NSG 6998 FNP PREDICTOR EXAM 2026/2027: THE ULTIMATE SOUTH
UNIVERSITY STUDY GUIDE – 200 HIGH-YIELD EXAM QUESTIONS
COVERING ALL TESTED TOPICS WITH DETAILED RATIONALES, VERIFIED
ANSWER AND GRADED A+ STANDARDS
1. A 76-year-old male with a history of COPD, diabetes mellitus, and
alcoholism has a chest x-ray that shows infiltrates. Which of the
following medications is the first-line treatment?
A. Amoxicillin
B. Levofloxacin
C. Azithromycin
D. Doxycycline
Correct Answer: B
Rationale: In patients with significant comorbidities such as COPD,
diabetes, or alcoholism, levofloxacin is a recommended first-line
outpatient treatment for community-acquired pneumonia due to its
broad-spectrum coverage of typical and atypical pathogens. Amoxicillin
and doxycycline are typically reserved for otherwise healthy patients
without comorbidities.
2. A 58-year-old female is found to be euthyroid. Which of the
following is the next step of care?
A. Repeat TSH in 4-6 weeks.
B. Increase levothyroxine until therapeutic.
C. Monitor TSH annually unless symptoms develop.
D. Decrease levothyroxine until therapeutic.
Correct Answer: C
,Rationale: For a patient who is clinically and biochemically euthyroid on
their current dose of levothyroxine, the standard of care is to monitor
TSH annually, or sooner if symptoms develop, without changing the
medication dose.
3. A 44-year-old obese woman complains of abdominal pain. What
physical assessment finding might indicate that the etiology of her
pain is acute cholecystitis?
A. Pain at McBurney's point.
B. Positive Murphy's sign
C. Severe epigastric pain
D. Tinkling bowel sounds
Correct Answer: B
Rationale: A positive Murphy's sign (inspiratory arrest during deep
palpation of the right upper quadrant) is a classic physical exam finding
associated with acute cholecystitis. McBurney's point tenderness is
associated with appendicitis.
4. A 76-year-old male with a history of COPD, diabetes mellitus, and
alcoholism has a chest x-ray that shows infiltrates. Which of the
following is the most likely pathogen?
A. H. influenzae
B. S. pneumoniae
C. B. pertussis
D. Viral infection
Correct Answer: A
Rationale: While S. pneumoniae is the most common overall cause of
CAP, patients with underlying COPD are particularly predisposed to
infection with Haemophilus influenzae. The presence of COPD is a key
risk factor for this pathogen.
,5. A 56-year-old male has suspected COPD. Which of the following
symptoms are indicative of COPD?
A. Progressive dyspnea
B. Acute cough
C. Sputum production over the past 2 months
D. FEV1/FVC ratio >0.70
Correct Answer: A
Rationale: Progressive dyspnea is a hallmark symptom of COPD. A
chronic cough with sputum production for >3 months per year for 2
consecutive years, and an FEV1/FVC ratio <0.70 are also diagnostic
criteria, not an acute cough or a ratio >0.70.
6. A 32-year-old man has acute bronchitis. He is a non-smoker and is
otherwise healthy. How should he be managed?
A. Treat symptoms only
B. Prescribe a macrolide antibiotic.
C. Prescribe an antitussive.
D. Prescribe an antibiotic and antitussive.
Correct Answer: A
Rationale: Acute bronchitis in healthy, non-smoking individuals is almost
always viral in origin. Therefore, antibiotics are not indicated.
Management is supportive and symptom-based (e.g., fluids, rest,
acetaminophen, honey).
7. An 84-year-old male has acute bronchitis. Which of the following
tests would you perform as the Nurse Practitioner?
A. Sputum culture
B. Chest X-ray
C. Chest CT
D. Chest MRI
, Correct Answer: B
Rationale: In an elderly patient (over 75 years old) presenting with
acute bronchitis, a chest X-ray is indicated to rule out pneumonia, as the
clinical presentation can be atypical and the risk of complications is
higher.
8. A 68-year-old male presents with a chronic cough and dyspnea on
exertion. Spirometry reveals an FEV1/FVC ratio of 0.65. What is the
most appropriate initial pharmacological therapy?
A. Inhaled corticosteroid
B. Short-acting beta-agonist
C. Long-acting beta-agonist
D. Oral prednisone
Correct Answer: B
Rationale: A short-acting beta-agonist (SABA) is the first-line rescue
medication for managing intermittent symptoms of COPD. Long-acting
agents and inhaled corticosteroids are added for persistent symptoms
or frequent exacerbations.
9. A 55-year-old female presents with fatigue, weight gain, and cold
intolerance. TSH is elevated and Free T4 is low. What is the most
appropriate treatment?
A. Levothyroxine
B. Methimazole
C. Radioactive iodine
D. Propranolol
Correct Answer: A
Rationale: The patient has primary hypothyroidism. Levothyroxine is the
standard replacement therapy. Methimazole and radioactive iodine are
treatments for hyperthyroidism.
