ADVANCED PRACTICE NURSING
NSG 6330 Final Exam
Questions and Answers
South University
Latest Version - 100% Correct - 2026/2027 Edition
Comprehensive Final Examination
150 Multiple-Choice Questions with Detailed Rationales
Section Topic Questions
1 Advanced Health Assessment & Diagnostic Reasoning 20
2 Pharmacology & Prescriptive Authority 15
3 Pathophysiology & Clinical Decision-Making 20
4 Acute & Chronic Disease Management 25
5 Health Promotion, Prevention, & Population Health 15
6 Professional Practice, Ethics, & Healthcare Policy 15
7 Leadership, Quality Improvement, & Patient Safety 10
8 Comprehensive Case Studies & Clinical Scenarios 30
TOTAL 150
Examination Instructions
• This examination consists of 150 multiple-choice questions distributed across eight content domains aligned
with South University NSG 6330 Advanced Practice Nursing curriculum.
South University - College of Nursing and Public Health - Advanced Practice Nursing Program
,NSG 6330 - Final Exam - Advanced Practice Nursing South University - 2026/2027 Edition
• Each question has four options (A, B, C, D). Select the one best answer. The correct answer is marked with
*[CORRECT]* and supported by a detailed rationale.
• Cognitive levels are distributed as approximately 20% recall, 40% application, and 40% analysis.
Approximately 75% of items are scenario-based and 25% are direct knowledge questions.
• Rationales reference national certification standards (AHA/ACC, IDSA, ADA, ACR, USPSTF, GOLD,
KDIGO, AASLD, GINA, ATS, ASCO, NCCN, etc.) and South University NSG 6330 course competencies.
100% CORRECT - VERIFIED 2026/2027 Page 2 Confidential - Examination Materials
,NSG 6330 - Final Exam - Advanced Practice Nursing South University - 2026/2027 Edition
Section 1: Advanced Health Assessment & Diagnostic
Reasoning
Comprehensive history-taking, physical examination, diagnostic reasoning, and differential diagnosis -
20 questions
Q1: A 58-year-old male presents with progressive dyspnea on exertion, orthopnea, and bilateral lower
extremity edema. On auscultation, you note bibasilar crackles and an S3 gallop. Which of the following
findings on physical examination would most strongly suggest a diagnosis of left-sided heart failure as the
primary cause of his symptoms?
A. Jugular venous distension greater than 4 cm above the sternal angle at 45 degrees
B. Bilateral basilar inspiratory crackles that do not clear with coughing *[CORRECT]*
C. Hepatojugular reflux positive with sustained pressure over the right upper quadrant
D. Bilateral pitting edema of the lower extremities extending to the mid-shin
Correct Answer: B
Rationale: Bilateral basilar inspiratory crackles that do not clear with coughing are classic for pulmonary edema
secondary to left-sided heart failure, reflecting fluid transudation into alveoli. JVD, hepatojugular reflux, and
peripheral edema are hallmarks of right-sided failure (or biventricular). The S3 gallop further supports left
ventricular dysfunction. Per NSG 6330 advanced health assessment curriculum and AHA/ACC guidelines,
differentiating left versus right failure on exam directs downstream workup (BNP, echocardiogram) and
management.
Q2: A 42-year-old female presents with new-onset severe headache described as 'the worst of my life,' reaching
maximum intensity within 60 seconds. She also reports photophobia and neck stiffness. Vital signs: BP 168/98,
HR 88, RR 18, T 37.1 C, SpO2 99%. Which finding on physical examination would be most concerning and
require emergent neuroimaging?
A. Pupils 4 mm and reactive bilaterally with conjugate gaze
B. Positive Brudzinski sign with kernig sign positive at 90 degrees flexion *[CORRECT]*
C. Symmetric deep tendon reflexes 2+ in all four extremities
D. Bilateral temporal artery pulses that are equal and nontender
Correct Answer: B
Rationale: A positive Brudzinski sign and Kernig sign indicate meningeal irritation, which combined with
thunderclap headache and photophobia raises concern for subarachnoid hemorrhage (SAH) or meningitis. The
American Heart Association/American Stroke Association guidelines mandate non-contrast CT head immediately
(sensitivity 100% within 6 hours). Options A, C, and D are reassuring findings. NSG 6330 diagnostic reasoning
curriculum emphasizes recognizing red-flag headache presentations for emergent imaging.
100% CORRECT - VERIFIED 2026/2027 Page 3 Confidential - Examination Materials
, NSG 6330 - Final Exam - Advanced Practice Nursing South University - 2026/2027 Edition
Q3: During a comprehensive health assessment of a 67-year-old male with a 40-pack-year smoking history,
you auscultate the chest and note decreased breath sounds in the right lower lobe with whispered pectoriloquy
and egophony (e-to-a change). What is the most likely underlying pathologic finding?
