NSG 554 Exam 4 V3 | NSG 554 Nurse Practitioners in Primary Care |
Wilkes University | 2026 Q&A with Rationale (Wilkes NSG554 Exam 4
2026)
Question 1
A 65-year-old male presents with urinary frequency, nocturia, and a weak urinary stream. The
Nurse Practitioner suspects Benign Prostatic Hyperplasia (BPH). Which of the following is the
first-line medication class for rapid symptom relief?
A. 5-alpha-reductase inhibitors
B. Alpha-1 adrenergic antagonists
C. Phosphodiesterase-5 inhibitors
D. Antimuscarinics
Answer: B
Question 2
A 24-year-old female presents with irregular menses, acne, and hirsutism. According to the
Rotterdam criteria, which diagnostic finding is required to confirm Polycystic Ovary
Syndrome (PCOS)?
A. Presence of at least two of three specific criteria
B. Elevated serum cortisol levels
C. Documented insulin resistance
D. Isolated hyperprolactinemia
Answer: A
Question 3
When evaluating a patient for suspected Iron Deficiency Anemia (IDA), which laboratory result
is the most sensitive indicator of depleted iron stores?
A. Low Serum Ferritin
,NSG 554 Exam 4 V3 | NSG 554 Nurse Practitioners in Primary Care |
Wilkes University | 2026 Q&A with Rationale (Wilkes NSG554 Exam 4
2026)
B. High Total Iron Binding Capacity (TIBC)
C. Low Serum Iron
D. Low Hemoglobin
Answer: A
Question 4
A patient with newly diagnosed primary hypothyroidism is started on Levothyroxine. When
should the Nurse Practitioner schedule the follow-up TSH laboratory test to evaluate the dosage?
A. 1 to 2 weeks
B. 6 to 8 weeks
C. 3 to 4 months
D. Immediately after starting therapy
Answer: B
Question 5
Which of the following is considered a "red flag" symptom in a patient presenting with
symptoms of Gastroesophageal Reflux Disease (GERD) that warrants immediate referral for
upper endoscopy?
A. Heartburn after large meals
B. Unintentional weight loss
C. Regurgitation of sour fluid
D. Belching and bloating
Answer: B
, NSG 554 Exam 4 V3 | NSG 554 Nurse Practitioners in Primary Care |
Wilkes University | 2026 Q&A with Rationale (Wilkes NSG554 Exam 4
2026)
Question 6
A 30-year-old female requires contraception and has a history of migraines with aura. Which
contraceptive method is contraindicated for this patient?
A. Progestin-only pill (Mini-pill)
B. Copper Intrauterine Device (IUD)
C. Combined Oral Contraceptives (COC)
D. Medroxyprogesterone acetate injection
Answer: C
Rationale: Estrogen-containing combined oral contraceptives are contraindicated in women with
migraine with aura because they significantly increase the risk of ischemic stroke. Safe
alternatives include progestin-only pills, the copper IUD, levonorgestrel-releasing IUDs,
implants, and depot medroxyprogesterone acetate.
Question 7
A 56-year-old man presents with progressive fatigue, reduced exercise tolerance, and exertional
dyspnea. Laboratory testing reveals a hemoglobin of 9.2 g/dL with a mean corpuscular volume
(MCV) of 72 fL. The patient denies overt bleeding.
Which diagnostic study should be performed next to evaluate the underlying cause?
A. Colonoscopy
B. Chest X-ray
C. Echocardiogram
D. Abdominal ultrasound
Answer: A
Rationale: In adults, especially men and postmenopausal women with iron deficiency anemia,
occult gastrointestinal blood loss must be excluded. Colonoscopy is recommended to evaluate
for colorectal cancer, polyps, or other sources of chronic bleeding.
Wilkes University | 2026 Q&A with Rationale (Wilkes NSG554 Exam 4
2026)
Question 1
A 65-year-old male presents with urinary frequency, nocturia, and a weak urinary stream. The
Nurse Practitioner suspects Benign Prostatic Hyperplasia (BPH). Which of the following is the
first-line medication class for rapid symptom relief?
A. 5-alpha-reductase inhibitors
B. Alpha-1 adrenergic antagonists
C. Phosphodiesterase-5 inhibitors
D. Antimuscarinics
Answer: B
Question 2
A 24-year-old female presents with irregular menses, acne, and hirsutism. According to the
Rotterdam criteria, which diagnostic finding is required to confirm Polycystic Ovary
Syndrome (PCOS)?
A. Presence of at least two of three specific criteria
B. Elevated serum cortisol levels
C. Documented insulin resistance
D. Isolated hyperprolactinemia
Answer: A
Question 3
When evaluating a patient for suspected Iron Deficiency Anemia (IDA), which laboratory result
is the most sensitive indicator of depleted iron stores?
A. Low Serum Ferritin
,NSG 554 Exam 4 V3 | NSG 554 Nurse Practitioners in Primary Care |
Wilkes University | 2026 Q&A with Rationale (Wilkes NSG554 Exam 4
2026)
B. High Total Iron Binding Capacity (TIBC)
C. Low Serum Iron
D. Low Hemoglobin
Answer: A
Question 4
A patient with newly diagnosed primary hypothyroidism is started on Levothyroxine. When
should the Nurse Practitioner schedule the follow-up TSH laboratory test to evaluate the dosage?
A. 1 to 2 weeks
B. 6 to 8 weeks
C. 3 to 4 months
D. Immediately after starting therapy
Answer: B
Question 5
Which of the following is considered a "red flag" symptom in a patient presenting with
symptoms of Gastroesophageal Reflux Disease (GERD) that warrants immediate referral for
upper endoscopy?
A. Heartburn after large meals
B. Unintentional weight loss
C. Regurgitation of sour fluid
D. Belching and bloating
Answer: B
, NSG 554 Exam 4 V3 | NSG 554 Nurse Practitioners in Primary Care |
Wilkes University | 2026 Q&A with Rationale (Wilkes NSG554 Exam 4
2026)
Question 6
A 30-year-old female requires contraception and has a history of migraines with aura. Which
contraceptive method is contraindicated for this patient?
A. Progestin-only pill (Mini-pill)
B. Copper Intrauterine Device (IUD)
C. Combined Oral Contraceptives (COC)
D. Medroxyprogesterone acetate injection
Answer: C
Rationale: Estrogen-containing combined oral contraceptives are contraindicated in women with
migraine with aura because they significantly increase the risk of ischemic stroke. Safe
alternatives include progestin-only pills, the copper IUD, levonorgestrel-releasing IUDs,
implants, and depot medroxyprogesterone acetate.
Question 7
A 56-year-old man presents with progressive fatigue, reduced exercise tolerance, and exertional
dyspnea. Laboratory testing reveals a hemoglobin of 9.2 g/dL with a mean corpuscular volume
(MCV) of 72 fL. The patient denies overt bleeding.
Which diagnostic study should be performed next to evaluate the underlying cause?
A. Colonoscopy
B. Chest X-ray
C. Echocardiogram
D. Abdominal ultrasound
Answer: A
Rationale: In adults, especially men and postmenopausal women with iron deficiency anemia,
occult gastrointestinal blood loss must be excluded. Colonoscopy is recommended to evaluate
for colorectal cancer, polyps, or other sources of chronic bleeding.
