NSG6998 PRE-PREDICTOR SOUTH
UNIVERSITY FNP EXAM 2026 | COMPLETE
STUDY GUIDE, PRACTICE QUESTIONS &
VERIFIED ANSWERS WITH RATIONALES
• This 200-question practice exam mirrors the NSG6998 FNP Pre-Predictor format
used at South University, covering the full scope of Family Nurse Practitioner board-
relevant clinical content tested in 2026.
• Use this material by reading each question carefully, selecting your answer before
checking the highlighted correct option, then studying the EXPERT RATIONALE
beneath it to reinforce clinical reasoning.
1. A 58-year-old male presents with crushing chest pain radiating to the left
arm, diaphoresis, and nausea for the past 45 minutes. ECG shows ST elevation
in leads II, III, and aVF. Which artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
E. Posterior descending artery
Correct Answer: C. Right coronary artery
EXPERT RATIONALE: ST elevation in leads II, III, and aVF indicates an inferior wall
MI. The right coronary artery (RCA) supplies the inferior wall of the left ventricle in
approximately 80% of patients, making RCA occlusion the most likely cause.
2. A 34-year-old female presents with fatigue, weight gain, cold intolerance,
constipation, and dry skin. TSH is 9.2 mIU/L and free T4 is low. What is the
most appropriate initial treatment?
A. Methimazole 10 mg daily
B. Propylthiouracil 100 mg three times daily
,C. Levothyroxine 25–50 mcg daily
D. Radioactive iodine ablation
E. Liothyronine 25 mcg daily
Correct Answer: C. Levothyroxine 25–50 mcg daily
EXPERT RATIONALE: The presentation is consistent with primary hypothyroidism.
Levothyroxine is the drug of choice. Lower starting doses are used in elderly or
cardiac patients; otherwise 1.6 mcg/kg/day is standard, starting low and titrating
based on TSH levels.
3. A 4-year-old presents with a barking cough, inspiratory stridor, and low-
grade fever. The child appears anxious but is maintaining oxygen saturation
at 97%. What is the most likely diagnosis?
A. Epiglottitis
B. Bacterial tracheitis
C. Foreign body aspiration
D. Croup (laryngotracheobronchitis)
E. Bronchiolitis
Correct Answer: D. Croup (laryngotracheobronchitis)
EXPERT RATIONALE: The classic triad of barking cough, inspiratory stridor, and
low-grade fever in a toddler describes croup, most commonly caused by
parainfluenza virus. Treatment includes corticosteroids and nebulized racemic
epinephrine for moderate-to-severe cases.
4. Which of the following findings is most consistent with bacterial vaginosis?
A. Thick, white, cottage cheese-like discharge with vulvar pruritus
B. Frothy, yellow-green discharge with strawberry cervix
,C. Thin, gray-white discharge with fishy odor and positive whiff test
D. Mucopurulent cervical discharge with dyspareunia
E. Bloody discharge with postcoital bleeding
Correct Answer: C. Thin, gray-white discharge with fishy odor and positive
whiff test EXPERT RATIONALE: Bacterial vaginosis is diagnosed using Amsel
criteria: thin gray-white discharge, pH >4.5, positive whiff test with KOH, and clue
cells on wet prep. The fishy odor results from volatile amines produced by
anaerobic bacteria.
5. A 72-year-old male with a history of hypertension and type 2 diabetes
presents with an acute onset of right-sided weakness and slurred speech that
resolved completely within 45 minutes. What is the most appropriate
immediate action?
A. Schedule an outpatient MRI in one week
B. Start aspirin and discharge home
C. Refer immediately to the emergency department for evaluation and imaging
D. Prescribe clopidogrel and follow up in 48 hours
E. Order carotid Doppler ultrasound and see in clinic next week
Correct Answer: C. Refer immediately to the emergency department for
evaluation and imaging
EXPERT RATIONALE: This presentation is a TIA, which carries a high short-term risk
of stroke. The ABCD2 score helps stratify risk, but all TIA patients require urgent
evaluation including brain imaging, vascular studies, and cardiac monitoring,
typically in an ED or stroke unit.
6. A 26-year-old female at 10 weeks gestation presents with severe nausea,
vomiting, and inability to keep fluids down. Her urine specific gravity is 1.030
and she has lost 5% of her body weight. What is the diagnosis?
, A. Morning sickness
B. Hyperemesis gravidarum
C. Gastroenteritis
D. Peptic ulcer disease
E. Cholestasis of pregnancy
Correct Answer: B. Hyperemesis gravidarum
EXPERT RATIONALE: Hyperemesis gravidarum is defined as persistent vomiting
during pregnancy causing greater than 5% weight loss, dehydration, ketonuria, and
electrolyte imbalances. It differs from morning sickness by severity and requires IV
fluids, antiemetics, and sometimes hospitalization.
7. A 45-year-old male with newly diagnosed hypertension also has a history of
benign prostatic hyperplasia (BPH). Which antihypertensive is most
appropriate?
A. Metoprolol succinate
B. Lisinopril
C. Doxazosin
D. Hydrochlorothiazide
E. Amlodipine
Correct Answer: C. Doxazosin
EXPERT RATIONALE: Alpha-1 blockers like doxazosin and terazosin treat both
hypertension and BPH simultaneously by relaxing smooth muscle in the prostate
and bladder neck while also reducing peripheral vascular resistance.
8. A child presents with a painless, non-tender scrotal mass that
transilluminates. There is no change in size with Valsalva. What is the most
likely diagnosis?
