NSG 555 EXAM 1 | NURSE PRACTITIONERS IN PRIMARY CARE I | LATEST 2026/2027 UPDATE
WILKES UNIVERSITY | GRADUATE NURSING & ADVANCED PRACTICE EDUCATION | GRADE A
NSG555 / NSG 555 EXAM 1 (LATEST
UPDATE)
NURSE PRACTITIONERS IN PRIMARY CARE I | COMPLETE GUIDE WITH
QUESTIONS AND VERIFIED ANSWERS
ALL MODULES COVERED | 100% CORRECT | GRADE A | WILKES
120 Questions | 8 Course Modules | 75% Scenario-Based Clinical Reasoning and 25% Direct Knowledge | Cognitive Mix: 20%
Recall, 50% Application, 30% Analysis | Every Item Followed by Its Verified Answer and a 2-4 Sentence Rationale Referencing
the NSG 555 Curriculum, AACN Essentials of Master’s Education, and Family Nurse Practitioner Primary Care Competencies
(2026/2027 Edition)
SECTION 1 - FOUNDATIONS OF PRIMARY CARE & FNP ROLE (Questions 1-15)
Q1: A master's-prepared faculty member is explaining the core definition of primary care to a
first-semester NP student. Which statement most accurately reflects the Institute of Medicine definition
of primary care that anchors the NSG 555 curriculum?
A. Episodic, fragmented care delivered only when a patient presents to a hospital emergency
department
B. Specialty-level management of complex single-organ disease referred by another provider
C. Integrated, accessible health care by clinicians accountable for the majority of personal health care
needs, developing a sustained partnership with patients in the context of family and community
[CORRECT]
D. Consultative services provided to a referring physician for a one-time clinical question
Correct Answer: C
Rationale: The IOM defines primary care as integrated, accessible services by clinicians who are accountable
for addressing the majority of personal health care needs, who develop a sustained and longitudinal partnership
with patients, and who practice in the context of family and community. This definition underpins the FNP role
in NSG 555 and the AACN Essentials emphasis on whole-person, population-based care. Option A describes
episodic emergency care, Option B describes specialty care, and Option D describes consultative care, none of
which capture the first-contact, longitudinal, comprehensive nature of primary care.
Wilkes University | Graduate Nursing & Advanced Practice Education | NSG 555 Exam 1 1
,NSG 555 EXAM 1 | NURSE PRACTITIONERS IN PRIMARY CARE I | LATEST 2026/2027 UPDATE
Q2: An FNP accepts a position in a state that grants full practice authority. Which activity is within the
NP's legal scope under this practice model?
A. Independently evaluating patients, diagnosing conditions, ordering and interpreting diagnostics, and
managing treatment including prescribing medications and controlled substances under the exclusive
authority of the state board of nursing [CORRECT]
B. Prescribing legend drugs only after obtaining a co-signature from a collaborating physician for
every prescription
C. Providing care only in settings where a physician is physically present and supervises all clinical
decisions
D. Evaluating and diagnosing patients independently but delegating all treatment decisions to the
collaborating physician
Correct Answer: A
Rationale: Full practice authority, as defined by the American Association of Nurse Practitioners, permits NPs
to evaluate patients; diagnose; order and interpret diagnostic tests; and initiate and manage treatments, including
prescribing medications and controlled substances, under the exclusive licensure authority of the state board of
nursing. Options B and D describe elements of reduced practice, and Option C describes restricted practice, in
which career-long supervision or delegation is required. Understanding state practice environments is a
professional-role competency emphasized in NSG 555 and tested on national certification examinations.
Q3: A primary care clinic is pursuing recognition as a patient-centered medical home. Which attribute
reflects one of the five core functions and characteristics of the PCMH model?
A. Care that is limited to acute, episodic urgent visits scheduled on the same day
B. Restricted after-hours access to reduce clinician workload
C. Physician-owned billing structure that excludes nursing input into care planning
D. Coordinated care across all elements of the broader health system, including transitions between
facilities and specialists [CORRECT]
Correct Answer: D
Rationale: The AHRQ describes the PCMH through five core functions: comprehensive care, patient-centered
care, coordinated care, accessible services, and a commitment to quality and safety. Coordinated care that
deliberately organizes patient care across the health system, including transitions from hospitals to home and
referrals to specialists, is a defining PCMH attribute. The remaining options contradict PCMH principles: the
model requires expanded rather than restricted access, comprehensive rather than episodic care, and
team-based rather than physician-only structures.
