1
NSG 6020 3P EXAM [QUESTION 1-200] AND ANSWERS
UPDATED 2026/2027 | 100% VERIFIED | DETAILED
RATIONALES – PASS GUARANTEED A+ GRADED
INSTANT DOWNLOAD
INTRODUCTION
The NSG 6020 3P (Primary Care of the Adult, Older Adult, and Family Across the Lifespan) Examination is a
comprehensive assessment designed for advanced practice nursing students, specifically those enrolled in
Family Nurse Practitioner (FNP) or Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) programs. This
rigorous 3P exam evaluates the student's mastery of primary care management across the continuum of adult
and geriatric patient populations, emphasizing health promotion, disease prevention, acute illness
management, and chronic disease management. The exam is a critical milestone in NP education, testing
clinical reasoning, evidence-based practice, diagnostic decision-making, and pharmacological management.
This question bank contains 200 advanced, scenario-based questions designed to simulate the actual NSG 6020
3P exam experience. Each question is crafted to test application-level clinical reasoning, prioritization, and
diagnostic skills, not mere memorization. With detailed rationales explaining both correct and incorrect
answers, this resource will prepare you to pass the NSG 6020 3P exam on your first attempt and excel in your
primary care clinical practice.
CORE DOMAINS TESTED
1. Health Promotion and Disease Prevention (15-20%) – Screenings, immunizations, lifestyle counseling,
risk factor assessment, and evidence-based prevention strategies across the adult and geriatric
lifespan.
2. Cardiovascular Disorders (12-15%) – Assessment and management of hypertension, hyperlipidemia,
coronary artery disease, heart failure, peripheral vascular disease, and dysrhythmias in primary care.
3. Respiratory Disorders (10-12%) – Diagnosis and management of COPD, asthma, pneumonia,
bronchitis, tuberculosis, and upper respiratory infections in adult and geriatric populations.
4. Endocrine and Metabolic Disorders (10-12%) – Management of diabetes mellitus, thyroid disorders,
adrenal disorders, metabolic syndrome, and obesity in primary care.
5. Gastrointestinal Disorders (8-10%) – Evaluation and management of GERD, peptic ulcer disease,
inflammatory bowel disease, irritable bowel syndrome, hepatitis, and liver disease.
6. Neurological and Musculoskeletal Disorders (10-12%) – Assessment and management of stroke,
dementia, Parkinson's disease, osteoarthritis, osteoporosis, back pain, and neuropathies.
7. Psychiatric and Behavioral Health (8-10%) – Diagnosis and management of depression, anxiety,
substance use disorders, insomnia, and mental health conditions in primary care.
8. Dermatologic and Infectious Diseases (8-10%) – Evaluation and management of common skin
conditions, cellulitis, wound care, and infectious diseases in the primary care setting.
,2
9. Renal and Genitourinary Disorders (6-8%) – Assessment and management of chronic kidney disease,
urinary tract infections, benign prostatic hyperplasia, incontinence, and erectile dysfunction.
10. Geriatric Syndromes and End-of-Life Care (8-10%) – Falls, frailty, polypharmacy, cognitive impairment,
advance care planning, and palliative care for older adults.
QUESTIONS 1-100
Q1: A 68-year-old male with a history of hypertension and type 2 diabetes
presents to the primary care clinic for a routine follow-up. His blood pressure
is 152/88 mm Hg, A1c is 7.4%, and LDL is 120 mg/dL. His current medications
include metformin 1000 mg BID, lisinopril 20 mg daily, and atorvastatin 20 mg
daily. The patient reports adherence to his medications and a low-sodium,
low-carbohydrate diet. Which of the following is the MOST appropriate next
step in managing this patient's hypertension?
A) Add hydrochlorothiazide 12.5 mg daily
B) Increase lisinopril to 40 mg daily
C) Add amlodipine 5 mg daily
D) Refer to cardiology for further evaluation
Rationale: The correct answer is C because adding a calcium channel blocker
(amlodipine) to an ACE inhibitor is the recommended next step for a patient
with hypertension and diabetes who is not at goal blood pressure (<140/90 mm
Hg for most patients, or <130/80 mm Hg for high-risk patients) despite maximal
or near-maximal ACE inhibitor therapy. Option A is incorrect because adding a
thiazide diuretic would be appropriate if the patient was not on a diuretic, but
the ACE inhibitor alone is insufficient; combination therapy with a CCB is
preferred in diabetic patients due to renal protective effects. Option B is
incorrect because increasing lisinopril beyond 20 mg may be appropriate, but
the BP is still significantly elevated and adding a second agent is more effective
than titrating a single agent. Option D is incorrect because this is a routine
hypertension management issue that can be managed in primary care without
immediate cardiology referral.
