NSG 554 EXAM 4 (WILKES) NEWEST 2026 ACTUAL EXAM| NSG554 FNP
EXAM 4 REVIEW WITH 300 COMPLETE REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
CORE DOMAINS
• Cardiovascular Disorders
• Endocrine and Metabolic Disorders
• Respiratory Disorders
• Gastrointestinal and Hepatic Disorders
• Renal and Genitourinary Disorders
• Musculoskeletal and Rheumatologic Disorders
• Dermatologic Disorders
• Women's Health
• Men's Health
• Geriatric and Mental Health
• Pharmacology and Health Promotion
INTRODUCTION
This comprehensive assessment is designed to evaluate mastery of advanced
family nurse practitioner knowledge for NSG 554 Exam 4. It assesses competency
across cardiovascular, endocrine, respiratory, gastrointestinal, renal,
musculoskeletal, dermatologic, women's health, men's health, geriatric, mental
health, and pharmacologic domains. The examination employs multiple-choice
and scenario-based questions to simulate real-world clinical decision-making in
primary care. Emphasis is placed on critical thinking, evidence-based practice,
diagnostic reasoning, and safe prescribing. This test bank prepares candidates for
the demands of the NSG 554 FNP Exam 4.
,SECTION ONE: QUESTIONS 1–300
Question 1
A 58-year-old man has BP 152/94 mmHg on two visits. He has no diabetes or CVD.
What is the most appropriate initial management?
A. Start lisinopril
B. Lifestyle modification and reassess in 1 month
C. Start hydrochlorothiazide
D. Start amlodipine
Correct answer: B
RATIONALE: Stage 1 hypertension without ASCVD, diabetes, or high risk can
initially be managed with lifestyle changes and reassessment. Option A, C, and D
are medications indicated if risk is high or lifestyle fails.
Question 2
A 65-year-old woman with HFrEF and LVEF 30% has persistent dyspnea. Which
medication class improves mortality?
A. Beta-blocker
B. Calcium channel blocker
C. Alpha-blocker
D. Loop diuretic
Correct answer: A
RATIONALE: Beta-blockers improve mortality in HFrEF. Option B can worsen
HF. Option C is not first-line. Option D treats congestion but does not improve
mortality.
Question 3
,A patient on warfarin has INR 6.2 without bleeding. What is the best next step?
A. Give vitamin K IV
B. Hold warfarin and give oral vitamin K
C. Give FFP
D. Continue warfarin and recheck in 1 week
Correct answer: B
RATIONALE: INR 6.2 without bleeding is managed by holding warfarin and
low-dose oral vitamin K. Option A is for severe bleeding. Option C is for major
bleeding. Option D is unsafe.
Question 4
A 70-year-old with atrial fibrillation and CHA2DS2-VASc 4 needs anticoagulation.
Which is preferred?
A. Aspirin
B. Apixaban
C. Clopidogrel
D. Warfarin only
Correct answer: B
RATIONALE: DOACs like apixaban are preferred over warfarin in most non-
valvular AF. Aspirin and clopidogrel are inadequate.
Question 5
Which finding is most consistent with acute decompensated heart failure?
A. Dry cough
B. Bibasilar crackles and JVD
C. Unilateral leg edema
D. Wheezing only
, Correct answer: B
RATIONALE: Crackles and JVD indicate pulmonary/systemic congestion.
Others are less specific.
Question 6
A 55-year-old has LDL 190 mg/dL and family history of premature CAD. What is
first-line?
A. Statin
B. Niacin
C. Fibrate
D. Fish oil
Correct answer: A
RATIONALE: High LDL warrants statin therapy. Others are adjuncts or not first-
line.
Question 7
A patient with stable angina has BP 128/78 and HR 72. Which medication is first-
line for symptom relief?
A. Nitroglycerin PRN
B. Beta-blocker
C. ACE inhibitor
D. Calcium channel blocker
Correct answer: B
RATIONALE: Beta-blockers are first-line antianginal. Nitroglycerin is PRN. ACE
inhibitors and CCBs are alternatives.
