NSG6998 Pre-Predictor Exam Study Guide
2026–2027 | South University FNP
Comprehensive Exam Prep | Practice
Questions, Verified Answers with Detailed
Rationales
NSG6998 Pre-Predictor Exam Study Guide 2026–2027 | South University FNP
Comprehensive Exam Prep
DOCUMENT OVERVIEW
• Comprehensive question practice bank designed to simulate the Family Nurse
Practitioner comprehensive examination with verified answers and detailed clinical
EXPERT RATIONALE for each question across all major content domains
• Effective study strategy: Work through questions by system/topic, review
incorrect answers thoroughly, note recurring clinical concepts, and use detailed
EXPERT RATIONALE to strengthen clinical reasoning and evidence-based decision-
making in primary care practice
QUESTIONS
1. A 68-year-old male presents with substernal chest pain that radiates to his
left arm and jaw. He has diaphoresis and dyspnea. His vital signs are: BP
145/92 mmHg, HR 102 bpm, RR 20/min. ECG shows ST elevation in leads II, III,
and aVF. What is the most appropriate initial management?
A) Administer aspirin 81 mg daily and refer to cardiology
B) Administer oxygen, aspirin 325 mg, nitroglycerin, and activate emergency cardiac
services for emergent reperfusion therapy
C) Perform a chest X-ray and troponin level
D) Admit to telemetry unit and monitor cardiac enzymes
E) Prescribe beta-blockers and schedule a stress test
,CORRECT ANSWER: B) Administer oxygen, aspirin 325 mg, nitroglycerin, and
activate emergency cardiac services for emergent reperfusion therapy
EXPERT RATIONALE: This patient presents with acute ST-elevation myocardial
infarction (STEMI) with classic symptoms and ECG changes indicating inferior wall
MI. Immediate management requires prompt reperfusion therapy (PCI or
thrombolytics) to minimize myocardial damage. Initial interventions include oxygen
supplementation, antiplatelet therapy (aspirin 325 mg), nitrates for symptom relief
and preload reduction, and urgent activation of emergency services. Time is
myocardium, and delays in reperfusion significantly increase morbidity and
mortality. All other options involve delays in definitive treatment.
2. A 45-year-old woman presents with a 3-month history of fatigue, weight
gain of 10 pounds, cold intolerance, and dry skin. TSH level is 8.2 mIU/L
(normal 0.4–4.0), and free T4 is 0.8 ng/dL (normal 0.8–1.8). Which is the most
appropriate initial management?
A) Check thyroid antibodies and begin levothyroxine therapy
B) Reassure patient this is normal aging and recheck TSH in 6 months
C) Prescribe iodine supplements and dietary counseling
D) Order thyroid ultrasound and refer to endocrinology
E) Initiate propranolol therapy and check TSH weekly
CORRECT ANSWER: A) Check thyroid antibodies and begin levothyroxine
therapy
EXPERT RATIONALE: This patient presents with clinical hypothyroidism evidenced
by classic symptoms and laboratory findings showing elevated TSH with low-normal
free T4. Initial management includes checking thyroid peroxidase (TPO) and
thyroglobulin antibodies to assess for Hashimoto's thyroiditis, then initiating
levothyroxine replacement. Initial dosing is typically 25–50 mcg daily for older
adults or those with cardiac disease, titrating based on TSH response. Checking
antibodies helps establish etiology. Reassurance without treatment is inappropriate
,for symptomatic hypothyroidism. Iodine supplementation is not standard therapy
and may worsen autoimmune thyroiditis.
3. A 52-year-old male with a 40-pack-year smoking history presents with a
chronic productive cough and shortness of breath. Spirometry shows
FEV1/FVC ratio of 0.62, FEV1 of 58% predicted, and DLCO of 75% predicted.
What is the most appropriate step in management?
A) Prescribe inhaled corticosteroids and long-acting beta-agonists
B) Counsel on smoking cessation, administer pneumococcal and influenza vaccines,
and consider long-acting bronchodilators
C) Refer for lung transplant evaluation
D) Order high-resolution CT chest and bronchoscopy
E) Prescribe oral corticosteroids and azathioprine
CORRECT ANSWER: B) Counsel on smoking cessation, administer
pneumococcal and influenza vaccines, and consider long-acting
bronchodilators
EXPERT RATIONALE: This patient has GOLD stage III (severe) COPD based on FEV1
of 58% predicted. Management priorities include cessation of the primary etiology
(smoking), preventive measures (vaccinations), and pharmacologic therapy based
on symptoms. Long-acting bronchodilators (LABA or LAMA) are first-line for
symptomatic patients. Combination therapy with inhaled corticosteroids is
considered if exacerbation history is present. DLCO at 75% suggests minimal
emphysema component. Early referral for transplant is not indicated at this stage.
