NSG 6998 APEA Predictor Final Exam Actual Exam
Style 2026/2027 | Nurse Practitioner Questions with
Verified Answers | 100% Correct | Pass Guaranteed
Grade A – Latest Update
Q01 A 45-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation.
Labs show TSH 12.4 mIU/L and free T4 0.6 ng/dL. What is the most likely diagnosis? Answer:
Primary hypothyroidism Rationale: Elevated TSH with low free T4 is diagnostic of primary
hypothyroidism (most commonly Hashimoto thyroiditis).
Q02 A 62-year-old man with type 2 diabetes has an A1C of 9.1% on metformin 1000 mg BID.
What is the most appropriate next pharmacologic agent? Answer: GLP-1 receptor agonist
Rationale: ADA guidelines recommend adding a GLP-1 RA (or SGLT2i) in patients with A1C
>8.5–9% despite metformin, especially with established CVD or high risk.
Q03 A 28-year-old woman at 34 weeks gestation has BP 152/96 mmHg, headache, and 2+
proteinuria. What is the definitive treatment? Answer: Delivery of the fetus Rationale: Severe
preeclampsia at ≥34 weeks is managed with prompt delivery after maternal stabilization.
Q04 A 55-year-old man with a 50-pack-year smoking history has a 2.8 cm solitary pulmonary
nodule on low-dose CT. What is the next most appropriate step? Answer: PET-CT scan
Rationale: For nodules 8–30 mm in high-risk patients, PET-CT is recommended to assess
metabolic activity before deciding on biopsy or surveillance.
Q05 A 48-year-old woman presents with palpitations, weight loss, heat intolerance, and fine
tremor. Labs show TSH <0.01 mIU/L and free T4 3.4 ng/dL. What is the most likely diagnosis?
Answer: Graves disease Rationale: Suppressed TSH with elevated free T4 in a young woman
with classic hyperthyroid symptoms is most consistent with Graves disease.
Q06 A 32-year-old woman presents with dysuria, frequency, and suprapubic pain. Urinalysis
shows pyuria and positive nitrites. What is the first-line treatment in a non-pregnant woman?
, Answer: Nitrofurantoin 100 mg BID × 5 days Rationale: Nitrofurantoin remains first-line for
uncomplicated cystitis per IDSA guidelines due to low resistance rates.
Q07 A 68-year-old man with hypertension is started on lisinopril. One week later he presents
with lip and tongue swelling without respiratory distress. What is the most likely cause?
Answer: ACE inhibitor-induced angioedema Rationale: Angioedema is a known adverse
effect of ACE inhibitors, occurring most commonly within the first week.
Q08 A 55-year-old man presents with chest pain radiating to the left arm, diaphoresis, and
nausea. ECG shows 3 mm ST elevation in leads V2–V4. What is the most likely diagnosis?
Answer: Anterior wall STEMI Rationale: ST elevation in V2–V4 indicates acute occlusion of
the left anterior descending artery (anterior MI).
Q09 A 72-year-old woman presents with acute right-sided weakness, facial droop, and aphasia.
CT head is negative for hemorrhage. What is the most appropriate initial treatment if within 4.5
hours? Answer: IV alteplase Rationale: Alteplase is indicated for acute ischemic stroke within
4.5 hours if no contraindications exist.
Q10 A 65-year-old man with atrial fibrillation on warfarin presents with INR 6.4 and no
bleeding. What is the most appropriate management? Answer: Hold warfarin and administer
low-dose oral vitamin K (1–2.5 mg) Rationale: INR >5 without bleeding is managed by
holding warfarin ± low-dose oral vitamin K.
Q11 A 40-year-old woman presents with heavy menstrual bleeding, fatigue, and pallor.
Hemoglobin 7.9 g/dL, ferritin 5 ng/mL. What is the most appropriate initial management?
Answer: Oral iron supplementation Rationale: Iron deficiency anemia is treated with oral iron
replacement (ferrous sulfate 325 mg daily).
Q12 A 25-year-old man presents with acute right testicular pain and swelling. Scrotal ultrasound
shows absent blood flow. What is the most appropriate management? Answer: Immediate
surgical exploration Rationale: Testicular torsion is a surgical emergency; detorsion within 6
hours maximizes salvage rate.
