SOUTH UNIVERSITY
COMPREHENSIVE FINAL EXAMINATION
NSG 6330 Advanced Practice
Nursing
Final Examination
Questions and Answers
One hundred fifty multiple-choice examination questions with
correct answers and detailed rationales, aligned with the South
University NSG 6330 course syllabus, Advanced Practice
Nursing competencies, and National Certification Standards.
Course NSG 6330 - Advanced Practice
Nursing
Examination Comprehensive Final - 150 Questions
Format Multiple Choice (A-D) with Rationales
Edition Latest Version - 2026/2027
Alignment National Certification Standards
LAT ES T VER S IO N · 20 26/20 27 ACADEMIC YEAR
,NSG 6330 Final Examination - South University 2026/2027 Edition
NSG 6330 FINAL EXAM QUESTIONS AND ANSWERS
SOUTH UNIVERSITY - LATEST VERSION 100% CORRECT 2026/2027
Comprehensive Final Examination - Advanced Practice Nursing Course Examination Preparation | 150 multiple-choice
questions (A-D, one best answer) with correct answers and rationales | Aligned with the South University NSG 6330 course
syllabus, Advanced Practice Nursing competencies, and National Certification Standards (2026/2027 Edition) | Cognitive
levels: 20% recall, 40% application, 40% analysis
Section 1: Advanced Health Assessment and Diagnostic Reasoning
Questions 1-20
Q1. A 58-year-old male presents to the primary care clinic for a new patient visit. He reports a 3-month history
of worsening fatigue and a 10-lb unintentional weight loss. Which element of the comprehensive health history
is MOST likely to reveal the underlying cause of his symptoms?
A. Family history of cardiovascular disease across three generations
B. A complete review of systems targeting constitutional, gastrointestinal, and respiratory symptoms
[CORRECT]
C. A detailed sexual history using the CDC five Ps approach
D. Immunization history including tetanus and influenza status
Correct Answer: B
Rationale: A focused, complete review of systems is the structured method for uncovering multisystem complaints
such as fatigue with weight loss, which may signal malignancy, thyroid disease, depression, or chronic infection. The
family history, sexual history, and immunization record are essential components of a comprehensive history but are
unlikely to localize the presenting complaint. This diagnostic reasoning approach reflects the NSG 6330 emphasis on
hypothesis-driven history taking consistent with ANCC and AANP certification blueprints.
Q2. Which physical examination maneuver is MOST appropriate to differentiate between a pleural effusion and
consolidation (pneumonia) in a patient with dullness to percussion over the right lower lung field?
A. Bronchophony and egophony testing over the area of dullness [CORRECT]
B. Measuring the apical-radial pulse deficit
C. Testing for shifting dullness in the abdomen
D. Auscultating for pericardial friction rub at the left sternal border
Correct Answer: A
Rationale: Voice transmission tests distinguish effusion from consolidation: consolidation increases transmission,
producing bronchophony, egophony (E to A change), and whispered pectoriloquy, whereas effusion decreases
transmission. The pulse deficit evaluates arrhythmia, shifting dullness assesses ascites, and a friction rub is a pericardial
finding, none of which address the lung question. Mastery of these examination techniques is a core advanced
assessment competency in the NSG 6330 curriculum and on national APRN certification examinations.
Graduate Advanced Practice Nursing 1
,NSG 6330 Final Examination - South University 2026/2027 Edition
Q3. A diagnostic test has a sensitivity of 95 percent and a specificity of 60 percent. The NP is screening for a
condition in which missing a diagnosis would be catastrophic. Which interpretation BEST guides the use of this
test?
A. The test is most useful for confirming disease after a positive screening battery
B. The test performs identically regardless of disease prevalence in the population
C. The test will produce few false-positive results, making confirmatory testing unnecessary
D. The test is most useful as a screening tool because it rarely misses true disease, although positive results
require confirmation [CORRECT]
Correct Answer: D
Rationale: High sensitivity means the test captures nearly all true cases, which is ideal for screening when missing
disease is dangerous; the trade-off of many false positives requires a specific confirmatory test. Option A confuses
sensitivity with specificity, option C describes the role of a highly specific test, and option D ignores that positive
predictive value falls as prevalence falls. Understanding sensitivity, specificity, and predictive values is required content
in NSG 6330 and appears consistently on ANCC and AANP examinations.
Q4. A 24-year-old woman presents with sharp chest pain that worsens with deep inspiration and improves when
she leans forward. The pain radiates to the left trapezius ridge. Which examination finding would BEST support
the suspected diagnosis?