Wilkes University | Graduate Nursing & Advanced Practice Education | NSG 555 Exam 1 2
,NSG 555 EXAM 1 | NURSE PRACTITIONERS IN PRIMARY CARE I | LATEST 2026/2027 UPDATE
Q4: A nurse practitioner joins a delivery system in which physicians, hospitals, and other providers
voluntarily form a network that is jointly accountable for the quality and total cost of care for an
assigned Medicare population, with the opportunity to share in savings when performance benchmarks
are met. This model is best described as a(n):
A. Exclusive provider organization that capitates all outpatient services
B. Accountable care organization operating under a value-based shared savings arrangement
[CORRECT]
C. Independent practice association that only negotiates fee-for-service contracts
D. Patient-centered medical home operating under NCQA recognition standards
Correct Answer: B
Rationale: An accountable care organization is a voluntary group of providers held accountable for the quality,
cost, and experience of care for a defined population, sharing savings with the payer when spending falls below
benchmarks while quality measures are maintained. This is a foundational value-based payment model in NSG
555 healthcare policy content. Option D is incorrect because the PCMH is a care delivery model, not a payment
entity; Option A and Option C describe managed-care contracting structures that do not carry shared
accountability for population cost and quality.
Q5: During a visit for poorly controlled type 2 diabetes, an FNP administers a social determinants of
health screener and learns that the patient skipped two insulin fills because of food insecurity and a loss
of transportation after job displacement. What is the most appropriate initial intervention?
A. Escalating the insulin dose to compensate for the missed doses while scheduling a three-month
recheck
B. Incorporating the screening findings into the plan of care and connecting the patient with a
community food pantry, a transportation assistance program, and the clinic care coordinator
[CORRECT]
C. Ordering an expanded laboratory panel to obtain more objective data before making any change
D. Informing the patient that medication adherence is essential and providing a printed handout on
insulin importance
Correct Answer: B
Rationale: Social determinants of health, including economic stability, neighborhood environment, and access
to care, are root drivers of clinical outcomes and must be integrated into the plan of care through resource
connection and care coordination. This reflects the FNP primary care competency of partnering with
communities and the AACN Essentials emphasis on clinical prevention and population health. Escalating
insulin in a food-insecure patient raises hypoglycemia risk, and education alone without addressing the
underlying barrier is a common primary care error that fails to close the loop.
Wilkes University | Graduate Nursing & Advanced Practice Education | NSG 555 Exam 1 3
, NSG 555 EXAM 1 | NURSE PRACTITIONERS IN PRIMARY CARE I | LATEST 2026/2027 UPDATE
Q6: Which statement best captures the fundamental distinction between value-based care and
traditional fee-for-service reimbursement?
A. Value-based care reimburses solely for the number of visits, tests, and procedures performed
B. Value-based care ties payment to quality of care, patient outcomes, and total cost of care rather than
the volume of services delivered [CORRECT]
C. Value-based care eliminates all financial accountability from providers
D. Value-based care requires patients to pay the full cost of services at the time of the visit
Correct Answer: B
Rationale: Value-based care models, including shared savings, bundled payments, and pay-for-performance,
link reimbursement to quality metrics, outcomes, and efficient total cost of care, whereas fee-for-service
rewards volume of services. This shift is a central theme of NSG 555 healthcare policy content because it
directly changes how primary care teams organize population health, prevention, and chronic disease
management. Options A and C describe fee-for-service and absent accountability respectively, and Option D
describes point-of-service cost shifting, not value-based design.
Q7: A Spanish-speaking patient with limited English proficiency arrives for a new-patient visit, and her
teenage son offers to interpret for his mother. What is the most appropriate action according to the
National CLAS Standards and NSG 555 communication competencies?
A. Proceed with the visit using the son as interpreter because family members provide the most
culturally nuanced translation
B. Use a qualified medical interpreter, in person or by telephonic or video service, for all clinical
discussion and documentation [CORRECT]
C. Postpone all care indefinitely until a bilingual clinician can be recruited to the practice
D. Simplify the visit to only vital signs and refills, reserving clinical discussion for a later appointment
Correct Answer: B
Rationale: The National CLAS Standards and legal requirements under Title VI and Section 1557 mandate the
use of qualified medical interpreters for patients with limited English proficiency; family members, and
especially minors, are inappropriate because they frequently omit, distort, or filter clinically important
information and compromise confidentiality. Professional interpreters improve diagnostic accuracy, patient
satisfaction, and safety. Option A violates these standards, Option C is unnecessarily disruptive to access, and
Option D withholds appropriate care.