Oral corticosteroids are reserved for acute exacerbations.
4. A 28-year-old woman at 32 weeks gestation presents with a BP of 150/95
mmHg, proteinuria of 2+, and right upper quadrant pain with nausea. Platelet
count is 95,000/μL. Which diagnosis is most likely?
A) Gestational hypertension
, B) Chronic hypertension with superimposed preeclampsia
C) Preeclampsia with severe features
D) Hemolytic uremic syndrome
E) Acute fatty liver of pregnancy
CORRECT ANSWER: C) Preeclampsia with severe features
EXPERT RATIONALE: This patient meets criteria for preeclampsia with severe
features: hypertension ≥160 systolic or ≥110 diastolic, proteinuria,
thrombocytopenia (<100,000/μL), and symptoms consistent with end-organ
dysfunction (RUQ pain suggests hepatic involvement, nausea may indicate severe
symptoms). At 32 weeks, management typically includes corticosteroids for fetal
lung maturity and consideration of expedited delivery if maternal or fetal condition
warrants. Close monitoring of labs, BP, and maternal symptoms is essential.
Gestational hypertension lacks proteinuria or end-organ dysfunction. AFLP and HUS
present differently.
5. A 7-year-old boy is brought by his mother with a 5-day history of high fever
(104°F), a maculopapular rash that spares the palms and soles, and oral
erythema with strawberry tongue. What is the most likely diagnosis?
A) Measles
B) Scarlet fever
C) Kawasaki disease
D) Roseola infantum
E) Fifth disease
CORRECT ANSWER: C) Kawasaki disease
EXPERT RATIONALE: This child meets the diagnostic criteria for Kawasaki disease:
fever ≥5 days, maculopapular rash sparing palms/soles, oral changes including
strawberry tongue and erythema, and age <8 years. Kawasaki disease is the leading
cause of acquired heart disease in children in developed countries and requires
2026–2027 | South University FNP
Comprehensive Exam Prep | Practice
Questions, Verified Answers with Detailed
Rationales
NSG6998 Pre-Predictor Exam Study Guide 2026–2027 | South University FNP
Comprehensive Exam Prep
DOCUMENT OVERVIEW
• Comprehensive question practice bank designed to simulate the Family Nurse
Practitioner comprehensive examination with verified answers and detailed clinical
EXPERT RATIONALE for each question across all major content domains
• Effective study strategy: Work through questions by system/topic, review
incorrect answers thoroughly, note recurring clinical concepts, and use detailed
EXPERT RATIONALE to strengthen clinical reasoning and evidence-based decision-
making in primary care practice
QUESTIONS
1. A 68-year-old male presents with substernal chest pain that radiates to his
left arm and jaw. He has diaphoresis and dyspnea. His vital signs are: BP
145/92 mmHg, HR 102 bpm, RR 20/min. ECG shows ST elevation in leads II, III,
and aVF. What is the most appropriate initial management?
A) Administer aspirin 81 mg daily and refer to cardiology
B) Administer oxygen, aspirin 325 mg, nitroglycerin, and activate emergency cardiac
services for emergent reperfusion therapy
C) Perform a chest X-ray and troponin level
D) Admit to telemetry unit and monitor cardiac enzymes
E) Prescribe beta-blockers and schedule a stress test
,CORRECT ANSWER: B) Administer oxygen, aspirin 325 mg, nitroglycerin, and
activate emergency cardiac services for emergent reperfusion therapy
EXPERT RATIONALE: This patient presents with acute ST-elevation myocardial
infarction (STEMI) with classic symptoms and ECG changes indicating inferior wall
MI. Immediate management requires prompt reperfusion therapy (PCI or
thrombolytics) to minimize myocardial damage. Initial interventions include oxygen
supplementation, antiplatelet therapy (aspirin 325 mg), nitrates for symptom relief
and preload reduction, and urgent activation of emergency services. Time is
myocardium, and delays in reperfusion significantly increase morbidity and
mortality. All other options involve delays in definitive treatment.
