Pre-Predictor Exam NSG6998 South University FNP Revised 2026–
2028 | Practice Questions & Answers | Complete Study Guide
Category Details
Course NSG6998 – Transition to Professional Nurse Practitioner Role
Institution South University
Exam Type Pre-Predictor Exam / APEA Predictor Exam
Format Multiple-choice, scenario-based questions
Advanced physical assessment, cardiovascular, respiratory, endocrine, gastrointestinal,
Focus
genitourinary, musculoskeletal, neurologic, infectious disease, dermatology, pharmacology
Areas
professional practice
Question 1
A 24-year-old female presents to the clinic complaining of severe facial swelling and
painful cheeks. On physical examination, you note bilateral parotid gland swelling,
giving her a distinct "chipmunk" appearance. Which of the following is the most likely
diagnosis?
A) Sialolithiasis
B) Mumps
C) Ludwig's Angina
D) Mononucleosis
Correct Answer: B) Mumps
Rationale: Mumps is an acute viral infection characterized by painful swelling of the
parotid glands, often referred to visually as "chipmunk" facies. Sialolithiasis usually
presents as unilateral salivary gland obstruction. Ludwig's angina is a life-threatening
infection of the submandibular space, not isolated parotitis.
,Question 2
An 18-year-old patient presents with a severe sore throat, significant fatigue, and
cervical lymphadenopathy. The Family Nurse Practitioner suspects infectious
mononucleosis. Which clinical action is most appropriate?
A) Order an immediate Heterophil antibody test (Monospot) and CBC
B) Initiate a 10-day course of oral amoxicillin
C) Perform vigorous abdominal palpation to check for splenomegaly
D) Prescription of oral acyclovir to shorten symptom duration
Correct Answer: A) Order an immediate Heterophil antibody test (Monospot) and
CBC
Rationale: The Heterophil antibody test (Monospot) along with a Complete Blood Count
showing atypical lymphocytes is the standard diagnostic protocol for infectious
mononucleosis. Amoxicillin must be avoided as it frequently triggers a maculopapular
rash in these patients. Deep or vigorous abdominal palpation is strictly contraindicated
due to the risk of splenic rupture, and antivirals provide no clinical benefit.
Question 3
During a routine physical examination on a 42-year-old female, the clinician auscultates
a distinct systolic bruit directly over the thyroid gland. This finding is most highly
suggestive of which endocrine pathology?
A) Hashimoto's thyroiditis
B) Thyroid malignancy
C) Graves' disease
D) Subacute thyroiditis
Correct Answer: C) Graves' disease
Rationale: A thyroid bruit is highly specific to hyperthyroidism, most commonly Graves'
disease. It occurs due to the marked increase in glandular vascularity and blood flow.
Hashimoto's thyroiditis typically presents as a firm, nontender, diffusely enlarged goiter
without a vascular bruit. Malignancies present as discrete, hard nodules.
Question 4
A 16-year-old male presents with severe, painful nodulocystic acne covering his face,
chest, and upper back. He has tried topical retinoids and oral doxycycline for six months
with zero clinical improvement. What is the most appropriate next-line treatment?
A) Topical clindamycin monotherapy
B) Oral isotretinoin
,C) Increased dosing of oral doxycycline
D) Intralesional corticosteroid injections
Correct Answer: B) Oral isotretinoin
Rationale: Oral isotretinoin is the gold-standard, first-line agent for severe, scarring
nodulocystic acne that has proven refractory to conservative therapies like oral
antibiotics and topical retinoids. Topical clindamycin will not be effective for severe
cystic lesions, and increasing the doxycycline dose risks toxicity without significant
therapeutic gain.
Question 5
A 68-year-old male with a history of hypertension presents with severe, spontaneous
bleeding from his right nares. After attempting direct pressure for 15 minutes, the
bleeding continues. If the source is localized to Kiesselbach's plexus, this represents an
injury to which anatomical region?
A) Posterior nasal cavity
B) Superior turbinate
C) Anterior nasal septum
D) Nasopharyngeal vault
Correct Answer: C) Anterior nasal septum
Rationale: Kiesselbach's plexus is a highly vascular network located on the anterior
nasal septum. It is responsible for over 90% of all epistaxis cases and is easily
accessible for direct visualization and local cautery or packing. Posterior nosebleeds
involve the sphenopalatine artery and are much more difficult to manage.
Question 6
A 45-year-old male presents with rapidly progressive swelling of the lower jaw, severe
tongue elevation, and difficulty swallowing. He notes he had a severe toothache last
week. The clinician notes a woody, firm induration of the submandibular space. What is
the most critical immediate priority?