A. Decreased breath sounds with dullness over the left lower lobe
B. A fixed split S2 heard at the pulmonic area
C. A harsh crescendo-decrescendo systolic murmur radiating to the carotids
D. A scratchy, high-pitched sound heard best at the left sternal border that increases when the patient sits
forward [CORRECT]
Correct Answer: D
Rationale: The scenario is classic for acute pericarditis, and a pericardial friction rub, a scratchy leathery sound best
heard at the left sternal border with the patient leaning forward, supports that diagnosis. The systolic murmur suggests
aortic stenosis, dullness with decreased breath sounds suggests effusion or consolidation, and a fixed split S2 suggests
atrial septal defect. Linking chest pain characteristics to examination findings demonstrates the clinical reasoning
competency emphasized throughout the NSG 6330 advanced assessment module.
Q5. During a comprehensive neurological examination, the NP asks the patient to walk heel-to-toe across the
examination room. Which system is the NP PRIMARILY assessing with this maneuver?
A. CN IX and CN X bulbar motor function
B. Cerebellar function and coordination [CORRECT]
C. Cortical sensory integration and two-point discrimination
D. Upper motor neuron strength in a myotomal distribution
Correct Answer: B
Rationale: Tandem gait evaluates cerebellar function, balance, and coordination; deterioration suggests cerebellar
pathology, proprioceptive loss, or intoxication. Cortical sensory testing uses graphesthesia and stereognosis, myotomal
strength is tested by resisted motion, and bulbar function is assessed by palate elevation, gag, and phonation. Systematic
neurologic assessment technique is an explicit competency of the NSG 6330 advanced health assessment course aligned
with NONPF practice inquiry standards.
Graduate Advanced Practice Nursing 2
, NSG 6330 Final Examination - South University 2026/2027 Edition
Q6. A 70-year-old female presents with acute severe pain in her right eye, blurred vision, halos around lights,
nausea, and vomiting. Pupil examination shows a mid-dilated pupil that is sluggish to light. What is the MOST
appropriate next step?
A. Apply a pressure patch and prescribe an oral analgesic for corneal abrasion
B. Reassure the patient and schedule follow-up in 2 weeks with an ophthalmologist
C. Initiate empiric antibiotic therapy for presumed bacterial conjunctivitis
D. Refer immediately to the emergency department for suspected acute angle-closure glaucoma
[CORRECT]
Correct Answer: D
Rationale: Acute angle-closure glaucoma is an ophthalmologic emergency presenting with a red, painful eye,
mid-dilated sluggish pupil, halos, and vagal symptoms; delayed treatment causes permanent optic nerve damage within
hours. Scheduling routine follow-up, treating with antibiotics, or patching all dangerously delay definitive therapy such
as intraocular pressure reduction. Recognizing red-flag presentation patterns requiring urgent referral is a central
diagnostic reasoning objective of the NSG 6330 curriculum and of APRN certification testing.
Q7. The NP performs an abdominal examination on a patient with right lower quadrant pain. Pain is elicited in
the right lower quadrant when pressure is applied to the left lower quadrant and released. This finding is known
as which of the following?
A. Murphy sign
B. Cullen sign
C. Grey-Turner sign
D. Rovsing sign [CORRECT]
Correct Answer: D
Rationale: Rovsing sign, right lower quadrant pain with left-sided palpation, supports peritoneal irritation as seen in
appendicitis. Murphy sign is right upper quadrant pain on inspiration during gallbladder palpation, Cullen sign is
periumbilical ecchymosis, and Grey-Turner sign is flank ecchymosis, both markers of retroperitoneal hemorrhage.
Accurate interpretation of special examination signs is emphasized in the NSG 6330 differential diagnosis framework
and tested routinely on national certification examinations.
Q8. A 65-year-old male with a 45-pack-year smoking history presents with a change in voice quality lasting 5
weeks, a new dry cough, and fatigue. There is no fever or sore throat. Which diagnostic reasoning conclusion is
MOST appropriate?
A. The most likely cause is gastroesophageal reflux, and a trial of a proton pump inhibitor should extend 6
months
B. The symptoms represent vocal cord dysfunction and can be managed with speech therapy alone
C. The presentation is consistent with viral laryngitis, and symptomatic care is sufficient
D. Hoarseness persisting beyond 2 to 3 weeks in a heavy smoker requires laryngoscopy to exclude
laryngeal or pulmonary malignancy [CORRECT]
Correct Answer: D
Rationale: Hoarseness lasting longer than 2 to 3 weeks, particularly in a patient with a heavy tobacco history, is a red
flag mandating direct visualization of the larynx and chest imaging to exclude malignancy. Attributing the change to
self-limited laryngitis or prolonged empiric reflux therapy without evaluation represents anchoring bias, a diagnostic
error the NSG 6330 curriculum explicitly trains APRN students to avoid. Speech therapy alone is inappropriate before
structural and neoplastic causes are excluded.
