NSG 554 Exam 3 - Nurse Practitioners in Primary Care I
Comprehensive Study Guide (Latest 2026-2027)
Pass your advanced practice nursing assessment on the first attempt with this
comprehensive study guide for NSG 554 Exam 3. This high-yield clinical resource
delivers an in-depth breakdown of primary care diagnostic algorithms, evidence-based
pharmacology management, and chronic disease protocols for adult populations.
Eliminate testing anxiety and master complex clinical reasoning using realistic patient
vignettes modeled directly after graduate-level Nurse Practitioner blueprints.
Question 1
A small, rural hospital is part of an Accountable Care Organization (ACO) and is
designated as a Level 1 ACO. What is part of this designation?
A) Bonuses based on achievement of benchmarks
B) Care coordination for chronic diseases
C) Standards for minimum cash reserves
D) Strict requirements for financial reporting
Rationale: A Level 1 ACO has the least amount of financial risk and requirements but
receives shared savings bonuses based on achievement of benchmarks for quality
measures and expenditures. Care coordination and minimum cash reserves are part of
Level 2 ACO requirements, while Level 3 ACOs require strict financial reporting .
Question 2
A primary care provider administers the "Newest Vital Sign" health literacy test to a
patient newly diagnosed with a chronic disease. What information is gained by
administering this test?
,A) Ability to calculate data, along with general knowledge about health
B) Ease of using technology and understanding of graphic data
C) Reading comprehension and numeracy skills related to health information
D) Patient's level of education and socioeconomic status
Rationale: The "Newest Vital Sign" is a health literacy screening tool that assesses a
patient's ability to read, comprehend, and apply numerical information from a nutrition
label. It evaluates both reading comprehension and numeracy skills related to health
information .
Question 3
After reviewing a client's chart, it is noted there was not an informed consent signed by
the patient scheduled for heart surgery. Failure to obtain this and perform the surgery
would be what tort?
A) False Imprisonment
B) Assault
C) Invasion of Privacy
D) Battery
Rationale: Performing a procedure without informed consent constitutes battery, which is
the unauthorized touching of another person. Assault is the threat of harm, while battery
is the actual harmful or offensive contact without consent .
,Question 4
A nurse takes steps to challenge an assignment that may not be within the practice
limits for nurses in the state where she works. Which law defines the limits of each
state's nursing practice?
A) Food, Drug, and Cosmetic Act
B) Contract Law
C) National Labor Relations Act
D) Nurse Practice Act
Rationale: The Nurse Practice Act is a state-specific law that defines the scope of nursing
practice, including the legal limits and responsibilities of nurses within that state. It
establishes the standards for nursing education, licensure, and practice .
Question 5
A nurse is caring for a 74-year-old male client who requires insertion of a central venous
catheter. Who is responsible for obtaining the informed consent?
A) The nurse assisting with the procedure
B) The provider performing the procedure
C) The charge nurse on the unit
D) The patient's family member
Rationale: The provider performing the procedure is legally responsible for obtaining
informed consent. The nurse can witness the signature but cannot provide the detailed
explanation of risks, benefits, and alternatives required for valid consent .
, Question 6
Which of the following is an example of a sentinel event that requires reporting to The
Joint Commission?
A) A patient fall with no injury
B) A medication error that was corrected before administration
C) An unexpected patient death unrelated to the natural course of illness
D) A patient complaint about food quality
Rationale: A sentinel event is an unexpected occurrence involving death or serious
physical or psychological injury, or the risk thereof. Unexpected patient death unrelated to
the natural course of illness meets this definition and requires reporting .
Question 7
A nurse practitioner is asked to perform a procedure that is outside their scope of
practice according to the state Nurse Practice Act. The NP should:
A) Perform the procedure and document it carefully
B) Refuse to perform the procedure and explain why
C) Perform the procedure under the physician's supervision
D) Ask another NP to perform the procedure
Rationale: Nurse practitioners must practice within the legal scope defined by their state's
Nurse Practice Act. Performing a procedure outside that scope is illegal and unethical. The
NP should refuse and explain the legal limitations .
