NSG 555 | Comprehensive Exam 1 | 2026/2027 UPDATE
NSG 555
NURSE PRACTITIONERS IN PRIMARY CARE II
Comprehensive Exam 1
UPDATE
50 Multiple-Choice Questions
Complete Answers with Explained Rationales
Aligned with Current Clinical Guidelines
Wilkes University | Advanced Practice Nursing
Cardiovascular • Pulmonary • Endocrine • GI • MSK • Infectious Disease
For academic study and clinical review • Verify with current institutional protocols
Page 1
,NSG 555 | Comprehensive Exam 1 | 2026/2027 UPDATE
How to Use This Review
This comprehensive exam review contains high-yield multiple-choice questions covering the core clinical
management topics of NSG 555. Each item is followed by the correct answer and rationales that explain the
underlying pathophysiology or guideline recommendation, why the correct option is preferred, and why the
distractors are incorrect.
Topics span cardiovascular, pulmonary, endocrine, GI, MSK, infectious disease, and preventive care guidelines.
Study tip: Attempt each question before reading the answer. Then carefully review the rationale.
Topic Index (Selected High-Yield Areas)
• Heart Failure & ARNI therapy
• SGLT2 inhibitors & cardiorenal protection
• COPD / Asthma & GOLD staging
• Atrial Fibrillation & anticoagulation
• Type 2 Diabetes management
• Thyroid disorders
• Gout & Osteoarthritis
• Community-acquired pneumonia
• Anemia work-up
• Hypertension guidelines
• BPH, CKD, Beers Criteria
• Ophthalmologic & surgical emergencies
• Infectious disease (Lyme, zoster)
Page 2
, NSG 555 | Comprehensive Exam 1 | 2026/2027 UPDATE
Question 1
A 65-year-old patient presents with a blood pressure of 148/92 mmHg on two separate occasions. According to the
ACC/AHA 2017 guidelines, how should this patient be classified?
A. Elevated Blood Pressure
B. Stage 2 Hypertension
C. Stage 1 Hypertension
D. Hypertensive Urgency
Answer: B
Rationale
According to the 2017 ACC/AHA guidelines, Stage 2 Hypertension is defined as a systolic pressure of at least 140 mmHg or a
diastolic pressure of at least 90 mmHg.
Question 2
Which of the following physical examination findings is most characteristic of a patient with chronic obstructive
pulmonary disease (COPD)?
A. Hyperresonance on percussion
B. Increased tactile fremitus
C. Vesicular breath sounds at the bases
D. Pectus excavatum
Answer: A
Rationale
Hyperresonance on percussion is a classic sign of lung hyperinflation, which is commonly seen in patients with COPD due to air
trapping.
Question 3
A 45-year-old male presents with a sudden onset of severe pain, redness, and swelling in his right first
metatarsophalangeal joint. What is the gold standard for diagnosing the suspected condition?
A. Serum uric acid level > 7.0 mg/dL
B. Radiographic evidence of ‘punched-out’ erosions
C. Joint aspiration with crystal analysis under polarized light
D. Response to colchicine therapy within 24 hours
Answer: C
Rationale
The definitive diagnosis of gout is made by demonstrating monosodium urate crystals in the synovial fluid of the affected joint
using polarized light microscopy.
Question 4
In the management of heart failure with reduced ejection fraction (HFrEF), which medication class is
recommended to be initiated first to reduce mortality and hospitalization?
A. Loop Diuretics
B. ACE Inhibitors or ARNI
C. Digoxin
D. Calcium Channel Blockers
Answer: B
Rationale
ACE inhibitors, ARBs, and now ARNI (angiotensin receptor-neprilysin inhibitors) are first-line therapies that have been proven
to reduce mortality in patients with HFrEF.
Page 3
NSG 555
NURSE PRACTITIONERS IN PRIMARY CARE II
Comprehensive Exam 1
UPDATE
50 Multiple-Choice Questions
Complete Answers with Explained Rationales
Aligned with Current Clinical Guidelines
Wilkes University | Advanced Practice Nursing
Cardiovascular • Pulmonary • Endocrine • GI • MSK • Infectious Disease
For academic study and clinical review • Verify with current institutional protocols
Page 1
,NSG 555 | Comprehensive Exam 1 | 2026/2027 UPDATE
How to Use This Review
This comprehensive exam review contains high-yield multiple-choice questions covering the core clinical
management topics of NSG 555. Each item is followed by the correct answer and rationales that explain the
underlying pathophysiology or guideline recommendation, why the correct option is preferred, and why the
distractors are incorrect.
Topics span cardiovascular, pulmonary, endocrine, GI, MSK, infectious disease, and preventive care guidelines.
Study tip: Attempt each question before reading the answer. Then carefully review the rationale.
Topic Index (Selected High-Yield Areas)
• Heart Failure & ARNI therapy
• SGLT2 inhibitors & cardiorenal protection
• COPD / Asthma & GOLD staging
• Atrial Fibrillation & anticoagulation
• Type 2 Diabetes management
• Thyroid disorders
• Gout & Osteoarthritis
• Community-acquired pneumonia
• Anemia work-up
• Hypertension guidelines
• BPH, CKD, Beers Criteria
• Ophthalmologic & surgical emergencies
• Infectious disease (Lyme, zoster)
Page 2
, NSG 555 | Comprehensive Exam 1 | 2026/2027 UPDATE
Question 1
A 65-year-old patient presents with a blood pressure of 148/92 mmHg on two separate occasions. According to the
ACC/AHA 2017 guidelines, how should this patient be classified?
A. Elevated Blood Pressure
B. Stage 2 Hypertension
C. Stage 1 Hypertension
D. Hypertensive Urgency
Answer: B
Rationale
According to the 2017 ACC/AHA guidelines, Stage 2 Hypertension is defined as a systolic pressure of at least 140 mmHg or a
diastolic pressure of at least 90 mmHg.
Question 2
Which of the following physical examination findings is most characteristic of a patient with chronic obstructive
pulmonary disease (COPD)?
A. Hyperresonance on percussion
B. Increased tactile fremitus
C. Vesicular breath sounds at the bases
D. Pectus excavatum
Answer: A
Rationale
Hyperresonance on percussion is a classic sign of lung hyperinflation, which is commonly seen in patients with COPD due to air
trapping.
Question 3
A 45-year-old male presents with a sudden onset of severe pain, redness, and swelling in his right first
metatarsophalangeal joint. What is the gold standard for diagnosing the suspected condition?
A. Serum uric acid level > 7.0 mg/dL
B. Radiographic evidence of ‘punched-out’ erosions
C. Joint aspiration with crystal analysis under polarized light
D. Response to colchicine therapy within 24 hours
Answer: C
Rationale
The definitive diagnosis of gout is made by demonstrating monosodium urate crystals in the synovial fluid of the affected joint
using polarized light microscopy.
Question 4
In the management of heart failure with reduced ejection fraction (HFrEF), which medication class is
recommended to be initiated first to reduce mortality and hospitalization?
A. Loop Diuretics
B. ACE Inhibitors or ARNI
C. Digoxin
D. Calcium Channel Blockers
Answer: B
Rationale
ACE inhibitors, ARBs, and now ARNI (angiotensin receptor-neprilysin inhibitors) are first-line therapies that have been proven
to reduce mortality in patients with HFrEF.
Page 3