Graduate Advanced Practice Nursing 3
COMPREHENSIVE FINAL EXAMINATION
NSG 6330 Advanced Practice
Nursing
Final Examination
Questions and Answers
One hundred fifty multiple-choice examination questions with
correct answers and detailed rationales, aligned with the South
University NSG 6330 course syllabus, Advanced Practice
Nursing competencies, and National Certification Standards.
Course NSG 6330 - Advanced Practice
Nursing
Examination Comprehensive Final - 150 Questions
Format Multiple Choice (A-D) with Rationales
Edition Latest Version - 2026/2027
Alignment National Certification Standards
LAT ES T VER S IO N · 20 26/20 27 ACADEMIC YEAR
,NSG 6330 Final Examination - South University 2026/2027 Edition
NSG 6330 FINAL EXAM QUESTIONS AND ANSWERS
SOUTH UNIVERSITY - LATEST VERSION 100% CORRECT 2026/2027
Comprehensive Final Examination - Advanced Practice Nursing Course Examination Preparation | 150 multiple-choice
questions (A-D, one best answer) with correct answers and rationales | Aligned with the South University NSG 6330 course
syllabus, Advanced Practice Nursing competencies, and National Certification Standards (2026/2027 Edition) | Cognitive
levels: 20% recall, 40% application, 40% analysis
Section 1: Advanced Health Assessment and Diagnostic Reasoning
Questions 1-20
Q1. A 58-year-old male presents to the primary care clinic for a new patient visit. He reports a 3-month history
of worsening fatigue and a 10-lb unintentional weight loss. Which element of the comprehensive health history
is MOST likely to reveal the underlying cause of his symptoms?
A. Family history of cardiovascular disease across three generations
B. A complete review of systems targeting constitutional, gastrointestinal, and respiratory symptoms
[CORRECT]
C. A detailed sexual history using the CDC five Ps approach
D. Immunization history including tetanus and influenza status
Correct Answer: B
Rationale: A focused, complete review of systems is the structured method for uncovering multisystem complaints
such as fatigue with weight loss, which may signal malignancy, thyroid disease, depression, or chronic infection. The
family history, sexual history, and immunization record are essential components of a comprehensive history but are
unlikely to localize the presenting complaint. This diagnostic reasoning approach reflects the NSG 6330 emphasis on
hypothesis-driven history taking consistent with ANCC and AANP certification blueprints.
Q2. Which physical examination maneuver is MOST appropriate to differentiate between a pleural effusion and
consolidation (pneumonia) in a patient with dullness to percussion over the right lower lung field?
A. Bronchophony and egophony testing over the area of dullness [CORRECT]
B. Measuring the apical-radial pulse deficit
C. Testing for shifting dullness in the abdomen
D. Auscultating for pericardial friction rub at the left sternal border
Correct Answer: A
Rationale: Voice transmission tests distinguish effusion from consolidation: consolidation increases transmission,
producing bronchophony, egophony (E to A change), and whispered pectoriloquy, whereas effusion decreases
transmission. The pulse deficit evaluates arrhythmia, shifting dullness assesses ascites, and a friction rub is a pericardial
finding, none of which address the lung question. Mastery of these examination techniques is a core advanced
assessment competency in the NSG 6330 curriculum and on national APRN certification examinations.
Graduate Advanced Practice Nursing 1
,NSG 6330 Final Examination - South University 2026/2027 Edition
Q3. A diagnostic test has a sensitivity of 95 percent and a specificity of 60 percent. The NP is screening for a
condition in which missing a diagnosis would be catastrophic. Which interpretation BEST guides the use of this
test?
A. The test is most useful for confirming disease after a positive screening battery
B. The test performs identically regardless of disease prevalence in the population
C. The test will produce few false-positive results, making confirmatory testing unnecessary
D. The test is most useful as a screening tool because it rarely misses true disease, although positive results
require confirmation [CORRECT]
Correct Answer: D
Rationale: High sensitivity means the test captures nearly all true cases, which is ideal for screening when missing
disease is dangerous; the trade-off of many false positives requires a specific confirmatory test. Option A confuses
sensitivity with specificity, option C describes the role of a highly specific test, and option D ignores that positive
predictive value falls as prevalence falls. Understanding sensitivity, specificity, and predictive values is required content
in NSG 6330 and appears consistently on ANCC and AANP examinations.
Q4. A 24-year-old woman presents with sharp chest pain that worsens with deep inspiration and improves when
she leans forward. The pain radiates to the left trapezius ridge. Which examination finding would BEST support
the suspected diagnosis?