Wilkes University | Graduate Nursing & Advanced Practice Education | NSG 555 Exam 1 4
WILKES UNIVERSITY | GRADUATE NURSING & ADVANCED PRACTICE EDUCATION | GRADE A
NSG555 / NSG 555 EXAM 1 (LATEST
UPDATE)
NURSE PRACTITIONERS IN PRIMARY CARE I | COMPLETE GUIDE WITH
QUESTIONS AND VERIFIED ANSWERS
ALL MODULES COVERED | 100% CORRECT | GRADE A | WILKES
120 Questions | 8 Course Modules | 75% Scenario-Based Clinical Reasoning and 25% Direct Knowledge | Cognitive Mix: 20%
Recall, 50% Application, 30% Analysis | Every Item Followed by Its Verified Answer and a 2-4 Sentence Rationale Referencing
the NSG 555 Curriculum, AACN Essentials of Master’s Education, and Family Nurse Practitioner Primary Care Competencies
(2026/2027 Edition)
SECTION 1 - FOUNDATIONS OF PRIMARY CARE & FNP ROLE (Questions 1-15)
Q1: A master's-prepared faculty member is explaining the core definition of primary care to a
first-semester NP student. Which statement most accurately reflects the Institute of Medicine definition
of primary care that anchors the NSG 555 curriculum?
A. Episodic, fragmented care delivered only when a patient presents to a hospital emergency
department
B. Specialty-level management of complex single-organ disease referred by another provider
C. Integrated, accessible health care by clinicians accountable for the majority of personal health care
needs, developing a sustained partnership with patients in the context of family and community
[CORRECT]
D. Consultative services provided to a referring physician for a one-time clinical question
Correct Answer: C
Rationale: The IOM defines primary care as integrated, accessible services by clinicians who are accountable
for addressing the majority of personal health care needs, who develop a sustained and longitudinal partnership
with patients, and who practice in the context of family and community. This definition underpins the FNP role
in NSG 555 and the AACN Essentials emphasis on whole-person, population-based care. Option A describes
episodic emergency care, Option B describes specialty care, and Option D describes consultative care, none of
which capture the first-contact, longitudinal, comprehensive nature of primary care.
Wilkes University | Graduate Nursing & Advanced Practice Education | NSG 555 Exam 1 1
,NSG 555 EXAM 1 | NURSE PRACTITIONERS IN PRIMARY CARE I | LATEST 2026/2027 UPDATE
Q2: An FNP accepts a position in a state that grants full practice authority. Which activity is within the
NP's legal scope under this practice model?
A. Independently evaluating patients, diagnosing conditions, ordering and interpreting diagnostics, and
managing treatment including prescribing medications and controlled substances under the exclusive
authority of the state board of nursing [CORRECT]
B. Prescribing legend drugs only after obtaining a co-signature from a collaborating physician for
every prescription
C. Providing care only in settings where a physician is physically present and supervises all clinical
decisions
D. Evaluating and diagnosing patients independently but delegating all treatment decisions to the
collaborating physician
Correct Answer: A
Rationale: Full practice authority, as defined by the American Association of Nurse Practitioners, permits NPs
to evaluate patients; diagnose; order and interpret diagnostic tests; and initiate and manage treatments, including
prescribing medications and controlled substances, under the exclusive licensure authority of the state board of
nursing. Options B and D describe elements of reduced practice, and Option C describes restricted practice, in
which career-long supervision or delegation is required. Understanding state practice environments is a
professional-role competency emphasized in NSG 555 and tested on national certification examinations.
Q3: A primary care clinic is pursuing recognition as a patient-centered medical home. Which attribute
reflects one of the five core functions and characteristics of the PCMH model?
A. Care that is limited to acute, episodic urgent visits scheduled on the same day
B. Restricted after-hours access to reduce clinician workload
C. Physician-owned billing structure that excludes nursing input into care planning
D. Coordinated care across all elements of the broader health system, including transitions between
facilities and specialists [CORRECT]
Correct Answer: D
Rationale: The AHRQ describes the PCMH through five core functions: comprehensive care, patient-centered
care, coordinated care, accessible services, and a commitment to quality and safety. Coordinated care that
deliberately organizes patient care across the health system, including transitions from hospitals to home and
referrals to specialists, is a defining PCMH attribute. The remaining options contradict PCMH principles: the
model requires expanded rather than restricted access, comprehensive rather than episodic care, and
team-based rather than physician-only structures.
