NSG 555 Exam 1 V2 | NSG 555 Nurse
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Exam 1 2026)
1. A 48-year-old male presents for a routine wellness exam. According to current USPSTF
guidelines, which screening should the nurse practitioner initiate for colorectal cancer?
A. Colonoscopy starting at age 50
B. Colonoscopy starting at age 45
C. Fecal occult blood test starting at age 55
D. Annual sigmoidoscopy starting at age 40
Answer: B
Rationale: The USPSTF updated its guidelines to recommend that colorectal cancer
screening begin at age 45 for individuals at average risk. This change reflects the increasing
incidence of colorectal cancer in younger adults. Screening should continue through age 75
with various modalities available including colonoscopy every 10 years.
2. Which component of the SOAP note includes the patient’s description of their symptoms
and the history of the present illness?
A. Plan
B. Objective
,C. Assessment
D. Subjective
Answer: D
Rationale: The Subjective section of a SOAP note contains information provided by the
patient, including the chief complaint and history of present illness. It documents the
patient’s perspective, sensations, and feelings regarding their health status. This section is
crucial for establishing the diagnostic direction before the physical exam is performed.
3. During a physical examination, the nurse practitioner notes a ‘pearly’ papule with
telangiectasia on a patient’s nose. This finding is most suggestive of:
A. Malignant Melanoma
B. Basal Cell Carcinoma
C. Squamous Cell Carcinoma
D. Actinic Keratosis
Answer: B
Rationale: Basal Cell Carcinoma typically presents as a slow-growing, pearly or waxy skin
nodule with prominent surface blood vessels (telangiectasia). It is the most common form
of skin cancer and is highly associated with chronic sun exposure. Definitive diagnosis
requires a skin biopsy to differentiate it from other skin malignancies.
, 4. When performing the Weber test on a patient with suspected hearing loss, the sound
lateralizes to the right ear. The Rinne test shows that Bone Conduction (BC) is greater than Air
Conduction (AC) in the right ear. What is the interpretation?
A. Sensorineural hearing loss in the left ear
B. Sensorineural hearing loss in the right ear
C. Normal hearing in both ears
D. Conductive hearing loss in the right ear
Answer: D
Rationale: In conductive hearing loss, the sound lateralizes to the affected ear during the
Weber test. The Rinne test confirms this when bone conduction is heard longer than air
conduction in that same ear. This occurs because the sound is transmitted through the skull
directly to the cochlea, bypassing the obstructed external or middle ear.
5. A 65-year-old female smoker presents with a persistent cough and shortness of breath. To
confirm a diagnosis of Chronic Obstructive Pulmonary Disease (COPD), which test is required?
A. Spirometry
B. Peak flow meter reading
C. Chest X-ray
D. Arterial blood gas
Answer: A
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Exam 1 2026)
1. A 48-year-old male presents for a routine wellness exam. According to current USPSTF
guidelines, which screening should the nurse practitioner initiate for colorectal cancer?
A. Colonoscopy starting at age 50
B. Colonoscopy starting at age 45
C. Fecal occult blood test starting at age 55
D. Annual sigmoidoscopy starting at age 40
Answer: B
Rationale: The USPSTF updated its guidelines to recommend that colorectal cancer
screening begin at age 45 for individuals at average risk. This change reflects the increasing
incidence of colorectal cancer in younger adults. Screening should continue through age 75
with various modalities available including colonoscopy every 10 years.
2. Which component of the SOAP note includes the patient’s description of their symptoms
and the history of the present illness?
A. Plan
B. Objective
,C. Assessment
D. Subjective
Answer: D
Rationale: The Subjective section of a SOAP note contains information provided by the
patient, including the chief complaint and history of present illness. It documents the
patient’s perspective, sensations, and feelings regarding their health status. This section is
crucial for establishing the diagnostic direction before the physical exam is performed.
3. During a physical examination, the nurse practitioner notes a ‘pearly’ papule with
telangiectasia on a patient’s nose. This finding is most suggestive of:
A. Malignant Melanoma
B. Basal Cell Carcinoma
C. Squamous Cell Carcinoma
D. Actinic Keratosis
Answer: B
Rationale: Basal Cell Carcinoma typically presents as a slow-growing, pearly or waxy skin
nodule with prominent surface blood vessels (telangiectasia). It is the most common form
of skin cancer and is highly associated with chronic sun exposure. Definitive diagnosis
requires a skin biopsy to differentiate it from other skin malignancies.
, 4. When performing the Weber test on a patient with suspected hearing loss, the sound
lateralizes to the right ear. The Rinne test shows that Bone Conduction (BC) is greater than Air
Conduction (AC) in the right ear. What is the interpretation?
A. Sensorineural hearing loss in the left ear
B. Sensorineural hearing loss in the right ear
C. Normal hearing in both ears
D. Conductive hearing loss in the right ear
Answer: D
Rationale: In conductive hearing loss, the sound lateralizes to the affected ear during the
Weber test. The Rinne test confirms this when bone conduction is heard longer than air
conduction in that same ear. This occurs because the sound is transmitted through the skull
directly to the cochlea, bypassing the obstructed external or middle ear.
5. A 65-year-old female smoker presents with a persistent cough and shortness of breath. To
confirm a diagnosis of Chronic Obstructive Pulmonary Disease (COPD), which test is required?
A. Spirometry
B. Peak flow meter reading
C. Chest X-ray
D. Arterial blood gas
Answer: A