Q2: A 72-year-old female presents with a 3-month history of progressive
memory loss, difficulty with word-finding, and personality changes. Her
,3
family reports she has become withdrawn and irritable. She has a history of
hypertension and hyperlipidemia. On exam, she has a Mini-Mental State
Examination (MMSE) score of 22/30 with deficits in short-term memory and
executive function. Which of the following is the MOST appropriate initial
diagnostic workup?
A) Order a stat CT scan of the head and refer to neurology
B) Obtain a complete blood count, comprehensive metabolic panel, thyroid-
stimulating hormone (TSH), and vitamin B12 level
C) Prescribe donepezil and schedule a follow-up in 3 months
D) Refer the patient for neuropsychological testing
Rationale: The correct answer is B because the initial workup for cognitive
impairment should include reversible causes such as metabolic abnormalities,
thyroid dysfunction, and vitamin deficiencies. A CBC, CMP, TSH, and vitamin B12
level are essential to rule out reversible causes of cognitive decline before
initiating further diagnostic testing or treatment. Option A is incorrect because
a CT scan is not the first step; reversible causes must be ruled out first. Option C
is incorrect because prescribing a cholinesterase inhibitor without a confirmed
diagnosis of Alzheimer's disease or ruling out reversible causes is premature
and potentially harmful. Option D is incorrect because neuropsychological
testing is appropriate after reversible causes are ruled out and a diagnosis is
suspected, not as the initial step.
Q3: A 58-year-old male with a 40 pack-year smoking history presents with a
chronic cough productive of sputum, dyspnea on exertion, and frequent
respiratory infections. Spirometry reveals a post-bronchodilator FEV1/FVC
ratio of 0.62 and FEV1 of 55% predicted. Which of the following is the MOST
appropriate initial management for this patient?
A) Prescribe a short-acting beta-agonist (SABA) as needed
B) Initiate a long-acting bronchodilator (LABA or LAMA) and refer for
pulmonary rehabilitation
C) Prescribe oral corticosteroids for 5 days
D) Refer for lung cancer screening with low-dose CT
, 4
Rationale: The correct answer is B because the patient has COPD (FEV1/FVC <
0.70) with moderate airflow limitation (FEV1 55% predicted, GOLD Stage 2).
Long-acting bronchodilators (LABA or LAMA) are the mainstay of treatment for
patients with frequent symptoms or exacerbations. Pulmonary rehabilitation
should also be initiated. Option A is incorrect because SABA alone is insufficient
for a patient with moderate COPD; long-acting bronchodilators are needed.
Option C is incorrect because oral corticosteroids are indicated for acute
exacerbations, not routine management. Option D is incorrect because while
lung cancer screening is indicated for patients aged 50-80 with a 20+ pack-year
smoking history, it is not the initial management for COPD symptoms; it is a
secondary prevention measure.
Q4: A 65-year-old female presents with a 2-week history of fatigue, weight
gain, cold intolerance, and constipation. Her physical exam reveals a
bradycardic heart rate of 52 bpm, dry skin, and a non-tender, diffusely
enlarged thyroid gland. Laboratory studies reveal a TSH of 15.6 mIU/L
(normal 0.4-4.0) and free T4 of 0.5 ng/dL (normal 0.8-1.8). Which of the
following is the MOST appropriate initial treatment?
A) Prescribe methimazole 10 mg daily
B) Initiate levothyroxine 50 mcg daily
C) Order a thyroid ultrasound
D) Refer to endocrinology for radioactive iodine therapy
Rationale: The correct answer is B because the patient has primary
hypothyroidism (elevated TSH, low free T4) with classic symptoms. The
treatment is levothyroxine replacement therapy, starting at a low dose (50 mcg
daily) and titrating based on TSH levels. Option A is incorrect because
methimazole is used for hyperthyroidism, not hypothyroidism. Option C is
incorrect because a thyroid ultrasound is not indicated for a diffusely enlarged
thyroid in the setting of hypothyroidism; it would be indicated for nodules.
Option D is incorrect because radioactive iodine is used for hyperthyroidism, not
hypothyroidism.
