NSG555 – Nurse Practitioners in Primary Care II Assessment
1,2,3and 4 Questions and Answerers-Wilkes
Coverage:
Hypertension
Diabetes mellitus
Hyperlipidemia
Heart failure
Asthma & COPD
Thyroid disorders
Infectious diseases
Women's health
Men's health
Musculoskeletal disorders
Dermatology
Gastroenterology
Neurology
Renal disorders
Evidence-based primary care
Pharmacology and clinical guidelines
1. A 58-year-old patient with hypertension and type 2 diabetes has persistent blood
pressure readings averaging 146/92 mmHg despite lifestyle modifications. Which
medication is the best first-line choice?
A. Hydrochlorothiazide
B. Lisinopril
C. Propranolol
D. Clonidine
2. According to current diabetes management principles, which A1C target is
appropriate for most nonpregnant adults?
A. <5.5%
B. <6.0%
C. <7.0%
D. <8.5%
3. A patient with asthma reports nighttime symptoms four times per week despite
using a low-dose inhaled corticosteroid. What is the next step?
A. Continue current therapy
B. Add a long-acting beta₂ agonist (LABA)
C. Stop the inhaled corticosteroid
D. Prescribe antibiotics
4. Which lipid-lowering medication is contraindicated during pregnancy?
,A. Ezetimibe
B. Atorvastatin
C. Cholestyramine
D. Omega-3 fatty acids
5. A patient presents with fever, dysuria, urinary frequency, and positive nitrites on
urinalysis. The most likely diagnosis is:
A. Pyelonephritis
B. Acute uncomplicated cystitis
C. Nephrolithiasis
D. Interstitial cystitis
6. Which laboratory test best confirms hypothyroidism?
A. Free T3 only
B. Elevated TSH with low Free T4
C. Elevated cortisol
D. Low TSH with high Free T4
7. Which vaccine is routinely recommended annually for adults?
A. Hepatitis A
B. MMR
C. Influenza vaccine
D. Varicella
8. Which finding is most consistent with bacterial pneumonia?
A. Wheezing only
B. Clear lung sounds
C. Fever, productive cough, and focal crackles
D. Bilateral ankle edema
9. Which antihypertensive medication is contraindicated during pregnancy?
A. Labetalol
B. Losartan
C. Nifedipine
D. Methyldopa
10. Which oral medication is recommended as first-line pharmacologic therapy for
most patients with type 2 diabetes?
A. Glyburide
B. Metformin
,C. Pioglitazone
D. Sitagliptin
11. Which patient requires immediate referral to the emergency department?
A. BP 144/88 mmHg
B. Mild ankle edema
C. Chest pain with diaphoresis and ST-segment elevation
D. Controlled asthma
12. A patient has COPD and continues smoking. Which intervention has the
greatest impact on slowing disease progression?
A. Daily antibiotics
B. Smoking cessation
C. Vitamin supplements
D. Mucolytics
13. Which organism most commonly causes uncomplicated urinary tract infections?
A. Klebsiella pneumoniae
B. Escherichia coli
C. Proteus mirabilis
D. Enterococcus faecalis
14. Which symptom is characteristic of hyperthyroidism?
A. Bradycardia
B. Weight gain
C. Heat intolerance and tachycardia
D. Constipation
15. Which screening test is recommended for adults aged 45–75 years at average
risk for colorectal cancer?
A. PSA
B. Colonoscopy or other recommended colorectal screening test
C. Chest CT
D. Stress ECG
16. Which physical examination finding is most suggestive of heart failure?
A. Hyperactive bowel sounds
B. Jugular venous distention
C. Dry mucous membranes
D. Absent pedal pulses
, 17. Which inhaler should be used for rapid relief during an acute asthma attack?
A. Salmeterol
B. Albuterol
C. Tiotropium
D. Fluticasone
18. Which fasting lipid value indicates elevated LDL cholesterol?
A. 70 mg/dL
B. 85 mg/dL
C. 170 mg/dL
D. 55 mg/dL
19. Which patient has the greatest risk factor for chronic kidney disease
progression?
A. Seasonal allergies
B. Diabetes mellitus with hypertension
C. Migraine headaches
D. Osteoarthritis
20. A patient presents with unilateral calf swelling, warmth, and pain after
prolonged travel. What is the priority diagnosis?
A. Cellulitis
B. Baker cyst
C. Deep vein thrombosis (DVT)
D. Muscle strai
21. A 67-year-old patient with heart failure reports worsening dyspnea, orthopnea,
and a 5-lb weight gain in one week. What is the most appropriate initial
intervention?
A. Increase fluid intake
B. Increase the prescribed loop diuretic and assess volume status
C. Discontinue the ACE inhibitor
D. Begin oral corticosteroids
22. Which physical examination finding is most consistent with acute bacterial
sinusitis?
