9/24/25, 11:11 PM NSG 6998 Pre-Predictor and Predictor Test Bank Updated 2025/2026 – Nursing Exam Prep Questions and Answer Guide with Sol…
NSG 6998 Pre-Predictor and Predictor Test
Bank Updated 2025/2026 – Nursing Exam
Prep Questions and Answer Guide with
Solutions and Test Bank
Question 1
Prescriptive authority:
Correct Answer
may be exercised by giving a verbal medication order to a pharmacist.
An example of exercising prescriptive authority is giving a verbal order to a
pharmacist or writing an order for a prescription medication. Prescriptive authority
rules and regulations vary from state to state. Prescriptive authority is granted only
to those APRNs who meet the requirements of the governing body for the state in
which the APRN practices.
Rationale:
Prescriptive authority allows APRNs to instruct pharmacists on medication orders, making it a
crucial aspect of their professional capabilities. By granting APRNs the ability to provide verbal
medication orders, prescriptive authority enables them to streamline the process, improve patient
care, and work efficiently with other healthcare professionals.
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,9/24/25, 11:11 PM NSG 6998 Pre-Predictor and Predictor Test Bank Updated 2025/2026 – Nursing Exam Prep Questions and Answer Guide with Sol…
Question 2
When examining a pregnant patient, where should the fundal height be at 22 weeks?
Correct Answer
Above the umbilicus
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly
above the symphysis pubis 16 weeks: fundus midway between the symphysis pubis
and umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3
fingerbreadths above the umbilicus 36 weeks: fundus just below the xiphoid process
Rationale:
The expected fundal height at 22 weeks correlates with the pattern of growth between 20 and 28
weeks, as it falls between the fundus at the level of the umbilicus and 3 fingerbreadths above the
umbilicus. By extrapolating from the given measurements, the fundal height at 22 weeks would
logically be somewhere between the umbilicus and 3 fingerbreadths above the umbilicus,
indicating a gradual increase in height as the pregnancy progresses.
Question 3
What intervention does the American College of Rheumatology recommend as first-
line therapy for osteoarthritis?
Correct Answer
Exercise and weight loss
Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA). Given
the adverse effects of medications used to treat OA, it is best to minimize dosage
and delay use as long as possible. An extensive diagnostic workup is not
recommended unless the presentation is in question. Patients who have severe
degenerative joint disease (DJD), joint fusion, or whose pain severity is not relieved
by more conservative therapies may be candidates for joint replacement.
Acetaminophen is recommended as a first-line medication.
Rationale:
The American College of Rheumatology recommends exercise and weight loss as first-line therapy
due to their non-invasive and non-pharmacological nature, which aligns with the goal of
minimizing medication dosage and delaying use whenever possible. This approach also
emphasizes conservative management, reserving more invasive treatments like joint replacement
for severe cases where conservative therapies are ineffective.
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,9/24/25, 11:11 PM NSG 6998 Pre-Predictor and Predictor Test Bank Updated 2025/2026 – Nursing Exam Prep Questions and Answer Guide with Sol…
Question 4
A 63-year-old male retired accountant complains of pain and stiffness in his feet and
hands of several years duration. He reports that the pain and stiffness become worse
with activity. On examination, he is noted to have Heberden's nodes but no other
bony deformities. Which of the following is the most probable diagnosis?
Correct Answer
Osteoarthritis (OA)
Although his vocation involved sedentary activity, this patient is not at great risk for
osteoarthritis. Rheumatoid arthritis is characterized by several joint deformities,
usually bilaterally symmetrical. RA is characterized by inflammatory processes, while
OA is not. RA and OA are chronic conditions. Gout is characterized by acute
exacerbations related to a defect in purine metabolism, increased uric acid
production, or decreased uric acid excretion.
Rationale:
The patient's symptoms of pain and stiffness worsening with activity, along with the presence of
Heberden's nodes, are characteristic of osteoarthritis (OA), a condition that typically affects
weight-bearing joints and joints involved in repetitive motion. The absence of inflammatory
processes, joint deformities, and acute exacerbations also points away from rheumatoid arthritis
and gout, respectively, supporting the diagnosis of OA.
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, 9/24/25, 11:11 PM NSG 6998 Pre-Predictor and Predictor Test Bank Updated 2025/2026 – Nursing Exam Prep Questions and Answer Guide with Sol…
Question 5
The family of a 78-year-old man moved him into an assisted living center because he
can no longer be left at home alone. He is unable to toilet when asked to do so and
he has had several episodes of incontinence. He has walked out of the facility twice
and been unable to find his way back from 3 blocks away. On examination, he is
pleasant but mildly confused. Which of his medications is LEAST likely contributing to
his behavior?
Correct Answer
ramipril (Altace®)
Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects which
are especially problematic in the elderly because they contribute to urinary
retention. Hydrochlorothiazide is a diuretic and may contribute to his incontinence.
Cimetidine is well known to produce adverse reactions such as confusion in elders.
Ramipril, an ACE inhibitor, is unlikely to contribute to this patient's incontinence or
confusion. Toileting may be a complicated by the anticholinergic medication and/or
the diuretic causing diuresis, urge incontinence, and inability to void at will.
Rationale:
Ramipril is an ACE inhibitor, and ACE inhibitors are known to have fewer side effects that
contribute to confusion and incontinence in the elderly, making it the least likely medication to
contribute to the patient's behavior. This is because ACE inhibitors do not have the anticholinergic
or diuretic effects that are problematic in this scenario.
