NSG 555 Exam 1, 2, 3, 4 & Final Review | Nurse
Practitioners in Primary Care | Wilkes
University 2026/2027 | 200 Q&A with
Rationales | Grade A Study Guide
Section 1: Risk Management & Professional Practice
Question 1
In outpatient settings, most 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
Rationale: 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 play a role in cases
with adverse patient outcomes .
,Question 2
What should NPs do to ensure compliance with standard of care?
A. Practice within the requirements of their nurse practice act and organizational policies
B. Only see patients they feel comfortable treating
C. Delegate all complex cases to physicians
D. Document only positive findings
Correct Answer: A
Rationale: NPs must practice within the requirements of their state nurse practice act,
organizational policies and procedures, and within established standards of care. This
includes documenting patient care assessment, observations, communications, and actions
in an objective, timely, and complete manner .
Question 3
Areas of risk for NPs with the highest claims include all of the following EXCEPT:
A. Neonatal and pediatric care
B. Underserved areas
C. Aging services facilities
D. Administrative roles
Correct Answer: D
Rationale: The specialties with the highest claims for NPs include neonatal and pediatric
areas, underserved areas, aging services facilities, NP office practice, behavioral/psych
,facilities, and emergency rooms. Administrative roles are not identified as high-risk clinical
practice areas .
Question 4
Which of the following is a practice to reduce risk in NP practice?
A. Avoid documentation of patient communications
B. Use a chain of command or risk management process when needed
C. Practice outside the scope of the nurse practice act when necessary
D. Delegate diagnosis to unlicensed personnel
Correct Answer: B
Rationale: Practices to reduce risk include: practicing within requirements of the NP act,
complying with organizational policies and standards of care, documenting patient care in
an objective and timely manner, and using a chain of command or risk management
process when concerns arise .
Question 5
What is the definition of disclosure of error?
A. Hiding errors to protect the provider
B. Informing the patient of a mistake that affected their care
, C. Documenting errors only in incident reports
D. Reporting errors only to insurance companies
Correct Answer: B
Rationale: Disclosure of error involves informing the patient when a mistake has been made
that affected their care. This is an ethical and professional obligation that maintains trust
and transparency in the provider-patient relationship .
Section 2: Cardiovascular Disorders
Question 6
A 45-year-old male presents with a new diagnosis of hypertension. According to JNC 8
guidelines, which of the following is an appropriate initial pharmacologic treatment for a non-
Black patient without chronic kidney disease?
A. Spironolactone
B. Metoprolol
C. Lisinopril
D. Clonidine
Correct Answer: C
Rationale: JNC 8 guidelines recommend ACE inhibitors, ARBs, calcium channel blockers,
or thiazide diuretics as first-line therapy for non-Black patients. Lisinopril is an ACE inhibitor
that provides effective blood pressure control and cardiovascular protection. Beta-blockers
Practitioners in Primary Care | Wilkes
University 2026/2027 | 200 Q&A with
Rationales | Grade A Study Guide
Section 1: Risk Management & Professional Practice
Question 1
In outpatient settings, most 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
Rationale: 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 play a role in cases
with adverse patient outcomes .
,Question 2
What should NPs do to ensure compliance with standard of care?
A. Practice within the requirements of their nurse practice act and organizational policies
B. Only see patients they feel comfortable treating
C. Delegate all complex cases to physicians
D. Document only positive findings
Correct Answer: A
Rationale: NPs must practice within the requirements of their state nurse practice act,
organizational policies and procedures, and within established standards of care. This
includes documenting patient care assessment, observations, communications, and actions
in an objective, timely, and complete manner .
Question 3
Areas of risk for NPs with the highest claims include all of the following EXCEPT:
A. Neonatal and pediatric care
B. Underserved areas
C. Aging services facilities
D. Administrative roles
Correct Answer: D
Rationale: The specialties with the highest claims for NPs include neonatal and pediatric
areas, underserved areas, aging services facilities, NP office practice, behavioral/psych
,facilities, and emergency rooms. Administrative roles are not identified as high-risk clinical
practice areas .
Question 4
Which of the following is a practice to reduce risk in NP practice?
A. Avoid documentation of patient communications
B. Use a chain of command or risk management process when needed
C. Practice outside the scope of the nurse practice act when necessary
D. Delegate diagnosis to unlicensed personnel
Correct Answer: B
Rationale: Practices to reduce risk include: practicing within requirements of the NP act,
complying with organizational policies and standards of care, documenting patient care in
an objective and timely manner, and using a chain of command or risk management
process when concerns arise .
Question 5
What is the definition of disclosure of error?
A. Hiding errors to protect the provider
B. Informing the patient of a mistake that affected their care
, C. Documenting errors only in incident reports
D. Reporting errors only to insurance companies
Correct Answer: B
Rationale: Disclosure of error involves informing the patient when a mistake has been made
that affected their care. This is an ethical and professional obligation that maintains trust
and transparency in the provider-patient relationship .
Section 2: Cardiovascular Disorders
Question 6
A 45-year-old male presents with a new diagnosis of hypertension. According to JNC 8
guidelines, which of the following is an appropriate initial pharmacologic treatment for a non-
Black patient without chronic kidney disease?
A. Spironolactone
B. Metoprolol
C. Lisinopril
D. Clonidine
Correct Answer: C
Rationale: JNC 8 guidelines recommend ACE inhibitors, ARBs, calcium channel blockers,
or thiazide diuretics as first-line therapy for non-Black patients. Lisinopril is an ACE inhibitor
that provides effective blood pressure control and cardiovascular protection. Beta-blockers