Wilkes University | Graduate Nursing & Advanced Practice Education | NSG 555 Exam 1 2
,NSG 555 EXAM 1 | NURSE PRACTITIONERS IN PRIMARY CARE I | LATEST 2026/2027 UPDATE
Q4: A nurse practitioner joins a delivery system in which physicians, hospitals, and other providers
voluntarily form a network that is jointly accountable for the quality and total cost of care for an
assigned Medicare population, with the opportunity to share in savings when performance benchmarks
are met. This model is best described as a(n):
A. Exclusive provider organization that capitates all outpatient services
B. Accountable care organization operating under a value-based shared savings arrangement
[CORRECT]
C. Independent practice association that only negotiates fee-for-service contracts
D. Patient-centered medical home operating under NCQA recognition standards
Correct Answer: B
Rationale: An accountable care organization is a voluntary group of providers held accountable for the quality,
cost, and experience of care for a defined population, sharing savings with the payer when spending falls below
benchmarks while quality measures are maintained. This is a foundational value-based payment model in NSG
555 healthcare policy content. Option D is incorrect because the PCMH is a care delivery model, not a payment
entity; Option A and Option C describe managed-care contracting structures that do not carry shared
accountability for population cost and quality.
Q5: During a visit for poorly controlled type 2 diabetes, an FNP administers a social determinants of
health screener and learns that the patient skipped two insulin fills because of food insecurity and a loss
of transportation after job displacement. What is the most appropriate initial intervention?
A. Escalating the insulin dose to compensate for the missed doses while scheduling a three-month
recheck
B. Incorporating the screening findings into the plan of care and connecting the patient with a
community food pantry, a transportation assistance program, and the clinic care coordinator
[CORRECT]
C. Ordering an expanded laboratory panel to obtain more objective data before making any change
D. Informing the patient that medication adherence is essential and providing a printed handout on
insulin importance
Correct Answer: B
Rationale: Social determinants of health, including economic stability, neighborhood environment, and access
to care, are root drivers of clinical outcomes and must be integrated into the plan of care through resource
connection and care coordination. This reflects the FNP primary care competency of partnering with
communities and the AACN Essentials emphasis on clinical prevention and population health. Escalating
insulin in a food-insecure patient raises hypoglycemia risk, and education alone without addressing the
underlying barrier is a common primary care error that fails to close the loop.
Wilkes University | Graduate Nursing & Advanced Practice Education | NSG 555 Exam 1 3
, NSG 555 EXAM 1 | NURSE PRACTITIONERS IN PRIMARY CARE I | LATEST 2026/2027 UPDATE
Q6: Which statement best captures the fundamental distinction between value-based care and
traditional fee-for-service reimbursement?
A. Value-based care reimburses solely for the number of visits, tests, and procedures performed
B. Value-based care ties payment to quality of care, patient outcomes, and total cost of care rather than
the volume of services delivered [CORRECT]
C. Value-based care eliminates all financial accountability from providers
D. Value-based care requires patients to pay the full cost of services at the time of the visit
Correct Answer: B
Rationale: Value-based care models, including shared savings, bundled payments, and pay-for-performance,
link reimbursement to quality metrics, outcomes, and efficient total cost of care, whereas fee-for-service
rewards volume of services. This shift is a central theme of NSG 555 healthcare policy content because it
directly changes how primary care teams organize population health, prevention, and chronic disease
management. Options A and C describe fee-for-service and absent accountability respectively, and Option D
describes point-of-service cost shifting, not value-based design.
Q7: A Spanish-speaking patient with limited English proficiency arrives for a new-patient visit, and her
teenage son offers to interpret for his mother. What is the most appropriate action according to the
National CLAS Standards and NSG 555 communication competencies?
A. Proceed with the visit using the son as interpreter because family members provide the most
culturally nuanced translation
B. Use a qualified medical interpreter, in person or by telephonic or video service, for all clinical
discussion and documentation [CORRECT]
C. Postpone all care indefinitely until a bilingual clinician can be recruited to the practice
D. Simplify the visit to only vital signs and refills, reserving clinical discussion for a later appointment
Correct Answer: B
Rationale: The National CLAS Standards and legal requirements under Title VI and Section 1557 mandate the
use of qualified medical interpreters for patients with limited English proficiency; family members, and
especially minors, are inappropriate because they frequently omit, distort, or filter clinically important
information and compromise confidentiality. Professional interpreters improve diagnostic accuracy, patient
satisfaction, and safety. Option A violates these standards, Option C is unnecessarily disruptive to access, and
Option D withholds appropriate care.
Wilkes University | Graduate Nursing & Advanced Practice Education | NSG 555 Exam 1 4
