1
NSG 6440 PREDICTOR TEST LATEST QUESTIONS AND ANSWERS ALL ARE
CORRECT 2026/27 UPDATED STUDY SOLUTIONS
1.
A 67-year-old man with hypertension, type 2 diabetes, hyperlipidemia, and
chronic kidney disease presents for a routine primary-care visit. His blood pressure
is 154/92 mmHg despite adherence to lisinopril. His A1C is 7.8%, LDL cholesterol
remains elevated, and his estimated GFR has decreased from 52 to 44
mL/min/1.73 m² over the past year. He denies chest pain or dyspnea. Which
approach best reflects comprehensive primary-care management?
A. Address blood pressure, glycemic control, lipid management, kidney protection,
lifestyle modification, medication adherence, and cardiovascular risk together
B. Focus exclusively on the elevated A1C because diabetes is the primary diagnosis
C. Discontinue antihypertensive therapy because his renal function is declining
D. Refer the patient immediately to emergency care despite the absence of acute
symptoms
Answer: A
2.
A 42-year-old woman presents with fatigue, constipation, dry skin, cold
intolerance, and a 15-lb weight gain over eight months. Her heart rate is 54/min,
and examination reveals delayed relaxation of deep tendon reflexes. She has no
palpable thyroid nodule. Which initial laboratory evaluation is most appropriate?
A. Serum cortisol and ACTH
B. TSH with free T4
C. Serum prolactin and FSH
D. Serum calcium and PTH
Answer: B
3.
,2
A 54-year-old man with a 40-pack-year smoking history reports chronic cough,
sputum production, and progressively worsening exertional dyspnea. Spirometry
demonstrates persistent airflow obstruction after bronchodilator administration.
He continues to smoke despite previous counseling. Which intervention is most
important for reducing continued pulmonary injury?
A. Restrict daily fluid intake
B. Begin chronic oral corticosteroid therapy for every patient
C. Recommend complete smoking cessation and provide evidence-based
cessation support
D. Avoid influenza and pneumococcal vaccination
Answer: C
4.
A 28-year-old woman presents with dysuria, urinary frequency, and urgency for
three days. She denies fever, flank pain, nausea, vomiting, vaginal discharge, or
pregnancy. Urinalysis is positive for leukocyte esterase and nitrites. Which
diagnosis is most likely?
A. Acute pyelonephritis
B. Nephrolithiasis
C. Pelvic inflammatory disease
D. Acute uncomplicated cystitis
Answer: D
5.
A 71-year-old woman reports a new headache involving the temporal region, scalp
tenderness, jaw discomfort while chewing, and two brief episodes of blurred
vision. She has no previous history of similar headaches. Which condition requires
urgent consideration?
A. Giant cell arteritis
B. Tension headache
,3
C. Temporomandibular joint syndrome
D. Migraine without aura
Answer: A
6.
A 36-year-old woman presents with recurrent episodes of wheezing, chest
tightness, and cough after exercise and exposure to cats. She is asymptomatic
between episodes. Which diagnostic approach is most appropriate for evaluating
suspected asthma?
A. Chest CT for every initial presentation
B. Spirometry with assessment of reversible airflow obstruction
C. Routine bronchoscopy
D. Serum troponin testing
Answer: B
7.
A 59-year-old man presents with crushing substernal chest pressure, diaphoresis,
nausea, and shortness of breath that began while he was resting. He has diabetes,
hypertension, and a 35-pack-year smoking history. Which action should take
priority?
A. Treat the symptoms as gastroesophageal reflux until proven otherwise
B. Schedule an outpatient stress test for next month
C. Arrange immediate evaluation for possible acute coronary syndrome
D. Recommend an antacid and reassess in 24 hours
Answer: C
8.
A 76-year-old woman takes lisinopril, hydrochlorothiazide, amlodipine, metformin,
atorvastatin, and several over-the-counter supplements. She reports dizziness and
two falls during the past month. Her blood pressure decreases significantly when
she stands. Which intervention is most appropriate?
, 4
A. Add another antihypertensive medication
B. Perform medication reconciliation and evaluate for orthostatic hypotension and
medication-related adverse effects
C. Tell the patient that falls are expected with aging
D. Discontinue all medications without further assessment
Answer: B
9.
A 63-year-old man presents with progressive difficulty swallowing. Initially he had
difficulty swallowing solid foods, but over the last several months he has also
developed difficulty swallowing liquids and has unintentionally lost 18 lb. Which
finding makes prompt diagnostic evaluation particularly important?
A. Progressive dysphagia associated with unintentional weight loss
B. Occasional belching after carbonated beverages
C. Mild heartburn occurring once monthly
D. Intermittent hiccups after eating quickly
Answer: A
10.
A 24-year-old woman presents with fever, sore throat, tonsillar exudates, and
tender anterior cervical lymphadenopathy. She denies cough. Which diagnostic
approach is most appropriate when evaluating suspected streptococcal
pharyngitis?
A. Treat every patient empirically without assessment
B. Use an appropriate streptococcal testing strategy based on clinical findings
C. Order a chest CT
D. Diagnose infectious mononucleosis without further evaluation
Answer: B
11.
