NSG 555 Nurse Practitioner Primary Care I
Practice Exam 2026 Practice Questions &
Study Guide | Complete Exam-Style Questions
with Correct Detailed Answers & Rationales
(Reliable Answers)
Question 1
A 52-year-old patient presents for a routine primary care visit.
Blood pressure is 158/94 mmHg. The patient denies headache,
chest pain, dyspnea, neurologic symptoms, or visual changes.
Which action is most appropriate before establishing a
diagnosis of chronic hypertension?
A. Diagnose stage 2 hypertension based on this single reading
B. Begin antihypertensive therapy immediately without
additional measurements
C. Repeat the measurement after several minutes and confirm
persistent elevation with out-of-office blood pressure
monitoring when appropriate
D. Reassure the patient that the reading is normal for middle
age
,Correct answer: C. Repeat the measurement after several
minutes and confirm persistent elevation with out-of-office
blood pressure monitoring when appropriate
An isolated elevated office blood pressure reading should not
automatically establish a diagnosis of chronic hypertension.
Proper technique includes allowing the patient to rest, using an
appropriately sized cuff, positioning the patient correctly, and
obtaining repeat measurements. When feasible, ambulatory or
home blood pressure monitoring can help confirm hypertension
and identify white-coat hypertension. A reading of 158/94
mmHg is clearly elevated and warrants follow-up, but the
clinical context and confirmation process are important before
labeling the patient with chronic hypertension.
Question 2
A 63-year-old patient with type 2 diabetes has an LDL
cholesterol level of 142 mg/dL and no history of myocardial
infarction, stroke, or peripheral arterial disease. Which
pharmacologic approach is generally appropriate for
cardiovascular risk reduction?
A. No lipid-lowering medication unless LDL exceeds 190 mg/dL
B. Moderate- to high-intensity statin therapy based on age and
overall cardiovascular risk
,C. Fibrate monotherapy as first-line treatment
D. Niacin as the preferred first-line agent
Correct answer: B. Moderate- to high-intensity statin therapy
based on age and overall cardiovascular risk
Adults with diabetes in this age range generally have an
indication for statin therapy for primary cardiovascular
prevention, with treatment intensity determined by
cardiovascular risk and clinical circumstances. Diabetes itself
substantially increases atherosclerotic cardiovascular risk.
Fibrates and niacin are not routine substitutes for statins for
primary LDL-lowering therapy. An LDL level does not need to
reach 190 mg/dL before a statin becomes appropriate in a
patient with diabetes.
Question 3
A 28-year-old woman presents with dysuria and urinary
frequency for 2 days. She denies vaginal discharge, pelvic pain,
fever, flank pain, nausea, or vomiting. Which diagnosis is most
likely?
A. Acute pyelonephritis
B. Acute uncomplicated cystitis
C. Pelvic inflammatory disease
D. Vaginitis
, Correct answer: B. Acute uncomplicated cystitis
Dysuria and urinary frequency without vaginal symptoms are
classic features of acute uncomplicated cystitis in a
nonpregnant reproductive-age woman. Pyelonephritis is more
likely when systemic symptoms such as fever, chills, nausea,
vomiting, or flank pain are present. Pelvic inflammatory disease
usually involves pelvic or lower abdominal pain and may be
associated with cervical motion, uterine, or adnexal tenderness.
Vaginitis commonly produces vaginal discharge, irritation,
itching, or odor.
Question 4
A 45-year-old patient reports episodic wheezing, cough, and
chest tightness that occur several times per week and
occasionally awaken the patient at night. Spirometry
demonstrates variable expiratory airflow limitation with
significant improvement after bronchodilator administration.
Which diagnosis is most consistent with these findings?
A. Asthma
B. Chronic bronchitis
C. Restrictive lung disease
D. Pulmonary fibrosis
Correct answer: A. Asthma
Practice Exam 2026 Practice Questions &
Study Guide | Complete Exam-Style Questions
with Correct Detailed Answers & Rationales
(Reliable Answers)
Question 1
A 52-year-old patient presents for a routine primary care visit.
Blood pressure is 158/94 mmHg. The patient denies headache,
chest pain, dyspnea, neurologic symptoms, or visual changes.
Which action is most appropriate before establishing a
diagnosis of chronic hypertension?
A. Diagnose stage 2 hypertension based on this single reading
B. Begin antihypertensive therapy immediately without
additional measurements
C. Repeat the measurement after several minutes and confirm
persistent elevation with out-of-office blood pressure
monitoring when appropriate
D. Reassure the patient that the reading is normal for middle
age
,Correct answer: C. Repeat the measurement after several
minutes and confirm persistent elevation with out-of-office
blood pressure monitoring when appropriate
An isolated elevated office blood pressure reading should not
automatically establish a diagnosis of chronic hypertension.
Proper technique includes allowing the patient to rest, using an
appropriately sized cuff, positioning the patient correctly, and
obtaining repeat measurements. When feasible, ambulatory or
home blood pressure monitoring can help confirm hypertension
and identify white-coat hypertension. A reading of 158/94
mmHg is clearly elevated and warrants follow-up, but the
clinical context and confirmation process are important before
labeling the patient with chronic hypertension.
Question 2
A 63-year-old patient with type 2 diabetes has an LDL
cholesterol level of 142 mg/dL and no history of myocardial
infarction, stroke, or peripheral arterial disease. Which
pharmacologic approach is generally appropriate for
cardiovascular risk reduction?
A. No lipid-lowering medication unless LDL exceeds 190 mg/dL
B. Moderate- to high-intensity statin therapy based on age and
overall cardiovascular risk
,C. Fibrate monotherapy as first-line treatment
D. Niacin as the preferred first-line agent
Correct answer: B. Moderate- to high-intensity statin therapy
based on age and overall cardiovascular risk
Adults with diabetes in this age range generally have an
indication for statin therapy for primary cardiovascular
prevention, with treatment intensity determined by
cardiovascular risk and clinical circumstances. Diabetes itself
substantially increases atherosclerotic cardiovascular risk.
Fibrates and niacin are not routine substitutes for statins for
primary LDL-lowering therapy. An LDL level does not need to
reach 190 mg/dL before a statin becomes appropriate in a
patient with diabetes.
Question 3
A 28-year-old woman presents with dysuria and urinary
frequency for 2 days. She denies vaginal discharge, pelvic pain,
fever, flank pain, nausea, or vomiting. Which diagnosis is most
likely?
A. Acute pyelonephritis
B. Acute uncomplicated cystitis
C. Pelvic inflammatory disease
D. Vaginitis
, Correct answer: B. Acute uncomplicated cystitis
Dysuria and urinary frequency without vaginal symptoms are
classic features of acute uncomplicated cystitis in a
nonpregnant reproductive-age woman. Pyelonephritis is more
likely when systemic symptoms such as fever, chills, nausea,
vomiting, or flank pain are present. Pelvic inflammatory disease
usually involves pelvic or lower abdominal pain and may be
associated with cervical motion, uterine, or adnexal tenderness.
Vaginitis commonly produces vaginal discharge, irritation,
itching, or odor.
Question 4
A 45-year-old patient reports episodic wheezing, cough, and
chest tightness that occur several times per week and
occasionally awaken the patient at night. Spirometry
demonstrates variable expiratory airflow limitation with
significant improvement after bronchodilator administration.
Which diagnosis is most consistent with these findings?
A. Asthma
B. Chronic bronchitis
C. Restrictive lung disease
D. Pulmonary fibrosis
Correct answer: A. Asthma