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NSG 6998 Pre-Predictor and Predictor Test
Bank Updated 2025/2026 – Nursing Exam
Prep Questions and Answer Guide with
Solutions and Test Bank
Question 1
Prescriptive authority:
Correct Answer
may be exercised by giving a verbal medication order to a pharmacist.
An example of exercising prescriptive authority is giving a verbal order to a
pharmacist or writing an order for a prescription medication. Prescriptive authority
rules and regulations vary from state to state. Prescriptive authority is granted only
to those APRNs who meet the requirements of the governing body for the state in
which the APRN practices.
Rationale:
Prescriptive authority allows APRNs to instruct pharmacists on medication orders, making it a
crucial aspect of their professional capabilities. By granting APRNs the ability to provide verbal
medication orders, prescriptive authority enables them to streamline the process, improve patient
care, and work efficiently with other healthcare professionals.
Page 1 of 65
1/65
,9/24/25, 11:11 PM NSG 6998 Pre-Predictor and Predictor Test Bank Updated 2025/2026 – Nursing Exam Prep Questions and Answer Guide with Sol…
Question 2
When examining a pregnant patient, where should the fundal height be at 22 weeks?
Correct Answer
Above the umbilicus
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly
above the symphysis pubis 16 weeks: fundus midway between the symphysis pubis
and umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3
fingerbreadths above the umbilicus 36 weeks: fundus just below the xiphoid process
Rationale:
The expected fundal height at 22 weeks correlates with the pattern of growth between 20 and 28
weeks, as it falls between the fundus at the level of the umbilicus and 3 fingerbreadths above the
umbilicus. By extrapolating from the given measurements, the fundal height at 22 weeks would
logically be somewhere between the umbilicus and 3 fingerbreadths above the umbilicus,
indicating a gradual increase in height as the pregnancy progresses.
Question 3
What intervention does the American College of Rheumatology recommend as first-
line therapy for osteoarthritis?
Correct Answer
Exercise and weight loss
Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA). Given
the adverse effects of medications used to treat OA, it is best to minimize dosage
and delay use as long as possible. An extensive diagnostic workup is not
recommended unless the presentation is in question. Patients who have severe
degenerative joint disease (DJD), joint fusion, or whose pain severity is not relieved
by more conservative therapies may be candidates for joint replacement.
Acetaminophen is recommended as a first-line medication.
Rationale:
The American College of Rheumatology recommends exercise and weight loss as first-line therapy
due to their non-invasive and non-pharmacological nature, which aligns with the goal of
minimizing medication dosage and delaying use whenever possible. This approach also
emphasizes conservative management, reserving more invasive treatments like joint replacement
for severe cases where conservative therapies are ineffective.
Page 2 of 65
2/65
,9/24/25, 11:11 PM NSG 6998 Pre-Predictor and Predictor Test Bank Updated 2025/2026 – Nursing Exam Prep Questions and Answer Guide with Sol…
Question 4
A 63-year-old male retired accountant complains of pain and stiffness in his feet and
hands of several years duration. He reports that the pain and stiffness become worse
with activity. On examination, he is noted to have Heberden's nodes but no other
bony deformities. Which of the following is the most probable diagnosis?
Correct Answer
Osteoarthritis (OA)
Although his vocation involved sedentary activity, this patient is not at great risk for
osteoarthritis. Rheumatoid arthritis is characterized by several joint deformities,
usually bilaterally symmetrical. RA is characterized by inflammatory processes, while
OA is not. RA and OA are chronic conditions. Gout is characterized by acute
exacerbations related to a defect in purine metabolism, increased uric acid
production, or decreased uric acid excretion.
Rationale:
The patient's symptoms of pain and stiffness worsening with activity, along with the presence of
Heberden's nodes, are characteristic of osteoarthritis (OA), a condition that typically affects
weight-bearing joints and joints involved in repetitive motion. The absence of inflammatory
processes, joint deformities, and acute exacerbations also points away from rheumatoid arthritis
and gout, respectively, supporting the diagnosis of OA.
Page 3 of 65
3/65
, 9/24/25, 11:11 PM NSG 6998 Pre-Predictor and Predictor Test Bank Updated 2025/2026 – Nursing Exam Prep Questions and Answer Guide with Sol…
Question 5
The family of a 78-year-old man moved him into an assisted living center because he
can no longer be left at home alone. He is unable to toilet when asked to do so and
he has had several episodes of incontinence. He has walked out of the facility twice
and been unable to find his way back from 3 blocks away. On examination, he is
pleasant but mildly confused. Which of his medications is LEAST likely contributing to
his behavior?
Correct Answer
ramipril (Altace®)
Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects which
are especially problematic in the elderly because they contribute to urinary
retention. Hydrochlorothiazide is a diuretic and may contribute to his incontinence.
Cimetidine is well known to produce adverse reactions such as confusion in elders.
Ramipril, an ACE inhibitor, is unlikely to contribute to this patient's incontinence or
confusion. Toileting may be a complicated by the anticholinergic medication and/or
the diuretic causing diuresis, urge incontinence, and inability to void at will.
Rationale:
Ramipril is an ACE inhibitor, and ACE inhibitors are known to have fewer side effects that
contribute to confusion and incontinence in the elderly, making it the least likely medication to
contribute to the patient's behavior. This is because ACE inhibitors do not have the anticholinergic
or diuretic effects that are problematic in this scenario.
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