NSG 6440 PREDICTOR TEST LATEST QUESTIONS AND ANSWERS ALL ARE
CORRECT 2026/27 UPDATED STUDY SOLUTIONS
1.
A 67-year-old man with hypertension, type 2 diabetes, hyperlipidemia, and
chronic kidney disease presents for a routine primary-care visit. His blood pressure
is 154/92 mmHg despite adherence to lisinopril. His A1C is 7.8%, LDL cholesterol
remains elevated, and his estimated GFR has decreased from 52 to 44
mL/min/1.73 m² over the past year. He denies chest pain or dyspnea. Which
approach best reflects comprehensive primary-care management?
A. Address blood pressure, glycemic control, lipid management, kidney protection,
lifestyle modification, medication adherence, and cardiovascular risk together
B. Focus exclusively on the elevated A1C because diabetes is the primary diagnosis
C. Discontinue antihypertensive therapy because his renal function is declining
D. Refer the patient immediately to emergency care despite the absence of acute
symptoms
Answer: A
2.
A 42-year-old woman presents with fatigue, constipation, dry skin, cold
intolerance, and a 15-lb weight gain over eight months. Her heart rate is 54/min,
and examination reveals delayed relaxation of deep tendon reflexes. She has no
palpable thyroid nodule. Which initial laboratory evaluation is most appropriate?
A. Serum cortisol and ACTH
B. TSH with free T4
C. Serum prolactin and FSH
D. Serum calcium and PTH
Answer: B
3.
,2
A 54-year-old man with a 40-pack-year smoking history reports chronic cough,
sputum production, and progressively worsening exertional dyspnea. Spirometry
demonstrates persistent airflow obstruction after bronchodilator administration.
He continues to smoke despite previous counseling. Which intervention is most
important for reducing continued pulmonary injury?
A. Restrict daily fluid intake
B. Begin chronic oral corticosteroid therapy for every patient
C. Recommend complete smoking cessation and provide evidence-based
cessation support
D. Avoid influenza and pneumococcal vaccination
Answer: C
4.
A 28-year-old woman presents with dysuria, urinary frequency, and urgency for
three days. She denies fever, flank pain, nausea, vomiting, vaginal discharge, or
pregnancy. Urinalysis is positive for leukocyte esterase and nitrites. Which
diagnosis is most likely?
A. Acute pyelonephritis
B. Nephrolithiasis
C. Pelvic inflammatory disease
D. Acute uncomplicated cystitis
Answer: D
5.
A 71-year-old woman reports a new headache involving the temporal region, scalp
tenderness, jaw discomfort while chewing, and two brief episodes of blurred
vision. She has no previous history of similar headaches. Which condition requires
urgent consideration?
A. Giant cell arteritis
B. Tension headache
,3
C. Temporomandibular joint syndrome
D. Migraine without aura
Answer: A
6.
A 36-year-old woman presents with recurrent episodes of wheezing, chest
tightness, and cough after exercise and exposure to cats. She is asymptomatic
between episodes. Which diagnostic approach is most appropriate for evaluating
suspected asthma?
A. Chest CT for every initial presentation
B. Spirometry with assessment of reversible airflow obstruction
C. Routine bronchoscopy
D. Serum troponin testing
Answer: B
7.
A 59-year-old man presents with crushing substernal chest pressure, diaphoresis,
nausea, and shortness of breath that began while he was resting. He has diabetes,
hypertension, and a 35-pack-year smoking history. Which action should take
priority?
A. Treat the symptoms as gastroesophageal reflux until proven otherwise
B. Schedule an outpatient stress test for next month
C. Arrange immediate evaluation for possible acute coronary syndrome
D. Recommend an antacid and reassess in 24 hours
Answer: C
8.
A 76-year-old woman takes lisinopril, hydrochlorothiazide, amlodipine, metformin,
atorvastatin, and several over-the-counter supplements. She reports dizziness and
two falls during the past month. Her blood pressure decreases significantly when
she stands. Which intervention is most appropriate?
, 4
A. Add another antihypertensive medication
B. Perform medication reconciliation and evaluate for orthostatic hypotension and
medication-related adverse effects
C. Tell the patient that falls are expected with aging
D. Discontinue all medications without further assessment
Answer: B
9.
A 63-year-old man presents with progressive difficulty swallowing. Initially he had
difficulty swallowing solid foods, but over the last several months he has also
developed difficulty swallowing liquids and has unintentionally lost 18 lb. Which
finding makes prompt diagnostic evaluation particularly important?
A. Progressive dysphagia associated with unintentional weight loss
B. Occasional belching after carbonated beverages
C. Mild heartburn occurring once monthly
D. Intermittent hiccups after eating quickly
Answer: A
10.
A 24-year-old woman presents with fever, sore throat, tonsillar exudates, and
tender anterior cervical lymphadenopathy. She denies cough. Which diagnostic
approach is most appropriate when evaluating suspected streptococcal
pharyngitis?
A. Treat every patient empirically without assessment
B. Use an appropriate streptococcal testing strategy based on clinical findings
C. Order a chest CT
D. Diagnose infectious mononucleosis without further evaluation
Answer: B
11.
