NSG 6006 PRE-SPECIALITY
EVALUATION EXAM LATEST
Course
NSG 6006 (NSG6006)
Question 1
A nurse practitioner is assessing a 67-year-old patient who reports crushing substernal chest pain
radiating to the left arm for 20 minutes. Which action is the highest priority?
A. Obtain a complete health history.
B. Administer aspirin if not contraindicated and activate emergency cardiac care.
C. Schedule an outpatient stress test.
D. Encourage the patient to rest for one hour.
Correct Answer: B. Administer aspirin if not contraindicated and activate emergency
cardiac care.
Rationale:
The patient's symptoms strongly suggest an acute myocardial infarction (AMI). Immediate
intervention improves survival. Aspirin decreases platelet aggregation and should be given
promptly unless contraindicated while emergency care is activated. A detailed history can be
completed after stabilization.
Question 2
Which laboratory value is most consistent with poorly controlled diabetes mellitus?
A. HbA1c 5.4%
B. HbA1c 6.0%
C. HbA1c 8.9%
D. HbA1c 5.7%
Correct Answer: C. HbA1c 8.9%
Rationale:
Hemoglobin A1c reflects average blood glucose over approximately three months. An HbA1c of
8.9% indicates chronic hyperglycemia and inadequate glycemic control.
Question 3
,A patient presents with fever, productive cough, and crackles in the right lower lung field. Which
diagnosis is most likely?
A. Asthma
B. Community-acquired pneumonia
C. Pulmonary embolism
D. Chronic sinusitis
Correct Answer: B. Community-acquired pneumonia
Rationale:
Fever, productive cough, localized crackles, and respiratory symptoms are classic findings of
bacterial pneumonia. Pulmonary embolism usually presents with sudden dyspnea and pleuritic
chest pain without productive sputum.
Question 4
Which antihypertensive medication should be avoided during pregnancy?
A. Labetalol
B. Methyldopa
C. Nifedipine
D. Lisinopril
Correct Answer: D. Lisinopril
Rationale:
ACE inhibitors such as lisinopril are contraindicated during pregnancy because they can cause
fetal renal damage, oligohydramnios, and fetal death. Labetalol, methyldopa, and nifedipine are
commonly used during pregnancy.
Question 5
Which patient requires immediate evaluation?
A. Temperature 99.0°F (37.2°C)
B. Blood pressure 124/76 mmHg
C. Oxygen saturation 84% on room air
D. Pulse 76 beats/minute
Correct Answer: C. Oxygen saturation 84% on room air
Rationale:
,An oxygen saturation below 90% indicates significant hypoxemia requiring immediate
intervention. Airway and breathing always take priority according to the ABCs.
Question 6
A patient has atrial fibrillation on ECG. What is the major complication associated with this
rhythm?
A. Hyperkalemia
B. Stroke
C. Asthma
D. Pneumothorax
Correct Answer: B. Stroke
Rationale:
Atrial fibrillation promotes blood stasis within the atria, increasing the risk of thrombus
formation and embolic stroke. Anticoagulation is often indicated based on stroke risk assessment.
Question 7
Which assessment finding is most consistent with hypothyroidism?
A. Weight loss and heat intolerance
B. Tachycardia and tremors
C. Fatigue, constipation, and cold intolerance
D. Exophthalmos
Correct Answer: C. Fatigue, constipation, and cold intolerance
Rationale:
Hypothyroidism slows metabolism, producing fatigue, constipation, weight gain, dry skin,
bradycardia, and intolerance to cold temperatures.
Question 8
A patient has the following arterial blood gas results:
pH: 7.30
PaCO₂: 52 mmHg
, HCO₃⁻: 25 mEq/L
What is the interpretation?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B. Respiratory acidosis
Rationale:
The pH is acidic (<7.35), and the PaCO₂ is elevated (>45 mmHg), indicating respiratory
acidosis. The bicarbonate remains within the normal range, suggesting little or no metabolic
compensation.
Question 9
A patient receiving warfarin develops black, tarry stools. What should the nurse practitioner do
first?
A. Continue the medication.
B. Assess for gastrointestinal bleeding and notify the healthcare provider immediately.
C. Double the dose.
D. Reassure the patient that this is expected.
Correct Answer: B. Assess for gastrointestinal bleeding and notify the healthcare provider
immediately.
Rationale:
Melena is a classic sign of upper gastrointestinal bleeding. Patients receiving anticoagulants have
an increased bleeding risk and require immediate evaluation.
Question 10
A nurse practitioner is educating a patient recently diagnosed with hypertension. Which lifestyle
modification has the greatest evidence for lowering blood pressure?
A. Eliminate all carbohydrates.
B. Follow the DASH diet, reduce sodium intake, exercise regularly, and maintain a healthy
weight.
