NSG 555 Exam 1 V1 | NSG 555 Nurse
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Exam 1 2026)
1. A 55-year-old male patient presents to the primary care clinic for a routine physical.
According to the USPSTF guidelines, which of the following is the most appropriate
recommendation for colorectal cancer screening?
A. Start screening at age 50 with annual fecal occult blood testing.
B. Delay screening until age 60 if there is no family history.
C. Initiate screening at age 45 using colonoscopy every 10 years.
D. Screening is only necessary if the patient exhibits symptoms of change in bowel habits.
Answer: C
Rationale: The USPSTF updated its guidelines to recommend that colorectal cancer
screening begin at age 45 for all average-risk adults. Colonoscopy every 10 years remains a
gold standard for detection and prevention of malignancy. This shift reflects an increasing
incidence of colorectal cancer in younger populations.
2. The Nurse Practitioner (NP) is assessing an older adult with low health literacy. Which
strategy is most effective for ensuring the patient understands the medication regimen?
A. Providing a detailed written pamphlet with medical terminology.
,B. Instructing the patient’s family member only to ensure compliance.
C. Asking the patient to read the labels aloud in the office.
D. Using the teach-back method to verify patient comprehension.
Answer: D
Rationale: The teach-back method is a validated tool for confirming that a patient
understands the clinical instructions provided during a visit. It requires the patient to
explain the information back in their own words, which reveals gaps in understanding. This
technique is particularly vital for patients with low health literacy to prevent medication
errors.
3. When applying the Principles of Antibiotic Stewardship, for which of the following
diagnoses should an NP generally avoid prescribing immediate antibiotics?
A. Acute Streptococcal Pharyngitis confirmed by rapid test.
B. Acute Pyelonephritis with systemic symptoms.
C. Uncomplicated Acute Bronchitis in a healthy adult.
D. Cellulitis with rapidly spreading erythema.
Answer: C
Rationale: Acute bronchitis is predominantly viral in origin, and routine antibiotic use
does not significantly improve outcomes or prevent complications in healthy adults.
Antibiotic stewardship aims to reduce the development of drug-resistant bacteria by
, limiting unnecessary prescriptions. Patients should instead be managed with supportive
care such as antitussives and hydration.
4. Which of the following is considered a ‘red flag’ in a patient presenting with acute low back
pain that warrants immediate imaging?
A. Pain that worsens with movement but is relieved by rest.
B. New onset of urinary incontinence or saddle anesthesia.
C. History of smoking and a sedentary lifestyle.
D. Mild tenderness over the paraspinal muscles.
Answer: B
Rationale: Urinary incontinence and saddle anesthesia are hallmark signs of Cauda Equina
Syndrome, a surgical emergency. These symptoms indicate significant nerve root
compression that requires immediate neurosurgical evaluation and imaging via MRI.
Failure to diagnose this promptly can lead to permanent neurological deficits.
5. An NP is selecting an E/M code for a patient visit. Which three key components
traditionally determine the level of service in a face-to-face encounter?
A. Chief Complaint, Review of Systems, and Patient Satisfaction.
B. History, Physical Examination, and Medical Decision Making.
C. Time spent, Vital Signs, and Diagnostic Results.
D. Insurance type, Age of patient, and Number of comorbidities.
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Exam 1 2026)
1. A 55-year-old male patient presents to the primary care clinic for a routine physical.
According to the USPSTF guidelines, which of the following is the most appropriate
recommendation for colorectal cancer screening?
A. Start screening at age 50 with annual fecal occult blood testing.
B. Delay screening until age 60 if there is no family history.
C. Initiate screening at age 45 using colonoscopy every 10 years.
D. Screening is only necessary if the patient exhibits symptoms of change in bowel habits.
Answer: C
Rationale: The USPSTF updated its guidelines to recommend that colorectal cancer
screening begin at age 45 for all average-risk adults. Colonoscopy every 10 years remains a
gold standard for detection and prevention of malignancy. This shift reflects an increasing
incidence of colorectal cancer in younger populations.
2. The Nurse Practitioner (NP) is assessing an older adult with low health literacy. Which
strategy is most effective for ensuring the patient understands the medication regimen?
A. Providing a detailed written pamphlet with medical terminology.
,B. Instructing the patient’s family member only to ensure compliance.
C. Asking the patient to read the labels aloud in the office.
D. Using the teach-back method to verify patient comprehension.
Answer: D
Rationale: The teach-back method is a validated tool for confirming that a patient
understands the clinical instructions provided during a visit. It requires the patient to
explain the information back in their own words, which reveals gaps in understanding. This
technique is particularly vital for patients with low health literacy to prevent medication
errors.
3. When applying the Principles of Antibiotic Stewardship, for which of the following
diagnoses should an NP generally avoid prescribing immediate antibiotics?
A. Acute Streptococcal Pharyngitis confirmed by rapid test.
B. Acute Pyelonephritis with systemic symptoms.
C. Uncomplicated Acute Bronchitis in a healthy adult.
D. Cellulitis with rapidly spreading erythema.
Answer: C
Rationale: Acute bronchitis is predominantly viral in origin, and routine antibiotic use
does not significantly improve outcomes or prevent complications in healthy adults.
Antibiotic stewardship aims to reduce the development of drug-resistant bacteria by
, limiting unnecessary prescriptions. Patients should instead be managed with supportive
care such as antitussives and hydration.
4. Which of the following is considered a ‘red flag’ in a patient presenting with acute low back
pain that warrants immediate imaging?
A. Pain that worsens with movement but is relieved by rest.
B. New onset of urinary incontinence or saddle anesthesia.
C. History of smoking and a sedentary lifestyle.
D. Mild tenderness over the paraspinal muscles.
Answer: B
Rationale: Urinary incontinence and saddle anesthesia are hallmark signs of Cauda Equina
Syndrome, a surgical emergency. These symptoms indicate significant nerve root
compression that requires immediate neurosurgical evaluation and imaging via MRI.
Failure to diagnose this promptly can lead to permanent neurological deficits.
5. An NP is selecting an E/M code for a patient visit. Which three key components
traditionally determine the level of service in a face-to-face encounter?
A. Chief Complaint, Review of Systems, and Patient Satisfaction.
B. History, Physical Examination, and Medical Decision Making.
C. Time spent, Vital Signs, and Diagnostic Results.
D. Insurance type, Age of patient, and Number of comorbidities.
