NSG 555 Exam 1 V3 – Nurse Practitioners in
Primary Care I 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 an annual primary-care
examination. The patient has no known chronic illnesses and
takes no medications. Blood pressure is 138/86 mm Hg. Which
finding is most important for the nurse practitioner to do next
when evaluating the patient's blood pressure?
A. Diagnose stage 1 hypertension immediately
B. Repeat the blood pressure after 5 minutes and average
appropriately obtained readings
C. Begin antihypertensive therapy at today's visit
D. Order a renal ultrasound before repeating the blood
pressure
Answer: B. Repeat the blood pressure after 5 minutes and
average appropriately obtained readings
,Rationale: Accurate blood-pressure measurement is essential
before labeling a patient with hypertension. The patient should
be positioned appropriately, allowed adequate rest, and have
properly sized equipment used. Multiple properly obtained
readings should be averaged rather than relying on a single
office measurement. The 2025 hypertension guideline
emphasizes standardized measurement and, when appropriate,
home or ambulatory monitoring to improve diagnostic
accuracy. A single elevated reading does not by itself establish
chronic hypertension, and immediate renal imaging is not
routinely indicated in an otherwise uncomplicated presentation.
Question 2
A 46-year-old patient has a fasting plasma glucose of 132 mg/dL
during a routine examination but has no symptoms of
hyperglycemia. Which is the most appropriate interpretation?
A. Normal fasting glucose
B. Prediabetes
C. Diabetes requiring confirmatory evaluation
D. Reactive hypoglycemia
Answer: C. Diabetes requiring confirmatory evaluation
Rationale: A fasting plasma glucose of at least 126 mg/dL
meets the laboratory threshold for diabetes. However, in a
,patient without unequivocal hyperglycemia, the diagnosis
generally requires confirmation with repeat testing or another
diagnostic test. Prediabetes corresponds to fasting glucose of
100–125 mg/dL. Therefore, this patient's 132 mg/dL result is in
the diabetes range but should be confirmed before the
diagnosis is formally established when there are no unequivocal
symptoms or crisis.
Question 3
A 68-year-old woman asks why screening for osteoporosis is
recommended even though she has never experienced a
fracture. Which explanation is most appropriate?
A. Osteoporosis always causes pain before a fracture occurs
B. Screening can identify low bone density before a clinically
apparent fracture occurs
C. Osteoporosis screening is recommended only after a fracture
D. Bone-density screening is unnecessary in postmenopausal
women
Answer: B. Screening can identify low bone density before a
clinically apparent fracture occurs
Rationale: Osteoporosis can remain clinically silent until a
fragility fracture occurs. Bone-mineral-density testing allows
identification of reduced bone density and fracture risk before
, the patient experiences a fracture. This is particularly important
in older postmenopausal women because age is a major risk
factor for osteoporosis and fracture. Preventive identification
permits individualized counseling and treatment decisions
intended to reduce future fracture risk.
Question 4
A 34-year-old patient reports fatigue, constipation, dry skin,
and sensitivity to cold. Physical examination reveals a mildly
enlarged, non-tender thyroid. Which laboratory test is the most
appropriate initial test?
A. Total T3
B. Thyroid-stimulating hormone
C. Thyroglobulin antibody only
D. Reverse T3
Answer: B. Thyroid-stimulating hormone
Rationale: TSH is generally the preferred initial laboratory
assessment when primary hypothyroidism is suspected. If TSH is
abnormal, free T4 is used to characterize thyroid function
further. T3 is usually less useful for diagnosing hypothyroidism
because it may remain normal despite significant thyroid
dysfunction. Thyroid antibodies can help identify autoimmune
thyroid disease after biochemical dysfunction has been
Primary Care I 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 an annual primary-care
examination. The patient has no known chronic illnesses and
takes no medications. Blood pressure is 138/86 mm Hg. Which
finding is most important for the nurse practitioner to do next
when evaluating the patient's blood pressure?
A. Diagnose stage 1 hypertension immediately
B. Repeat the blood pressure after 5 minutes and average
appropriately obtained readings
C. Begin antihypertensive therapy at today's visit
D. Order a renal ultrasound before repeating the blood
pressure
Answer: B. Repeat the blood pressure after 5 minutes and
average appropriately obtained readings
,Rationale: Accurate blood-pressure measurement is essential
before labeling a patient with hypertension. The patient should
be positioned appropriately, allowed adequate rest, and have
properly sized equipment used. Multiple properly obtained
readings should be averaged rather than relying on a single
office measurement. The 2025 hypertension guideline
emphasizes standardized measurement and, when appropriate,
home or ambulatory monitoring to improve diagnostic
accuracy. A single elevated reading does not by itself establish
chronic hypertension, and immediate renal imaging is not
routinely indicated in an otherwise uncomplicated presentation.
Question 2
A 46-year-old patient has a fasting plasma glucose of 132 mg/dL
during a routine examination but has no symptoms of
hyperglycemia. Which is the most appropriate interpretation?
A. Normal fasting glucose
B. Prediabetes
C. Diabetes requiring confirmatory evaluation
D. Reactive hypoglycemia
Answer: C. Diabetes requiring confirmatory evaluation
Rationale: A fasting plasma glucose of at least 126 mg/dL
meets the laboratory threshold for diabetes. However, in a
,patient without unequivocal hyperglycemia, the diagnosis
generally requires confirmation with repeat testing or another
diagnostic test. Prediabetes corresponds to fasting glucose of
100–125 mg/dL. Therefore, this patient's 132 mg/dL result is in
the diabetes range but should be confirmed before the
diagnosis is formally established when there are no unequivocal
symptoms or crisis.
Question 3
A 68-year-old woman asks why screening for osteoporosis is
recommended even though she has never experienced a
fracture. Which explanation is most appropriate?
A. Osteoporosis always causes pain before a fracture occurs
B. Screening can identify low bone density before a clinically
apparent fracture occurs
C. Osteoporosis screening is recommended only after a fracture
D. Bone-density screening is unnecessary in postmenopausal
women
Answer: B. Screening can identify low bone density before a
clinically apparent fracture occurs
Rationale: Osteoporosis can remain clinically silent until a
fragility fracture occurs. Bone-mineral-density testing allows
identification of reduced bone density and fracture risk before
, the patient experiences a fracture. This is particularly important
in older postmenopausal women because age is a major risk
factor for osteoporosis and fracture. Preventive identification
permits individualized counseling and treatment decisions
intended to reduce future fracture risk.
Question 4
A 34-year-old patient reports fatigue, constipation, dry skin,
and sensitivity to cold. Physical examination reveals a mildly
enlarged, non-tender thyroid. Which laboratory test is the most
appropriate initial test?
A. Total T3
B. Thyroid-stimulating hormone
C. Thyroglobulin antibody only
D. Reverse T3
Answer: B. Thyroid-stimulating hormone
Rationale: TSH is generally the preferred initial laboratory
assessment when primary hypothyroidism is suspected. If TSH is
abnormal, free T4 is used to characterize thyroid function
further. T3 is usually less useful for diagnosing hypothyroidism
because it may remain normal despite significant thyroid
dysfunction. Thyroid antibodies can help identify autoimmune
thyroid disease after biochemical dysfunction has been
