NSG 555 | Exam 3 Advanced Clinical Management | 2026/2027 UPDATE
NSG 555
NURSE PRACTITIONERS IN PRIMARY CARE II
Advanced Clinical Management – Exam 3
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 | Exam 3 Advanced Clinical Management | 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 | Exam 3 Advanced Clinical Management | 2026/2027 UPDATE
Question 1
A 65-year-old patient with Chronic Obstructive Pulmonary Disease (COPD) presents with an acute exacerbation.
According to the GOLD guidelines, which of the following is the most appropriate first-line treatment for a patient
categorized in Group C?
A. Short-acting beta-agonist (SABA) only
B. Inhaled corticosteroid (ICS) monotherapy
C. Long-acting muscarinic antagonist (LAMA)
D. LAMA plus Long-acting beta-agonist (LABA) combination
Answer: C
Rationale
According to the GOLD guidelines, Group C patients (low symptom burden but high risk of exacerbation) should be started on a
LAMA. Long-acting muscarinic antagonists are superior to LABAs in preventing exacerbations.
Question 2
A 54-year-old African American male is diagnosed with Stage 1 Hypertension. His past medical history is
significant for Type 2 Diabetes but no evidence of Chronic Kidney Disease (CKD). What is the recommended
first-line antihypertensive medication?
A. Lisinopril
B. Metoprolol
C. Amlodipine
D. Losartan
Answer: C
Rationale
JNC 8 and ACC/AHA guidelines recommend that for the African American population without CKD, initial antihypertensive
treatment should include a thiazide-type diuretic or a Calcium Channel Blocker (CCB) like Amlodipine.
Question 3
A patient with Type 2 Diabetes has an A1c of 9.2% despite being on maximum doses of Metformin and a GLP-1
receptor agonist. The patient has a history of Heart Failure with reduced Ejection Fraction (HFrEF). Which
medication should be added next?
A. Glipizide
B. Empagliflozin
C. Pioglitazone
D. Sitagliptin
Answer: B
Rationale
SGLT2 inhibitors like Empagliflozin have demonstrated significant benefits in reducing hospitalizations for heart failure and are
recommended for patients with T2DM and HFrEF.
Page 3
NSG 555
NURSE PRACTITIONERS IN PRIMARY CARE II
Advanced Clinical Management – Exam 3
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 | Exam 3 Advanced Clinical Management | 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 | Exam 3 Advanced Clinical Management | 2026/2027 UPDATE
Question 1
A 65-year-old patient with Chronic Obstructive Pulmonary Disease (COPD) presents with an acute exacerbation.
According to the GOLD guidelines, which of the following is the most appropriate first-line treatment for a patient
categorized in Group C?
A. Short-acting beta-agonist (SABA) only
B. Inhaled corticosteroid (ICS) monotherapy
C. Long-acting muscarinic antagonist (LAMA)
D. LAMA plus Long-acting beta-agonist (LABA) combination
Answer: C
Rationale
According to the GOLD guidelines, Group C patients (low symptom burden but high risk of exacerbation) should be started on a
LAMA. Long-acting muscarinic antagonists are superior to LABAs in preventing exacerbations.
Question 2
A 54-year-old African American male is diagnosed with Stage 1 Hypertension. His past medical history is
significant for Type 2 Diabetes but no evidence of Chronic Kidney Disease (CKD). What is the recommended
first-line antihypertensive medication?
A. Lisinopril
B. Metoprolol
C. Amlodipine
D. Losartan
Answer: C
Rationale
JNC 8 and ACC/AHA guidelines recommend that for the African American population without CKD, initial antihypertensive
treatment should include a thiazide-type diuretic or a Calcium Channel Blocker (CCB) like Amlodipine.
Question 3
A patient with Type 2 Diabetes has an A1c of 9.2% despite being on maximum doses of Metformin and a GLP-1
receptor agonist. The patient has a history of Heart Failure with reduced Ejection Fraction (HFrEF). Which
medication should be added next?
A. Glipizide
B. Empagliflozin
C. Pioglitazone
D. Sitagliptin
Answer: B
Rationale
SGLT2 inhibitors like Empagliflozin have demonstrated significant benefits in reducing hospitalizations for heart failure and are
recommended for patients with T2DM and HFrEF.
Page 3
