NSG 555 Exam 3 — Primary Care I (2026/2027) Wilkes University | Grade A Verified
NSG 555 / NSG555 EXAM 3
Nurse Practitioners in Primary Care I
Complete Guide with Questions and Verified Answers | Update
All Modules Covered | 100% Correct | Grade A | Wilkes University
Exam Component Specification
Total Questions 120 multiple-choice questions (4 options, one best answer)
Cognitive Distribution 20% Recall | 50% Application | 30% Analysis
Question Style 75% scenario-based (clinical reasoning) | 25% direct knowledge
Special Inclusions 20 clinical reasoning scenarios, 15 health promotion, 10 special populations
Sections 8 content domains aligned with NSG 555 syllabus and FNP competencies
Curriculum Standards AACN Essentials of Master's Education, FNP Primary Care Competencies, USPSTF, CDC, ACOG, AAP
Answer Format Verified answer + 2-4 sentence rationale with curriculum reference
Section Content Domain Questions Count
1 Women's Health in Primary Care Q1 - Q18 18
2 Men's Health in Primary Care Q19 - Q33 15
3 Pediatric & Adolescent Health in Primary Care Q34 - Q51 18
4 Geriatric Health in Primary Care Q52 - Q69 18
5 Mental Health in Primary Care Q70 - Q84 15
6 Infectious Diseases in Primary Care Q85 - Q96 12
7 Dermatological Conditions in Primary Care Q97 - Q108 12
8 Health Promotion & Disease Prevention Across the Lifespan Q109 - Q120 12
TOTAL 120
Exam Instructions:
• Select the single best answer for each question. Mark your selection on the answer sheet provided.
• Questions are organized by content domain. Cognitive level is intentionally varied: 20% recall, 50% application,
30% analysis.
Page 1 | NSG 555 Primary Care I | 120 Questions
,NSG 555 Exam 3 — Primary Care I (2026/2027) Wilkes University | Grade A Verified
• Verified answers and rationales follow each question. Rationales cite NSG 555 curriculum, AACN Essentials,
and FNP Primary Care Competencies.
• Pharmacologic dosing reflects current CDC, ACOG, AAP, USPSTF, and FDA guidance as of 2026/2027
publication.
• Always verify clinical decisions against the most recent evidence-based guidelines and individual patient
factors.
Section 1: Women's Health in Primary Care
Questions 1-18 | 18 Questions | Cognitive levels: Recall / Application / Analysis
Q1. A 26-year-old nulliparous woman presents for a well-woman visit. She is sexually active with one
male partner and uses condoms inconsistently. Her last Pap test was performed 3 years ago and was
normal. According to current ASCCP guidelines, what is the recommended cervical cancer screening
strategy for this patient?
A. Repeat Pap test every year
B. Primary hrHPV testing every 5 years starting at age 25
C. Pap test alone every 2 years
D. Co-testing every 3 years starting immediately
Correct Answer: B
Rationale: Current ASCCP guidelines recommend primary high-risk HPV (hrHPV) testing every 5 years starting at
age 25, or co-testing (Pap + HPV) every 5 years for ages 25-65. Annual Pap testing is no longer recommended due to
overtreatment of transient HPV infections. Pap alone every 2 years or immediate co-testing does not align with the
2019 ASCCP risk-based management framework.
Q2. A 31-year-old woman's Pap test returns as ASC-US with positive high-risk HPV. She is up to date
with prior screenings, all of which were normal. What is the recommended next step per ASCCP
risk-based management guidelines?
A. Repeat co-testing in 6 months
B. Immediate colposcopy with endocervical sampling
C. Treat with topical estrogen and recheck in 3 months
D. Return to routine screening in 5 years
Correct Answer: B
Rationale: ASC-US with positive hrHPV carries sufficient risk (≥4% CIN 3+) to warrant colposcopy. Observation or
returning to routine screening would miss significant disease. Topical estrogen is only used for atrophic
vaginitis-related changes. NSG 555 curriculum emphasizes ASCCP risk-based triage and FNP competency in
cytologic result interpretation.
Page 2 | NSG 555 Primary Care I | 120 Questions
,NSG 555 Exam 3 — Primary Care I (2026/2027) Wilkes University | Grade A Verified
Q3. A 14-year-old female presents for her annual well-child visit. Her mother asks about the HPV
vaccine. Which statement by the NP is most accurate regarding HPV vaccination?