A. Decreased breath sounds with dullness over the left lower lobe
B. A fixed split S2 heard at the pulmonic area
C. A harsh crescendo-decrescendo systolic murmur radiating to the carotids
D. A scratchy, high-pitched sound heard best at the left sternal border that increases when the patient sits
forward [CORRECT]
Correct Answer: D
Rationale: The scenario is classic for acute pericarditis, and a pericardial friction rub, a scratchy leathery sound best
heard at the left sternal border with the patient leaning forward, supports that diagnosis. The systolic murmur suggests
aortic stenosis, dullness with decreased breath sounds suggests effusion or consolidation, and a fixed split S2 suggests
atrial septal defect. Linking chest pain characteristics to examination findings demonstrates the clinical reasoning
competency emphasized throughout the NSG 6330 advanced assessment module.
Q5. During a comprehensive neurological examination, the NP asks the patient to walk heel-to-toe across the
examination room. Which system is the NP PRIMARILY assessing with this maneuver?
A. CN IX and CN X bulbar motor function
B. Cerebellar function and coordination [CORRECT]
C. Cortical sensory integration and two-point discrimination
D. Upper motor neuron strength in a myotomal distribution
Correct Answer: B
Rationale: Tandem gait evaluates cerebellar function, balance, and coordination; deterioration suggests cerebellar
pathology, proprioceptive loss, or intoxication. Cortical sensory testing uses graphesthesia and stereognosis, myotomal
strength is tested by resisted motion, and bulbar function is assessed by palate elevation, gag, and phonation. Systematic
neurologic assessment technique is an explicit competency of the NSG 6330 advanced health assessment course aligned
with NONPF practice inquiry standards.
Graduate Advanced Practice Nursing 2
, NSG 6330 Final Examination - South University 2026/2027 Edition
Q6. A 70-year-old female presents with acute severe pain in her right eye, blurred vision, halos around lights,
nausea, and vomiting. Pupil examination shows a mid-dilated pupil that is sluggish to light. What is the MOST
appropriate next step?
A. Apply a pressure patch and prescribe an oral analgesic for corneal abrasion
B. Reassure the patient and schedule follow-up in 2 weeks with an ophthalmologist
C. Initiate empiric antibiotic therapy for presumed bacterial conjunctivitis
D. Refer immediately to the emergency department for suspected acute angle-closure glaucoma
[CORRECT]
Correct Answer: D
Rationale: Acute angle-closure glaucoma is an ophthalmologic emergency presenting with a red, painful eye,
mid-dilated sluggish pupil, halos, and vagal symptoms; delayed treatment causes permanent optic nerve damage within
hours. Scheduling routine follow-up, treating with antibiotics, or patching all dangerously delay definitive therapy such
as intraocular pressure reduction. Recognizing red-flag presentation patterns requiring urgent referral is a central
diagnostic reasoning objective of the NSG 6330 curriculum and of APRN certification testing.
Q7. The NP performs an abdominal examination on a patient with right lower quadrant pain. Pain is elicited in
the right lower quadrant when pressure is applied to the left lower quadrant and released. This finding is known
as which of the following?
A. Murphy sign
B. Cullen sign
C. Grey-Turner sign
D. Rovsing sign [CORRECT]
Correct Answer: D
Rationale: Rovsing sign, right lower quadrant pain with left-sided palpation, supports peritoneal irritation as seen in
appendicitis. Murphy sign is right upper quadrant pain on inspiration during gallbladder palpation, Cullen sign is
periumbilical ecchymosis, and Grey-Turner sign is flank ecchymosis, both markers of retroperitoneal hemorrhage.
Accurate interpretation of special examination signs is emphasized in the NSG 6330 differential diagnosis framework
and tested routinely on national certification examinations.
Q8. A 65-year-old male with a 45-pack-year smoking history presents with a change in voice quality lasting 5
weeks, a new dry cough, and fatigue. There is no fever or sore throat. Which diagnostic reasoning conclusion is
MOST appropriate?
A. The most likely cause is gastroesophageal reflux, and a trial of a proton pump inhibitor should extend 6
months
B. The symptoms represent vocal cord dysfunction and can be managed with speech therapy alone
C. The presentation is consistent with viral laryngitis, and symptomatic care is sufficient
D. Hoarseness persisting beyond 2 to 3 weeks in a heavy smoker requires laryngoscopy to exclude
laryngeal or pulmonary malignancy [CORRECT]
Correct Answer: D
Rationale: Hoarseness lasting longer than 2 to 3 weeks, particularly in a patient with a heavy tobacco history, is a red
flag mandating direct visualization of the larynx and chest imaging to exclude malignancy. Attributing the change to
self-limited laryngitis or prolonged empiric reflux therapy without evaluation represents anchoring bias, a diagnostic
error the NSG 6330 curriculum explicitly trains APRN students to avoid. Speech therapy alone is inappropriate before
structural and neoplastic causes are excluded.
Graduate Advanced Practice Nursing 3
