NSG 555 / NSG555 Nurse
Practitioners in Primary Care II
Wilkes University
NSG 555 / NSG555 Exam 1
Questions & Answers Plus
Detailed Rationales
Latest 2026 | PDF
THIS EXAM CONTAINS:
✓100% Pass
✓Multiple Choice ( A-D)
✓Detailed Rationales For Each Question
✓Correct Answers For Each Question
✓250 Qs & Answers
,SECTION 1: CHRONIC DISEASE MANAGEMENT (Questions 1–
20)
1. A 65-year-old patient with type 2 diabetes has a
hemoglobin A1c of 8.5%. Current medications include
metformin 1000 mg BID. What is the most appropriate next
step?
A) Add a sulfonylurea
B) Add an SGLT-2 inhibitor
C) Add insulin glargine
D) Increase metformin to 2000 mg BID
Answer: B) Add an SGLT-2 inhibitor
Rationale: For patients with type 2 diabetes not at goal (A1c
<7%), adding a second agent is appropriate. SGLT-2
inhibitors have cardiovascular and renal benefits and are
preferred in patients with established cardiovascular disease
or chronic kidney disease.
2. Which finding is most concerning in a patient with chronic
hypertension?
A) Blood pressure 145/90 mmHg
B) Left ventricular hypertrophy on ECG
C) Trace proteinuria
D) Mild pedal edema
Answer: B) Left ventricular hypertrophy on ECG
Rationale: Left ventricular hypertrophy (LVH) is a sign of
end-organ damage from chronic hypertension and
significantly increases the risk of cardiovascular events,
including heart failure, arrhythmias, and sudden cardiac
death. It requires aggressive blood pressure management.
,3. A patient with chronic kidney disease (CKD) stage 3 has an
eGFR of 45 mL/min/1.73m². Which medication should be
avoided?
A) Lisinopril
B) Metformin
C) Atorvastatin
D) Amlodipine
Answer: B) Metformin
Rationale: Metformin is contraindicated in patients with
eGFR <30 mL/min/1.73m² and should be used with caution
in stage 3 CKD (eGFR 30-59). Doses should be reduced, and
the drug may need to be held if renal function deteriorates.
4. A 68-year-old patient with osteoarthritis reports knee pain
that worsens with activity and improves with rest. Which
non-pharmacologic intervention should be recommended
first?
A) Total knee replacement
B) Weight loss and low-impact exercise
C) Intra-articular corticosteroid injections
D) Opioid analgesics
Answer: B) Weight loss and low-impact exercise
Rationale: Non-pharmacologic interventions including
weight loss, exercise, and physical therapy are first-line for
osteoarthritis management. Exercise strengthens
periarticular muscles, improves function, and reduces pain.
, 5. What is the leading cause of serious long-term disability in
the United States?
A) Diabetes
B) Stroke
C) Osteoarthritis
D) Heart disease
Answer: B) Stroke
Rationale: Stroke is the leading cause of serious long-term
disability in the United States. Approximately half of stroke
survivors experience significant long-term functional
limitations.
6. A patient with heart failure with reduced ejection fraction
(HFrEF) is on an ACE inhibitor and beta-blocker. What
additional medication class has been shown to provide
mortality benefit?
A) Calcium channel blockers
B) SGLT-2 inhibitors
C) Alpha-blockers
D) Nitrates
Answer: B) SGLT-2 inhibitors
Rationale: SGLT-2 inhibitors (empagliflozin, dapagliflozin)
have demonstrated significant mortality and hospitalization
benefits in patients with HFrEF, regardless of diabetes status,
and are now guideline-recommended as part of foundational
therapy.
Practitioners in Primary Care II
Wilkes University
NSG 555 / NSG555 Exam 1
Questions & Answers Plus
Detailed Rationales
Latest 2026 | PDF
THIS EXAM CONTAINS:
✓100% Pass
✓Multiple Choice ( A-D)
✓Detailed Rationales For Each Question
✓Correct Answers For Each Question
✓250 Qs & Answers
,SECTION 1: CHRONIC DISEASE MANAGEMENT (Questions 1–
20)
1. A 65-year-old patient with type 2 diabetes has a
hemoglobin A1c of 8.5%. Current medications include
metformin 1000 mg BID. What is the most appropriate next
step?
A) Add a sulfonylurea
B) Add an SGLT-2 inhibitor
C) Add insulin glargine
D) Increase metformin to 2000 mg BID
Answer: B) Add an SGLT-2 inhibitor
Rationale: For patients with type 2 diabetes not at goal (A1c
<7%), adding a second agent is appropriate. SGLT-2
inhibitors have cardiovascular and renal benefits and are
preferred in patients with established cardiovascular disease
or chronic kidney disease.
2. Which finding is most concerning in a patient with chronic
hypertension?
A) Blood pressure 145/90 mmHg
B) Left ventricular hypertrophy on ECG
C) Trace proteinuria
D) Mild pedal edema
Answer: B) Left ventricular hypertrophy on ECG
Rationale: Left ventricular hypertrophy (LVH) is a sign of
end-organ damage from chronic hypertension and
significantly increases the risk of cardiovascular events,
including heart failure, arrhythmias, and sudden cardiac
death. It requires aggressive blood pressure management.
,3. A patient with chronic kidney disease (CKD) stage 3 has an
eGFR of 45 mL/min/1.73m². Which medication should be
avoided?
A) Lisinopril
B) Metformin
C) Atorvastatin
D) Amlodipine
Answer: B) Metformin
Rationale: Metformin is contraindicated in patients with
eGFR <30 mL/min/1.73m² and should be used with caution
in stage 3 CKD (eGFR 30-59). Doses should be reduced, and
the drug may need to be held if renal function deteriorates.
4. A 68-year-old patient with osteoarthritis reports knee pain
that worsens with activity and improves with rest. Which
non-pharmacologic intervention should be recommended
first?
A) Total knee replacement
B) Weight loss and low-impact exercise
C) Intra-articular corticosteroid injections
D) Opioid analgesics
Answer: B) Weight loss and low-impact exercise
Rationale: Non-pharmacologic interventions including
weight loss, exercise, and physical therapy are first-line for
osteoarthritis management. Exercise strengthens
periarticular muscles, improves function, and reduces pain.
, 5. What is the leading cause of serious long-term disability in
the United States?
A) Diabetes
B) Stroke
C) Osteoarthritis
D) Heart disease
Answer: B) Stroke
Rationale: Stroke is the leading cause of serious long-term
disability in the United States. Approximately half of stroke
survivors experience significant long-term functional
limitations.
6. A patient with heart failure with reduced ejection fraction
(HFrEF) is on an ACE inhibitor and beta-blocker. What
additional medication class has been shown to provide
mortality benefit?
A) Calcium channel blockers
B) SGLT-2 inhibitors
C) Alpha-blockers
D) Nitrates
Answer: B) SGLT-2 inhibitors
Rationale: SGLT-2 inhibitors (empagliflozin, dapagliflozin)
have demonstrated significant mortality and hospitalization
benefits in patients with HFrEF, regardless of diabetes status,
and are now guideline-recommended as part of foundational
therapy.
