NSG 6998 Exam | Multiple Choice Practice
Questions & Answers
NSG 6998 Exam | Multiple Choice Practice Questions & Answers
Examination Overview
This comprehensive examination contains 200 multiple-choice questions designed to assess
readiness for the NSG 6998 capstone course, which synthesizes knowledge across the Family Nurse
Practitioner curriculum. The examination covers advanced health assessment, diagnostic reasoning,
pharmacotherapeutics, pathophysiology, health promotion, professional role transition, evidence-
based practice, and legal/ethical considerations relevant to autonomous NP practice.
Format: Each question presents a clinical scenario or knowledge-based prompt with four answer
options. The correct answer is identified with a complete rationale explaining the underlying concept
and distinguishing it from distractors.
Table of Contents
Section Questions Topic Area
I 1–20 Cardiovascular Disorders
II 21–40 Respiratory Disorders
III 41–60 Endocrine & Metabolic Disorders
IV 61–80 Gastrointestinal & Renal Disorders
V 81–100 Musculoskeletal & Neurologic Disorders
VI 101–120 Dermatologic & HEENT Disorders
VII 121–140 Pediatrics & Women's Health
VIII 141–160 Pharmacology & Therapeutics
IX 161–180 Health Promotion & Disease Prevention
X 181–200 Professional Role, Ethics & Practice Management
pg. 1
,Questions 1–200
Section I: Cardiovascular Disorders
Q1. A 58-year-old male presents with chest pressure that occurs with exertion and resolves with
rest. He describes the sensation as "heavy pressure" in the substernal area radiating to the left jaw.
Which finding is most consistent with stable angina?
A. Pain that is sharp and pleuritic, worsening with inspiration
B. Pain reproducible with palpation of the chest wall
C. Pain provoked by exertion and relieved within minutes by rest or nitroglycerin
D. Pain constant for hours with diaphoresis and nausea
Correct Answer: C. Pain provoked by exertion and relieved within minutes by rest or nitroglycerin
Rationale: Stable angina is characterized by chest discomfort provoked by physical exertion or
emotional stress that is relieved by rest or sublingual nitroglycerin within 5–10 minutes. Pleuritic
pain suggests pericarditis. Reproducible pain with palpation suggests costochondritis. Prolonged
pain with diaphoresis and nausea suggests acute myocardial infarction.
Q2. A 65-year-old male presents with sudden onset of severe, tearing chest pain radiating to the
back. Blood pressure is 100/50 in the right arm and 140/80 in the left arm. Which diagnosis is most
likely?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct Answer: C. Aortic dissection
Rationale: Aortic dissection presents with sudden, severe, tearing chest pain radiating to the back
and differential blood pressures between arms. This is a surgical emergency requiring immediate CT
angiography or transesophageal echocardiogram. MI, PE, and pericarditis do not cause differential
blood pressure readings.
Q3. A client with heart failure is prescribed carvedilol. Which assessment finding would indicate the
medication is having the desired therapeutic effect?
A. Increased blood pressure
B. Decreased heart rate and improved ejection fraction
C. Increased shortness of breath
D. Weight gain of 3 pounds in 24 hours
Correct Answer: B. Decreased heart rate and improved ejection fraction
Rationale: Carvedilol is a beta-blocker used in heart failure to reduce heart rate, decrease
myocardial oxygen demand, and improve left ventricular ejection fraction over time. Desired effects
include reduced heart rate, improved EF, and reduced symptoms. Weight gain and increased
dyspnea indicate worsening heart failure.
pg. 2
,Q4. A client with atrial fibrillation is prescribed apixaban. Which statement by the client indicates
understanding of this medication?
A. "I will need monthly blood tests to check my levels."
B. "I will stop taking this medication if I notice bruising."
C. "I will report any signs of bleeding, such as blood in my urine or black tarry stools."
D. "I will take this medication with food every morning."
Correct Answer: C. "I will report any signs of bleeding, such as blood in my urine or black tarry
stools."
Rationale: Direct oral anticoagulants do not require routine INR monitoring, but patients must be
educated about signs of bleeding. Black tarry stools may indicate GI bleeding. Patients should not
stop DOACs without provider instructions due to increased stroke risk.
Q5. During cardiac auscultation, you hear a mid-systolic click followed by a late systolic murmur at
the apex, best heard with the bell. This is most consistent with:
A. Aortic stenosis
B. Mitral valve prolapse
C. Hypertrophic cardiomyopathy
D. Tricuspid regurgitation
Correct Answer: B. Mitral valve prolapse
Rationale: Mitral valve prolapse is characterized by a mid-systolic click followed by a late systolic
murmur at the apex. The click represents chordae tendineae tension, and the murmur represents
mitral regurgitation. The murmur may increase with standing or Valsalva maneuver.
Q6. A 72-year-old female with hypertension and diabetes presents with bilateral lower extremity
edema, jugular venous distension, and an S3 gallop. Which diagnosis is most likely?
