NSG 554 Exam 1 V1 | NSG 554 Nurse
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG554 Exam 1 2026)
1. According to the USPSTF guidelines, at what age should routine screening for colorectal
cancer begin for an average-risk adult?
A. 50 years
B. 45 years
C. 40 years
D. 55 years
Answer: B
Rationale: The USPSTF updated its recommendations in 2021 to start screening at age 45
for individuals at average risk. This change was implemented due to the rising incidence of
colorectal cancer in younger populations. Screening methods include stool-based tests or
direct visualization such as colonoscopy every 10 years.
2. A 65-year-old male smoker with a 35 pack-year history presents for a physical. Which
screening is indicated by the USPSTF?
A. Annual low-dose CT scan for lung cancer
B. Abdominal ultrasound for AAA
,C. Carotid artery duplex scan
D. Alpha-fetoprotein for liver cancer
Answer: B
Rationale: The USPSTF recommends a one-time screening for abdominal aortic aneurysm
(AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked. This is a
Grade B recommendation intended to prevent rupture-related mortality. It is specifically
targeted at this demographic due to the high prevalence of aneurysms in male smokers.
3. A patient presents with a ‘honey-colored’ crusted lesion on the perioral area. What is the
most likely diagnosis?
A. Herpes Simplex
B. Contact Dermatitis
C. Impetigo
D. Erysipelas
Answer: C
Rationale: Impetigo is a highly contagious superficial skin infection most commonly
caused by Staphylococcus aureus or Streptococcus pyogenes. The classic clinical
presentation is a lesion with a honey-colored crust. Management typically involves topical
mupirocin for localized cases or oral antibiotics for widespread infection.
, 4. Which of the following is the first-line treatment for an adult with uncomplicated Acute
Bacterial Rhinosinusitis (ABRS)?
A. Ciprofloxacin
B. Azithromycin
C. Doxycycline
D. Amoxicillin-clavulanate
Answer: D
Rationale: Amoxicillin-clavulanate is the current first-line recommendation for ABRS in
adults according to IDSA guidelines. This combination provides coverage against both
Streptococcus pneumoniae and Haemophilus influenzae, including beta-lactamase-
producing strains. If the patient has a penicillin allergy, doxycycline is often recommended
as an alternative.
5. During a physical exam, a 12-month-old is noted to have a white pupillary reflex
(leukocoria). What is the immediate priority?
A. Recheck at the 15-month visit
B. Refer to ophthalmology for suspected retinoblastoma
C. Document as a normal finding in infants
D. Prescribe antibiotic eye drops for infection
Answer: B
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG554 Exam 1 2026)
1. According to the USPSTF guidelines, at what age should routine screening for colorectal
cancer begin for an average-risk adult?
A. 50 years
B. 45 years
C. 40 years
D. 55 years
Answer: B
Rationale: The USPSTF updated its recommendations in 2021 to start screening at age 45
for individuals at average risk. This change was implemented due to the rising incidence of
colorectal cancer in younger populations. Screening methods include stool-based tests or
direct visualization such as colonoscopy every 10 years.
2. A 65-year-old male smoker with a 35 pack-year history presents for a physical. Which
screening is indicated by the USPSTF?
A. Annual low-dose CT scan for lung cancer
B. Abdominal ultrasound for AAA
,C. Carotid artery duplex scan
D. Alpha-fetoprotein for liver cancer
Answer: B
Rationale: The USPSTF recommends a one-time screening for abdominal aortic aneurysm
(AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked. This is a
Grade B recommendation intended to prevent rupture-related mortality. It is specifically
targeted at this demographic due to the high prevalence of aneurysms in male smokers.
3. A patient presents with a ‘honey-colored’ crusted lesion on the perioral area. What is the
most likely diagnosis?
A. Herpes Simplex
B. Contact Dermatitis
C. Impetigo
D. Erysipelas
Answer: C
Rationale: Impetigo is a highly contagious superficial skin infection most commonly
caused by Staphylococcus aureus or Streptococcus pyogenes. The classic clinical
presentation is a lesion with a honey-colored crust. Management typically involves topical
mupirocin for localized cases or oral antibiotics for widespread infection.
, 4. Which of the following is the first-line treatment for an adult with uncomplicated Acute
Bacterial Rhinosinusitis (ABRS)?
A. Ciprofloxacin
B. Azithromycin
C. Doxycycline
D. Amoxicillin-clavulanate
Answer: D
Rationale: Amoxicillin-clavulanate is the current first-line recommendation for ABRS in
adults according to IDSA guidelines. This combination provides coverage against both
Streptococcus pneumoniae and Haemophilus influenzae, including beta-lactamase-
producing strains. If the patient has a penicillin allergy, doxycycline is often recommended
as an alternative.
5. During a physical exam, a 12-month-old is noted to have a white pupillary reflex
(leukocoria). What is the immediate priority?
A. Recheck at the 15-month visit
B. Refer to ophthalmology for suspected retinoblastoma
C. Document as a normal finding in infants
D. Prescribe antibiotic eye drops for infection
Answer: B
