Nurse Practitioners in Primary
Care I
Wilkes University
NSG554/NSG 554 Exam 1
Questions & Answers Plus
Detailed Rationales
Latest 2026 | PDF
THIS EXAM CONTAINS:
✓100% Pass
✓Multiple Choice ( A-D)
✓Detailed Rationales For Each Question
✓Correct Answers For Each Question
✓100 Qs & Answers
,SECTION 1: Health Assessment and Diagnostic Reasoning
(Questions 1-15)
Question 1
A 45-year-old male patient presents for a routine physical
examination. He has no complaints. His blood pressure is 138/86
mmHg, heart rate is 72 bpm, and BMI is 31 kg/m². Laboratory
results show fasting glucose of 112 mg/dL and LDL cholesterol of
155 mg/dL. What is the most appropriate next step?
A. Reassure the patient that all findings are normal
B. Start metformin 500 mg twice daily
C. Order a hemoglobin A1c and repeat fasting glucose
D. Start atorvastatin 20 mg daily
Answer: C. Order a hemoglobin A1c and repeat fasting
glucose
Rationale: The patient has prediabetes (fasting glucose 100-125
mg/dL) with obesity and elevated LDL. A hemoglobin A1c and
repeat fasting glucose should be ordered to confirm the diagnosis
and guide management. Lifestyle modifications (weight loss, diet,
exercise) are the first-line treatment for prediabetes. Metformin is
not indicated until diabetes is diagnosed. Statin therapy may be
indicated if cardiovascular risk is elevated, but confirming the
diabetes status is the priority.
Question 2
A 62-year-old female patient reports occasional dizziness when
,standing up quickly. She has a history of hypertension treated
with lisinopril 10 mg daily. Her blood pressure is 118/74 mmHg
sitting and 102/68 mmHg standing. What is the most appropriate
management?
A. Increase the lisinopril dose
B. Decrease the lisinopril dose
C. Add a calcium channel blocker
D. Order an echocardiogram
Answer: B. Decrease the lisinopril dose
Rationale: This patient has orthostatic hypotension (systolic
drop > 20 mmHg or diastolic drop > 10 mmHg upon standing)
likely related to her antihypertensive medication. The most
appropriate management is to decrease the lisinopril dose or
consider alternative therapy. Increasing the dose would worsen
the symptoms. Adding a calcium channel blocker would further
lower blood pressure. An echocardiogram is not indicated
without other cardiac symptoms.
Question 3
During a preplacement screening for a job requiring heavy lifting,
a primary care provider notes a history of GERD, recurrent
eczema, a previous ankle fracture, and normal lower back
strength and flexibility. A urine drug screen is negative. What will
be included in the report to the employer? (Select all that apply.)
A. GERD history
B. History of allergies and eczema
C. History of ankle fracture
, D. Lower back screening results
ℯ. Urine drug screening results
Answer: D, ℯ. Lower back screening results and Urine drug
screening results
Rationale: Only findings related to the ability of the individual to
perform position requirements for the job are included in the
report. Lower back strength and flexibility are relevant to heavy
lifting requirements. A negative urine drug screen is relevant for
employment. GERD, eczema, and ankle fracture history are not
related to the ability to perform heavy lifting and should not be
included in the employer report.
Question 4
A female college student seeks information about emergency
contraception. What is the most important part of the assessment
of this patient?
A. Cultural considerations for use of contraception
B. Feelings of guilt about a possible pregnancy
C. Possible concerns about confidentiality
D. The female's sense of control in sexual situations
Answer: D. The female's sense of control in sexual situations
Rationale: Because college women are at greater risk for sexual
violence and assault, a request for emergency contraception must
be followed by an evaluation of possible rape or assault. The other
considerations may be part of the assessment but are not as
important as determining whether a rape has occurred. Assessing
Care I
Wilkes University
NSG554/NSG 554 Exam 1
Questions & Answers Plus
Detailed Rationales
Latest 2026 | PDF
THIS EXAM CONTAINS:
✓100% Pass
✓Multiple Choice ( A-D)
✓Detailed Rationales For Each Question
✓Correct Answers For Each Question
✓100 Qs & Answers
,SECTION 1: Health Assessment and Diagnostic Reasoning
(Questions 1-15)
Question 1
A 45-year-old male patient presents for a routine physical
examination. He has no complaints. His blood pressure is 138/86
mmHg, heart rate is 72 bpm, and BMI is 31 kg/m². Laboratory
results show fasting glucose of 112 mg/dL and LDL cholesterol of
155 mg/dL. What is the most appropriate next step?
A. Reassure the patient that all findings are normal
B. Start metformin 500 mg twice daily
C. Order a hemoglobin A1c and repeat fasting glucose
D. Start atorvastatin 20 mg daily
Answer: C. Order a hemoglobin A1c and repeat fasting
glucose
Rationale: The patient has prediabetes (fasting glucose 100-125
mg/dL) with obesity and elevated LDL. A hemoglobin A1c and
repeat fasting glucose should be ordered to confirm the diagnosis
and guide management. Lifestyle modifications (weight loss, diet,
exercise) are the first-line treatment for prediabetes. Metformin is
not indicated until diabetes is diagnosed. Statin therapy may be
indicated if cardiovascular risk is elevated, but confirming the
diabetes status is the priority.
Question 2
A 62-year-old female patient reports occasional dizziness when
,standing up quickly. She has a history of hypertension treated
with lisinopril 10 mg daily. Her blood pressure is 118/74 mmHg
sitting and 102/68 mmHg standing. What is the most appropriate
management?
A. Increase the lisinopril dose
B. Decrease the lisinopril dose
C. Add a calcium channel blocker
D. Order an echocardiogram
Answer: B. Decrease the lisinopril dose
Rationale: This patient has orthostatic hypotension (systolic
drop > 20 mmHg or diastolic drop > 10 mmHg upon standing)
likely related to her antihypertensive medication. The most
appropriate management is to decrease the lisinopril dose or
consider alternative therapy. Increasing the dose would worsen
the symptoms. Adding a calcium channel blocker would further
lower blood pressure. An echocardiogram is not indicated
without other cardiac symptoms.
Question 3
During a preplacement screening for a job requiring heavy lifting,
a primary care provider notes a history of GERD, recurrent
eczema, a previous ankle fracture, and normal lower back
strength and flexibility. A urine drug screen is negative. What will
be included in the report to the employer? (Select all that apply.)
A. GERD history
B. History of allergies and eczema
C. History of ankle fracture
, D. Lower back screening results
ℯ. Urine drug screening results
Answer: D, ℯ. Lower back screening results and Urine drug
screening results
Rationale: Only findings related to the ability of the individual to
perform position requirements for the job are included in the
report. Lower back strength and flexibility are relevant to heavy
lifting requirements. A negative urine drug screen is relevant for
employment. GERD, eczema, and ankle fracture history are not
related to the ability to perform heavy lifting and should not be
included in the employer report.
Question 4
A female college student seeks information about emergency
contraception. What is the most important part of the assessment
of this patient?
A. Cultural considerations for use of contraception
B. Feelings of guilt about a possible pregnancy
C. Possible concerns about confidentiality
D. The female's sense of control in sexual situations
Answer: D. The female's sense of control in sexual situations
Rationale: Because college women are at greater risk for sexual
violence and assault, a request for emergency contraception must
be followed by an evaluation of possible rape or assault. The other
considerations may be part of the assessment but are not as
important as determining whether a rape has occurred. Assessing
