NSG 555 Final Exam V2 | NSG 555 Nurse
Practitioners in Primary Care I | Wilkes University
| 2026 Q&A with Rationale (Wilkes NSG555 Final
Exam 2026)
1. A 67-year-old male patient presents with a blood pressure reading of 152/94 mmHg on two
separate occasions. According to the JNC 8 guidelines, what is the target blood pressure for
this patient?
A. <150/90
B. <140/90
C. <130/80
D. <160/100
Correct Answer: A
Explanation: For patients aged 60 years or older without diabetes or chronic kidney
disease, the JNC 8 guidelines recommend a target blood pressure of less than 150/90
mmHg. This higher threshold is intended to reduce the risk of adverse effects from
polypharmacy and hypotension in the elderly population. The nurse practitioner should
initiate pharmacological therapy if the blood pressure exceeds these parameters.
2. Which of the following Hemoglobin A1c levels is the minimum threshold for diagnosing a
patient with Type 2 Diabetes Mellitus?
A. 5.7%
,B. 6.0%
C. 7.0%
D. 6.5%
Correct Answer: D
Explanation: The diagnosis of Type 2 Diabetes Mellitus is confirmed with a Hemoglobin
A1c level of 6.5% or higher according to ADA standards. This test reflects the average blood
glucose levels over the past two to three months by measuring glycated hemoglobin. It is a
preferred diagnostic tool because it does not require fasting and provides a more stable
measure of long-term glycemic control.
3. A 22-year-old female presents with a sore throat, fever of 101.5 F, and anterior cervical
lymphadenopathy. She denies having a cough. According to the Centor criteria, what is the
most appropriate next step?
A. Prescribe Amoxicillin immediately
B. Perform a Rapid Antigen Detection Test (RADT)
C. Reassure the patient it is viral
D. Order a chest X-ray
Correct Answer: B
Explanation: The Centor criteria are used to estimate the probability of Group A Beta-
Hemolytic Streptococcal pharyngitis. A score of 3 or 4, based on fever, exudates, nodes, and
, lack of cough, warrants testing with RADT or throat culture. Treatment should only be
initiated after a positive test result to avoid unnecessary antibiotic use.
4. What is the first-line pharmacological treatment for a patient newly diagnosed with mild
Osteoarthritis of the knee?
A. Oral Prednisone
B. Acetaminophen or Topical NSAIDs
C. Morphine Sulfate
D. Intra-articular Hyaluronic Acid
Correct Answer: B
Explanation: Acetaminophen and topical NSAIDs are considered first-line treatments for
mild osteoarthritis because of their favorable safety profile. Oral NSAIDs may also be used
but carry risks of gastrointestinal bleeding and renal impairment, especially in older adults.
The primary goal is pain management and improving joint function through the least
invasive means possible.
5. According to the USPSTF guidelines, at what age should routine screening for breast cancer
with mammography begin for a woman at average risk?
A. Age 50
B. Age 40
C. Age 35
Practitioners in Primary Care I | Wilkes University
| 2026 Q&A with Rationale (Wilkes NSG555 Final
Exam 2026)
1. A 67-year-old male patient presents with a blood pressure reading of 152/94 mmHg on two
separate occasions. According to the JNC 8 guidelines, what is the target blood pressure for
this patient?
A. <150/90
B. <140/90
C. <130/80
D. <160/100
Correct Answer: A
Explanation: For patients aged 60 years or older without diabetes or chronic kidney
disease, the JNC 8 guidelines recommend a target blood pressure of less than 150/90
mmHg. This higher threshold is intended to reduce the risk of adverse effects from
polypharmacy and hypotension in the elderly population. The nurse practitioner should
initiate pharmacological therapy if the blood pressure exceeds these parameters.
2. Which of the following Hemoglobin A1c levels is the minimum threshold for diagnosing a
patient with Type 2 Diabetes Mellitus?
A. 5.7%
,B. 6.0%
C. 7.0%
D. 6.5%
Correct Answer: D
Explanation: The diagnosis of Type 2 Diabetes Mellitus is confirmed with a Hemoglobin
A1c level of 6.5% or higher according to ADA standards. This test reflects the average blood
glucose levels over the past two to three months by measuring glycated hemoglobin. It is a
preferred diagnostic tool because it does not require fasting and provides a more stable
measure of long-term glycemic control.
3. A 22-year-old female presents with a sore throat, fever of 101.5 F, and anterior cervical
lymphadenopathy. She denies having a cough. According to the Centor criteria, what is the
most appropriate next step?
A. Prescribe Amoxicillin immediately
B. Perform a Rapid Antigen Detection Test (RADT)
C. Reassure the patient it is viral
D. Order a chest X-ray
Correct Answer: B
Explanation: The Centor criteria are used to estimate the probability of Group A Beta-
Hemolytic Streptococcal pharyngitis. A score of 3 or 4, based on fever, exudates, nodes, and
, lack of cough, warrants testing with RADT or throat culture. Treatment should only be
initiated after a positive test result to avoid unnecessary antibiotic use.
4. What is the first-line pharmacological treatment for a patient newly diagnosed with mild
Osteoarthritis of the knee?
A. Oral Prednisone
B. Acetaminophen or Topical NSAIDs
C. Morphine Sulfate
D. Intra-articular Hyaluronic Acid
Correct Answer: B
Explanation: Acetaminophen and topical NSAIDs are considered first-line treatments for
mild osteoarthritis because of their favorable safety profile. Oral NSAIDs may also be used
but carry risks of gastrointestinal bleeding and renal impairment, especially in older adults.
The primary goal is pain management and improving joint function through the least
invasive means possible.
5. According to the USPSTF guidelines, at what age should routine screening for breast cancer
with mammography begin for a woman at average risk?
A. Age 50
B. Age 40
C. Age 35