A. HPV vaccination is recommended only for sexually active adolescents
B. The 9-valent HPV vaccine is routinely administered as a 2-dose series if started before age 15
C. HPV vaccination requires 3 doses regardless of initiation age
D. The HPV vaccine is only licensed for females aged 13-26
Correct Answer: B
Rationale: ACIP recommends routine HPV vaccination at age 11-12 with 2 doses if initiated before the 15th birthday;
3 doses are required if started at age 15 or older, or in immunocompromised persons. Vaccination is recommended
regardless of sexual activity to ensure protection before exposure. ACIP also recommends catch-up vaccination
through age 26, with shared clinical decision-making for ages 27-45.
Q4. A 28-year-old woman requests contraception. She has a BMI of 32, smokes one pack of cigarettes
per day, and has well-controlled hypertension. She prefers a daily oral method. Which contraceptive
option is safest for this patient?
A. Combined oral contraceptive (ethinyl estradiol 35 mcg + norethindrone)
B. Combined oral contraceptive (ethinyl estradiol 20 mcg + drospirenone)
C. Progestin-only oral contraceptive (norethindrone 0.35 mg)
D. Contraceptive patch (norelgestromin/ethinyl estradiol)
Correct Answer: C
Rationale: Combined hormonal contraceptives are US MEC Category 4 (unacceptable risk) for women ≥35 who
smoke, and Category 3 for women <35 who smoke with comorbid hypertension or BMI ≥30. The patch carries even
higher VTE risk than pills. Progestin-only pills (Category 2) avoid estrogen-related thrombotic risk and are
appropriate for this patient per FNP primary care competencies.
Q5. A 24-year-old nulliparous woman requests long-acting reversible contraception. She has a history
of STI 6 months ago (treated chlamydia) and is concerned about pain with insertion. Which IUD is
most appropriate and why?
A. Copper IUD because it provides immediate contraception without hormonal side effects
B. Levonorgestrel IUD 52 mg because it reduces menstrual bleeding and dysmenorrhea
C. Copper IUD because nulliparous women cannot use hormonal IUDs
D. Neither IUD is appropriate given her recent STI history
Correct Answer: B
Rationale: Both copper and levonorgestrel IUDs are safe in nulliparous women (US MEC Category 2). The 52 mg
LNG-IUD additionally reduces menstrual bleeding and dysmenorrhea, providing therapeutic benefit. History of
treated STI is not a contraindication; current purulent cervicitis or chlamydia/gonorrhea at insertion is. NSG 555
curriculum emphasizes LARC as first-line per AAP and ACOG.
Page 3 | NSG 555 Primary Care I | 120 Questions
, NSG 555 Exam 3 — Primary Care I (2026/2027) Wilkes University | Grade A Verified
Q6. A 19-year-old college student presents 36 hours after condomless intercourse. She is not on
contraception and is ovulating per her cycle tracking app. She weighs 75 kg. The most effective
emergency contraception for her is:
A. Levonorgestrel 1.5 mg orally (single dose)
B. Ulipristal acetate 30 mg orally (single dose)
C. Insertion of copper IUD within 5 days
D. Combined regimen (Yuzpe method) with two OCP packs
Correct Answer: B
Rationale: Ulipristal acetate is more effective than levonorgestrel, particularly for women with BMI >25 and for
intercourse occurring 3-5 days prior. Copper IUD is the most effective EC method overall but requires a procedure
visit. The Yuzpe method has higher nausea rates and lower efficacy. LNG effectiveness decreases with BMI >25 and
after 72 hours.
Q7. A 52-year-old woman presents for a routine physical. She is asymptomatic, has no family history
of breast cancer, and is in good health. Per USPSTF 2024 guidelines, what is the recommended breast
cancer screening strategy?
A. Annual mammography starting at age 40
B. Biennial mammography from ages 40-74
C. Annual mammography plus MRI starting at age 50
D. Clinical breast exam annually; mammography every 3 years
Correct Answer: B
Rationale: USPSTF 2024 recommends biennial mammography for women ages 40-74 (lowering the starting age from
50 in prior guidance). Annual mammography increases false positives. MRI is reserved for high-risk women (BRCA
carriers, lifetime risk >20%). Clinical breast exam alone is insufficient for screening. The FNP should individualize
based on risk and patient preference.
Q8. A 35-year-old woman reports finding a palpable, mobile, rubbery 1.5 cm breast mass on
self-examination. It has been present for 2 months and does not change with her menstrual cycle.
What is the most appropriate next step?
A. Reassure the patient and recheck in 6 months
B. Refer for diagnostic mammography and ultrasound
C. Order a screening mammogram
D. Prescribe oral contraceptives to suppress ovulation
Correct Answer: B
Rationale: Any palpable dominant breast mass in an adult woman requires diagnostic evaluation, not screening.
Diagnostic mammography plus targeted ultrasound is the appropriate workup. Screening mammography is for
asymptomatic women only. Observation without imaging may miss malignancy. OCPs do not address the underlying
mass and would delay diagnosis.