UNIVERSITY FNP EXAM 2026 | COMPLETE
STUDY GUIDE, PRACTICE QUESTIONS &
VERIFIED ANSWERS WITH RATIONALES
• This 200-question practice exam mirrors the NSG6998 FNP Pre-Predictor format
used at South University, covering the full scope of Family Nurse Practitioner board-
relevant clinical content tested in 2026.
• Use this material by reading each question carefully, selecting your answer before
checking the highlighted correct option, then studying the EXPERT RATIONALE
beneath it to reinforce clinical reasoning.
1. A 58-year-old male presents with crushing chest pain radiating to the left
arm, diaphoresis, and nausea for the past 45 minutes. ECG shows ST elevation
in leads II, III, and aVF. Which artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
E. Posterior descending artery
Correct Answer: C. Right coronary artery
EXPERT RATIONALE: ST elevation in leads II, III, and aVF indicates an inferior wall
MI. The right coronary artery (RCA) supplies the inferior wall of the left ventricle in
approximately 80% of patients, making RCA occlusion the most likely cause.
2. A 34-year-old female presents with fatigue, weight gain, cold intolerance,
constipation, and dry skin. TSH is 9.2 mIU/L and free T4 is low. What is the
most appropriate initial treatment?
A. Methimazole 10 mg daily
B. Propylthiouracil 100 mg three times daily
,C. Levothyroxine 25–50 mcg daily
D. Radioactive iodine ablation
E. Liothyronine 25 mcg daily
Correct Answer: C. Levothyroxine 25–50 mcg daily
EXPERT RATIONALE: The presentation is consistent with primary hypothyroidism.
Levothyroxine is the drug of choice. Lower starting doses are used in elderly or
cardiac patients; otherwise 1.6 mcg/kg/day is standard, starting low and titrating
based on TSH levels.
3. A 4-year-old presents with a barking cough, inspiratory stridor, and low-
grade fever. The child appears anxious but is maintaining oxygen saturation
at 97%. What is the most likely diagnosis?
A. Epiglottitis
B. Bacterial tracheitis
C. Foreign body aspiration
D. Croup (laryngotracheobronchitis)
E. Bronchiolitis
Correct Answer: D. Croup (laryngotracheobronchitis)
EXPERT RATIONALE: The classic triad of barking cough, inspiratory stridor, and
low-grade fever in a toddler describes croup, most commonly caused by
parainfluenza virus. Treatment includes corticosteroids and nebulized racemic
epinephrine for moderate-to-severe cases.
4. Which of the following findings is most consistent with bacterial vaginosis?
A. Thick, white, cottage cheese-like discharge with vulvar pruritus
B. Frothy, yellow-green discharge with strawberry cervix
,C. Thin, gray-white discharge with fishy odor and positive whiff test
D. Mucopurulent cervical discharge with dyspareunia
E. Bloody discharge with postcoital bleeding
Correct Answer: C. Thin, gray-white discharge with fishy odor and positive
whiff test EXPERT RATIONALE: Bacterial vaginosis is diagnosed using Amsel
criteria: thin gray-white discharge, pH >4.5, positive whiff test with KOH, and clue
cells on wet prep. The fishy odor results from volatile amines produced by
anaerobic bacteria.
5. A 72-year-old male with a history of hypertension and type 2 diabetes
presents with an acute onset of right-sided weakness and slurred speech that
resolved completely within 45 minutes. What is the most appropriate
immediate action?
A. Schedule an outpatient MRI in one week
B. Start aspirin and discharge home
C. Refer immediately to the emergency department for evaluation and imaging
D. Prescribe clopidogrel and follow up in 48 hours
E. Order carotid Doppler ultrasound and see in clinic next week
Correct Answer: C. Refer immediately to the emergency department for
evaluation and imaging
EXPERT RATIONALE: This presentation is a TIA, which carries a high short-term risk
of stroke. The ABCD2 score helps stratify risk, but all TIA patients require urgent
evaluation including brain imaging, vascular studies, and cardiac monitoring,
typically in an ED or stroke unit.
6. A 26-year-old female at 10 weeks gestation presents with severe nausea,
vomiting, and inability to keep fluids down. Her urine specific gravity is 1.030
and she has lost 5% of her body weight. What is the diagnosis?
, A. Morning sickness
B. Hyperemesis gravidarum
C. Gastroenteritis
D. Peptic ulcer disease
E. Cholestasis of pregnancy
Correct Answer: B. Hyperemesis gravidarum
EXPERT RATIONALE: Hyperemesis gravidarum is defined as persistent vomiting
during pregnancy causing greater than 5% weight loss, dehydration, ketonuria, and
electrolyte imbalances. It differs from morning sickness by severity and requires IV
fluids, antiemetics, and sometimes hospitalization.
7. A 45-year-old male with newly diagnosed hypertension also has a history of
benign prostatic hyperplasia (BPH). Which antihypertensive is most
appropriate?
A. Metoprolol succinate
B. Lisinopril
C. Doxazosin
D. Hydrochlorothiazide
E. Amlodipine
Correct Answer: C. Doxazosin
EXPERT RATIONALE: Alpha-1 blockers like doxazosin and terazosin treat both
hypertension and BPH simultaneously by relaxing smooth muscle in the prostate
and bladder neck while also reducing peripheral vascular resistance.
8. A child presents with a painless, non-tender scrotal mass that
transilluminates. There is no change in size with Valsalva. What is the most
likely diagnosis?