A) Order an outpatient neck CT scan
B) Prescribe oral amoxicillin-clavulanate
C) Secure the airway and arrange emergency transfer
D) Perform an incision and drainage in the clinic
Correct Answer: C) Secure the airway and arrange emergency transfer
Rationale: This presentation describes Ludwig's angina, a rapidly expanding cellulitis of
the submandibular space typically originating from an infected lower molar. The highest
, priority is securing the airway, as tongue displacement leads to complete occlusion.
Outpatient management or delayed imaging is unsafe.
Question 7
A 34-year-old female presents for evaluation of a thyroid nodule. Laboratory results
reveal a normal TSH level. Her physical exam reveals a firm, nontender, diffusely
enlarged thyroid. Anti-thyroid peroxidase (anti-TPO) antibodies are highly elevated.
What is the most likely diagnosis?
A) Graves' disease
B) Hashimoto's thyroiditis
C) Toxic multinodular goiter
D) Subacute granulomatous thyroiditis
Correct Answer: B) Hashimoto's thyroiditis
Rationale: Hashimoto's thyroiditis is the most common cause of hypothyroidism in the
US, but patients can initially present in euthyroid or hyperthyroid states (Hashitoxicosis).
A firm, nontender, diffusely enlarged thyroid combined with elevated anti-TPO
antibodies confirms this autoimmune condition.
Question 8
A 52-year-old male smoker presents with a dry, hacking cough that has persisted for
two weeks following an upper respiratory infection. He is afebrile, and his lungs are
clear to auscultation bilaterally. A chest X-ray shows no infiltrates. What is the most
appropriate management?
A) Prescribe a 5-day course of azithromycin
B) Initiate a trial of oral prednisone
C) Recommend supportive care with antitussives and hydration
D) Order a high-resolution chest CT scan
Correct Answer: C) Recommend supportive care with antitussives and hydration
Rationale: Acute bronchitis is primarily viral, and antibiotics like azithromycin are not
indicated in healthy adults with clear chest radiographs and no systemic signs of
bacterial infection. Management is purely supportive to alleviate coughing symptoms.
Question 9
An 11-year-old child presents with a bright red, warm, sand-paper-like rash that started
2028 | Practice Questions & Answers | Complete Study Guide
Category Details
Course NSG6998 – Transition to Professional Nurse Practitioner Role
Institution South University
Exam Type Pre-Predictor Exam / APEA Predictor Exam
Format Multiple-choice, scenario-based questions
Advanced physical assessment, cardiovascular, respiratory, endocrine, gastrointestinal,
Focus
genitourinary, musculoskeletal, neurologic, infectious disease, dermatology, pharmacology
Areas
professional practice
Question 1
A 24-year-old female presents to the clinic complaining of severe facial swelling and
painful cheeks. On physical examination, you note bilateral parotid gland swelling,
giving her a distinct "chipmunk" appearance. Which of the following is the most likely
diagnosis?
A) Sialolithiasis
B) Mumps
C) Ludwig's Angina
D) Mononucleosis
Correct Answer: B) Mumps
Rationale: Mumps is an acute viral infection characterized by painful swelling of the
parotid glands, often referred to visually as "chipmunk" facies. Sialolithiasis usually
presents as unilateral salivary gland obstruction. Ludwig's angina is a life-threatening
infection of the submandibular space, not isolated parotitis.
,Question 2
An 18-year-old patient presents with a severe sore throat, significant fatigue, and
cervical lymphadenopathy. The Family Nurse Practitioner suspects infectious
mononucleosis. Which clinical action is most appropriate?
A) Order an immediate Heterophil antibody test (Monospot) and CBC
B) Initiate a 10-day course of oral amoxicillin
C) Perform vigorous abdominal palpation to check for splenomegaly
D) Prescription of oral acyclovir to shorten symptom duration
Correct Answer: A) Order an immediate Heterophil antibody test (Monospot) and
CBC
Rationale: The Heterophil antibody test (Monospot) along with a Complete Blood Count
showing atypical lymphocytes is the standard diagnostic protocol for infectious
mononucleosis. Amoxicillin must be avoided as it frequently triggers a maculopapular
rash in these patients. Deep or vigorous abdominal palpation is strictly contraindicated
due to the risk of splenic rupture, and antivirals provide no clinical benefit.
Question 3
During a routine physical examination on a 42-year-old female, the clinician auscultates
a distinct systolic bruit directly over the thyroid gland. This finding is most highly
suggestive of which endocrine pathology?
