NSG 555 Final Exam V1 | NSG 555 Nurse
Practitioners in Primary Care I | Wilkes University
| 2026 Q&A with Rationale (Wilkes NSG555 Final
Exam 2026)
1. A 45-year-old male presents with a blood pressure of 152/94 mmHg on two separate
occasions. According to the JNC 8 guidelines, which of the following is the most appropriate
initial pharmacological intervention for a non-African American patient without chronic
kidney disease?
A. Clonidine 0.1 mg twice daily
B. Lisinopril 10 mg daily
C. Furosemide 20 mg daily
D. Metoprolol succinate 25 mg daily
Correct Answer: B
Explanation: According to JNC 8 guidelines, initial treatment for hypertension in the
general non-African American population should include a thiazide-type diuretic, calcium
channel blocker (CCB), ACE inhibitor (ACEI), or angiotensin receptor blocker (ARB).
Lisinopril is an ACE inhibitor and is a recommended first-line agent. Beta-blockers like
Metoprolol are no longer considered first-line for primary hypertension unless a
compelling indication like HF or post-MI exists.
,2. A 22-year-old female presents with a sore throat, fever of 101.5°F, and cervical
lymphadenopathy. She lacks a cough. Which tool is most appropriate to determine the
necessity of a rapid strep test?
A. CURB-65 Scale
B. CHA2DS2-VASc Score
C. PHQ-9 Questionnaire
D. Centor Criteria
Correct Answer: D
Explanation: The Centor Criteria is used to estimate the probability that a sore throat is
caused by Group A Beta-hemolytic Streptococcus (GABHS). It includes four components:
fever, tonsillar exudates, tender anterior cervical lymphadenopathy, and absence of cough.
A score of 2 or higher usually warrants further testing with a rapid antigen detection test or
culture.
3. A 68-year-old patient with a history of COPD presents with increased sputum purulence
and dyspnea. His FEV1 is 45% of predicted. Which classification of COPD severity does this
represent according to GOLD guidelines?
A. GOLD 1 (Mild)
B. GOLD 3 (Severe)
C. GOLD 2 (Moderate)
D. GOLD 4 (Very Severe)
, Correct Answer: B
Explanation: GOLD 3 (Severe) is defined by an FEV1 between 30% and 49% of the
predicted value. GOLD 2 is 50-79%, while GOLD 4 is less than 30%. This classification helps
clinicians determine the appropriate escalation of inhaled therapies such as LAMA and
LABA combinations.
4. Which of the following physical exam findings is most suggestive of iron deficiency anemia?
A. Loss of vibratory sense
B. Glossitis and koilonychia
C. Splenomegaly and jaundice
D. Petechiae and purpura
Correct Answer: B
Explanation: Glossitis (inflammation of the tongue) and koilonychia (spoon-shaped nails)
are classic physical signs of chronic iron deficiency. Loss of vibratory sense is more
commonly associated with Vitamin B12 deficiency (macrocytic anemia). Jaundice and
splenomegaly often point toward hemolytic anemias.
5. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
smaller maculopapular lesions on the trunk. What is the most likely diagnosis?
A. Tinea Corporis
B. Psoriasis
Practitioners in Primary Care I | Wilkes University
| 2026 Q&A with Rationale (Wilkes NSG555 Final
Exam 2026)
1. A 45-year-old male presents with a blood pressure of 152/94 mmHg on two separate
occasions. According to the JNC 8 guidelines, which of the following is the most appropriate
initial pharmacological intervention for a non-African American patient without chronic
kidney disease?
A. Clonidine 0.1 mg twice daily
B. Lisinopril 10 mg daily
C. Furosemide 20 mg daily
D. Metoprolol succinate 25 mg daily
Correct Answer: B
Explanation: According to JNC 8 guidelines, initial treatment for hypertension in the
general non-African American population should include a thiazide-type diuretic, calcium
channel blocker (CCB), ACE inhibitor (ACEI), or angiotensin receptor blocker (ARB).
Lisinopril is an ACE inhibitor and is a recommended first-line agent. Beta-blockers like
Metoprolol are no longer considered first-line for primary hypertension unless a
compelling indication like HF or post-MI exists.
,2. A 22-year-old female presents with a sore throat, fever of 101.5°F, and cervical
lymphadenopathy. She lacks a cough. Which tool is most appropriate to determine the
necessity of a rapid strep test?
A. CURB-65 Scale
B. CHA2DS2-VASc Score
C. PHQ-9 Questionnaire
D. Centor Criteria
Correct Answer: D
Explanation: The Centor Criteria is used to estimate the probability that a sore throat is
caused by Group A Beta-hemolytic Streptococcus (GABHS). It includes four components:
fever, tonsillar exudates, tender anterior cervical lymphadenopathy, and absence of cough.
A score of 2 or higher usually warrants further testing with a rapid antigen detection test or
culture.
3. A 68-year-old patient with a history of COPD presents with increased sputum purulence
and dyspnea. His FEV1 is 45% of predicted. Which classification of COPD severity does this
represent according to GOLD guidelines?
A. GOLD 1 (Mild)
B. GOLD 3 (Severe)
C. GOLD 2 (Moderate)
D. GOLD 4 (Very Severe)
, Correct Answer: B
Explanation: GOLD 3 (Severe) is defined by an FEV1 between 30% and 49% of the
predicted value. GOLD 2 is 50-79%, while GOLD 4 is less than 30%. This classification helps
clinicians determine the appropriate escalation of inhaled therapies such as LAMA and
LABA combinations.
4. Which of the following physical exam findings is most suggestive of iron deficiency anemia?
A. Loss of vibratory sense
B. Glossitis and koilonychia
C. Splenomegaly and jaundice
D. Petechiae and purpura
Correct Answer: B
Explanation: Glossitis (inflammation of the tongue) and koilonychia (spoon-shaped nails)
are classic physical signs of chronic iron deficiency. Loss of vibratory sense is more
commonly associated with Vitamin B12 deficiency (macrocytic anemia). Jaundice and
splenomegaly often point toward hemolytic anemias.
5. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
smaller maculopapular lesions on the trunk. What is the most likely diagnosis?
A. Tinea Corporis
B. Psoriasis