EVALUATION EXAM LATEST
Course
NSG 6006 (NSG6006)
Question 1
A nurse practitioner is assessing a 67-year-old patient who reports crushing substernal chest pain
radiating to the left arm for 20 minutes. Which action is the highest priority?
A. Obtain a complete health history.
B. Administer aspirin if not contraindicated and activate emergency cardiac care.
C. Schedule an outpatient stress test.
D. Encourage the patient to rest for one hour.
Correct Answer: B. Administer aspirin if not contraindicated and activate emergency
cardiac care.
Rationale:
The patient's symptoms strongly suggest an acute myocardial infarction (AMI). Immediate
intervention improves survival. Aspirin decreases platelet aggregation and should be given
promptly unless contraindicated while emergency care is activated. A detailed history can be
completed after stabilization.
Question 2
Which laboratory value is most consistent with poorly controlled diabetes mellitus?
A. HbA1c 5.4%
B. HbA1c 6.0%
C. HbA1c 8.9%
D. HbA1c 5.7%
Correct Answer: C. HbA1c 8.9%
Rationale:
Hemoglobin A1c reflects average blood glucose over approximately three months. An HbA1c of
8.9% indicates chronic hyperglycemia and inadequate glycemic control.
Question 3
,A patient presents with fever, productive cough, and crackles in the right lower lung field. Which
diagnosis is most likely?
A. Asthma
B. Community-acquired pneumonia
C. Pulmonary embolism
D. Chronic sinusitis
Correct Answer: B. Community-acquired pneumonia
Rationale:
Fever, productive cough, localized crackles, and respiratory symptoms are classic findings of
bacterial pneumonia. Pulmonary embolism usually presents with sudden dyspnea and pleuritic
chest pain without productive sputum.
Question 4
Which antihypertensive medication should be avoided during pregnancy?
A. Labetalol
B. Methyldopa
C. Nifedipine
D. Lisinopril
Correct Answer: D. Lisinopril
Rationale:
ACE inhibitors such as lisinopril are contraindicated during pregnancy because they can cause
fetal renal damage, oligohydramnios, and fetal death. Labetalol, methyldopa, and nifedipine are
commonly used during pregnancy.
Question 5
Which patient requires immediate evaluation?
A. Temperature 99.0°F (37.2°C)
B. Blood pressure 124/76 mmHg
C. Oxygen saturation 84% on room air
D. Pulse 76 beats/minute
Correct Answer: C. Oxygen saturation 84% on room air
Rationale:
,An oxygen saturation below 90% indicates significant hypoxemia requiring immediate
intervention. Airway and breathing always take priority according to the ABCs.
Question 6
A patient has atrial fibrillation on ECG. What is the major complication associated with this
rhythm?
A. Hyperkalemia
B. Stroke
C. Asthma
D. Pneumothorax
Correct Answer: B. Stroke
Rationale:
Atrial fibrillation promotes blood stasis within the atria, increasing the risk of thrombus
formation and embolic stroke. Anticoagulation is often indicated based on stroke risk assessment.
Question 7
Which assessment finding is most consistent with hypothyroidism?
A. Weight loss and heat intolerance
B. Tachycardia and tremors
C. Fatigue, constipation, and cold intolerance
D. Exophthalmos
Correct Answer: C. Fatigue, constipation, and cold intolerance
Rationale:
Hypothyroidism slows metabolism, producing fatigue, constipation, weight gain, dry skin,
bradycardia, and intolerance to cold temperatures.
Question 8
A patient has the following arterial blood gas results:
pH: 7.30
PaCO₂: 52 mmHg
, HCO₃⁻: 25 mEq/L
What is the interpretation?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B. Respiratory acidosis
Rationale:
The pH is acidic (<7.35), and the PaCO₂ is elevated (>45 mmHg), indicating respiratory
acidosis. The bicarbonate remains within the normal range, suggesting little or no metabolic
compensation.
Question 9
A patient receiving warfarin develops black, tarry stools. What should the nurse practitioner do
first?
A. Continue the medication.
B. Assess for gastrointestinal bleeding and notify the healthcare provider immediately.
C. Double the dose.
D. Reassure the patient that this is expected.
Correct Answer: B. Assess for gastrointestinal bleeding and notify the healthcare provider
immediately.
Rationale:
Melena is a classic sign of upper gastrointestinal bleeding. Patients receiving anticoagulants have
an increased bleeding risk and require immediate evaluation.
Question 10
A nurse practitioner is educating a patient recently diagnosed with hypertension. Which lifestyle
modification has the greatest evidence for lowering blood pressure?
A. Eliminate all carbohydrates.
B. Follow the DASH diet, reduce sodium intake, exercise regularly, and maintain a healthy
weight.