Comprehensive Study Guide (Latest 2026-2027)
Pass your advanced practice nursing assessment on the first attempt with this
comprehensive study guide for NSG 554 Exam 3. This high-yield clinical resource
delivers an in-depth breakdown of primary care diagnostic algorithms, evidence-based
pharmacology management, and chronic disease protocols for adult populations.
Eliminate testing anxiety and master complex clinical reasoning using realistic patient
vignettes modeled directly after graduate-level Nurse Practitioner blueprints.
Question 1
A small, rural hospital is part of an Accountable Care Organization (ACO) and is
designated as a Level 1 ACO. What is part of this designation?
A) Bonuses based on achievement of benchmarks
B) Care coordination for chronic diseases
C) Standards for minimum cash reserves
D) Strict requirements for financial reporting
Rationale: A Level 1 ACO has the least amount of financial risk and requirements but
receives shared savings bonuses based on achievement of benchmarks for quality
measures and expenditures. Care coordination and minimum cash reserves are part of
Level 2 ACO requirements, while Level 3 ACOs require strict financial reporting .
Question 2
A primary care provider administers the "Newest Vital Sign" health literacy test to a
patient newly diagnosed with a chronic disease. What information is gained by
administering this test?
,A) Ability to calculate data, along with general knowledge about health
B) Ease of using technology and understanding of graphic data
C) Reading comprehension and numeracy skills related to health information
D) Patient's level of education and socioeconomic status
Rationale: The "Newest Vital Sign" is a health literacy screening tool that assesses a
patient's ability to read, comprehend, and apply numerical information from a nutrition
label. It evaluates both reading comprehension and numeracy skills related to health
information .
Question 3
After reviewing a client's chart, it is noted there was not an informed consent signed by
the patient scheduled for heart surgery. Failure to obtain this and perform the surgery
would be what tort?
A) False Imprisonment
B) Assault
C) Invasion of Privacy
D) Battery
Rationale: Performing a procedure without informed consent constitutes battery, which is
the unauthorized touching of another person. Assault is the threat of harm, while battery
is the actual harmful or offensive contact without consent .
,Question 4
A nurse takes steps to challenge an assignment that may not be within the practice
limits for nurses in the state where she works. Which law defines the limits of each
state's nursing practice?
A) Food, Drug, and Cosmetic Act
B) Contract Law
C) National Labor Relations Act
D) Nurse Practice Act
Rationale: The Nurse Practice Act is a state-specific law that defines the scope of nursing
practice, including the legal limits and responsibilities of nurses within that state. It
establishes the standards for nursing education, licensure, and practice .
Question 5
A nurse is caring for a 74-year-old male client who requires insertion of a central venous
catheter. Who is responsible for obtaining the informed consent?
A) The nurse assisting with the procedure
B) The provider performing the procedure
C) The charge nurse on the unit
D) The patient's family member
Rationale: The provider performing the procedure is legally responsible for obtaining
informed consent. The nurse can witness the signature but cannot provide the detailed
explanation of risks, benefits, and alternatives required for valid consent .
, Question 6
Which of the following is an example of a sentinel event that requires reporting to The
Joint Commission?
A) A patient fall with no injury
B) A medication error that was corrected before administration
C) An unexpected patient death unrelated to the natural course of illness
D) A patient complaint about food quality
Rationale: A sentinel event is an unexpected occurrence involving death or serious
physical or psychological injury, or the risk thereof. Unexpected patient death unrelated to
the natural course of illness meets this definition and requires reporting .
Question 7
A nurse practitioner is asked to perform a procedure that is outside their scope of
practice according to the state Nurse Practice Act. The NP should:
A) Perform the procedure and document it carefully
B) Refuse to perform the procedure and explain why
C) Perform the procedure under the physician's supervision
D) Ask another NP to perform the procedure
Rationale: Nurse practitioners must practice within the legal scope defined by their state's
Nurse Practice Act. Performing a procedure outside that scope is illegal and unethical. The
NP should refuse and explain the legal limitations .
