NSG 555 Exam 1 V3 | NSG 555 Nurse
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Exam 1 2026)
1. A 52-year-old female presents for a routine physical. According to the USPSTF, which
breast cancer screening schedule is recommended for a woman at average risk?
A. Annual mammography starting at age 40.
B. Biennial mammography for women aged 50 to 74 years.
C. Mammography every 3 years starting at age 50.
D. Monthly breast self-exams and annual clinical exams only.
Answer: B
Rationale: The USPSTF currently recommends biennial screening mammography for
women aged 50 to 74 years who are at average risk for breast cancer. While other
organizations may suggest starting at age 40, the USPSTF emphasizes that the decision to
start earlier should be individualized. This guideline aims to balance the benefits of early
detection with the risks of overdiagnosis and unnecessary procedures.
2. Which of the following findings on a physical exam is most indicative of bacterial sinusitis
rather than a viral upper respiratory infection?
A. Clear rhinorrhea and generalized malaise.
,B. Symptoms lasting for 5 days with gradual improvement.
C. Bilateral nasal congestion and mild sore throat.
D. Unilateral facial pain and ‘double sickening’ phenomenon.
Answer: D
Rationale: Bacterial sinusitis is often characterized by unilateral symptoms, purulent nasal
discharge, and a duration of more than 10 days. The ‘double sickening’ phenomenon occurs
when a patient initially improves from a viral URI but then develops worsening symptoms.
These clinical markers help the primary care provider differentiate between self-limiting
viral infections and those requiring antibiotic intervention.
3. An NP is evaluating a 19-year-old male with a sore throat. Using the Centor Criteria, which
of the following scores would warrant an immediate Rapid Antigen Detection Test (RADT)?
A. A score of 3 or higher.
B. A score of 1.
C. A score of 0.
D. A score of -1.
Answer: A
Rationale: The Centor Criteria include fever, tonsillar exudates, tender anterior cervical
adenopathy, and the absence of a cough. A score of 3 or 4 indicates a higher probability of
,Group A Streptococcus and suggests that testing is appropriate. Correct application of these
criteria reduces the unnecessary use of antibiotics for viral pharyngitis.
4. Which pharmacological agent is considered first-line treatment for a patient diagnosed
with uncomplicated hypertension who is of African American descent?
A. Lisinopril (ACE Inhibitor).
B. Losartan (ARB).
C. Amlodipine (Calcium Channel Blocker).
D. Metoprolol (Beta-Blocker).
Answer: C
Rationale: According to JNC 8 and current hypertension guidelines, Calcium Channel
Blockers (CCBs) or thiazide-type diuretics are preferred as initial therapy in the Black
population. ACE inhibitors and ARBs are generally less effective in lowering blood pressure
in this demographic unless comorbid conditions like CKD are present. Selecting the correct
class of medication is vital for achieving target blood pressure goals and reducing
cardiovascular risk.
5. A patient presents with a ‘velvety, hyperpigmented’ plaque on the back of the neck. This
clinical finding, known as Acanthosis Nigricans, is most commonly associated with which
underlying condition?
A. Iron deficiency anemia.
B. Insulin resistance or Diabetes Mellitus.
, C. Systemic Lupus Erythematosus.
D. Hypothyroidism.
Answer: B
Rationale: Acanthosis nigricans is a dermatological manifestation frequently linked to
hyperinsulinemia and insulin resistance. It serves as a clinical red flag for providers to
screen the patient for metabolic syndrome or Type 2 Diabetes. Identifying this skin change
early can lead to lifestyle interventions that prevent the progression of endocrine
disorders.
6. When screening for Colorectal Cancer (CRC) in an average-risk 45-year-old patient, which of
the following is an acceptable screening method according to the updated 2021 USPSTF
guidelines?
A. Digital rectal exam annually.
B. Fecal Occult Blood Test (FOBT) every 5 years.
C. Colonoscopy every 10 years.
D. Carcinoembryonic antigen (CEA) blood test annually.
Answer: C
Rationale: The USPSTF updated its guidelines in 2021 to recommend that CRC screening
begin at age 45 for average-risk adults. Colonoscopy every 10 years remains a gold
standard for both detection and prevention through polyp removal. Other options like
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Exam 1 2026)
1. A 52-year-old female presents for a routine physical. According to the USPSTF, which
breast cancer screening schedule is recommended for a woman at average risk?