Style 2026/2027 | Nurse Practitioner Questions with
Verified Answers | 100% Correct | Pass Guaranteed
Grade A – Latest Update
Q01 A 45-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation.
Labs show TSH 12.4 mIU/L and free T4 0.6 ng/dL. What is the most likely diagnosis? Answer:
Primary hypothyroidism Rationale: Elevated TSH with low free T4 is diagnostic of primary
hypothyroidism (most commonly Hashimoto thyroiditis).
Q02 A 62-year-old man with type 2 diabetes has an A1C of 9.1% on metformin 1000 mg BID.
What is the most appropriate next pharmacologic agent? Answer: GLP-1 receptor agonist
Rationale: ADA guidelines recommend adding a GLP-1 RA (or SGLT2i) in patients with A1C
>8.5–9% despite metformin, especially with established CVD or high risk.
Q03 A 28-year-old woman at 34 weeks gestation has BP 152/96 mmHg, headache, and 2+
proteinuria. What is the definitive treatment? Answer: Delivery of the fetus Rationale: Severe
preeclampsia at ≥34 weeks is managed with prompt delivery after maternal stabilization.
Q04 A 55-year-old man with a 50-pack-year smoking history has a 2.8 cm solitary pulmonary
nodule on low-dose CT. What is the next most appropriate step? Answer: PET-CT scan
Rationale: For nodules 8–30 mm in high-risk patients, PET-CT is recommended to assess
metabolic activity before deciding on biopsy or surveillance.
Q05 A 48-year-old woman presents with palpitations, weight loss, heat intolerance, and fine
tremor. Labs show TSH <0.01 mIU/L and free T4 3.4 ng/dL. What is the most likely diagnosis?
Answer: Graves disease Rationale: Suppressed TSH with elevated free T4 in a young woman
with classic hyperthyroid symptoms is most consistent with Graves disease.
Q06 A 32-year-old woman presents with dysuria, frequency, and suprapubic pain. Urinalysis
shows pyuria and positive nitrites. What is the first-line treatment in a non-pregnant woman?
, Answer: Nitrofurantoin 100 mg BID × 5 days Rationale: Nitrofurantoin remains first-line for
uncomplicated cystitis per IDSA guidelines due to low resistance rates.
Q07 A 68-year-old man with hypertension is started on lisinopril. One week later he presents
with lip and tongue swelling without respiratory distress. What is the most likely cause?
Answer: ACE inhibitor-induced angioedema Rationale: Angioedema is a known adverse
effect of ACE inhibitors, occurring most commonly within the first week.
Q08 A 55-year-old man presents with chest pain radiating to the left arm, diaphoresis, and
nausea. ECG shows 3 mm ST elevation in leads V2–V4. What is the most likely diagnosis?
Answer: Anterior wall STEMI Rationale: ST elevation in V2–V4 indicates acute occlusion of
the left anterior descending artery (anterior MI).
Q09 A 72-year-old woman presents with acute right-sided weakness, facial droop, and aphasia.
CT head is negative for hemorrhage. What is the most appropriate initial treatment if within 4.5
hours? Answer: IV alteplase Rationale: Alteplase is indicated for acute ischemic stroke within
4.5 hours if no contraindications exist.
Q10 A 65-year-old man with atrial fibrillation on warfarin presents with INR 6.4 and no
bleeding. What is the most appropriate management? Answer: Hold warfarin and administer
low-dose oral vitamin K (1–2.5 mg) Rationale: INR >5 without bleeding is managed by
holding warfarin ± low-dose oral vitamin K.
Q11 A 40-year-old woman presents with heavy menstrual bleeding, fatigue, and pallor.
Hemoglobin 7.9 g/dL, ferritin 5 ng/mL. What is the most appropriate initial management?
Answer: Oral iron supplementation Rationale: Iron deficiency anemia is treated with oral iron
replacement (ferrous sulfate 325 mg daily).
Q12 A 25-year-old man presents with acute right testicular pain and swelling. Scrotal ultrasound
shows absent blood flow. What is the most appropriate management? Answer: Immediate
surgical exploration Rationale: Testicular torsion is a surgical emergency; detorsion within 6
hours maximizes salvage rate.