A. Nephrotic syndrome
B. Cirrhosis
C. Heart failure with reduced ejection fraction
D. Chronic venous insufficiency
Correct Answer: C. Heart failure with reduced ejection fraction
Rationale: The combination of bilateral edema, JVD, and an S3 gallop is classic for heart failure with
reduced ejection fraction. S3 gallop indicates volume overload and ventricular dysfunction.
Nephrotic syndrome and cirrhosis may cause edema but do not typically present with JVD or S3.
Q7. A patient on warfarin has an INR of 6.5 and no active bleeding. Which intervention is most
appropriate?
pg. 3
, A. Administer vitamin K 10 mg IV
B. Hold warfarin and administer oral vitamin K 2.5 mg
C. Continue warfarin at the same dose
D. Administer fresh frozen plasma immediately
Correct Answer: B. Hold warfarin and administer oral vitamin K 2.5 mg
Rationale: For an INR of 5–9 without bleeding, guidelines recommend holding warfarin and
administering low-dose oral vitamin K (2.5 mg). IV vitamin K and FFP are reserved for serious
bleeding or very high INR with bleeding risk. Continuing warfarin would increase bleeding risk.
Q8. Which ECG finding is most characteristic of hyperkalemia?
A. Prolonged QT interval
B. Tall, peaked T waves
C. Prominent U waves
D. ST elevation
Correct Answer: B. Tall, peaked T waves
Rationale: Hyperkalemia classically presents with tall, peaked T waves, followed by widening of the
QRS complex and eventually a sine wave pattern. Prominent U waves are associated with
hypokalemia. Prolonged QT and ST elevation have other etiologies.
Q9. A 45-year-old male with no prior cardiac history presents with palpitations. ECG shows
irregularly irregular rhythm with absent P waves. Which is the most appropriate initial management?
A. Immediate cardioversion
B. Rate control with beta-blocker or calcium channel blocker
C. Amiodarone infusion
D. Observation without intervention
Correct Answer: B. Rate control with beta-blocker or calcium channel blocker
Rationale: New-onset atrial fibrillation is initially managed with rate control using beta-blockers or
non-dihydropyridine calcium channel blockers. Cardioversion is considered after rate control and
anticoagulation assessment. Amiodarone is typically for rhythm control in specific circumstances.
Q10. Which finding on physical examination is most consistent with abdominal aortic aneurysm?
A. Pulsatile mass in the epigastric area
B. Murphy's sign
C. McBurney's point tenderness
D. Cullen's sign
Correct Answer: A. Pulsatile mass in the epigastric area
pg. 4
Questions & Answers
NSG 6998 Exam | Multiple Choice Practice Questions & Answers
Examination Overview
This comprehensive examination contains 200 multiple-choice questions designed to assess
readiness for the NSG 6998 capstone course, which synthesizes knowledge across the Family Nurse
Practitioner curriculum. The examination covers advanced health assessment, diagnostic reasoning,
pharmacotherapeutics, pathophysiology, health promotion, professional role transition, evidence-
based practice, and legal/ethical considerations relevant to autonomous NP practice.
Format: Each question presents a clinical scenario or knowledge-based prompt with four answer
options. The correct answer is identified with a complete rationale explaining the underlying concept
and distinguishing it from distractors.
Table of Contents
Section Questions Topic Area
I 1–20 Cardiovascular Disorders
II 21–40 Respiratory Disorders
III 41–60 Endocrine & Metabolic Disorders
IV 61–80 Gastrointestinal & Renal Disorders
V 81–100 Musculoskeletal & Neurologic Disorders
VI 101–120 Dermatologic & HEENT Disorders
VII 121–140 Pediatrics & Women's Health
VIII 141–160 Pharmacology & Therapeutics
IX 161–180 Health Promotion & Disease Prevention
X 181–200 Professional Role, Ethics & Practice Management
pg. 1
,Questions 1–200
Section I: Cardiovascular Disorders
Q1. A 58-year-old male presents with chest pressure that occurs with exertion and resolves with
rest. He describes the sensation as "heavy pressure" in the substernal area radiating to the left jaw.
Which finding is most consistent with stable angina?
A. Pain that is sharp and pleuritic, worsening with inspiration
B. Pain reproducible with palpation of the chest wall
C. Pain provoked by exertion and relieved within minutes by rest or nitroglycerin
D. Pain constant for hours with diaphoresis and nausea
Correct Answer: C. Pain provoked by exertion and relieved within minutes by rest or nitroglycerin
Rationale: Stable angina is characterized by chest discomfort provoked by physical exertion or
emotional stress that is relieved by rest or sublingual nitroglycerin within 5–10 minutes. Pleuritic
pain suggests pericarditis. Reproducible pain with palpation suggests costochondritis. Prolonged
pain with diaphoresis and nausea suggests acute myocardial infarction.