Page 4 | NSG 555 Primary Care I | 120 Questions
NSG 555 / NSG555 EXAM 3
Nurse Practitioners in Primary Care I
Complete Guide with Questions and Verified Answers | Update
All Modules Covered | 100% Correct | Grade A | Wilkes University
Exam Component Specification
Total Questions 120 multiple-choice questions (4 options, one best answer)
Cognitive Distribution 20% Recall | 50% Application | 30% Analysis
Question Style 75% scenario-based (clinical reasoning) | 25% direct knowledge
Special Inclusions 20 clinical reasoning scenarios, 15 health promotion, 10 special populations
Sections 8 content domains aligned with NSG 555 syllabus and FNP competencies
Curriculum Standards AACN Essentials of Master's Education, FNP Primary Care Competencies, USPSTF, CDC, ACOG, AAP
Answer Format Verified answer + 2-4 sentence rationale with curriculum reference
Section Content Domain Questions Count
1 Women's Health in Primary Care Q1 - Q18 18
2 Men's Health in Primary Care Q19 - Q33 15
3 Pediatric & Adolescent Health in Primary Care Q34 - Q51 18
4 Geriatric Health in Primary Care Q52 - Q69 18
5 Mental Health in Primary Care Q70 - Q84 15
6 Infectious Diseases in Primary Care Q85 - Q96 12
7 Dermatological Conditions in Primary Care Q97 - Q108 12
8 Health Promotion & Disease Prevention Across the Lifespan Q109 - Q120 12
TOTAL 120
Exam Instructions:
• Select the single best answer for each question. Mark your selection on the answer sheet provided.
• Questions are organized by content domain. Cognitive level is intentionally varied: 20% recall, 50% application,
30% analysis.
Page 1 | NSG 555 Primary Care I | 120 Questions
,NSG 555 Exam 3 — Primary Care I (2026/2027) Wilkes University | Grade A Verified
• Verified answers and rationales follow each question. Rationales cite NSG 555 curriculum, AACN Essentials,
and FNP Primary Care Competencies.
• Pharmacologic dosing reflects current CDC, ACOG, AAP, USPSTF, and FDA guidance as of 2026/2027
publication.
• Always verify clinical decisions against the most recent evidence-based guidelines and individual patient
factors.
Section 1: Women's Health in Primary Care
Questions 1-18 | 18 Questions | Cognitive levels: Recall / Application / Analysis
Q1. A 26-year-old nulliparous woman presents for a well-woman visit. She is sexually active with one
male partner and uses condoms inconsistently. Her last Pap test was performed 3 years ago and was
normal. According to current ASCCP guidelines, what is the recommended cervical cancer screening
strategy for this patient?
A. Repeat Pap test every year
B. Primary hrHPV testing every 5 years starting at age 25
C. Pap test alone every 2 years
D. Co-testing every 3 years starting immediately
Correct Answer: B
Rationale: Current ASCCP guidelines recommend primary high-risk HPV (hrHPV) testing every 5 years starting at
age 25, or co-testing (Pap + HPV) every 5 years for ages 25-65. Annual Pap testing is no longer recommended due to
overtreatment of transient HPV infections. Pap alone every 2 years or immediate co-testing does not align with the
2019 ASCCP risk-based management framework.
Q2. A 31-year-old woman's Pap test returns as ASC-US with positive high-risk HPV. She is up to date
with prior screenings, all of which were normal. What is the recommended next step per ASCCP
risk-based management guidelines?
A. Repeat co-testing in 6 months
B. Immediate colposcopy with endocervical sampling
C. Treat with topical estrogen and recheck in 3 months
D. Return to routine screening in 5 years
Correct Answer: B
Rationale: ASC-US with positive hrHPV carries sufficient risk (≥4% CIN 3+) to warrant colposcopy. Observation or
returning to routine screening would miss significant disease. Topical estrogen is only used for atrophic
vaginitis-related changes. NSG 555 curriculum emphasizes ASCCP risk-based triage and FNP competency in
cytologic result interpretation.
Page 2 | NSG 555 Primary Care I | 120 Questions
,NSG 555 Exam 3 — Primary Care I (2026/2027) Wilkes University | Grade A Verified
Q3. A 14-year-old female presents for her annual well-child visit. Her mother asks about the HPV
vaccine. Which statement by the NP is most accurate regarding HPV vaccination?
A. HPV vaccination is recommended only for sexually active adolescents
B. The 9-valent HPV vaccine is routinely administered as a 2-dose series if started before age 15
C. HPV vaccination requires 3 doses regardless of initiation age
D. The HPV vaccine is only licensed for females aged 13-26
Correct Answer: B
Rationale: ACIP recommends routine HPV vaccination at age 11-12 with 2 doses if initiated before the 15th birthday;
3 doses are required if started at age 15 or older, or in immunocompromised persons. Vaccination is recommended
regardless of sexual activity to ensure protection before exposure. ACIP also recommends catch-up vaccination
through age 26, with shared clinical decision-making for ages 27-45.