UNIVERSITY STUDY GUIDE – 200 HIGH-YIELD EXAM QUESTIONS
COVERING ALL TESTED TOPICS WITH DETAILED RATIONALES, VERIFIED
ANSWER AND GRADED A+ STANDARDS
1. A 76-year-old male with a history of COPD, diabetes mellitus, and
alcoholism has a chest x-ray that shows infiltrates. Which of the
following medications is the first-line treatment?
A. Amoxicillin
B. Levofloxacin
C. Azithromycin
D. Doxycycline
Correct Answer: B
Rationale: In patients with significant comorbidities such as COPD,
diabetes, or alcoholism, levofloxacin is a recommended first-line
outpatient treatment for community-acquired pneumonia due to its
broad-spectrum coverage of typical and atypical pathogens. Amoxicillin
and doxycycline are typically reserved for otherwise healthy patients
without comorbidities.
2. A 58-year-old female is found to be euthyroid. Which of the
following is the next step of care?
A. Repeat TSH in 4-6 weeks.
B. Increase levothyroxine until therapeutic.
C. Monitor TSH annually unless symptoms develop.
D. Decrease levothyroxine until therapeutic.
Correct Answer: C
,Rationale: For a patient who is clinically and biochemically euthyroid on
their current dose of levothyroxine, the standard of care is to monitor
TSH annually, or sooner if symptoms develop, without changing the
medication dose.
3. A 44-year-old obese woman complains of abdominal pain. What
physical assessment finding might indicate that the etiology of her
pain is acute cholecystitis?
A. Pain at McBurney's point.
B. Positive Murphy's sign
C. Severe epigastric pain
D. Tinkling bowel sounds
Correct Answer: B
Rationale: A positive Murphy's sign (inspiratory arrest during deep
palpation of the right upper quadrant) is a classic physical exam finding
associated with acute cholecystitis. McBurney's point tenderness is
associated with appendicitis.
4. A 76-year-old male with a history of COPD, diabetes mellitus, and
alcoholism has a chest x-ray that shows infiltrates. Which of the
following is the most likely pathogen?
A. H. influenzae
B. S. pneumoniae
C. B. pertussis
D. Viral infection
Correct Answer: A
Rationale: While S. pneumoniae is the most common overall cause of
CAP, patients with underlying COPD are particularly predisposed to
infection with Haemophilus influenzae. The presence of COPD is a key
risk factor for this pathogen.
,5. A 56-year-old male has suspected COPD. Which of the following
symptoms are indicative of COPD?
A. Progressive dyspnea
B. Acute cough
C. Sputum production over the past 2 months
D. FEV1/FVC ratio >0.70
Correct Answer: A
Rationale: Progressive dyspnea is a hallmark symptom of COPD. A
chronic cough with sputum production for >3 months per year for 2
consecutive years, and an FEV1/FVC ratio <0.70 are also diagnostic
criteria, not an acute cough or a ratio >0.70.
6. A 32-year-old man has acute bronchitis. He is a non-smoker and is
otherwise healthy. How should he be managed?
A. Treat symptoms only
B. Prescribe a macrolide antibiotic.
C. Prescribe an antitussive.
D. Prescribe an antibiotic and antitussive.
Correct Answer: A
Rationale: Acute bronchitis in healthy, non-smoking individuals is almost
always viral in origin. Therefore, antibiotics are not indicated.
Management is supportive and symptom-based (e.g., fluids, rest,
acetaminophen, honey).
7. An 84-year-old male has acute bronchitis. Which of the following
tests would you perform as the Nurse Practitioner?
A. Sputum culture
B. Chest X-ray
C. Chest CT
D. Chest MRI
, Correct Answer: B
Rationale: In an elderly patient (over 75 years old) presenting with
acute bronchitis, a chest X-ray is indicated to rule out pneumonia, as the
clinical presentation can be atypical and the risk of complications is
higher.
8. A 68-year-old male presents with a chronic cough and dyspnea on
exertion. Spirometry reveals an FEV1/FVC ratio of 0.65. What is the
most appropriate initial pharmacological therapy?
A. Inhaled corticosteroid
B. Short-acting beta-agonist
C. Long-acting beta-agonist
D. Oral prednisone
Correct Answer: B
Rationale: A short-acting beta-agonist (SABA) is the first-line rescue
medication for managing intermittent symptoms of COPD. Long-acting
agents and inhaled corticosteroids are added for persistent symptoms
or frequent exacerbations.
9. A 55-year-old female presents with fatigue, weight gain, and cold
intolerance. TSH is elevated and Free T4 is low. What is the most
appropriate treatment?
A. Levothyroxine
B. Methimazole
C. Radioactive iodine
D. Propranolol
Correct Answer: A
Rationale: The patient has primary hypothyroidism. Levothyroxine is the
standard replacement therapy. Methimazole and radioactive iodine are
treatments for hyperthyroidism.