Q2. A 65-year-old male presents with sudden onset of severe, tearing chest pain radiating to the
back. Blood pressure is 100/50 in the right arm and 140/80 in the left arm. Which diagnosis is most
likely?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct Answer: C. Aortic dissection
Rationale: Aortic dissection presents with sudden, severe, tearing chest pain radiating to the back
and differential blood pressures between arms. This is a surgical emergency requiring immediate CT
angiography or transesophageal echocardiogram. MI, PE, and pericarditis do not cause differential
blood pressure readings.
Q3. A client with heart failure is prescribed carvedilol. Which assessment finding would indicate the
medication is having the desired therapeutic effect?
A. Increased blood pressure
B. Decreased heart rate and improved ejection fraction
C. Increased shortness of breath
D. Weight gain of 3 pounds in 24 hours
Correct Answer: B. Decreased heart rate and improved ejection fraction
Rationale: Carvedilol is a beta-blocker used in heart failure to reduce heart rate, decrease
myocardial oxygen demand, and improve left ventricular ejection fraction over time. Desired effects
include reduced heart rate, improved EF, and reduced symptoms. Weight gain and increased
dyspnea indicate worsening heart failure.
pg. 2
,Q4. A client with atrial fibrillation is prescribed apixaban. Which statement by the client indicates
understanding of this medication?
A. "I will need monthly blood tests to check my levels."
B. "I will stop taking this medication if I notice bruising."
C. "I will report any signs of bleeding, such as blood in my urine or black tarry stools."
D. "I will take this medication with food every morning."
Correct Answer: C. "I will report any signs of bleeding, such as blood in my urine or black tarry
stools."
Rationale: Direct oral anticoagulants do not require routine INR monitoring, but patients must be
educated about signs of bleeding. Black tarry stools may indicate GI bleeding. Patients should not
stop DOACs without provider instructions due to increased stroke risk.
Q5. During cardiac auscultation, you hear a mid-systolic click followed by a late systolic murmur at
the apex, best heard with the bell. This is most consistent with:
A. Aortic stenosis
B. Mitral valve prolapse
C. Hypertrophic cardiomyopathy
D. Tricuspid regurgitation
Correct Answer: B. Mitral valve prolapse
Rationale: Mitral valve prolapse is characterized by a mid-systolic click followed by a late systolic
murmur at the apex. The click represents chordae tendineae tension, and the murmur represents
mitral regurgitation. The murmur may increase with standing or Valsalva maneuver.
Q6. A 72-year-old female with hypertension and diabetes presents with bilateral lower extremity
edema, jugular venous distension, and an S3 gallop. Which diagnosis is most likely?
A. Nephrotic syndrome
B. Cirrhosis
C. Heart failure with reduced ejection fraction
D. Chronic venous insufficiency
Correct Answer: C. Heart failure with reduced ejection fraction
Rationale: The combination of bilateral edema, JVD, and an S3 gallop is classic for heart failure with
reduced ejection fraction. S3 gallop indicates volume overload and ventricular dysfunction.
Nephrotic syndrome and cirrhosis may cause edema but do not typically present with JVD or S3.
Q7. A patient on warfarin has an INR of 6.5 and no active bleeding. Which intervention is most
appropriate?
pg. 3
, A. Administer vitamin K 10 mg IV
B. Hold warfarin and administer oral vitamin K 2.5 mg
C. Continue warfarin at the same dose
D. Administer fresh frozen plasma immediately
Correct Answer: B. Hold warfarin and administer oral vitamin K 2.5 mg
Rationale: For an INR of 5–9 without bleeding, guidelines recommend holding warfarin and
administering low-dose oral vitamin K (2.5 mg). IV vitamin K and FFP are reserved for serious
bleeding or very high INR with bleeding risk. Continuing warfarin would increase bleeding risk.
Q8. Which ECG finding is most characteristic of hyperkalemia?
A. Prolonged QT interval
B. Tall, peaked T waves
C. Prominent U waves
D. ST elevation
Correct Answer: B. Tall, peaked T waves
Rationale: Hyperkalemia classically presents with tall, peaked T waves, followed by widening of the
QRS complex and eventually a sine wave pattern. Prominent U waves are associated with
hypokalemia. Prolonged QT and ST elevation have other etiologies.
Q9. A 45-year-old male with no prior cardiac history presents with palpitations. ECG shows
irregularly irregular rhythm with absent P waves. Which is the most appropriate initial management?
A. Immediate cardioversion
B. Rate control with beta-blocker or calcium channel blocker
C. Amiodarone infusion
D. Observation without intervention
Correct Answer: B. Rate control with beta-blocker or calcium channel blocker
Rationale: New-onset atrial fibrillation is initially managed with rate control using beta-blockers or
non-dihydropyridine calcium channel blockers. Cardioversion is considered after rate control and
anticoagulation assessment. Amiodarone is typically for rhythm control in specific circumstances.
Q10. Which finding on physical examination is most consistent with abdominal aortic aneurysm?
A. Pulsatile mass in the epigastric area
B. Murphy's sign
C. McBurney's point tenderness
D. Cullen's sign
Correct Answer: A. Pulsatile mass in the epigastric area
pg. 4
