NSG 554 Exam 3 – Nurse Practitioners in Primary Care I | 65
Actual Questions and Answers + Expert Rationales | 2026/27
Updates | 100% correct
1. Pelvic Inflammatory Disease (PID): Definition
• A) An infection of the female reproductive organs, including the uterus, fallopian
tubes, and ovaries, often resulting from the ascent of bacteria from the lower
genital tract
• B) A viral infection of the cervix
• C) A fungal infection of the vagina
• D) A bacterial infection of the urinary bladder
Correct Answer: A) An infection of the female reproductive organs, including the
uterus, fallopian tubes, and ovaries, often resulting from the ascent of bacteria from the
lower genital tract
Expert Rationale: PID is a polymicrobial infection that ascends from the cervix and
vagina to involve the endometrium, fallopian tubes, and ovaries. It is most commonly
caused by sexually transmitted organisms (Chlamydia trachomatis and Neisseria
gonorrhoeae), though other bacteria can also be involved. If untreated, it can lead to
serious complications including infertility, ectopic pregnancy, and chronic pelvic pain .
2. PID: Most Common Causes
• A) Chlamydia trachomatis and Neisseria gonorrhoeae
• B) Escherichia coli and Staphylococcus aureus
• C) Candida albicans and Trichomonas vaginalis
• D) Human papillomavirus and herpes simplex virus
Correct Answer: A) Chlamydia trachomatis and Neisseria gonorrhoeae
Expert Rationale: The most common pathogens associated with PID are Chlamydia
trachomatis and Neisseria gonorrhoeae, which ascend from the lower genital tract.
Other organisms such as bacterial vaginosis-associated bacteria (Gardnerella vaginalis,
Mycoplasma genitalium) can also contribute .
,3. Exercise Stress Test: Indications
• A) Used to assess CAD in patients with chest pain or dyspnea with intermediate
risk of ACS; also shows functional capacity which is a predictor of future cardiac
events
• B) Used for detection of ischemia in asymptomatic patients with no history of
revascularization
• C) Used only in patients with known coronary artery disease
• D) Used as a screening test for all patients over 50
Correct Answer: A) Used to assess CAD in patients with chest pain or dyspnea with
intermediate risk of ACS; also shows functional capacity which is a predictor of future
cardiac events
Expert Rationale: Exercise stress testing is indicated for patients with symptoms
suggestive of coronary artery disease (CAD), such as chest pain or dyspnea on exertion,
particularly those with intermediate pretest probability. It is NOT recommended for
routine screening in asymptomatic patients without risk factors or history of
revascularization. The test provides important prognostic information about functional
capacity .
4. Exercise Stress Test: Positive vs. Negative Results
• A) Positive if development of horizontal or downsloping ST depression of ≥1
mm; Negative if patient exercises to at least 85% of age-predicted max heart rate
without evidence of inducible ischemia
• B) Positive if ST elevation occurs; Negative if any ST changes occur
• C) Positive if patient cannot reach target heart rate; Negative if patient reaches
target heart rate
• D) Positive only if chest pain occurs during the test
Correct Answer: A) Positive if development of horizontal or downsloping ST depression
of ≥1 mm; Negative if patient exercises to at least 85% of age-predicted max heart rate
without evidence of inducible ischemia
Expert Rationale: An exercise stress test is considered positive (abnormal) when there is
≥1 mm horizontal or downsloping ST-segment depression measured 60-80 ms after the
J point. A negative test requires the patient to achieve at least 85% of their maximum
, predicted heart rate (220 – age) without ECG changes or symptoms, providing good
prognostic value .
5. Medications That Reduce Exercise Test Diagnostic Accuracy
• A) Beta-blockers, digoxin, calcium channel blockers, antihypertensives
• B) Statins and aspirin
• C) ACE inhibitors and ARBs
• D) Diuretics and nitrates
Correct Answer: A) Beta-blockers, digoxin, calcium channel blockers, antihypertensives
Expert Rationale: Medications that lower heart rate or alter myocardial oxygen demand
reduce the diagnostic accuracy of exercise stress testing. Beta-blockers, calcium channel
blockers, and digoxin prevent achieving target heart rate. Antihypertensives may affect
blood pressure response. Consultation with cardiology is recommended before
withholding these medications .
6. Pharmacologic Stress Testing: Indications
• A) Used when the patient cannot use a treadmill; uses coronary vasodilators
(dipyridamole, adenosine) or inotropic drugs (dobutamine)
• B) Used as first-line testing for all patients
• C) Used only for patients with known CAD
• D) Used exclusively in patients under 50
Correct Answer: A) Used when the patient cannot use a treadmill; uses coronary
vasodilators (dipyridamole, adenosine) or inotropic drugs (dobutamine)
Expert Rationale: Pharmacologic stress testing is indicated for patients who cannot
exercise adequately (e.g., orthopedic limitations, peripheral vascular disease, severe
deconditioning). Vasodilators (dipyridamole, adenosine) test coronary flow reserve,
while dobutamine increases myocardial oxygen demand. Dipyridamole can be reversed
with aminophylline; adenosine and dobutamine effects resolve when infusion stops .
