NSG 6020 3P EXAM 2026/2027- EXAM ACCURATE REAL EXAM
QUESTIONS AND VERIFIED ANSWERS WITH DETAILED RATIONALES
EACH | CURRENTLY TESTING AND FREQUENTLY TESTED QUESTIONS |
GRADED A+ (SOUTH UNIVERSITY)
SECTION 1: ADVANCED HEALTH ASSESSMENT & PHYSICAL EXAMINATION
(Questions 1-120)
QUESTION 1:
A 72-year-old male presents for an annual physical. He reports feeling "tired"
but otherwise well. Which question is most important to ask next?
A. "Do you have any chest pain?"
B. "Have you had any recent falls?"
C. "How is your appetite?"
D. "Are you sleeping well at night?"
ANSWER: B
RATIONALE: Falls in the elderly are a major safety concern and may indicate
underlying neuropathy, orthostatic hypotension, or medication side effects.
Asking about falls should be prioritized in the geriatric assessment as falls
are a leading cause of morbidity and mortality in older adults. The CDC
recommends annual fall screening for all adults aged 65 and older.
QUESTION 2:
A patient's blood pressure is 148/92 mm Hg on two separate visits. According
to JNC-8 guidelines, what is the initial treatment recommendation?
A. Lifestyle modification only
B. Start a thiazide diuretic
C. Start a beta-blocker
D. Lifestyle modification + pharmacotherapy
ANSWER: D
1
,RATIONALE: For patients over 60 with BP ≥150/90, JNC-8 recommends
pharmacotherapy plus lifestyle changes. For those under 60, treatment begins
at ≥140/90. This patient's BP of 148/92 exceeds the threshold for
pharmacologic intervention, and lifestyle modifications alone would be
insufficient. A thiazide diuretic may be appropriate but is not the only
first-line option.
QUESTION 3:
A 35-year-old woman reports fatigue, weight gain, and cold intolerance. Her
vital signs are normal. What is the best initial screening test?
A. Free T4
B. TSH
C. Total T3
D. Thyroid peroxidase antibodies
ANSWER: B
RATIONALE: TSH is the most sensitive initial screening test for thyroid
dysfunction. The symptoms of fatigue, weight gain, and cold intolerance are
classic for hypothyroidism. A TSH level will help determine if the thyroid
gland is underactive. If TSH is elevated, further testing with Free T4 would
be indicated. TPO antibodies may be checked if autoimmune thyroiditis is
suspected.
QUESTION 4:
A 45-year-old presents with chest pain that is reproducible with palpation of
the chest wall. This suggests:
A. Angina pectoris
B. Pericarditis
C. Musculoskeletal chest pain
D. Pulmonary embolism
2
,ANSWER: C
RATIONALE: Reproducible pain with palpation is a classic finding of
musculoskeletal chest pain (costochondritis or chest wall syndrome). Angina
pectoris is typically not reproducible with palpation and is often related to
exertion. Pericarditis pain is usually positional (worse when lying flat,
better when leaning forward). Pulmonary embolism presents with pleuritic
chest pain, dyspnea, and tachycardia.
QUESTION 5:
Which of the following best describes the purpose of a functional assessment?
A. To evaluate the patient's ability to perform activities of daily living
B. To assess the patient's cognitive function
C. To evaluate the patient's mental status
D. To assess the patient's nutritional status
ANSWER: A
RATIONALE: A functional assessment evaluates the patient's ability to perform
activities of daily living (ADLs) and instrumental activities of daily living
(IADLs). This assessment is crucial for determining the patient's level of
independence and need for support services. It includes bathing, dressing,
toileting, transferring, continence, and feeding.
QUESTION 6:
Heberden's nodes are commonly found in which condition?
A. Rheumatoid arthritis
B. Degenerative joint disease (osteoarthritis)
C. Gout
D. Psoriatic arthritis
ANSWER: B
3
, RATIONALE: Heberden's nodes are bony enlargements of the distal
interphalangeal
(DIP) joints and are a classic finding in osteoarthritis (degenerative joint
disease). They represent osteophyte formation and cartilage degeneration.
Bouchard's nodes affect the proximal interphalangeal (PIP) joints and are also
seen in osteoarthritis. Rheumatoid arthritis typically affects the MCP and PIP
joints symmetrically.
QUESTION 7:
A patient presents with a blood pressure of 160/100 mm Hg in the right arm and
130/80 mm Hg in the left arm. This finding is concerning for:
A. Normal variation
B. Coarctation of the aorta
C. Aortic dissection
D. Subclavian artery stenosis
ANSWER: C
RATIONALE: A significant difference in blood pressure between arms (>20 mm Hg
systolic) is concerning for aortic dissection, especially when accompanied by
chest pain. Coarctation of the aorta typically presents with hypertension in
the upper extremities and hypotension in the lower extremities. Subclavian
artery stenosis can cause a difference but is less emergent.
QUESTION 8:
A 58-year-old female reports headaches, palpitations, and excessive sweating.
Her blood pressure is 180/110 mm Hg. Which condition should be ruled out?
