1|Page
NSG 555 EXAM 4 (WILKES) NEWEST 2026 ACTUAL
EXAM| NURSE PRACTITIONERS IN PRIMARY CARE I
EXAM 4 REVIEW WITH COMPLETE 300 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
What is the clinical presentation of Raynaud's phenomenon (RP)? -
ANSWER - Paroxysmal bilateral digital pallor and cyanosis followed by
rubor, typically asymptomatic between attacks.
What color changes occur in fingers/toes during RP episodes? -
ANSWER - White (ischemia) -> blue (cyanosis) -> red (rubor).
What initial diagnostics are used for secondary RP? - ANSWER -
Nailfold capillary abnormalities visualized with an ophthalmoscope,
ANA and autoimmune panels, TSH to rule out hypothyroidism.
What are the management strategies for Raynaud's phenomenon? -
ANSWER - Keeping warm, wearing gloves, protecting hands, using
softening lotion, stopping smoking, and considering sympathectomy for
severe cases.
What are the common drug classifications for managing Raynaud's
phenomenon? - ANSWER - CCBs, angiotensin II receptor blockers,
topical nitrates, phosphodiesterase inhibitors, and SSRIs.
pg. 1
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What is the prevalence of rheumatoid arthritis (RA)? - ANSWER - 1%,
more common in women than men (3:1).
What is the peak onset age for RA in women and men? - ANSWER - 4th
or 5th decade for women and 6th-8th decades for men.
What are the main immune components involved in RA
pathophysiology? - ANSWER - T cells, B cells, macrophages, and pro-
inflammatory cytokines like TNF-α and IL-6.
What are common clinical presentations of RA? - ANSWER - Insidious
onset, symmetrical polyarthritis, morning stiffness > 30 min, fatigue,
low-grade fever.
What joints are commonly affected by rheumatoid arthritis? - ANSWER
- Small joints of the hands (MCP, PIP) and feet (MTP).
What are some extra-articular features of RA? - ANSWER - Rheumatoid
nodules, interstitial lung disease, vasculitis.
What are the complications associated with RA? - ANSWER - CV
disease, pulmonary complications, infections, osteoporosis, rheumatoid
vasculitis, malignancy, neuropsychiatric complications.
pg. 2
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What are the initial diagnostics for RA? - ANSWER - Persistent
symmetric polyarthritis, elevated inflammatory markers (CRP, ESR),
serologic testing for RF and ACPA.
What is the 2010 ACR/EULAR Classification criteria for RA? -
ANSWER - Requires >1 swollen joint, exclusion of other diagnoses, and
≥6 out of 10 points from joint involvement, serology, acute-phase
reactants, and symptom duration.
What radiographic findings are specific for RA? - ANSWER - Juxta-
articular osteoporosis, joint erosions, and joint space narrowing.
What is the significance of rheumatoid factor (RF) in RA? - ANSWER -
Positive in 70-80% of cases, but can occur in other autoimmune diseases
and chronic infections.
What lifestyle modifications are recommended for RA patients? -
ANSWER - Cigarette smoking cessation and weight management.
What is the role of sympathomimetic drugs in managing Raynaud's
phenomenon? - ANSWER - They should be avoided as they can
exacerbate symptoms.
What is the typical recovery phase after an attack of RP? - ANSWER -
Intense rubor, throbbing, paresthesia, pain, and slight swelling.
pg. 3
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What is the relationship between RA and cardiovascular disease? -
ANSWER - CV disease is the leading cause of premature mortality in
RA due to systemic inflammation.
What are the common infections associated with RA? - ANSWER -
Pneumonia, sepsis, and opportunistic infections due to
immunosuppressive therapy.
What are the effects of chronic inflammation on bone health in RA
patients? - ANSWER - Increased risk of osteoporosis and fractures.
What is the role of regular follow-up in RA management? - ANSWER -
To assess for progression to connective tissue disease and monitor for
ulcers or signs of ischemia.
What are the common symptoms of acute RA flares? - ANSWER - Joint
pain, swelling, decreased range of motion, and morning stiffness.
What is the impact of obesity on RA? - ANSWER - It is a modifiable
risk factor that can worsen disease outcomes.