A. Clear nasal discharge for 2 days
B. Sneezing with itchy eyes
C. Purulent nasal discharge with facial pain lasting more than 10 days
D. Dry cough only
1,2,3and 4 Questions and Answerers-Wilkes
Coverage:
Hypertension
Diabetes mellitus
Hyperlipidemia
Heart failure
Asthma & COPD
Thyroid disorders
Infectious diseases
Women's health
Men's health
Musculoskeletal disorders
Dermatology
Gastroenterology
Neurology
Renal disorders
Evidence-based primary care
Pharmacology and clinical guidelines
1. A 58-year-old patient with hypertension and type 2 diabetes has persistent blood
pressure readings averaging 146/92 mmHg despite lifestyle modifications. Which
medication is the best first-line choice?
A. Hydrochlorothiazide
B. Lisinopril
C. Propranolol
D. Clonidine
2. According to current diabetes management principles, which A1C target is
appropriate for most nonpregnant adults?
A. <5.5%
B. <6.0%
C. <7.0%
D. <8.5%
3. A patient with asthma reports nighttime symptoms four times per week despite
using a low-dose inhaled corticosteroid. What is the next step?
A. Continue current therapy
B. Add a long-acting beta₂ agonist (LABA)
C. Stop the inhaled corticosteroid
D. Prescribe antibiotics
4. Which lipid-lowering medication is contraindicated during pregnancy?
,A. Ezetimibe
B. Atorvastatin
C. Cholestyramine
D. Omega-3 fatty acids
5. A patient presents with fever, dysuria, urinary frequency, and positive nitrites on
urinalysis. The most likely diagnosis is:
A. Pyelonephritis
B. Acute uncomplicated cystitis
C. Nephrolithiasis
D. Interstitial cystitis
6. Which laboratory test best confirms hypothyroidism?
A. Free T3 only
B. Elevated TSH with low Free T4
C. Elevated cortisol
D. Low TSH with high Free T4
7. Which vaccine is routinely recommended annually for adults?
A. Hepatitis A
B. MMR
C. Influenza vaccine
D. Varicella
8. Which finding is most consistent with bacterial pneumonia?
A. Wheezing only
B. Clear lung sounds
C. Fever, productive cough, and focal crackles
D. Bilateral ankle edema
9. Which antihypertensive medication is contraindicated during pregnancy?
A. Labetalol
B. Losartan
C. Nifedipine
D. Methyldopa
10. Which oral medication is recommended as first-line pharmacologic therapy for
most patients with type 2 diabetes?
A. Glyburide
B. Metformin
,C. Pioglitazone
D. Sitagliptin
11. Which patient requires immediate referral to the emergency department?
A. BP 144/88 mmHg
B. Mild ankle edema
C. Chest pain with diaphoresis and ST-segment elevation
D. Controlled asthma
12. A patient has COPD and continues smoking. Which intervention has the
greatest impact on slowing disease progression?
A. Daily antibiotics
B. Smoking cessation
C. Vitamin supplements
D. Mucolytics
13. Which organism most commonly causes uncomplicated urinary tract infections?
A. Klebsiella pneumoniae
B. Escherichia coli
C. Proteus mirabilis
D. Enterococcus faecalis
14. Which symptom is characteristic of hyperthyroidism?
A. Bradycardia
B. Weight gain
C. Heat intolerance and tachycardia
D. Constipation
15. Which screening test is recommended for adults aged 45–75 years at average
risk for colorectal cancer?
A. PSA
B. Colonoscopy or other recommended colorectal screening test
C. Chest CT
D. Stress ECG
16. Which physical examination finding is most suggestive of heart failure?
A. Hyperactive bowel sounds
B. Jugular venous distention
C. Dry mucous membranes
D. Absent pedal pulses
, 17. Which inhaler should be used for rapid relief during an acute asthma attack?
A. Salmeterol
B. Albuterol
C. Tiotropium
D. Fluticasone
18. Which fasting lipid value indicates elevated LDL cholesterol?
A. 70 mg/dL
B. 85 mg/dL
C. 170 mg/dL
D. 55 mg/dL
19. Which patient has the greatest risk factor for chronic kidney disease
progression?
A. Seasonal allergies
B. Diabetes mellitus with hypertension
C. Migraine headaches
D. Osteoarthritis
20. A patient presents with unilateral calf swelling, warmth, and pain after
prolonged travel. What is the priority diagnosis?
A. Cellulitis
B. Baker cyst
C. Deep vein thrombosis (DVT)
D. Muscle strai
21. A 67-year-old patient with heart failure reports worsening dyspnea, orthopnea,
and a 5-lb weight gain in one week. What is the most appropriate initial
intervention?
A. Increase fluid intake
B. Increase the prescribed loop diuretic and assess volume status
C. Discontinue the ACE inhibitor
D. Begin oral corticosteroids
22. Which physical examination finding is most consistent with acute bacterial
sinusitis?
A. Clear nasal discharge for 2 days
B. Sneezing with itchy eyes
C. Purulent nasal discharge with facial pain lasting more than 10 days
D. Dry cough only
