyma.
2. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-year-old patient
without diabetes or chronic kidney disease?
A. <130/80 mmHg
,B. <140/90 mmHg
C. <150/90 mmHg
D. <120/80 mmHg
Answer: C
Rationale: JNC 8 guidelines recommend a higher threshold for initiating treatment in
patients aged 65 and older who do not have comorbidities like DM or CKD. The target for
this specific population is set at less than 150/90 mmHg to avoid adverse effects of
polypharmacy and hypotension. However, many clinicians may still aim for lower targets
based on more recent ACC/AHA guidelines, but the JNC 8 standard remains a core testing
point.
3. A patient presents with a ‘honey-colored’ crusted lesion on their upper lip. Which
pathogen is most commonly associated with this presentation of non-bullous impetigo?
A. Pseudomonas aeruginosa
B. Haemophilus influenzae
C. Escherichia coli
D. Staphylococcus aureus
Answer: D
Rationale: Staphylococcus aureus is the most frequent cause of non-bullous impetigo,
often characterized by classic honey-colored crusting. Streptococcus pyogenes can also
, cause this condition, though it is less common than S. aureus in modern clinical settings.
Treatment typically involves topical mupirocin or oral antibiotics if the infection is
widespread.
4. Which of the following laboratory findings is most characteristic of iron deficiency anemia?
A. Increased Ferritin
B. Decreased Mean Corpuscular Volume (MCV)
C. Decreased Total Iron Binding Capacity (TIBC)
D. Increased Reticulocyte Count
Answer: B
Rationale: Iron deficiency anemia is a microcytic anemia, which is reflected by a decreased
MCV. Ferritin levels are typically low because they represent iron stores, while TIBC is
increased as the body attempts to compensate for low iron. The reticulocyte count is
usually low or normal because the marrow lacks the raw materials to produce new red
blood cells.
5. A 12-month-old infant is in the clinic for a well-child checkup. Which of the following
vaccines is typically administered at this age according to the CDC schedule?
A. Rotavirus
B. Meningococcal B
C. HPV
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG554 Exam 3 2026)
1. A 45-year-old male patient presents with symptoms of productive cough, fever, and
dyspnea. On physical examination, you note dullness to percussion and increased tactile
fremitus on the right lower lobe. Which of the following is the most likely diagnosis?
A. Community-Acquired Pneumonia
B. Acute Bronchitis
C. Pleural Effusion
D. Pneumothorax
Answer: A
Rationale: Community-acquired pneumonia typically presents with clinical signs of
consolidation, such as increased tactile fremitus and dullness to percussion. In contrast,
pleural effusions would show decreased tactile fremitus due to fluid separating the lung
from the chest wall. The presence of a productive cough and fever further supports an
infectious process within the lung parenchyma.
2. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-year-old patient
without diabetes or chronic kidney disease?
A. <130/80 mmHg
,B. <140/90 mmHg
C. <150/90 mmHg
D. <120/80 mmHg
Answer: C
Rationale: JNC 8 guidelines recommend a higher threshold for initiating treatment in
patients aged 65 and older who do not have comorbidities like DM or CKD. The target for
this specific population is set at less than 150/90 mmHg to avoid adverse effects of
polypharmacy and hypotension. However, many clinicians may still aim for lower targets
based on more recent ACC/AHA guidelines, but the JNC 8 standard remains a core testing
point.
3. A patient presents with a ‘honey-colored’ crusted lesion on their upper lip. Which
pathogen is most commonly associated with this presentation of non-bullous impetigo?
A. Pseudomonas aeruginosa
B. Haemophilus influenzae
C. Escherichia coli
D. Staphylococcus aureus
Answer: D
Rationale: Staphylococcus aureus is the most frequent cause of non-bullous impetigo,
often characterized by classic honey-colored crusting. Streptococcus pyogenes can also
, cause this condition, though it is less common than S. aureus in modern clinical settings.
Treatment typically involves topical mupirocin or oral antibiotics if the infection is
widespread.
4. Which of the following laboratory findings is most characteristic of iron deficiency anemia?
A. Increased Ferritin
B. Decreased Mean Corpuscular Volume (MCV)
C. Decreased Total Iron Binding Capacity (TIBC)
D. Increased Reticulocyte Count
Answer: B
Rationale: Iron deficiency anemia is a microcytic anemia, which is reflected by a decreased
MCV. Ferritin levels are typically low because they represent iron stores, while TIBC is
increased as the body attempts to compensate for low iron. The reticulocyte count is
usually low or normal because the marrow lacks the raw materials to produce new red
blood cells.
5. A 12-month-old infant is in the clinic for a well-child checkup. Which of the following
vaccines is typically administered at this age according to the CDC schedule?
A. Rotavirus
B. Meningococcal B
C. HPV
