NSG 555 Final Exam V1 | NSG 555 Nurse
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Final Exam 2026)
1. A 55-year-old male with a 30-pack-year smoking history presents with a chronic cough and
dyspnea on exertion. What is the gold standard for confirming the diagnosis of Chronic
Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray
B. Peak Flow Meter
C. Arterial Blood Gas
D. Spirometry
Answer: D
Rationale: Spirometry is the primary tool used to diagnose COPD and assess its severity. A
post-bronchodilator FEV1/FVC ratio of less than 0.70 is diagnostic of persistent airflow
limitation. While imaging can assist in ruling out other conditions, it cannot confirm the
functional deficit characteristic of COPD.
2. According to the current USPSTF guidelines, at what age should routine screening for
colorectal cancer begin for adults with average risk?
A. 40 years
,B. 45 years
C. 50 years
D. 55 years
Answer: B
Rationale: The USPSTF updated its recommendation to begin colorectal cancer screening
at age 45 for average-risk individuals. This change reflects the increasing incidence of
early-onset colorectal cancer in the population. Screening continues through age 75 for
most patients based on individual risk and health status.
3. A patient presents with a sore throat, fever of 101.5°F, and cervical lymphadenopathy but
lacks a cough. Based on the Centor criteria, what is the most appropriate next step?
A. Prescribe Amoxicillin immediately
B. Perform a Rapid Antigen Detection Test (RADT)
C. Observe for 48 hours with supportive care
D. Order a chest radiograph
Answer: B
Rationale: A Centor score of 3 or 4 indicates a high probability of Group A Streptococcus
(GAS) pharyngitis. Current guidelines recommend performing a rapid test or throat culture
before initiating antibiotic therapy to prevent resistance. This approach ensures that only
patients with confirmed bacterial infections receive treatment.
, 4. Which laboratory finding is most characteristic of iron deficiency anemia in its early stages?
A. Elevated Mean Corpuscular Volume (MCV)
B. Decreased Total Iron Binding Capacity (TIBC)
C. Increased Reticulocyte count
D. Low serum ferritin levels
Answer: D
Rationale: Serum ferritin is the most sensitive and specific indicator of iron stores in the
body. In the early stages of iron deficiency, ferritin levels drop before changes in
hemoglobin or MCV occur. TIBC would typically be elevated, not decreased, as the body
attempts to compensate for low iron.
5. A 62-year-old female presents with a new onset of unilateral headache and jaw
claudication. What is the most critical initial diagnostic test to perform?
A. MRI of the brain
B. Erythrocyte Sedimentation Rate (ESR)
C. Temporal artery biopsy
D. Carotid ultrasound
Answer: B
Rationale: Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) are
essential screening tests for suspected Giant Cell Arteritis (GCA). GCA is a medical
Practitioners in Primary Care I | Wilkes
University | 2026 Q&A with Rationale
(Wilkes NSG555 Final Exam 2026)
1. A 55-year-old male with a 30-pack-year smoking history presents with a chronic cough and
dyspnea on exertion. What is the gold standard for confirming the diagnosis of Chronic
Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray
B. Peak Flow Meter
C. Arterial Blood Gas
D. Spirometry
Answer: D
Rationale: Spirometry is the primary tool used to diagnose COPD and assess its severity. A
post-bronchodilator FEV1/FVC ratio of less than 0.70 is diagnostic of persistent airflow
limitation. While imaging can assist in ruling out other conditions, it cannot confirm the
functional deficit characteristic of COPD.
2. According to the current USPSTF guidelines, at what age should routine screening for
colorectal cancer begin for adults with average risk?
A. 40 years
,B. 45 years
C. 50 years
D. 55 years
Answer: B
Rationale: The USPSTF updated its recommendation to begin colorectal cancer screening
at age 45 for average-risk individuals. This change reflects the increasing incidence of
early-onset colorectal cancer in the population. Screening continues through age 75 for
most patients based on individual risk and health status.
3. A patient presents with a sore throat, fever of 101.5°F, and cervical lymphadenopathy but
lacks a cough. Based on the Centor criteria, what is the most appropriate next step?
A. Prescribe Amoxicillin immediately
B. Perform a Rapid Antigen Detection Test (RADT)
C. Observe for 48 hours with supportive care
D. Order a chest radiograph
Answer: B
Rationale: A Centor score of 3 or 4 indicates a high probability of Group A Streptococcus
(GAS) pharyngitis. Current guidelines recommend performing a rapid test or throat culture
before initiating antibiotic therapy to prevent resistance. This approach ensures that only
patients with confirmed bacterial infections receive treatment.
, 4. Which laboratory finding is most characteristic of iron deficiency anemia in its early stages?
A. Elevated Mean Corpuscular Volume (MCV)
B. Decreased Total Iron Binding Capacity (TIBC)
C. Increased Reticulocyte count
D. Low serum ferritin levels
Answer: D
Rationale: Serum ferritin is the most sensitive and specific indicator of iron stores in the
body. In the early stages of iron deficiency, ferritin levels drop before changes in
hemoglobin or MCV occur. TIBC would typically be elevated, not decreased, as the body
attempts to compensate for low iron.
5. A 62-year-old female presents with a new onset of unilateral headache and jaw
claudication. What is the most critical initial diagnostic test to perform?
A. MRI of the brain
B. Erythrocyte Sedimentation Rate (ESR)
C. Temporal artery biopsy
D. Carotid ultrasound
Answer: B
Rationale: Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) are
essential screening tests for suspected Giant Cell Arteritis (GCA). GCA is a medical