NSG 6020 3P EXAM [QUESTION 1-200] AND ANSWERS
UPDATED 2026/2027 | 100% VERIFIED | DETAILED
RATIONALES – PASS GUARANTEED A+ GRADED
INSTANT DOWNLOAD
INTRODUCTION
The NSG 6020 3P (Primary Care of the Adult, Older Adult, and Family Across the Lifespan) Examination is a
comprehensive assessment designed for advanced practice nursing students, specifically those enrolled in
Family Nurse Practitioner (FNP) or Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) programs. This
rigorous 3P exam evaluates the student's mastery of primary care management across the continuum of adult
and geriatric patient populations, emphasizing health promotion, disease prevention, acute illness
management, and chronic disease management. The exam is a critical milestone in NP education, testing
clinical reasoning, evidence-based practice, diagnostic decision-making, and pharmacological management.
This question bank contains 200 advanced, scenario-based questions designed to simulate the actual NSG 6020
3P exam experience. Each question is crafted to test application-level clinical reasoning, prioritization, and
diagnostic skills, not mere memorization. With detailed rationales explaining both correct and incorrect
answers, this resource will prepare you to pass the NSG 6020 3P exam on your first attempt and excel in your
primary care clinical practice.
CORE DOMAINS TESTED
1. Health Promotion and Disease Prevention (15-20%) – Screenings, immunizations, lifestyle counseling,
risk factor assessment, and evidence-based prevention strategies across the adult and geriatric
lifespan.
2. Cardiovascular Disorders (12-15%) – Assessment and management of hypertension, hyperlipidemia,
coronary artery disease, heart failure, peripheral vascular disease, and dysrhythmias in primary care.
3. Respiratory Disorders (10-12%) – Diagnosis and management of COPD, asthma, pneumonia,
bronchitis, tuberculosis, and upper respiratory infections in adult and geriatric populations.
4. Endocrine and Metabolic Disorders (10-12%) – Management of diabetes mellitus, thyroid disorders,
adrenal disorders, metabolic syndrome, and obesity in primary care.
5. Gastrointestinal Disorders (8-10%) – Evaluation and management of GERD, peptic ulcer disease,
inflammatory bowel disease, irritable bowel syndrome, hepatitis, and liver disease.
6. Neurological and Musculoskeletal Disorders (10-12%) – Assessment and management of stroke,
dementia, Parkinson's disease, osteoarthritis, osteoporosis, back pain, and neuropathies.
7. Psychiatric and Behavioral Health (8-10%) – Diagnosis and management of depression, anxiety,
substance use disorders, insomnia, and mental health conditions in primary care.
8. Dermatologic and Infectious Diseases (8-10%) – Evaluation and management of common skin
conditions, cellulitis, wound care, and infectious diseases in the primary care setting.
,2
9. Renal and Genitourinary Disorders (6-8%) – Assessment and management of chronic kidney disease,
urinary tract infections, benign prostatic hyperplasia, incontinence, and erectile dysfunction.
10. Geriatric Syndromes and End-of-Life Care (8-10%) – Falls, frailty, polypharmacy, cognitive impairment,
advance care planning, and palliative care for older adults.
QUESTIONS 1-100
Q1: A 68-year-old male with a history of hypertension and type 2 diabetes
presents to the primary care clinic for a routine follow-up. His blood pressure
is 152/88 mm Hg, A1c is 7.4%, and LDL is 120 mg/dL. His current medications
include metformin 1000 mg BID, lisinopril 20 mg daily, and atorvastatin 20 mg
daily. The patient reports adherence to his medications and a low-sodium,
low-carbohydrate diet. Which of the following is the MOST appropriate next
step in managing this patient's hypertension?
A) Add hydrochlorothiazide 12.5 mg daily
B) Increase lisinopril to 40 mg daily
C) Add amlodipine 5 mg daily
D) Refer to cardiology for further evaluation
Rationale: The correct answer is C because adding a calcium channel blocker
(amlodipine) to an ACE inhibitor is the recommended next step for a patient
with hypertension and diabetes who is not at goal blood pressure (<140/90 mm
Hg for most patients, or <130/80 mm Hg for high-risk patients) despite maximal
or near-maximal ACE inhibitor therapy. Option A is incorrect because adding a
thiazide diuretic would be appropriate if the patient was not on a diuretic, but
the ACE inhibitor alone is insufficient; combination therapy with a CCB is
preferred in diabetic patients due to renal protective effects. Option B is
incorrect because increasing lisinopril beyond 20 mg may be appropriate, but
the BP is still significantly elevated and adding a second agent is more effective
than titrating a single agent. Option D is incorrect because this is a routine
hypertension management issue that can be managed in primary care without
immediate cardiology referral.
