NSG 555 Exam 1 V3 | NSG 555 Nurse Practitioners in
Primary Care I | Wilkes University | 2026 Q&A with
Rationale (Wilkes NSG555 Exam 1 2026) Free PDF
2026/2027.
Section 1: Risk Management & Patient Safety
1. In outpatient settings, most common malpractice claims are due to what?
A) Communication failures between shifts
B) Diagnosis, medications, medical and surgical treatment
C) Improper informed consent
D) Failure to obtain insurance authorization
Correct Answer: B
The majority of outpatient malpractice claims arise from issues with diagnosis (failure to
diagnose or delay in diagnosis), medication errors, and medical/surgical treatment
complications. Handoff communication and electronic health records also play a role in
cases with adverse patient outcomes.
2. What is the disclosure of errors in malpractice?
A) A legal document signed by the patient waiving rights to sue
B) A policy of sharing investigative findings of adverse events with patients and families;
a process of apologizing and offering compensation
C) A mandatory report to the state Board of Nursing
D) A risk management strategy that involves concealing minor errors
Correct Answer: B
Disclosure is an ethical and legal obligation that involves transparency with patients and
families about adverse events. Apologizing and offering compensation has been shown to
work better than litigation. Key components include acknowledging the event occurred,
empathizing/apologizing if appropriate, and taking steps to minimize further harm.
,3. Which of the following is a key risk management strategy?
A) Documenting only positive findings
B) Limiting patient questions during visits
C) Patient first approach, addressing communication issues, addressing patient
concerns, and ensuring patient adherence
D) Referring all complex cases to specialists
Correct Answer: C
Risk management strategies focus on patient-centered care, open communication,
addressing patient complaints and concerns promptly, and ensuring patient
understanding and adherence to treatment plans. These proactive approaches reduce
liability exposure.
4. Which of the following is a category of diagnosis-related malpractice claims?
A) Failure to obtain specialist referral
B) Failure to identify observation findings or change in condition; failure to order correct
testing to establish a diagnosis; delay in establishing a diagnosis; failure to order or
address diagnostic test results
C) Improper billing practices
D) Inadequate informed consent for surgery
Correct Answer: B
Diagnosis-related claims include: (1) failure to identify observation findings or change in
condition, (2) failure to order correct testing, (3) delay in establishing a diagnosis, (4)
failure to order or address diagnostic test results.
Section 2: Diagnostic Testing Principles
5. Specificity is defined as:
A) Looking for patients WITH disease
B) Looking for patients WITHOUT disease
C) The true positive rate
D) The ability to rule in a diagnosis
,Correct Answer: B
Specificity identifies patients who do NOT have the disease (true negatives). High
specificity = low false positives. "SPIN" = Specificity rules IN.
6. Sensitivity is defined as:
A) Looking for patients WITHOUT disease
B) The true negative rate
C) Looking for patients WITH disease
D) The ability to rule out a diagnosis
Correct Answer: C
Sensitivity identifies patients who DO have the disease (true positives). High sensitivity =
low false negatives. "SNOUT" = Sensitivity rules OUT.
7. The equation for sensitivity is:
A) TN / (TN + FP)
B) TP / (TP + FN)
C) (TP + TN) / Total
D) TP / (TP + FP)
Correct Answer: B
Sensitivity = True Positives ÷ (True Positives + False Negatives). It measures the
proportion of actual positive cases correctly identified.
8. The equation for specificity is:
A) TP / (TP + FN)
B) TN / (TN + FP)
C) (TP + TN) / Total
D) TN / (TP + TN)
Correct Answer: B
Specificity = True Negatives ÷ (True Negatives + False Positives). It measures the
proportion of actual negative cases correctly identified.
, Section 3: Gastrointestinal & Genitourinary Disorders
9. A 42-year-old male presents with symptoms of dyspepsia and epigastric pain
that improves after eating. Which diagnostic test is the gold standard for
identifying H. pylori infection?
A. Serum H. pylori IgG antibody test
B. Urea Breath Test (UBT)
C. Stool antigen test
D. Endoscopy with gastric biopsy
Correct Answer: D
While non-invasive tests like the Urea Breath Test and stool antigen are commonly used,
endoscopy with biopsy remains the gold standard for definitive diagnosis. This procedure
allows for histopathological examination and rapid urease testing (CLOtest) directly from
gastric tissue. It also provides the benefit of direct visualization to rule out gastric ulcers or
malignancy.
10. Which physical examination maneuver is most specific for diagnosing acute
cholecystitis in a primary care setting?
A. Rovsing's sign
B. Murphy's sign
C. Psoas sign
D. Obturator sign
Correct Answer: B
Murphy's sign is elicited by palpating the right upper quadrant while the patient takes a
deep breath, resulting in an inspiratory arrest due to pain. This finding is highly indicative
of gallbladder inflammation or acute cholecystitis. In contrast, Rovsing's, Psoas, and
Obturator signs are clinical indicators primarily associated with acute appendicitis.
11. A patient presents with sudden onset of severe periumbilical pain that later
migrates to the right lower quadrant (RLQ). What is the most likely diagnosis?
