NSG555 Practice Exam 1– Nurse Practitioners
in Primary Care II- WILKES
1. Hypertension Management
A 52-year-old male presents with BP 152/94 mmHg despite lifestyle changes.
Which is the most appropriate first-line pharmacologic therapy?
A. Beta-blocker
B. ACE inhibitor
C. Loop diuretic
D. Alpha-2 agonist
Answer: B. ACE inhibitor – First-line for hypertension in most patients, especially
with comorbid diabetes or CKD.
2. Diabetes Screening
At what age should routine screening for type 2 diabetes begin in asymptomatic
adults without risk factors?
A. 25 years
B. 35 years
C. 45 years
D. 55 years
Answer: C. 45 years – ADA recommends screening starting at age 45.
3. Asthma vs COPD
Which finding most strongly supports a diagnosis of asthma rather than COPD?
A. Chronic sputum production
B. Irreversible airflow limitation
C. Symptom improvement with bronchodilator
D. Onset after age 60
Answer: C. Symptom improvement with bronchodilator – Asthma is reversible,
COPD is not.
4. Preventive Care
Which vaccine is recommended for all adults ≥50 years old, regardless of prior
infection history?
A. Influenza
B. Shingles (zoster)
C. Pneumococcal
D. Hepatitis B
Answer: B. Shingles (zoster) – Recommended for adults ≥50.
5. Hyperlipidemia
Which statin intensity is appropriate for a 60-year-old with diabetes and LDL 160
mg/dL?
A. Low-intensity statin
B. Moderate-intensity statin
C. High-intensity statin
D. No statin needed
,Answer: C. High-intensity statin – Diabetes + LDL > 70 mg/dL warrants high-
intensity therapy.
6. Thyroid Disorder
A patient presents with weight loss, tremor, and tachycardia. Labs show suppressed
TSH and elevated free T4. What is the most likely diagnosis?
A. Hypothyroidism
B. Subclinical hypothyroidism
C. Hyperthyroidism
D. Euthyroid sick syndrome
Answer: C. Hyperthyroidism – Classic presentation with low TSH and high T4.
7. Osteoporosis Screening
At what age should women begin routine DEXA screening for osteoporosis if no risk
factors are present?
A. 50 years
B. 60 years
C. 65 years
D. 70 years
Answer: C. 65 years – USPSTF recommends screening at 65.
8. COPD Management
Which inhaler is first-line for stable COPD with mild symptoms?
A. Inhaled corticosteroid
B. Long-acting beta agonist
C. Short-acting bronchodilator
D. Oral theophylline
Answer: C. Short-acting bronchodilator – Initial therapy for mild COPD.
9. Depression Screening
Which tool is most commonly used in primary care to screen for depression?
A. GAD-7
B. PHQ-9
C. Beck Depression Inventory
D. Hamilton Rating Scale
Answer: B. PHQ-9 – Widely used in primary care.
10. Pediatric Immunization
At what age is the first dose of MMR vaccine recommended?
A. 6 months
B. 9 months
C. 12 months
D. 18 months
Answer: C. 12 months – First dose at 12–15 months.
11. Heart Failure
Which medication improves survival in patients with HFrEF?
A. Digoxin
B. Loop diuretic
, C. ACE inhibitor
D. Nitrate
Answer: C. ACE inhibitor – Proven mortality benefit.
12. Breast Cancer Screening
USPSTF recommends biennial mammography for women aged:
A. 30–50
B. 40–74
C. 45–65
D. 50–70
Answer: B. 40–74 – Biennial screening.
13. GERD Management
Which is the most effective initial therapy for moderate GERD?
A. Antacids
B. H2 blockers
C. Proton pump inhibitors
D. Prokinetics
Answer: C. Proton pump inhibitors – Most effective.
14. Stroke Risk
Which score is used to assess stroke risk in atrial fibrillation?
A. CHA₂DS₂-VASc
B. Wells score
C. CURB-65
D. APGAR
Answer: A. CHA₂DS₂-VASc – Standard risk tool.
15. Obesity Management
Which BMI threshold defines obesity?
A. ≥25
B. ≥30
C. ≥35
D. ≥40
Answer: B. ≥30 – Obesity classification.
16. Smoking Cessation
Which medication is contraindicated in patients with seizure disorder?
A. Nicotine patch
B. Bupropion
C. Varenicline
D. Nicotine gum
Answer: B. Bupropion – Lowers seizure threshold.
17. Hypertension in Pregnancy
Which antihypertensive is safe in pregnancy?
