NSG 555 Exam 1 V1 | NSG 555 Nurse Practitioners
in Primary Care I | Wilkes University | 2026 Q&A
with Rationale (Wilkes NSG555 Exam 1 2026)
1. A 24-year-old patient presents with a ‘herald patch’ followed by a Christmas tree pattern of
smaller lesions on the trunk. What is the most likely diagnosis?
A. Tinea Corporis
B. Psoriasis
C. Pityriasis Rosea
D. Secondary Syphilis
Correct Answer: C
Explanation: Pityriasis rosea typically begins with a solitary herald patch before spreading
in a Christmas tree distribution. This condition is usually self-limiting and lasts six to eight
weeks. Clinicians should distinguish this from secondary syphilis by evaluating for lesions
on the palms and soles.
2. Which of the following findings is most diagnostic for Acute Otitis Media (AOM)?
A. Erythema of the ear canal
B. Bulging of the tympanic membrane
C. Presence of fluid in the absence of inflammation
D. Retraction of the tympanic membrane
,Correct Answer: B
Explanation: The key diagnostic indicator for Acute Otitis Media is the bulging of the
tympanic membrane, which signifies acute inflammation and middle ear effusion.
Erythema alone is not sufficient as it can be caused by crying or fever. A non-bulging
membrane with fluid is more indicative of Otitis Media with Effusion (OME).
3. A patient with a history of asthma presents with symptoms more than twice a week but
not daily. Which category of asthma severity does this fall under?
A. Intermittent
B. Mild Persistent
C. Moderate Persistent
D. Severe Persistent
Correct Answer: B
Explanation: Mild persistent asthma is characterized by symptoms occurring more than
twice a week but not every day. These patients typically require a daily low-dose inhaled
corticosteroid in addition to their rescue inhaler. Correct classification is essential for
determining the appropriate step-up therapy.
4. When treating Bacterial Conjunctivitis in a patient who wears contact lenses, which
pathogen must the provider specifically target?
A. Pseudomonas aeruginosa
B. Streptococcus pneumoniae
, C. Staphylococcus aureus
D. Haemophilus influenzae
Correct Answer: A
Explanation: Contact lens wearers are at a significantly higher risk for Pseudomonas
aeruginosa infections. Fluoroquinolone ophthalmic drops are typically preferred for these
patients to provide adequate coverage. Failure to treat this pathogen appropriately can
lead to rapid corneal ulceration.
5. According to the Centor criteria, which of the following signs increases the probability of
Group A Beta-Hemolytic Streptococcal (GABHS) pharyngitis?
A. Cough
B. Rhinorrhea
C. Tonsillar exudates
D. Conjunctival injection
Correct Answer: C
Explanation: The Centor criteria include tonsillar exudates, tender anterior cervical
lymphadenopathy, fever, and the absence of a cough. The presence of a cough or rhinorrhea
usually points toward a viral etiology rather than bacterial. A higher Centor score indicates
a greater need for rapid antigen testing or throat culture.
in Primary Care I | Wilkes University | 2026 Q&A
with Rationale (Wilkes NSG555 Exam 1 2026)
1. A 24-year-old patient presents with a ‘herald patch’ followed by a Christmas tree pattern of
smaller lesions on the trunk. What is the most likely diagnosis?
A. Tinea Corporis
B. Psoriasis
C. Pityriasis Rosea
D. Secondary Syphilis
Correct Answer: C
Explanation: Pityriasis rosea typically begins with a solitary herald patch before spreading
in a Christmas tree distribution. This condition is usually self-limiting and lasts six to eight
weeks. Clinicians should distinguish this from secondary syphilis by evaluating for lesions
on the palms and soles.
2. Which of the following findings is most diagnostic for Acute Otitis Media (AOM)?
A. Erythema of the ear canal
B. Bulging of the tympanic membrane
C. Presence of fluid in the absence of inflammation
D. Retraction of the tympanic membrane
,Correct Answer: B
Explanation: The key diagnostic indicator for Acute Otitis Media is the bulging of the
tympanic membrane, which signifies acute inflammation and middle ear effusion.
Erythema alone is not sufficient as it can be caused by crying or fever. A non-bulging
membrane with fluid is more indicative of Otitis Media with Effusion (OME).
3. A patient with a history of asthma presents with symptoms more than twice a week but
not daily. Which category of asthma severity does this fall under?
A. Intermittent
B. Mild Persistent
C. Moderate Persistent
D. Severe Persistent
Correct Answer: B
Explanation: Mild persistent asthma is characterized by symptoms occurring more than
twice a week but not every day. These patients typically require a daily low-dose inhaled
corticosteroid in addition to their rescue inhaler. Correct classification is essential for
determining the appropriate step-up therapy.
4. When treating Bacterial Conjunctivitis in a patient who wears contact lenses, which
pathogen must the provider specifically target?
A. Pseudomonas aeruginosa
B. Streptococcus pneumoniae
, C. Staphylococcus aureus
D. Haemophilus influenzae
Correct Answer: A
Explanation: Contact lens wearers are at a significantly higher risk for Pseudomonas
aeruginosa infections. Fluoroquinolone ophthalmic drops are typically preferred for these
patients to provide adequate coverage. Failure to treat this pathogen appropriately can
lead to rapid corneal ulceration.
5. According to the Centor criteria, which of the following signs increases the probability of
Group A Beta-Hemolytic Streptococcal (GABHS) pharyngitis?
A. Cough
B. Rhinorrhea
C. Tonsillar exudates
D. Conjunctival injection
Correct Answer: C
Explanation: The Centor criteria include tonsillar exudates, tender anterior cervical
lymphadenopathy, fever, and the absence of a cough. The presence of a cough or rhinorrhea
usually points toward a viral etiology rather than bacterial. A higher Centor score indicates
a greater need for rapid antigen testing or throat culture.