A. Annual mammography starting at age 40.
B. Biennial mammography for women aged 50 to 74 years.
C. Mammography every 3 years starting at age 50.
D. Monthly breast self-exams and annual clinical exams only.
Answer: B
Rationale: The USPSTF currently recommends biennial screening mammography for
women aged 50 to 74 years who are at average risk for breast cancer. While other
organizations may suggest starting at age 40, the USPSTF emphasizes that the decision to
start earlier should be individualized. This guideline aims to balance the benefits of early
detection with the risks of overdiagnosis and unnecessary procedures.
2. Which of the following findings on a physical exam is most indicative of bacterial sinusitis
rather than a viral upper respiratory infection?
A. Clear rhinorrhea and generalized malaise.
,B. Symptoms lasting for 5 days with gradual improvement.
C. Bilateral nasal congestion and mild sore throat.
D. Unilateral facial pain and ‘double sickening’ phenomenon.
Answer: D
Rationale: Bacterial sinusitis is often characterized by unilateral symptoms, purulent nasal
discharge, and a duration of more than 10 days. The ‘double sickening’ phenomenon occurs
when a patient initially improves from a viral URI but then develops worsening symptoms.
These clinical markers help the primary care provider differentiate between self-limiting
viral infections and those requiring antibiotic intervention.
3. An NP is evaluating a 19-year-old male with a sore throat. Using the Centor Criteria, which
of the following scores would warrant an immediate Rapid Antigen Detection Test (RADT)?
A. A score of 3 or higher.
B. A score of 1.
C. A score of 0.
D. A score of -1.
Answer: A
Rationale: The Centor Criteria include fever, tonsillar exudates, tender anterior cervical
adenopathy, and the absence of a cough. A score of 3 or 4 indicates a higher probability of
,Group A Streptococcus and suggests that testing is appropriate. Correct application of these
criteria reduces the unnecessary use of antibiotics for viral pharyngitis.
4. Which pharmacological agent is considered first-line treatment for a patient diagnosed
with uncomplicated hypertension who is of African American descent?
A. Lisinopril (ACE Inhibitor).
B. Losartan (ARB).
C. Amlodipine (Calcium Channel Blocker).
D. Metoprolol (Beta-Blocker).
Answer: C
Rationale: According to JNC 8 and current hypertension guidelines, Calcium Channel
Blockers (CCBs) or thiazide-type diuretics are preferred as initial therapy in the Black
population. ACE inhibitors and ARBs are generally less effective in lowering blood pressure
in this demographic unless comorbid conditions like CKD are present. Selecting the correct
class of medication is vital for achieving target blood pressure goals and reducing
cardiovascular risk.
5. A patient presents with a ‘velvety, hyperpigmented’ plaque on the back of the neck. This
clinical finding, known as Acanthosis Nigricans, is most commonly associated with which
underlying condition?
A. Iron deficiency anemia.
B. Insulin resistance or Diabetes Mellitus.
, C. Systemic Lupus Erythematosus.
D. Hypothyroidism.
Answer: B
Rationale: Acanthosis nigricans is a dermatological manifestation frequently linked to
hyperinsulinemia and insulin resistance. It serves as a clinical red flag for providers to
screen the patient for metabolic syndrome or Type 2 Diabetes. Identifying this skin change
early can lead to lifestyle interventions that prevent the progression of endocrine
disorders.
6. When screening for Colorectal Cancer (CRC) in an average-risk 45-year-old patient, which of
the following is an acceptable screening method according to the updated 2021 USPSTF
guidelines?
A. Digital rectal exam annually.
B. Fecal Occult Blood Test (FOBT) every 5 years.
C. Colonoscopy every 10 years.
D. Carcinoembryonic antigen (CEA) blood test annually.
Answer: C
Rationale: The USPSTF updated its guidelines in 2021 to recommend that CRC screening
begin at age 45 for average-risk adults. Colonoscopy every 10 years remains a gold
standard for both detection and prevention through polyp removal. Other options like