Q2: A 72-year-old female presents with a 3-month history of progressive
memory loss, difficulty with word-finding, and personality changes. Her
,3
family reports she has become withdrawn and irritable. She has a history of
hypertension and hyperlipidemia. On exam, she has a Mini-Mental State
Examination (MMSE) score of 22/30 with deficits in short-term memory and
executive function. Which of the following is the MOST appropriate initial
diagnostic workup?
A) Order a stat CT scan of the head and refer to neurology
B) Obtain a complete blood count, comprehensive metabolic panel, thyroid-
stimulating hormone (TSH), and vitamin B12 level
C) Prescribe donepezil and schedule a follow-up in 3 months
D) Refer the patient for neuropsychological testing
Rationale: The correct answer is B because the initial workup for cognitive
impairment should include reversible causes such as metabolic abnormalities,
thyroid dysfunction, and vitamin deficiencies. A CBC, CMP, TSH, and vitamin B12
level are essential to rule out reversible causes of cognitive decline before
initiating further diagnostic testing or treatment. Option A is incorrect because
a CT scan is not the first step; reversible causes must be ruled out first. Option C
is incorrect because prescribing a cholinesterase inhibitor without a confirmed
diagnosis of Alzheimer's disease or ruling out reversible causes is premature
and potentially harmful. Option D is incorrect because neuropsychological
testing is appropriate after reversible causes are ruled out and a diagnosis is
suspected, not as the initial step.
Q3: A 58-year-old male with a 40 pack-year smoking history presents with a
chronic cough productive of sputum, dyspnea on exertion, and frequent
respiratory infections. Spirometry reveals a post-bronchodilator FEV1/FVC
ratio of 0.62 and FEV1 of 55% predicted. Which of the following is the MOST
appropriate initial management for this patient?
A) Prescribe a short-acting beta-agonist (SABA) as needed
B) Initiate a long-acting bronchodilator (LABA or LAMA) and refer for
pulmonary rehabilitation
C) Prescribe oral corticosteroids for 5 days
D) Refer for lung cancer screening with low-dose CT
, 4
Rationale: The correct answer is B because the patient has COPD (FEV1/FVC <
0.70) with moderate airflow limitation (FEV1 55% predicted, GOLD Stage 2).
Long-acting bronchodilators (LABA or LAMA) are the mainstay of treatment for
patients with frequent symptoms or exacerbations. Pulmonary rehabilitation
should also be initiated. Option A is incorrect because SABA alone is insufficient
for a patient with moderate COPD; long-acting bronchodilators are needed.
Option C is incorrect because oral corticosteroids are indicated for acute
exacerbations, not routine management. Option D is incorrect because while
lung cancer screening is indicated for patients aged 50-80 with a 20+ pack-year
smoking history, it is not the initial management for COPD symptoms; it is a
secondary prevention measure.
Q4: A 65-year-old female presents with a 2-week history of fatigue, weight
gain, cold intolerance, and constipation. Her physical exam reveals a
bradycardic heart rate of 52 bpm, dry skin, and a non-tender, diffusely
enlarged thyroid gland. Laboratory studies reveal a TSH of 15.6 mIU/L
(normal 0.4-4.0) and free T4 of 0.5 ng/dL (normal 0.8-1.8). Which of the
following is the MOST appropriate initial treatment?
A) Prescribe methimazole 10 mg daily
B) Initiate levothyroxine 50 mcg daily
C) Order a thyroid ultrasound
D) Refer to endocrinology for radioactive iodine therapy
Rationale: The correct answer is B because the patient has primary
hypothyroidism (elevated TSH, low free T4) with classic symptoms. The
treatment is levothyroxine replacement therapy, starting at a low dose (50 mcg
daily) and titrating based on TSH levels. Option A is incorrect because
methimazole is used for hyperthyroidism, not hypothyroidism. Option C is
incorrect because a thyroid ultrasound is not indicated for a diffusely enlarged
thyroid in the setting of hypothyroidism; it would be indicated for nodules.
Option D is incorrect because radioactive iodine is used for hyperthyroidism, not
hypothyroidism.