What is the significance of morning stiffness in RA? - ANSWER - It is a
hallmark symptom indicating inflammation and joint involvement.
pg. 4
NSG 555 EXAM 4 (WILKES) NEWEST 2026 ACTUAL
EXAM| NURSE PRACTITIONERS IN PRIMARY CARE I
EXAM 4 REVIEW WITH COMPLETE 300 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
What is the clinical presentation of Raynaud's phenomenon (RP)? -
ANSWER - Paroxysmal bilateral digital pallor and cyanosis followed by
rubor, typically asymptomatic between attacks.
What color changes occur in fingers/toes during RP episodes? -
ANSWER - White (ischemia) -> blue (cyanosis) -> red (rubor).
What initial diagnostics are used for secondary RP? - ANSWER -
Nailfold capillary abnormalities visualized with an ophthalmoscope,
ANA and autoimmune panels, TSH to rule out hypothyroidism.
What are the management strategies for Raynaud's phenomenon? -
ANSWER - Keeping warm, wearing gloves, protecting hands, using
softening lotion, stopping smoking, and considering sympathectomy for
severe cases.
What are the common drug classifications for managing Raynaud's
phenomenon? - ANSWER - CCBs, angiotensin II receptor blockers,
topical nitrates, phosphodiesterase inhibitors, and SSRIs.
pg. 1
,2|Page
What is the prevalence of rheumatoid arthritis (RA)? - ANSWER - 1%,
more common in women than men (3:1).
What is the peak onset age for RA in women and men? - ANSWER - 4th
or 5th decade for women and 6th-8th decades for men.
What are the main immune components involved in RA
pathophysiology? - ANSWER - T cells, B cells, macrophages, and pro-
inflammatory cytokines like TNF-α and IL-6.
What are common clinical presentations of RA? - ANSWER - Insidious
onset, symmetrical polyarthritis, morning stiffness > 30 min, fatigue,
low-grade fever.
What joints are commonly affected by rheumatoid arthritis? - ANSWER
- Small joints of the hands (MCP, PIP) and feet (MTP).
What are some extra-articular features of RA? - ANSWER - Rheumatoid
nodules, interstitial lung disease, vasculitis.
What are the complications associated with RA? - ANSWER - CV
disease, pulmonary complications, infections, osteoporosis, rheumatoid
vasculitis, malignancy, neuropsychiatric complications.
pg. 2
,3|Page
What are the initial diagnostics for RA? - ANSWER - Persistent
symmetric polyarthritis, elevated inflammatory markers (CRP, ESR),
serologic testing for RF and ACPA.
What is the 2010 ACR/EULAR Classification criteria for RA? -
ANSWER - Requires >1 swollen joint, exclusion of other diagnoses, and
≥6 out of 10 points from joint involvement, serology, acute-phase
reactants, and symptom duration.
What radiographic findings are specific for RA? - ANSWER - Juxta-
articular osteoporosis, joint erosions, and joint space narrowing.
What is the significance of rheumatoid factor (RF) in RA? - ANSWER -
Positive in 70-80% of cases, but can occur in other autoimmune diseases
and chronic infections.
What lifestyle modifications are recommended for RA patients? -
ANSWER - Cigarette smoking cessation and weight management.
What is the role of sympathomimetic drugs in managing Raynaud's
phenomenon? - ANSWER - They should be avoided as they can
exacerbate symptoms.
What is the typical recovery phase after an attack of RP? - ANSWER -
Intense rubor, throbbing, paresthesia, pain, and slight swelling.
pg. 3
, 4|Page
What is the relationship between RA and cardiovascular disease? -
ANSWER - CV disease is the leading cause of premature mortality in
RA due to systemic inflammation.
What are the common infections associated with RA? - ANSWER -
Pneumonia, sepsis, and opportunistic infections due to
immunosuppressive therapy.
What are the effects of chronic inflammation on bone health in RA
patients? - ANSWER - Increased risk of osteoporosis and fractures.
What is the role of regular follow-up in RA management? - ANSWER -
To assess for progression to connective tissue disease and monitor for
ulcers or signs of ischemia.
What are the common symptoms of acute RA flares? - ANSWER - Joint
pain, swelling, decreased range of motion, and morning stiffness.
What is the impact of obesity on RA? - ANSWER - It is a modifiable
risk factor that can worsen disease outcomes.
What is the significance of morning stiffness in RA? - ANSWER - It is a
hallmark symptom indicating inflammation and joint involvement.
pg. 4