EXAM 4 REVIEW WITH 300 COMPLETE REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
CORE DOMAINS
• Cardiovascular Disorders
• Endocrine and Metabolic Disorders
• Respiratory Disorders
• Gastrointestinal and Hepatic Disorders
• Renal and Genitourinary Disorders
• Musculoskeletal and Rheumatologic Disorders
• Dermatologic Disorders
• Women's Health
• Men's Health
• Geriatric and Mental Health
• Pharmacology and Health Promotion
INTRODUCTION
This comprehensive assessment is designed to evaluate mastery of advanced
family nurse practitioner knowledge for NSG 554 Exam 4. It assesses competency
across cardiovascular, endocrine, respiratory, gastrointestinal, renal,
musculoskeletal, dermatologic, women's health, men's health, geriatric, mental
health, and pharmacologic domains. The examination employs multiple-choice
and scenario-based questions to simulate real-world clinical decision-making in
primary care. Emphasis is placed on critical thinking, evidence-based practice,
diagnostic reasoning, and safe prescribing. This test bank prepares candidates for
the demands of the NSG 554 FNP Exam 4.
,SECTION ONE: QUESTIONS 1–300
Question 1
A 58-year-old man has BP 152/94 mmHg on two visits. He has no diabetes or CVD.
What is the most appropriate initial management?
A. Start lisinopril
B. Lifestyle modification and reassess in 1 month
C. Start hydrochlorothiazide
D. Start amlodipine
Correct answer: B
RATIONALE: Stage 1 hypertension without ASCVD, diabetes, or high risk can
initially be managed with lifestyle changes and reassessment. Option A, C, and D
are medications indicated if risk is high or lifestyle fails.
Question 2
A 65-year-old woman with HFrEF and LVEF 30% has persistent dyspnea. Which
medication class improves mortality?
A. Beta-blocker
B. Calcium channel blocker
C. Alpha-blocker
D. Loop diuretic
Correct answer: A
RATIONALE: Beta-blockers improve mortality in HFrEF. Option B can worsen
HF. Option C is not first-line. Option D treats congestion but does not improve
mortality.
Question 3
,A patient on warfarin has INR 6.2 without bleeding. What is the best next step?
A. Give vitamin K IV
B. Hold warfarin and give oral vitamin K
C. Give FFP
D. Continue warfarin and recheck in 1 week
Correct answer: B
RATIONALE: INR 6.2 without bleeding is managed by holding warfarin and
low-dose oral vitamin K. Option A is for severe bleeding. Option C is for major
bleeding. Option D is unsafe.
Question 4
A 70-year-old with atrial fibrillation and CHA2DS2-VASc 4 needs anticoagulation.
Which is preferred?
A. Aspirin
B. Apixaban
C. Clopidogrel
D. Warfarin only
Correct answer: B
RATIONALE: DOACs like apixaban are preferred over warfarin in most non-
valvular AF. Aspirin and clopidogrel are inadequate.
Question 5
Which finding is most consistent with acute decompensated heart failure?
A. Dry cough
B. Bibasilar crackles and JVD
C. Unilateral leg edema
D. Wheezing only
, Correct answer: B
RATIONALE: Crackles and JVD indicate pulmonary/systemic congestion.
Others are less specific.
Question 6
A 55-year-old has LDL 190 mg/dL and family history of premature CAD. What is
first-line?
A. Statin
B. Niacin
C. Fibrate
D. Fish oil
Correct answer: A
RATIONALE: High LDL warrants statin therapy. Others are adjuncts or not first-
line.
Question 7
A patient with stable angina has BP 128/78 and HR 72. Which medication is first-
line for symptom relief?
A. Nitroglycerin PRN
B. Beta-blocker
C. ACE inhibitor
D. Calcium channel blocker
Correct answer: B
RATIONALE: Beta-blockers are first-line antianginal. Nitroglycerin is PRN. ACE
inhibitors and CCBs are alternatives.
