NSG 555 – Nurse Practitioners in Primary Care
I Practice Exam 2026/2027 Practice Questions
& Study Guide | Complete Exam-Style
Questions with Correct Detailed Answers &
Rationales (Reliable Answers)
Question 1
A 52-year-old patient presents for a routine primary-care visit.
The patient has no history of cardiovascular disease, diabetes,
or chronic kidney disease. Blood pressure measurements
obtained during two separate visits have been approximately
146/92 mmHg. Which classification best describes this patient's
blood pressure?
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Correct Answer: D. Stage 2 hypertension
Rationale: Under the ACC/AHA blood-pressure classification
system, stage 2 hypertension is defined as a systolic pressure of
at least 140 mmHg or a diastolic pressure of at least 90 mmHg.
,This patient's readings meet both thresholds. Because the
elevated measurements have been documented on separate
occasions, the finding is more consistent with persistent
hypertension rather than an isolated abnormal reading.
Accurate classification is important because stage 2
hypertension generally warrants prompt evaluation for
cardiovascular risk factors and initiation of appropriate
treatment rather than observation alone.
Question 2
A 48-year-old patient reports progressive fatigue, constipation,
dry skin, and an unexplained 7-kg weight gain over the past 6
months. Which laboratory pattern is most consistent with
primary hypothyroidism?
A. Low TSH and high free T4
B. High TSH and low free T4
C. Low TSH and low free T4
D. High TSH and high free T4
Correct Answer: B. High TSH and low free T4
Rationale: In primary hypothyroidism, the thyroid gland fails to
produce sufficient thyroid hormone. The pituitary responds by
increasing thyroid-stimulating hormone (TSH) secretion,
resulting in an elevated TSH and decreased free thyroxine (T4).
,The patient's fatigue, constipation, dry skin, and weight gain
are classic manifestations of hypothyroidism. A low TSH with a
high free T4 would instead suggest primary hyperthyroidism.
Question 3
A 61-year-old patient presents with sudden, painless loss of
vision in one eye. The patient describes a curtain-like shadow
moving across the visual field. Which condition should the
nurse practitioner suspect most strongly?
A. Cataract
B. Retinal detachment
C. Open-angle glaucoma
D. Viral conjunctivitis
Correct Answer: B. Retinal detachment
Rationale: A sudden painless visual-field defect described as a
curtain or shadow is highly concerning for retinal detachment.
Patients may also report flashes of light or a sudden increase in
floaters. Retinal detachment is an ophthalmologic emergency
because prolonged separation of the retina from its supporting
tissues can result in permanent vision loss. Cataracts generally
cause gradual, painless blurring rather than an abrupt curtain-
like field defect.
, Question 4
A 45-year-old patient has a body mass index of 34 kg/m² and
asks about the health implications of obesity. Which
complication is strongly associated with obesity and should be
routinely considered during primary-care assessment?
A. Reduced risk of type 2 diabetes
B. Increased risk of obstructive sleep apnea
C. Reduced risk of osteoarthritis
D. Decreased cardiovascular risk
Correct Answer: B. Increased risk of obstructive sleep apnea
Rationale: Obesity is a major risk factor for obstructive sleep
apnea because excess tissue around the upper airway can
contribute to airway narrowing during sleep. Obesity is also
associated with type 2 diabetes, hypertension, dyslipidemia,
cardiovascular disease, osteoarthritis, and several malignancies.
Therefore, primary-care assessment should include evaluation
for symptoms such as loud snoring, witnessed apneas, morning
headaches, and excessive daytime sleepiness when clinically
appropriate.
Question 5
A 70-year-old patient presents with dysuria, urinary frequency,
and suprapubic discomfort. The patient has no flank pain, fever,
I Practice Exam 2026/2027 Practice Questions
& Study Guide | Complete Exam-Style
Questions with Correct Detailed Answers &
Rationales (Reliable Answers)
Question 1
A 52-year-old patient presents for a routine primary-care visit.
The patient has no history of cardiovascular disease, diabetes,
or chronic kidney disease. Blood pressure measurements
obtained during two separate visits have been approximately
146/92 mmHg. Which classification best describes this patient's
blood pressure?
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Correct Answer: D. Stage 2 hypertension
Rationale: Under the ACC/AHA blood-pressure classification
system, stage 2 hypertension is defined as a systolic pressure of
at least 140 mmHg or a diastolic pressure of at least 90 mmHg.
,This patient's readings meet both thresholds. Because the
elevated measurements have been documented on separate
occasions, the finding is more consistent with persistent
hypertension rather than an isolated abnormal reading.
Accurate classification is important because stage 2
hypertension generally warrants prompt evaluation for
cardiovascular risk factors and initiation of appropriate
treatment rather than observation alone.
Question 2
A 48-year-old patient reports progressive fatigue, constipation,
dry skin, and an unexplained 7-kg weight gain over the past 6
months. Which laboratory pattern is most consistent with
primary hypothyroidism?
A. Low TSH and high free T4
B. High TSH and low free T4
C. Low TSH and low free T4
D. High TSH and high free T4
Correct Answer: B. High TSH and low free T4
Rationale: In primary hypothyroidism, the thyroid gland fails to
produce sufficient thyroid hormone. The pituitary responds by
increasing thyroid-stimulating hormone (TSH) secretion,
resulting in an elevated TSH and decreased free thyroxine (T4).
,The patient's fatigue, constipation, dry skin, and weight gain
are classic manifestations of hypothyroidism. A low TSH with a
high free T4 would instead suggest primary hyperthyroidism.
Question 3
A 61-year-old patient presents with sudden, painless loss of
vision in one eye. The patient describes a curtain-like shadow
moving across the visual field. Which condition should the
nurse practitioner suspect most strongly?
A. Cataract
B. Retinal detachment
C. Open-angle glaucoma
D. Viral conjunctivitis
Correct Answer: B. Retinal detachment
Rationale: A sudden painless visual-field defect described as a
curtain or shadow is highly concerning for retinal detachment.
Patients may also report flashes of light or a sudden increase in
floaters. Retinal detachment is an ophthalmologic emergency
because prolonged separation of the retina from its supporting
tissues can result in permanent vision loss. Cataracts generally
cause gradual, painless blurring rather than an abrupt curtain-
like field defect.
, Question 4
A 45-year-old patient has a body mass index of 34 kg/m² and
asks about the health implications of obesity. Which
complication is strongly associated with obesity and should be
routinely considered during primary-care assessment?
A. Reduced risk of type 2 diabetes
B. Increased risk of obstructive sleep apnea
C. Reduced risk of osteoarthritis
D. Decreased cardiovascular risk
Correct Answer: B. Increased risk of obstructive sleep apnea
Rationale: Obesity is a major risk factor for obstructive sleep
apnea because excess tissue around the upper airway can
contribute to airway narrowing during sleep. Obesity is also
associated with type 2 diabetes, hypertension, dyslipidemia,
cardiovascular disease, osteoarthritis, and several malignancies.
Therefore, primary-care assessment should include evaluation
for symptoms such as loud snoring, witnessed apneas, morning
headaches, and excessive daytime sleepiness when clinically
appropriate.
Question 5
A 70-year-old patient presents with dysuria, urinary frequency,
and suprapubic discomfort. The patient has no flank pain, fever,
