NSG 555 Exam 2 V3 | NSG 555 Nurse
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Exam 2 2026)
1. A 45-year-old male presents with a persistent cough and night sweats. A TST is performed,
and the induration measures 12 mm. He has no known risk factors for TB. How should the
Nurse Practitioner interpret this result?
A. Positive
B. False-positive
C. Indeterminate
D. Negative
Answer: D
Rationale: For individuals with no known risk factors for tuberculosis, an induration of 15
mm or more is required for a positive TST result. A 12 mm induration is considered
negative in this low-risk category according to CDC guidelines. The Nurse Practitioner must
assess patient risk factors accurately to interpret the tuberculin skin test correctly.
2. When evaluating a patient with suspected Chronic Obstructive Pulmonary Disease (COPD),
which spirometry value is diagnostic for airflow limitation?
A. TLC > 120% predicted
,B. FEV1 > 80% predicted
C. FVC < 70% predicted
D. FEV1/FVC ratio < 0.70 after bronchodilator
Answer: D
Rationale: The GOLD guidelines specify that a post-bronchodilator FEV1/FVC ratio of less
than 0.70 confirms the presence of persistent airflow limitation. This objective
measurement is essential for distinguishing COPD from other respiratory conditions like
asthma. Spirometry remains the gold standard for the diagnosis and staging of COPD
severity.
3. A 62-year-old female presents with acute onset of shortness of breath and pleuritic chest
pain. She recently underwent hip replacement surgery. What is the most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Pneumonia
D. Pneumothorax
Answer: B
Rationale: Recent major surgery such as hip replacement is a significant risk factor for
deep vein thrombosis and subsequent pulmonary embolism. Pleuritic chest pain combined
, with sudden dyspnea in a post-surgical patient strongly suggests this diagnosis. Rapid
assessment and imaging like a CT pulmonary angiogram are necessary for confirmation.
4. Which of the following is the first-line treatment for a patient diagnosed with mild
intermittent asthma?
A. Inhaled corticosteroid (ICS) daily
B. Short-acting beta-agonist (SABA) as needed
C. Long-acting beta-agonist (LABA) as needed
D. Oral leukotriene receptor antagonist
Answer: B
Rationale: According to traditional GINA and NAEPP guidelines, mild intermittent asthma
is managed with an as-needed SABA for symptom relief. However, current updates
increasingly suggest using low-dose ICS-formoterol as the preferred reliever. For the
purposes of standard examinations, SABA as needed remains a classic answer for
intermittent classification.
5. A patient presents with a ‘velvety,’ hyperpigmented plaque on the back of the neck. What
underlying condition should the Nurse Practitioner screen for?
A. Hypothyroidism
B. Addison’s Disease
C. Systemic Lupus Erythematosus
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Exam 2 2026)
1. A 45-year-old male presents with a persistent cough and night sweats. A TST is performed,
and the induration measures 12 mm. He has no known risk factors for TB. How should the
Nurse Practitioner interpret this result?
A. Positive
B. False-positive
C. Indeterminate
D. Negative
Answer: D
Rationale: For individuals with no known risk factors for tuberculosis, an induration of 15
mm or more is required for a positive TST result. A 12 mm induration is considered
negative in this low-risk category according to CDC guidelines. The Nurse Practitioner must
assess patient risk factors accurately to interpret the tuberculin skin test correctly.
2. When evaluating a patient with suspected Chronic Obstructive Pulmonary Disease (COPD),
which spirometry value is diagnostic for airflow limitation?
A. TLC > 120% predicted
,B. FEV1 > 80% predicted
C. FVC < 70% predicted
D. FEV1/FVC ratio < 0.70 after bronchodilator
Answer: D
Rationale: The GOLD guidelines specify that a post-bronchodilator FEV1/FVC ratio of less
than 0.70 confirms the presence of persistent airflow limitation. This objective
measurement is essential for distinguishing COPD from other respiratory conditions like
asthma. Spirometry remains the gold standard for the diagnosis and staging of COPD
severity.
3. A 62-year-old female presents with acute onset of shortness of breath and pleuritic chest
pain. She recently underwent hip replacement surgery. What is the most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Pneumonia
D. Pneumothorax
Answer: B
Rationale: Recent major surgery such as hip replacement is a significant risk factor for
deep vein thrombosis and subsequent pulmonary embolism. Pleuritic chest pain combined
, with sudden dyspnea in a post-surgical patient strongly suggests this diagnosis. Rapid
assessment and imaging like a CT pulmonary angiogram are necessary for confirmation.
4. Which of the following is the first-line treatment for a patient diagnosed with mild
intermittent asthma?
A. Inhaled corticosteroid (ICS) daily
B. Short-acting beta-agonist (SABA) as needed
C. Long-acting beta-agonist (LABA) as needed
D. Oral leukotriene receptor antagonist
Answer: B
Rationale: According to traditional GINA and NAEPP guidelines, mild intermittent asthma
is managed with an as-needed SABA for symptom relief. However, current updates
increasingly suggest using low-dose ICS-formoterol as the preferred reliever. For the
purposes of standard examinations, SABA as needed remains a classic answer for
intermittent classification.
5. A patient presents with a ‘velvety,’ hyperpigmented plaque on the back of the neck. What
underlying condition should the Nurse Practitioner screen for?
A. Hypothyroidism
B. Addison’s Disease
C. Systemic Lupus Erythematosus