2. A 45-year-old woman presents with a 3-month history of fatigue, weight
gain of 10 pounds, cold intolerance, and dry skin. TSH level is 8.2 mIU/L
(normal 0.4–4.0), and free T4 is 0.8 ng/dL (normal 0.8–1.8). Which is the most
appropriate initial management?
A) Check thyroid antibodies and begin levothyroxine therapy
B) Reassure patient this is normal aging and recheck TSH in 6 months
C) Prescribe iodine supplements and dietary counseling
D) Order thyroid ultrasound and refer to endocrinology
E) Initiate propranolol therapy and check TSH weekly
CORRECT ANSWER: A) Check thyroid antibodies and begin levothyroxine
therapy
EXPERT RATIONALE: This patient presents with clinical hypothyroidism evidenced
by classic symptoms and laboratory findings showing elevated TSH with low-normal
free T4. Initial management includes checking thyroid peroxidase (TPO) and
thyroglobulin antibodies to assess for Hashimoto's thyroiditis, then initiating
levothyroxine replacement. Initial dosing is typically 25–50 mcg daily for older
adults or those with cardiac disease, titrating based on TSH response. Checking
antibodies helps establish etiology. Reassurance without treatment is inappropriate
,for symptomatic hypothyroidism. Iodine supplementation is not standard therapy
and may worsen autoimmune thyroiditis.
3. A 52-year-old male with a 40-pack-year smoking history presents with a
chronic productive cough and shortness of breath. Spirometry shows
FEV1/FVC ratio of 0.62, FEV1 of 58% predicted, and DLCO of 75% predicted.
What is the most appropriate step in management?
A) Prescribe inhaled corticosteroids and long-acting beta-agonists
B) Counsel on smoking cessation, administer pneumococcal and influenza vaccines,
and consider long-acting bronchodilators
C) Refer for lung transplant evaluation
D) Order high-resolution CT chest and bronchoscopy
E) Prescribe oral corticosteroids and azathioprine
CORRECT ANSWER: B) Counsel on smoking cessation, administer
pneumococcal and influenza vaccines, and consider long-acting
bronchodilators
EXPERT RATIONALE: This patient has GOLD stage III (severe) COPD based on FEV1
of 58% predicted. Management priorities include cessation of the primary etiology
(smoking), preventive measures (vaccinations), and pharmacologic therapy based
on symptoms. Long-acting bronchodilators (LABA or LAMA) are first-line for
symptomatic patients. Combination therapy with inhaled corticosteroids is
considered if exacerbation history is present. DLCO at 75% suggests minimal
emphysema component. Early referral for transplant is not indicated at this stage.
Oral corticosteroids are reserved for acute exacerbations.
4. A 28-year-old woman at 32 weeks gestation presents with a BP of 150/95
mmHg, proteinuria of 2+, and right upper quadrant pain with nausea. Platelet
count is 95,000/μL. Which diagnosis is most likely?
A) Gestational hypertension
, B) Chronic hypertension with superimposed preeclampsia
C) Preeclampsia with severe features
D) Hemolytic uremic syndrome
E) Acute fatty liver of pregnancy
CORRECT ANSWER: C) Preeclampsia with severe features
EXPERT RATIONALE: This patient meets criteria for preeclampsia with severe
features: hypertension ≥160 systolic or ≥110 diastolic, proteinuria,
thrombocytopenia (<100,000/μL), and symptoms consistent with end-organ
dysfunction (RUQ pain suggests hepatic involvement, nausea may indicate severe
symptoms). At 32 weeks, management typically includes corticosteroids for fetal
lung maturity and consideration of expedited delivery if maternal or fetal condition
warrants. Close monitoring of labs, BP, and maternal symptoms is essential.
Gestational hypertension lacks proteinuria or end-organ dysfunction. AFLP and HUS
present differently.
5. A 7-year-old boy is brought by his mother with a 5-day history of high fever
(104°F), a maculopapular rash that spares the palms and soles, and oral
erythema with strawberry tongue. What is the most likely diagnosis?
A) Measles
B) Scarlet fever
C) Kawasaki disease
D) Roseola infantum
E) Fifth disease
CORRECT ANSWER: C) Kawasaki disease
EXPERT RATIONALE: This child meets the diagnostic criteria for Kawasaki disease:
fever ≥5 days, maculopapular rash sparing palms/soles, oral changes including
strawberry tongue and erythema, and age <8 years. Kawasaki disease is the leading
cause of acquired heart disease in children in developed countries and requires