A. Pleural effusion with atelectasis adjacent to the effusion
B. Consolidation of the lung parenchyma, most likely pneumonia *[CORRECT]*
C. Pneumothorax with partial collapse of the right lung
D. Chronic obstructive pulmonary disease with hyperinflation
Correct Answer: B
Rationale: Whispered pectoriloquy and egophony (e-to-a change) are classic findings of lung consolidation, where
solid tissue transmits sound more effectively than air-filled lung. This pattern most commonly indicates bacterial
pneumonia. Pleural effusion would produce decreased fremitus and dullness to percussion without pectoriloquy.
Pneumothorax produces hyperresonance and absent breath sounds. COPD produces diminished sounds globally
without focal egophony. NSG 6330 advanced assessment emphasizes the diagnostic triad of fremitus, egophony, and
pectoriloquy for consolidation.
Q4: A 35-year-old female presents with fatigue, weight gain, cold intolerance, and constipation. On thyroid
examination, you note an enlarged, firm, non-tender thyroid gland with a palpable nodule in the right lobe.
Which of the following findings would be most consistent with Hashimoto's thyroiditis as the underlying
diagnosis?
A. A solitary hard nodule with cervical lymphadenopathy
B. Diffusely enlarged, firm thyroid with anti-TPO antibodies elevated *[CORRECT]*
C. A tender, warm thyroid with elevated ESR and recent viral illness
D. A palpable thrill over the thyroid with bruit on auscultation
Correct Answer: B
Rationale: Hashimoto's thyroiditis presents with a diffusely enlarged, firm, non-tender thyroid gland and elevated
anti-thyroid peroxidase (anti-TPO) antibodies, often with hypothyroid symptoms. A solitary hard nodule with
lymphadenopathy suggests malignancy and requires fine needle aspiration. A tender warm thyroid with elevated
ESR suggests subacute (de Quervain's) thyroiditis. A palpable thrill/bruit suggests Graves' disease with
hyperthyroidism. NSG 6330 assessment curriculum and ATA guidelines emphasize the autoimmune workup for
Hashimoto's.
100% CORRECT - VERIFIED 2026/2027 Page 4 Confidential - Examination Materials
NSG 6330 Final Exam
Questions and Answers
South University
Latest Version - 100% Correct - 2026/2027 Edition
Comprehensive Final Examination
150 Multiple-Choice Questions with Detailed Rationales
Section Topic Questions
1 Advanced Health Assessment & Diagnostic Reasoning 20
2 Pharmacology & Prescriptive Authority 15
3 Pathophysiology & Clinical Decision-Making 20
4 Acute & Chronic Disease Management 25
5 Health Promotion, Prevention, & Population Health 15
6 Professional Practice, Ethics, & Healthcare Policy 15
7 Leadership, Quality Improvement, & Patient Safety 10
8 Comprehensive Case Studies & Clinical Scenarios 30
TOTAL 150
Examination Instructions
• This examination consists of 150 multiple-choice questions distributed across eight content domains aligned
with South University NSG 6330 Advanced Practice Nursing curriculum.
South University - College of Nursing and Public Health - Advanced Practice Nursing Program
,NSG 6330 - Final Exam - Advanced Practice Nursing South University - 2026/2027 Edition
• Each question has four options (A, B, C, D). Select the one best answer. The correct answer is marked with
*[CORRECT]* and supported by a detailed rationale.
• Cognitive levels are distributed as approximately 20% recall, 40% application, and 40% analysis.
Approximately 75% of items are scenario-based and 25% are direct knowledge questions.
• Rationales reference national certification standards (AHA/ACC, IDSA, ADA, ACR, USPSTF, GOLD,
KDIGO, AASLD, GINA, ATS, ASCO, NCCN, etc.) and South University NSG 6330 course competencies.
100% CORRECT - VERIFIED 2026/2027 Page 2 Confidential - Examination Materials
,NSG 6330 - Final Exam - Advanced Practice Nursing South University - 2026/2027 Edition
Section 1: Advanced Health Assessment & Diagnostic
Reasoning
Comprehensive history-taking, physical examination, diagnostic reasoning, and differential diagnosis -
20 questions
Q1: A 58-year-old male presents with progressive dyspnea on exertion, orthopnea, and bilateral lower
extremity edema. On auscultation, you note bibasilar crackles and an S3 gallop. Which of the following
findings on physical examination would most strongly suggest a diagnosis of left-sided heart failure as the
primary cause of his symptoms?