A. ACE inhibitor
B. Methyldopa
in Primary Care II- WILKES
1. Hypertension Management
A 52-year-old male presents with BP 152/94 mmHg despite lifestyle changes.
Which is the most appropriate first-line pharmacologic therapy?
A. Beta-blocker
B. ACE inhibitor
C. Loop diuretic
D. Alpha-2 agonist
Answer: B. ACE inhibitor – First-line for hypertension in most patients, especially
with comorbid diabetes or CKD.
2. Diabetes Screening
At what age should routine screening for type 2 diabetes begin in asymptomatic
adults without risk factors?
A. 25 years
B. 35 years
C. 45 years
D. 55 years
Answer: C. 45 years – ADA recommends screening starting at age 45.
3. Asthma vs COPD
Which finding most strongly supports a diagnosis of asthma rather than COPD?
A. Chronic sputum production
B. Irreversible airflow limitation
C. Symptom improvement with bronchodilator
D. Onset after age 60
Answer: C. Symptom improvement with bronchodilator – Asthma is reversible,
COPD is not.
4. Preventive Care
Which vaccine is recommended for all adults ≥50 years old, regardless of prior
infection history?
A. Influenza
B. Shingles (zoster)
C. Pneumococcal
D. Hepatitis B
Answer: B. Shingles (zoster) – Recommended for adults ≥50.
5. Hyperlipidemia
Which statin intensity is appropriate for a 60-year-old with diabetes and LDL 160
mg/dL?
A. Low-intensity statin
B. Moderate-intensity statin
C. High-intensity statin
D. No statin needed
,Answer: C. High-intensity statin – Diabetes + LDL > 70 mg/dL warrants high-
intensity therapy.
6. Thyroid Disorder
A patient presents with weight loss, tremor, and tachycardia. Labs show suppressed
TSH and elevated free T4. What is the most likely diagnosis?
A. Hypothyroidism
B. Subclinical hypothyroidism
C. Hyperthyroidism
D. Euthyroid sick syndrome
Answer: C. Hyperthyroidism – Classic presentation with low TSH and high T4.
7. Osteoporosis Screening
At what age should women begin routine DEXA screening for osteoporosis if no risk
factors are present?
A. 50 years
B. 60 years
C. 65 years
D. 70 years
Answer: C. 65 years – USPSTF recommends screening at 65.
8. COPD Management
Which inhaler is first-line for stable COPD with mild symptoms?
A. Inhaled corticosteroid
B. Long-acting beta agonist
C. Short-acting bronchodilator
D. Oral theophylline
Answer: C. Short-acting bronchodilator – Initial therapy for mild COPD.
9. Depression Screening
Which tool is most commonly used in primary care to screen for depression?
A. GAD-7
B. PHQ-9
C. Beck Depression Inventory
D. Hamilton Rating Scale
Answer: B. PHQ-9 – Widely used in primary care.
10. Pediatric Immunization
At what age is the first dose of MMR vaccine recommended?
A. 6 months
B. 9 months
C. 12 months
D. 18 months
Answer: C. 12 months – First dose at 12–15 months.
11. Heart Failure
Which medication improves survival in patients with HFrEF?
A. Digoxin
B. Loop diuretic
, C. ACE inhibitor
D. Nitrate
Answer: C. ACE inhibitor – Proven mortality benefit.
12. Breast Cancer Screening
USPSTF recommends biennial mammography for women aged:
A. 30–50
B. 40–74
C. 45–65
D. 50–70
Answer: B. 40–74 – Biennial screening.
13. GERD Management
Which is the most effective initial therapy for moderate GERD?
A. Antacids
B. H2 blockers
C. Proton pump inhibitors
D. Prokinetics
Answer: C. Proton pump inhibitors – Most effective.
14. Stroke Risk
Which score is used to assess stroke risk in atrial fibrillation?
A. CHA₂DS₂-VASc
B. Wells score
C. CURB-65
D. APGAR
Answer: A. CHA₂DS₂-VASc – Standard risk tool.
15. Obesity Management
Which BMI threshold defines obesity?
A. ≥25
B. ≥30
C. ≥35
D. ≥40
Answer: B. ≥30 – Obesity classification.
16. Smoking Cessation
Which medication is contraindicated in patients with seizure disorder?
A. Nicotine patch
B. Bupropion
C. Varenicline
D. Nicotine gum
Answer: B. Bupropion – Lowers seizure threshold.
17. Hypertension in Pregnancy
Which antihypertensive is safe in pregnancy?
A. ACE inhibitor
B. Methyldopa
