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 55-year-old male presents for a routine physical with a blood pressure of 148/92 mmHg.
According to the ACC/AHA 2017 guidelines, what is the most appropriate next step in
management for this patient with no other comorbidities?
A. Confirm the diagnosis with out-of-office measurements or a repeat visit.
B. Diagnose Stage 2 Hypertension and reassess in one month after lifestyle modifications.
C. Initiate therapy with a calcium channel blocker immediately.
D. Start low-dose Lisinopril and check a BMP in two weeks.
Correct Answer: A
Explanation: A single elevated blood pressure reading is insufficient to diagnose
hypertension in the absence of a hypertensive emergency. The provider should confirm the
diagnosis through ambulatory blood pressure monitoring or repeat office visits to avoid
over-diagnosis. Lifestyle modifications should also be discussed as part of the initial plan
for a patient in this pressure range.
2. A 62-year-old female presents with a new complaint of an itchy, circular red lesion on her
forearm with central clearing. Which of the following is the most likely diagnosis?
A. Psoriasis
B. Tinea Corporis
,C. Lyme Disease (Erythema Migrans)
D. Atopic Dermatitis
Correct Answer: B
Explanation: Tinea Corporis typically presents as an annular lesion with a scaly border
and central clearing, often referred to as ‘ringworm’. Psoriasis would generally show silver
scaling and be found on extensor surfaces. Lyme disease usually presents with a larger,
non-pruritic ‘bullseye’ rash rather than a classic scaly fungal appearance.
3. Which of the following screening tests is recommended by the USPSTF for a 52-year-old
asymptomatic male with no family history of colorectal cancer?
A. Fecal occult blood test (FOBT) every 3 years
B. Colonoscopy every 10 years
C. Sigmoidoscopy every 15 years
D. Screening should start at age 45, but no test is indicated yet if previous results were
normal.
Correct Answer: B
Explanation: The USPSTF recommends screening for colorectal cancer in all adults aged
45 to 75 years. Colonoscopy every 10 years remains a gold-standard screening modality for
average-risk individuals. Annual FIT or FOBT tests are also acceptable alternatives for
those who prefer non-invasive options.
, 4. A 24-year-old female patient presents with a sore throat, fever of 101.5°F, and anterior
cervical lymphadenopathy. She denies having a cough. Based on the Centor criteria, what is
the best management strategy?
A. Prescribe Amoxicillin 500mg BID for 10 days immediately.
B. Order a chest X-ray to rule out pneumonia.
C. Advise supportive care with NSAIDs only as this is likely viral.
D. Perform a Rapid Antigen Detection Test (RADT).
Correct Answer: D
Explanation: The patient has a Centor score of 3 (fever, no cough, cervical adenopathy),
which indicates a high likelihood of Group A Streptococcus. According to evidence-based
guidelines, patients with a score of 2 or 3 should be tested via RADT to confirm infection
before starting antibiotics. If the RADT is negative in a pediatric patient, a culture is needed,
though not always required in adults.
5. Which laboratory finding is most diagnostic for primary hypothyroidism?
A. High TSH and Low Free T4
B. High TSH and High Free T4
C. Low TSH and Low Free T4
D. Normal TSH and Low Free T4
Correct Answer: A
in Primary Care I | Wilkes University | 2026 Q&A
with Rationale (Wilkes NSG555 Exam 1 2026)
1. A 55-year-old male presents for a routine physical with a blood pressure of 148/92 mmHg.
According to the ACC/AHA 2017 guidelines, what is the most appropriate next step in
management for this patient with no other comorbidities?
A. Confirm the diagnosis with out-of-office measurements or a repeat visit.
B. Diagnose Stage 2 Hypertension and reassess in one month after lifestyle modifications.
C. Initiate therapy with a calcium channel blocker immediately.
D. Start low-dose Lisinopril and check a BMP in two weeks.
Correct Answer: A
Explanation: A single elevated blood pressure reading is insufficient to diagnose
hypertension in the absence of a hypertensive emergency. The provider should confirm the
diagnosis through ambulatory blood pressure monitoring or repeat office visits to avoid
over-diagnosis. Lifestyle modifications should also be discussed as part of the initial plan
for a patient in this pressure range.
2. A 62-year-old female presents with a new complaint of an itchy, circular red lesion on her
forearm with central clearing. Which of the following is the most likely diagnosis?
A. Psoriasis
B. Tinea Corporis
,C. Lyme Disease (Erythema Migrans)
D. Atopic Dermatitis
Correct Answer: B
Explanation: Tinea Corporis typically presents as an annular lesion with a scaly border
and central clearing, often referred to as ‘ringworm’. Psoriasis would generally show silver
scaling and be found on extensor surfaces. Lyme disease usually presents with a larger,
non-pruritic ‘bullseye’ rash rather than a classic scaly fungal appearance.
3. Which of the following screening tests is recommended by the USPSTF for a 52-year-old
asymptomatic male with no family history of colorectal cancer?
A. Fecal occult blood test (FOBT) every 3 years
B. Colonoscopy every 10 years
C. Sigmoidoscopy every 15 years
D. Screening should start at age 45, but no test is indicated yet if previous results were
normal.
Correct Answer: B
Explanation: The USPSTF recommends screening for colorectal cancer in all adults aged
45 to 75 years. Colonoscopy every 10 years remains a gold-standard screening modality for
average-risk individuals. Annual FIT or FOBT tests are also acceptable alternatives for
those who prefer non-invasive options.
, 4. A 24-year-old female patient presents with a sore throat, fever of 101.5°F, and anterior
cervical lymphadenopathy. She denies having a cough. Based on the Centor criteria, what is
the best management strategy?
A. Prescribe Amoxicillin 500mg BID for 10 days immediately.
B. Order a chest X-ray to rule out pneumonia.
C. Advise supportive care with NSAIDs only as this is likely viral.
D. Perform a Rapid Antigen Detection Test (RADT).
Correct Answer: D
Explanation: The patient has a Centor score of 3 (fever, no cough, cervical adenopathy),
which indicates a high likelihood of Group A Streptococcus. According to evidence-based
guidelines, patients with a score of 2 or 3 should be tested via RADT to confirm infection
before starting antibiotics. If the RADT is negative in a pediatric patient, a culture is needed,
though not always required in adults.
5. Which laboratory finding is most diagnostic for primary hypothyroidism?
A. High TSH and Low Free T4
B. High TSH and High Free T4
C. Low TSH and Low Free T4
D. Normal TSH and Low Free T4
Correct Answer: A
