NSG 555 Primary Care I Exam 1 – 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.
The patient has no acute complaints but reports a 20-pack-year
smoking history and currently smokes one pack per day. Which
intervention is most appropriate during this visit?
A. Recommend annual chest radiography
B. Recommend screening spirometry for all current smokers
C. Provide tobacco-cessation counseling and discuss evidence-
based cessation treatment
D. Recommend that the patient switch from cigarettes to
smokeless tobacco
Correct Answer: C
Smoking cessation is one of the most effective preventive
interventions available in primary care. Counseling should be
combined, when appropriate, with evidence-based
,pharmacologic treatment such as nicotine replacement therapy,
varenicline, or bupropion. Routine chest radiography is not an
effective screening test for lung cancer, and spirometry is not
recommended solely because a person smokes in the absence of
symptoms or other indications. Switching to smokeless tobacco
does not eliminate tobacco-related health risks and is not an
appropriate cessation strategy.
Question 2
A 45-year-old patient reports several months of fatigue. The
patient has no weight loss, fever, bleeding, or other concerning
symptoms. Which component of the history is most important
to obtain initially?
A. Childhood immunization history only
B. Sleep pattern, mood, medications, substance use, diet, and
associated symptoms
C. Family history of skin cancer only
D. Previous orthopedic injuries
Correct Answer: B
Fatigue is a nonspecific symptom with a broad differential
diagnosis. A focused but comprehensive history should assess
sleep quality, depression and anxiety, medication effects,
alcohol and substance use, nutritional status, cardiopulmonary
,symptoms, endocrine symptoms, infection-related symptoms,
and other associated findings. A targeted history helps
determine whether laboratory testing or additional evaluation
is warranted rather than ordering indiscriminate tests.
Question 3
A 67-year-old patient reports dizziness when standing after
sitting for several minutes. Which measurement is most useful
for evaluating suspected orthostatic hypotension?
A. Respiratory rate after exercise
B. Apical pulse after eating
C. Blood pressure and heart rate measured supine and again
after standing
D. Oxygen saturation while sleeping
Correct Answer: C
Orthostatic vital signs evaluate changes in blood pressure and
pulse associated with positional changes. Measurements are
obtained after the patient has been resting and then repeated
after standing according to accepted clinical protocols. A
significant postural fall in blood pressure, particularly when
accompanied by symptoms, supports orthostatic hypotension.
Medication effects, dehydration, autonomic dysfunction, and
other conditions may contribute.
, Question 4
A 58-year-old patient with hypertension is being evaluated
during a routine primary care visit. Which finding requires the
most immediate additional assessment?
A. Blood pressure of 138/84 mm Hg
B. Occasional mild headache without neurologic symptoms
C. Blood pressure of 214/118 mm Hg with new confusion and
unilateral weakness
D. Blood pressure of 142/88 mm Hg after missing one
medication dose
Correct Answer: C
Severely elevated blood pressure accompanied by acute
neurologic findings such as confusion and unilateral weakness
raises concern for acute target-organ injury and requires
immediate evaluation. The clinician should not simply adjust
outpatient medication and send the patient home. The
combination of markedly elevated blood pressure and acute
neurologic deficits warrants urgent emergency assessment.
Question 5
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.
The patient has no acute complaints but reports a 20-pack-year
smoking history and currently smokes one pack per day. Which
intervention is most appropriate during this visit?
A. Recommend annual chest radiography
B. Recommend screening spirometry for all current smokers
C. Provide tobacco-cessation counseling and discuss evidence-
based cessation treatment
D. Recommend that the patient switch from cigarettes to
smokeless tobacco
Correct Answer: C
Smoking cessation is one of the most effective preventive
interventions available in primary care. Counseling should be
combined, when appropriate, with evidence-based
,pharmacologic treatment such as nicotine replacement therapy,
varenicline, or bupropion. Routine chest radiography is not an
effective screening test for lung cancer, and spirometry is not
recommended solely because a person smokes in the absence of
symptoms or other indications. Switching to smokeless tobacco
does not eliminate tobacco-related health risks and is not an
appropriate cessation strategy.
Question 2
A 45-year-old patient reports several months of fatigue. The
patient has no weight loss, fever, bleeding, or other concerning
symptoms. Which component of the history is most important
to obtain initially?
A. Childhood immunization history only
B. Sleep pattern, mood, medications, substance use, diet, and
associated symptoms
C. Family history of skin cancer only
D. Previous orthopedic injuries
Correct Answer: B
Fatigue is a nonspecific symptom with a broad differential
diagnosis. A focused but comprehensive history should assess
sleep quality, depression and anxiety, medication effects,
alcohol and substance use, nutritional status, cardiopulmonary
,symptoms, endocrine symptoms, infection-related symptoms,
and other associated findings. A targeted history helps
determine whether laboratory testing or additional evaluation
is warranted rather than ordering indiscriminate tests.
Question 3
A 67-year-old patient reports dizziness when standing after
sitting for several minutes. Which measurement is most useful
for evaluating suspected orthostatic hypotension?
A. Respiratory rate after exercise
B. Apical pulse after eating
C. Blood pressure and heart rate measured supine and again
after standing
D. Oxygen saturation while sleeping
Correct Answer: C
Orthostatic vital signs evaluate changes in blood pressure and
pulse associated with positional changes. Measurements are
obtained after the patient has been resting and then repeated
after standing according to accepted clinical protocols. A
significant postural fall in blood pressure, particularly when
accompanied by symptoms, supports orthostatic hypotension.
Medication effects, dehydration, autonomic dysfunction, and
other conditions may contribute.
, Question 4
A 58-year-old patient with hypertension is being evaluated
during a routine primary care visit. Which finding requires the
most immediate additional assessment?
A. Blood pressure of 138/84 mm Hg
B. Occasional mild headache without neurologic symptoms
C. Blood pressure of 214/118 mm Hg with new confusion and
unilateral weakness
D. Blood pressure of 142/88 mm Hg after missing one
medication dose
Correct Answer: C
Severely elevated blood pressure accompanied by acute
neurologic findings such as confusion and unilateral weakness
raises concern for acute target-organ injury and requires
immediate evaluation. The clinician should not simply adjust
outpatient medication and send the patient home. The
combination of markedly elevated blood pressure and acute
neurologic deficits warrants urgent emergency assessment.
Question 5