A. Jugular venous distension greater than 4 cm above the sternal angle at 45 degrees
B. Bilateral basilar inspiratory crackles that do not clear with coughing *[CORRECT]*
C. Hepatojugular reflux positive with sustained pressure over the right upper quadrant
D. Bilateral pitting edema of the lower extremities extending to the mid-shin
Correct Answer: B
Rationale: Bilateral basilar inspiratory crackles that do not clear with coughing are classic for pulmonary edema
secondary to left-sided heart failure, reflecting fluid transudation into alveoli. JVD, hepatojugular reflux, and
peripheral edema are hallmarks of right-sided failure (or biventricular). The S3 gallop further supports left
ventricular dysfunction. Per NSG 6330 advanced health assessment curriculum and AHA/ACC guidelines,
differentiating left versus right failure on exam directs downstream workup (BNP, echocardiogram) and
management.
Q2: A 42-year-old female presents with new-onset severe headache described as 'the worst of my life,' reaching
maximum intensity within 60 seconds. She also reports photophobia and neck stiffness. Vital signs: BP 168/98,
HR 88, RR 18, T 37.1 C, SpO2 99%. Which finding on physical examination would be most concerning and
require emergent neuroimaging?
A. Pupils 4 mm and reactive bilaterally with conjugate gaze
B. Positive Brudzinski sign with kernig sign positive at 90 degrees flexion *[CORRECT]*
C. Symmetric deep tendon reflexes 2+ in all four extremities
D. Bilateral temporal artery pulses that are equal and nontender
Correct Answer: B
Rationale: A positive Brudzinski sign and Kernig sign indicate meningeal irritation, which combined with
thunderclap headache and photophobia raises concern for subarachnoid hemorrhage (SAH) or meningitis. The
American Heart Association/American Stroke Association guidelines mandate non-contrast CT head immediately
(sensitivity 100% within 6 hours). Options A, C, and D are reassuring findings. NSG 6330 diagnostic reasoning
curriculum emphasizes recognizing red-flag headache presentations for emergent imaging.
100% CORRECT - VERIFIED 2026/2027 Page 3 Confidential - Examination Materials
, NSG 6330 - Final Exam - Advanced Practice Nursing South University - 2026/2027 Edition
Q3: During a comprehensive health assessment of a 67-year-old male with a 40-pack-year smoking history,
you auscultate the chest and note decreased breath sounds in the right lower lobe with whispered pectoriloquy
and egophony (e-to-a change). What is the most likely underlying pathologic finding?
A. Pleural effusion with atelectasis adjacent to the effusion
B. Consolidation of the lung parenchyma, most likely pneumonia *[CORRECT]*
C. Pneumothorax with partial collapse of the right lung
D. Chronic obstructive pulmonary disease with hyperinflation
Correct Answer: B
Rationale: Whispered pectoriloquy and egophony (e-to-a change) are classic findings of lung consolidation, where
solid tissue transmits sound more effectively than air-filled lung. This pattern most commonly indicates bacterial
pneumonia. Pleural effusion would produce decreased fremitus and dullness to percussion without pectoriloquy.
Pneumothorax produces hyperresonance and absent breath sounds. COPD produces diminished sounds globally
without focal egophony. NSG 6330 advanced assessment emphasizes the diagnostic triad of fremitus, egophony, and
pectoriloquy for consolidation.
Q4: A 35-year-old female presents with fatigue, weight gain, cold intolerance, and constipation. On thyroid
examination, you note an enlarged, firm, non-tender thyroid gland with a palpable nodule in the right lobe.
Which of the following findings would be most consistent with Hashimoto's thyroiditis as the underlying
diagnosis?
A. A solitary hard nodule with cervical lymphadenopathy
B. Diffusely enlarged, firm thyroid with anti-TPO antibodies elevated *[CORRECT]*
C. A tender, warm thyroid with elevated ESR and recent viral illness
D. A palpable thrill over the thyroid with bruit on auscultation
Correct Answer: B
Rationale: Hashimoto's thyroiditis presents with a diffusely enlarged, firm, non-tender thyroid gland and elevated
anti-thyroid peroxidase (anti-TPO) antibodies, often with hypothyroid symptoms. A solitary hard nodule with
lymphadenopathy suggests malignancy and requires fine needle aspiration. A tender warm thyroid with elevated
ESR suggests subacute (de Quervain's) thyroiditis. A palpable thrill/bruit suggests Graves' disease with
hyperthyroidism. NSG 6330 assessment curriculum and ATA guidelines emphasize the autoimmune workup for
Hashimoto's.
100% CORRECT - VERIFIED 2026/2027 Page 4 Confidential - Examination Materials