A) Hashimoto's thyroiditis
B) Thyroid malignancy
C) Graves' disease
D) Subacute thyroiditis
Correct Answer: C) Graves' disease
Rationale: A thyroid bruit is highly specific to hyperthyroidism, most commonly Graves'
disease. It occurs due to the marked increase in glandular vascularity and blood flow.
Hashimoto's thyroiditis typically presents as a firm, nontender, diffusely enlarged goiter
without a vascular bruit. Malignancies present as discrete, hard nodules.
Question 4
A 16-year-old male presents with severe, painful nodulocystic acne covering his face,
chest, and upper back. He has tried topical retinoids and oral doxycycline for six months
with zero clinical improvement. What is the most appropriate next-line treatment?
A) Topical clindamycin monotherapy
B) Oral isotretinoin
,C) Increased dosing of oral doxycycline
D) Intralesional corticosteroid injections
Correct Answer: B) Oral isotretinoin
Rationale: Oral isotretinoin is the gold-standard, first-line agent for severe, scarring
nodulocystic acne that has proven refractory to conservative therapies like oral
antibiotics and topical retinoids. Topical clindamycin will not be effective for severe
cystic lesions, and increasing the doxycycline dose risks toxicity without significant
therapeutic gain.
Question 5
A 68-year-old male with a history of hypertension presents with severe, spontaneous
bleeding from his right nares. After attempting direct pressure for 15 minutes, the
bleeding continues. If the source is localized to Kiesselbach's plexus, this represents an
injury to which anatomical region?
A) Posterior nasal cavity
B) Superior turbinate
C) Anterior nasal septum
D) Nasopharyngeal vault
Correct Answer: C) Anterior nasal septum
Rationale: Kiesselbach's plexus is a highly vascular network located on the anterior
nasal septum. It is responsible for over 90% of all epistaxis cases and is easily
accessible for direct visualization and local cautery or packing. Posterior nosebleeds
involve the sphenopalatine artery and are much more difficult to manage.
Question 6
A 45-year-old male presents with rapidly progressive swelling of the lower jaw, severe
tongue elevation, and difficulty swallowing. He notes he had a severe toothache last
week. The clinician notes a woody, firm induration of the submandibular space. What is
the most critical immediate priority?
A) Order an outpatient neck CT scan
B) Prescribe oral amoxicillin-clavulanate
C) Secure the airway and arrange emergency transfer
D) Perform an incision and drainage in the clinic
Correct Answer: C) Secure the airway and arrange emergency transfer
Rationale: This presentation describes Ludwig's angina, a rapidly expanding cellulitis of
the submandibular space typically originating from an infected lower molar. The highest
, priority is securing the airway, as tongue displacement leads to complete occlusion.
Outpatient management or delayed imaging is unsafe.
Question 7
A 34-year-old female presents for evaluation of a thyroid nodule. Laboratory results
reveal a normal TSH level. Her physical exam reveals a firm, nontender, diffusely
enlarged thyroid. Anti-thyroid peroxidase (anti-TPO) antibodies are highly elevated.
What is the most likely diagnosis?
A) Graves' disease
B) Hashimoto's thyroiditis
C) Toxic multinodular goiter
D) Subacute granulomatous thyroiditis
Correct Answer: B) Hashimoto's thyroiditis
Rationale: Hashimoto's thyroiditis is the most common cause of hypothyroidism in the
US, but patients can initially present in euthyroid or hyperthyroid states (Hashitoxicosis).
A firm, nontender, diffusely enlarged thyroid combined with elevated anti-TPO
antibodies confirms this autoimmune condition.
Question 8
A 52-year-old male smoker presents with a dry, hacking cough that has persisted for
two weeks following an upper respiratory infection. He is afebrile, and his lungs are
clear to auscultation bilaterally. A chest X-ray shows no infiltrates. What is the most
appropriate management?
A) Prescribe a 5-day course of azithromycin
B) Initiate a trial of oral prednisone
C) Recommend supportive care with antitussives and hydration
D) Order a high-resolution chest CT scan
Correct Answer: C) Recommend supportive care with antitussives and hydration
Rationale: Acute bronchitis is primarily viral, and antibiotics like azithromycin are not
indicated in healthy adults with clear chest radiographs and no systemic signs of
bacterial infection. Management is purely supportive to alleviate coughing symptoms.
Question 9
An 11-year-old child presents with a bright red, warm, sand-paper-like rash that started