A. Primary hypertension
B. Pheochromocytoma
C. Renal artery stenosis
D. Hypothyroidism
4
QUESTIONS AND VERIFIED ANSWERS WITH DETAILED RATIONALES
EACH | CURRENTLY TESTING AND FREQUENTLY TESTED QUESTIONS |
GRADED A+ (SOUTH UNIVERSITY)
SECTION 1: ADVANCED HEALTH ASSESSMENT & PHYSICAL EXAMINATION
(Questions 1-120)
QUESTION 1:
A 72-year-old male presents for an annual physical. He reports feeling "tired"
but otherwise well. Which question is most important to ask next?
A. "Do you have any chest pain?"
B. "Have you had any recent falls?"
C. "How is your appetite?"
D. "Are you sleeping well at night?"
ANSWER: B
RATIONALE: Falls in the elderly are a major safety concern and may indicate
underlying neuropathy, orthostatic hypotension, or medication side effects.
Asking about falls should be prioritized in the geriatric assessment as falls
are a leading cause of morbidity and mortality in older adults. The CDC
recommends annual fall screening for all adults aged 65 and older.
QUESTION 2:
A patient's blood pressure is 148/92 mm Hg on two separate visits. According
to JNC-8 guidelines, what is the initial treatment recommendation?
A. Lifestyle modification only
B. Start a thiazide diuretic
C. Start a beta-blocker
D. Lifestyle modification + pharmacotherapy
ANSWER: D
1
,RATIONALE: For patients over 60 with BP ≥150/90, JNC-8 recommends
pharmacotherapy plus lifestyle changes. For those under 60, treatment begins
at ≥140/90. This patient's BP of 148/92 exceeds the threshold for
pharmacologic intervention, and lifestyle modifications alone would be
insufficient. A thiazide diuretic may be appropriate but is not the only
first-line option.
QUESTION 3:
A 35-year-old woman reports fatigue, weight gain, and cold intolerance. Her
vital signs are normal. What is the best initial screening test?
A. Free T4
B. TSH
C. Total T3
D. Thyroid peroxidase antibodies
ANSWER: B
RATIONALE: TSH is the most sensitive initial screening test for thyroid
dysfunction. The symptoms of fatigue, weight gain, and cold intolerance are
classic for hypothyroidism. A TSH level will help determine if the thyroid
gland is underactive. If TSH is elevated, further testing with Free T4 would
be indicated. TPO antibodies may be checked if autoimmune thyroiditis is
suspected.
QUESTION 4:
A 45-year-old presents with chest pain that is reproducible with palpation of
the chest wall. This suggests:
A. Angina pectoris
B. Pericarditis
C. Musculoskeletal chest pain
D. Pulmonary embolism
2
,ANSWER: C
RATIONALE: Reproducible pain with palpation is a classic finding of
musculoskeletal chest pain (costochondritis or chest wall syndrome). Angina
pectoris is typically not reproducible with palpation and is often related to
exertion. Pericarditis pain is usually positional (worse when lying flat,
better when leaning forward). Pulmonary embolism presents with pleuritic
chest pain, dyspnea, and tachycardia.
QUESTION 5:
Which of the following best describes the purpose of a functional assessment?
A. To evaluate the patient's ability to perform activities of daily living
B. To assess the patient's cognitive function
C. To evaluate the patient's mental status
D. To assess the patient's nutritional status
ANSWER: A
RATIONALE: A functional assessment evaluates the patient's ability to perform
activities of daily living (ADLs) and instrumental activities of daily living
(IADLs). This assessment is crucial for determining the patient's level of
independence and need for support services. It includes bathing, dressing,
toileting, transferring, continence, and feeding.
QUESTION 6:
Heberden's nodes are commonly found in which condition?
A. Rheumatoid arthritis
B. Degenerative joint disease (osteoarthritis)
C. Gout
D. Psoriatic arthritis
ANSWER: B
3
, RATIONALE: Heberden's nodes are bony enlargements of the distal
interphalangeal
(DIP) joints and are a classic finding in osteoarthritis (degenerative joint
disease). They represent osteophyte formation and cartilage degeneration.
Bouchard's nodes affect the proximal interphalangeal (PIP) joints and are also
seen in osteoarthritis. Rheumatoid arthritis typically affects the MCP and PIP
joints symmetrically.
QUESTION 7:
A patient presents with a blood pressure of 160/100 mm Hg in the right arm and
130/80 mm Hg in the left arm. This finding is concerning for:
A. Normal variation
B. Coarctation of the aorta
C. Aortic dissection
D. Subclavian artery stenosis
ANSWER: C
RATIONALE: A significant difference in blood pressure between arms (>20 mm Hg
systolic) is concerning for aortic dissection, especially when accompanied by
chest pain. Coarctation of the aorta typically presents with hypertension in
the upper extremities and hypotension in the lower extremities. Subclavian
artery stenosis can cause a difference but is less emergent.
QUESTION 8:
A 58-year-old female reports headaches, palpitations, and excessive sweating.
Her blood pressure is 180/110 mm Hg. Which condition should be ruled out?
A. Primary hypertension
B. Pheochromocytoma
C. Renal artery stenosis
D. Hypothyroidism
4