A. Acute Diverticulitis
B. Nephrolithiasis
C. Acute Appendicitis
D. Choledocholithiasis
Primary Care I | Wilkes University | 2026 Q&A with
Rationale (Wilkes NSG555 Exam 1 2026) Free PDF
2026/2027.
Section 1: Risk Management & Patient Safety
1. In outpatient settings, most common malpractice claims are due to what?
A) Communication failures between shifts
B) Diagnosis, medications, medical and surgical treatment
C) Improper informed consent
D) Failure to obtain insurance authorization
Correct Answer: B
The majority of outpatient malpractice claims arise from issues with diagnosis (failure to
diagnose or delay in diagnosis), medication errors, and medical/surgical treatment
complications. Handoff communication and electronic health records also play a role in
cases with adverse patient outcomes.
2. What is the disclosure of errors in malpractice?
A) A legal document signed by the patient waiving rights to sue
B) A policy of sharing investigative findings of adverse events with patients and families;
a process of apologizing and offering compensation
C) A mandatory report to the state Board of Nursing
D) A risk management strategy that involves concealing minor errors
Correct Answer: B
Disclosure is an ethical and legal obligation that involves transparency with patients and
families about adverse events. Apologizing and offering compensation has been shown to
work better than litigation. Key components include acknowledging the event occurred,
empathizing/apologizing if appropriate, and taking steps to minimize further harm.
,3. Which of the following is a key risk management strategy?
A) Documenting only positive findings
B) Limiting patient questions during visits
C) Patient first approach, addressing communication issues, addressing patient
concerns, and ensuring patient adherence
D) Referring all complex cases to specialists
Correct Answer: C
Risk management strategies focus on patient-centered care, open communication,
addressing patient complaints and concerns promptly, and ensuring patient
understanding and adherence to treatment plans. These proactive approaches reduce
liability exposure.
4. Which of the following is a category of diagnosis-related malpractice claims?
A) Failure to obtain specialist referral
B) Failure to identify observation findings or change in condition; failure to order correct
testing to establish a diagnosis; delay in establishing a diagnosis; failure to order or
address diagnostic test results
C) Improper billing practices
D) Inadequate informed consent for surgery
Correct Answer: B
Diagnosis-related claims include: (1) failure to identify observation findings or change in
condition, (2) failure to order correct testing, (3) delay in establishing a diagnosis, (4)
failure to order or address diagnostic test results.
Section 2: Diagnostic Testing Principles
5. Specificity is defined as:
A) Looking for patients WITH disease
B) Looking for patients WITHOUT disease
C) The true positive rate
D) The ability to rule in a diagnosis
,Correct Answer: B
Specificity identifies patients who do NOT have the disease (true negatives). High
specificity = low false positives. "SPIN" = Specificity rules IN.
6. Sensitivity is defined as:
A) Looking for patients WITHOUT disease
B) The true negative rate
C) Looking for patients WITH disease
D) The ability to rule out a diagnosis
Correct Answer: C
Sensitivity identifies patients who DO have the disease (true positives). High sensitivity =
low false negatives. "SNOUT" = Sensitivity rules OUT.
7. The equation for sensitivity is:
A) TN / (TN + FP)
B) TP / (TP + FN)
C) (TP + TN) / Total
D) TP / (TP + FP)
Correct Answer: B
Sensitivity = True Positives ÷ (True Positives + False Negatives). It measures the
proportion of actual positive cases correctly identified.
8. The equation for specificity is:
A) TP / (TP + FN)
B) TN / (TN + FP)
C) (TP + TN) / Total
D) TN / (TP + TN)
Correct Answer: B
Specificity = True Negatives ÷ (True Negatives + False Positives). It measures the
proportion of actual negative cases correctly identified.
, Section 3: Gastrointestinal & Genitourinary Disorders
9. A 42-year-old male presents with symptoms of dyspepsia and epigastric pain
that improves after eating. Which diagnostic test is the gold standard for
identifying H. pylori infection?
A. Serum H. pylori IgG antibody test
B. Urea Breath Test (UBT)
C. Stool antigen test
D. Endoscopy with gastric biopsy
Correct Answer: D
While non-invasive tests like the Urea Breath Test and stool antigen are commonly used,
endoscopy with biopsy remains the gold standard for definitive diagnosis. This procedure
allows for histopathological examination and rapid urease testing (CLOtest) directly from
gastric tissue. It also provides the benefit of direct visualization to rule out gastric ulcers or
malignancy.
10. Which physical examination maneuver is most specific for diagnosing acute
cholecystitis in a primary care setting?
A. Rovsing's sign
B. Murphy's sign
C. Psoas sign
D. Obturator sign
Correct Answer: B
Murphy's sign is elicited by palpating the right upper quadrant while the patient takes a
deep breath, resulting in an inspiratory arrest due to pain. This finding is highly indicative
of gallbladder inflammation or acute cholecystitis. In contrast, Rovsing's, Psoas, and
Obturator signs are clinical indicators primarily associated with acute appendicitis.
11. A patient presents with sudden onset of severe periumbilical pain that later
migrates to the right lower quadrant (RLQ). What is the most likely diagnosis?
A. Acute Diverticulitis
B. Nephrolithiasis
C. Acute Appendicitis
D. Choledocholithiasis
