NSG 555 | Exam 3 Review | 2026/2027 UPDATE
NSG 555
ADVANCED PRIMARY CARE II
Exam 3 Review
UPDATE
50 Multiple-Choice Questions
Complete Answers with Explained Rationales
Aligned with Current Clinical Guidelines
Wilkes University | Advanced Practice Nursing
Cardiovascular • Pulmonary • Endocrine • GI • MSK • Infectious Disease
For academic study and clinical review • Verify with current institutional protocols
Page 1
,NSG 555 | Exam 3 Review | 2026/2027 UPDATE
How to Use This Review
This comprehensive exam review contains high-yield multiple-choice questions covering the core clinical
management topics of NSG 555. Each item is followed by the correct answer and rationales that explain the
underlying pathophysiology or guideline recommendation, why the correct option is preferred, and why the
distractors are incorrect.
Topics span cardiovascular, pulmonary, endocrine, GI, MSK, infectious disease, and preventive care guidelines.
Study tip: Attempt each question before reading the answer. Then carefully review the rationale.
Topic Index (Selected High-Yield Areas)
• Heart Failure & ARNI therapy
• SGLT2 inhibitors & cardiorenal protection
• COPD / Asthma & GOLD staging
• Atrial Fibrillation & anticoagulation
• Type 2 Diabetes management
• Thyroid disorders
• Gout & Osteoarthritis
• Community-acquired pneumonia
• Anemia work-up
• Hypertension guidelines
• BPH, CKD, Beers Criteria
• Ophthalmologic & surgical emergencies
• Infectious disease (Lyme, zoster)
Page 2
, NSG 555 | Exam 3 Review | 2026/2027 UPDATE
Question 1
A 45-year-old female presents with a TSH of 7.2 mIU/L and a normal free T4 level. She reports mild fatigue but no
other symptoms. What is the most appropriate next step in management?
A. Start Levothyroxine 25 mcg daily
B. Recheck TSH and T4 in 3-6 months
C. Order a thyroid ultrasound
D. Refer to endocrinology for immediate biopsy
Answer: B
Rationale
Subclinical hypothyroidism (elevated TSH, normal T4) usually does not require treatment unless TSH is >10 or the patient is
symptomatic/pregnant. The standard approach is to monitor.
Question 2
Which of the following findings is most characteristic of Vitamin B12 deficiency anemia compared to Folic acid
deficiency?
A. Elevated Methylmalonic Acid (MMA) levels
B. Presence of Howell-Jolly bodies
C. Increased Mean Corpuscular Volume (MCV)
D. Hypersegmented neutrophils on peripheral smear
Answer: A
Rationale
While both cause macrocytic anemia and hypersegmented neutrophils, only Vitamin B12 deficiency results in elevated
Methylmalonic Acid (MMA) levels.
Question 3
A patient with Type 2 Diabetes and a history of heart failure with reduced ejection fraction (HFrEF) requires an
additional agent for glucose control. Which class is most beneficial for this patient?
A. DPP-4 inhibitors
B. Sulfonylureas
C. Thiazolidinediones
D. SGLT2 inhibitors
Answer: D
Rationale
SGLT2 inhibitors have been shown to reduce hospitalizations for heart failure and are preferred in patients with HFrEF and
T2DM.
Question 4
To meet the Rotterdam criteria for Polycystic Ovary Syndrome (PCOS), how many of the three clinical features
must be present?
A. One
B. None, it is a diagnosis of exclusion
C. Three
D. Two
Answer: D
Rationale
The Rotterdam criteria require at least two of the following: oligo- or anovulation, clinical/biochemical signs of
hyperandrogenism, and polycystic ovaries on ultrasound.
Page 3
NSG 555
ADVANCED PRIMARY CARE II
Exam 3 Review
UPDATE
50 Multiple-Choice Questions
Complete Answers with Explained Rationales
Aligned with Current Clinical Guidelines
Wilkes University | Advanced Practice Nursing
Cardiovascular • Pulmonary • Endocrine • GI • MSK • Infectious Disease
For academic study and clinical review • Verify with current institutional protocols
Page 1
,NSG 555 | Exam 3 Review | 2026/2027 UPDATE
How to Use This Review
This comprehensive exam review contains high-yield multiple-choice questions covering the core clinical
management topics of NSG 555. Each item is followed by the correct answer and rationales that explain the
underlying pathophysiology or guideline recommendation, why the correct option is preferred, and why the
distractors are incorrect.
Topics span cardiovascular, pulmonary, endocrine, GI, MSK, infectious disease, and preventive care guidelines.
Study tip: Attempt each question before reading the answer. Then carefully review the rationale.
Topic Index (Selected High-Yield Areas)
• Heart Failure & ARNI therapy
• SGLT2 inhibitors & cardiorenal protection
• COPD / Asthma & GOLD staging
• Atrial Fibrillation & anticoagulation
• Type 2 Diabetes management
• Thyroid disorders
• Gout & Osteoarthritis
• Community-acquired pneumonia
• Anemia work-up
• Hypertension guidelines
• BPH, CKD, Beers Criteria
• Ophthalmologic & surgical emergencies
• Infectious disease (Lyme, zoster)
Page 2
, NSG 555 | Exam 3 Review | 2026/2027 UPDATE
Question 1
A 45-year-old female presents with a TSH of 7.2 mIU/L and a normal free T4 level. She reports mild fatigue but no
other symptoms. What is the most appropriate next step in management?
A. Start Levothyroxine 25 mcg daily
B. Recheck TSH and T4 in 3-6 months
C. Order a thyroid ultrasound
D. Refer to endocrinology for immediate biopsy
Answer: B
Rationale
Subclinical hypothyroidism (elevated TSH, normal T4) usually does not require treatment unless TSH is >10 or the patient is
symptomatic/pregnant. The standard approach is to monitor.
Question 2
Which of the following findings is most characteristic of Vitamin B12 deficiency anemia compared to Folic acid
deficiency?
A. Elevated Methylmalonic Acid (MMA) levels
B. Presence of Howell-Jolly bodies
C. Increased Mean Corpuscular Volume (MCV)
D. Hypersegmented neutrophils on peripheral smear
Answer: A
Rationale
While both cause macrocytic anemia and hypersegmented neutrophils, only Vitamin B12 deficiency results in elevated
Methylmalonic Acid (MMA) levels.
Question 3
A patient with Type 2 Diabetes and a history of heart failure with reduced ejection fraction (HFrEF) requires an
additional agent for glucose control. Which class is most beneficial for this patient?
A. DPP-4 inhibitors
B. Sulfonylureas
C. Thiazolidinediones
D. SGLT2 inhibitors
Answer: D
Rationale
SGLT2 inhibitors have been shown to reduce hospitalizations for heart failure and are preferred in patients with HFrEF and
T2DM.
Question 4
To meet the Rotterdam criteria for Polycystic Ovary Syndrome (PCOS), how many of the three clinical features
must be present?
A. One
B. None, it is a diagnosis of exclusion
C. Three
D. Two
Answer: D
Rationale
The Rotterdam criteria require at least two of the following: oligo- or anovulation, clinical/biochemical signs of
hyperandrogenism, and polycystic ovaries on ultrasound.
Page 3