Actual Questions and Answers + Expert Rationales | 2026/27
Updates | 100% correct
1. Pelvic Inflammatory Disease (PID): Definition
• A) An infection of the female reproductive organs, including the uterus, fallopian
tubes, and ovaries, often resulting from the ascent of bacteria from the lower
genital tract
• B) A viral infection of the cervix
• C) A fungal infection of the vagina
• D) A bacterial infection of the urinary bladder
Correct Answer: A) An infection of the female reproductive organs, including the
uterus, fallopian tubes, and ovaries, often resulting from the ascent of bacteria from the
lower genital tract
Expert Rationale: PID is a polymicrobial infection that ascends from the cervix and
vagina to involve the endometrium, fallopian tubes, and ovaries. It is most commonly
caused by sexually transmitted organisms (Chlamydia trachomatis and Neisseria
gonorrhoeae), though other bacteria can also be involved. If untreated, it can lead to
serious complications including infertility, ectopic pregnancy, and chronic pelvic pain .
2. PID: Most Common Causes
• A) Chlamydia trachomatis and Neisseria gonorrhoeae
• B) Escherichia coli and Staphylococcus aureus
• C) Candida albicans and Trichomonas vaginalis
• D) Human papillomavirus and herpes simplex virus
Correct Answer: A) Chlamydia trachomatis and Neisseria gonorrhoeae
Expert Rationale: The most common pathogens associated with PID are Chlamydia
trachomatis and Neisseria gonorrhoeae, which ascend from the lower genital tract.
Other organisms such as bacterial vaginosis-associated bacteria (Gardnerella vaginalis,
Mycoplasma genitalium) can also contribute .
,3. Exercise Stress Test: Indications
• A) Used to assess CAD in patients with chest pain or dyspnea with intermediate
risk of ACS; also shows functional capacity which is a predictor of future cardiac
events
• B) Used for detection of ischemia in asymptomatic patients with no history of
revascularization
• C) Used only in patients with known coronary artery disease
• D) Used as a screening test for all patients over 50
Correct Answer: A) Used to assess CAD in patients with chest pain or dyspnea with
intermediate risk of ACS; also shows functional capacity which is a predictor of future
cardiac events
Expert Rationale: Exercise stress testing is indicated for patients with symptoms
suggestive of coronary artery disease (CAD), such as chest pain or dyspnea on exertion,
particularly those with intermediate pretest probability. It is NOT recommended for
routine screening in asymptomatic patients without risk factors or history of
revascularization. The test provides important prognostic information about functional
capacity .
4. Exercise Stress Test: Positive vs. Negative Results
• A) Positive if development of horizontal or downsloping ST depression of ≥1
mm; Negative if patient exercises to at least 85% of age-predicted max heart rate
without evidence of inducible ischemia
• B) Positive if ST elevation occurs; Negative if any ST changes occur
• C) Positive if patient cannot reach target heart rate; Negative if patient reaches
target heart rate
• D) Positive only if chest pain occurs during the test
Correct Answer: A) Positive if development of horizontal or downsloping ST depression
of ≥1 mm; Negative if patient exercises to at least 85% of age-predicted max heart rate
without evidence of inducible ischemia
Expert Rationale: An exercise stress test is considered positive (abnormal) when there is
≥1 mm horizontal or downsloping ST-segment depression measured 60-80 ms after the
J point. A negative test requires the patient to achieve at least 85% of their maximum
, predicted heart rate (220 – age) without ECG changes or symptoms, providing good
prognostic value .
5. Medications That Reduce Exercise Test Diagnostic Accuracy
• A) Beta-blockers, digoxin, calcium channel blockers, antihypertensives
• B) Statins and aspirin
• C) ACE inhibitors and ARBs
• D) Diuretics and nitrates
Correct Answer: A) Beta-blockers, digoxin, calcium channel blockers, antihypertensives
Expert Rationale: Medications that lower heart rate or alter myocardial oxygen demand
reduce the diagnostic accuracy of exercise stress testing. Beta-blockers, calcium channel
blockers, and digoxin prevent achieving target heart rate. Antihypertensives may affect
blood pressure response. Consultation with cardiology is recommended before
withholding these medications .
6. Pharmacologic Stress Testing: Indications
• A) Used when the patient cannot use a treadmill; uses coronary vasodilators
(dipyridamole, adenosine) or inotropic drugs (dobutamine)
• B) Used as first-line testing for all patients
• C) Used only for patients with known CAD
• D) Used exclusively in patients under 50
Correct Answer: A) Used when the patient cannot use a treadmill; uses coronary
vasodilators (dipyridamole, adenosine) or inotropic drugs (dobutamine)
Expert Rationale: Pharmacologic stress testing is indicated for patients who cannot
exercise adequately (e.g., orthopedic limitations, peripheral vascular disease, severe
deconditioning). Vasodilators (dipyridamole, adenosine) test coronary flow reserve,
while dobutamine increases myocardial oxygen demand. Dipyridamole can be reversed
with aminophylline; adenosine and dobutamine effects resolve when infusion stops .