Q4. A 28-year-old woman requests contraception. She has a BMI of 32, smokes one pack of cigarettes
per day, and has well-controlled hypertension. She prefers a daily oral method. Which contraceptive
option is safest for this patient?
A. Combined oral contraceptive (ethinyl estradiol 35 mcg + norethindrone)
B. Combined oral contraceptive (ethinyl estradiol 20 mcg + drospirenone)
C. Progestin-only oral contraceptive (norethindrone 0.35 mg)
D. Contraceptive patch (norelgestromin/ethinyl estradiol)
Correct Answer: C
Rationale: Combined hormonal contraceptives are US MEC Category 4 (unacceptable risk) for women ≥35 who
smoke, and Category 3 for women <35 who smoke with comorbid hypertension or BMI ≥30. The patch carries even
higher VTE risk than pills. Progestin-only pills (Category 2) avoid estrogen-related thrombotic risk and are
appropriate for this patient per FNP primary care competencies.
Q5. A 24-year-old nulliparous woman requests long-acting reversible contraception. She has a history
of STI 6 months ago (treated chlamydia) and is concerned about pain with insertion. Which IUD is
most appropriate and why?
A. Copper IUD because it provides immediate contraception without hormonal side effects
B. Levonorgestrel IUD 52 mg because it reduces menstrual bleeding and dysmenorrhea
C. Copper IUD because nulliparous women cannot use hormonal IUDs
D. Neither IUD is appropriate given her recent STI history
Correct Answer: B
Rationale: Both copper and levonorgestrel IUDs are safe in nulliparous women (US MEC Category 2). The 52 mg
LNG-IUD additionally reduces menstrual bleeding and dysmenorrhea, providing therapeutic benefit. History of
treated STI is not a contraindication; current purulent cervicitis or chlamydia/gonorrhea at insertion is. NSG 555
curriculum emphasizes LARC as first-line per AAP and ACOG.
Page 3 | NSG 555 Primary Care I | 120 Questions
, NSG 555 Exam 3 — Primary Care I (2026/2027) Wilkes University | Grade A Verified
Q6. A 19-year-old college student presents 36 hours after condomless intercourse. She is not on
contraception and is ovulating per her cycle tracking app. She weighs 75 kg. The most effective
emergency contraception for her is:
A. Levonorgestrel 1.5 mg orally (single dose)
B. Ulipristal acetate 30 mg orally (single dose)
C. Insertion of copper IUD within 5 days
D. Combined regimen (Yuzpe method) with two OCP packs
Correct Answer: B
Rationale: Ulipristal acetate is more effective than levonorgestrel, particularly for women with BMI >25 and for
intercourse occurring 3-5 days prior. Copper IUD is the most effective EC method overall but requires a procedure
visit. The Yuzpe method has higher nausea rates and lower efficacy. LNG effectiveness decreases with BMI >25 and
after 72 hours.
Q7. A 52-year-old woman presents for a routine physical. She is asymptomatic, has no family history
of breast cancer, and is in good health. Per USPSTF 2024 guidelines, what is the recommended breast
cancer screening strategy?
A. Annual mammography starting at age 40
B. Biennial mammography from ages 40-74
C. Annual mammography plus MRI starting at age 50
D. Clinical breast exam annually; mammography every 3 years
Correct Answer: B
Rationale: USPSTF 2024 recommends biennial mammography for women ages 40-74 (lowering the starting age from
50 in prior guidance). Annual mammography increases false positives. MRI is reserved for high-risk women (BRCA
carriers, lifetime risk >20%). Clinical breast exam alone is insufficient for screening. The FNP should individualize
based on risk and patient preference.
Q8. A 35-year-old woman reports finding a palpable, mobile, rubbery 1.5 cm breast mass on
self-examination. It has been present for 2 months and does not change with her menstrual cycle.
What is the most appropriate next step?
A. Reassure the patient and recheck in 6 months
B. Refer for diagnostic mammography and ultrasound
C. Order a screening mammogram
D. Prescribe oral contraceptives to suppress ovulation
Correct Answer: B
Rationale: Any palpable dominant breast mass in an adult woman requires diagnostic evaluation, not screening.
Diagnostic mammography plus targeted ultrasound is the appropriate workup. Screening mammography is for
asymptomatic women only. Observation without imaging may miss malignancy. OCPs do not address the underlying
mass and would delay diagnosis.
Page 4 | NSG 555 Primary Care I | 120 Questions
