1
NSG 6020 3P EXAM QUESTIONS AND ANSWERS
1.
A 67-year-old patient presents to the primary care clinic reporting progressive
fatigue, decreased appetite, and an unintended 12-pound weight loss over four
months. During the interview, the patient states that the symptoms began
gradually and denies fever or acute pain. Which additional assessment question
would provide the most clinically useful information when evaluating this patient's
unexplained weight loss?
A. “How many hours do you sleep each night?”
B. “Have you recently changed your favorite foods?”
C. “Have you noticed changes in your bowel habits, appetite, swallowing, or ability
to obtain and prepare food?”
D. “Do you prefer taking medications in the morning or evening?”
Answer: C
2.
A patient reports experiencing intermittent substernal chest discomfort when
climbing stairs that resolves after several minutes of rest. The patient has
hypertension, diabetes, and a history of cigarette smoking. Which interpretation is
most appropriate?
A. The symptom pattern is concerning for stable exertional angina and warrants
cardiovascular evaluation.
B. The symptoms are most consistent with acute pericarditis.
C. The symptoms are characteristic of pleuritic chest pain from pneumonia.
D. The symptoms are diagnostic of gastroesophageal reflux disease.
Answer: A
3.
A 54-year-old patient reports severe epigastric pain that radiates to the back and
began after several days of heavy alcohol consumption. The patient is vomiting
,2
and appears uncomfortable. Which laboratory finding would most strongly
support the suspected diagnosis?
A. Decreased serum sodium
B. Elevated serum lipase
C. Decreased hemoglobin A1c
D. Elevated thyroid-stimulating hormone
Answer: B
4.
A patient with a history of hypertension presents with sudden severe headache
described as “the worst headache of my life,” accompanied by vomiting and neck
stiffness. Which condition should the advanced practice nurse consider most
urgently?
A. Tension headache
B. Sinus headache
C. Migraine without aura
D. Subarachnoid hemorrhage
Answer: D
5.
A 72-year-old patient reports gradually worsening difficulty hearing conversations,
particularly when several people are speaking simultaneously. Otoscopic
examination reveals no cerumen obstruction or acute infection. Which age-related
process is most consistent with these findings?
A. Presbycusis
B. Acute otitis media
C. Conductive hearing loss from cerumen
D. Otitis externa
Answer: A
6.
,3
A patient presents with unilateral facial weakness involving the forehead, inability
to close the affected eye completely, and drooping of the corner of the mouth.
Which cranial nerve is primarily involved?
A. Cranial nerve V
B. Cranial nerve VIII
C. Cranial nerve VII
D. Cranial nerve XII
Answer: C
7.
A 45-year-old patient complains of progressive difficulty swallowing both liquids
and solids. The patient denies odynophagia but reports that food sometimes
seems to “stick” behind the sternum. Which finding requires further evaluation for
an esophageal motility or structural disorder?
A. Difficulty swallowing only cold liquids
B. Dysphagia involving both solids and liquids
C. Occasional belching after meals
D. Mild thirst during exercise
Answer: B
8.
A patient with a long history of smoking presents with chronic cough, sputum
production, and exertional dyspnea. Pulmonary function testing demonstrates
persistent airflow limitation that is not completely reversible. Which
pathophysiologic process best explains the patient's condition?
A. Reversible bronchial smooth-muscle contraction only
B. Acute alveolar hemorrhage
C. Pulmonary edema caused by left-sided heart failure
D. Chronic airway inflammation and structural changes producing persistent
airflow limitation
, 4
Answer: D
9.
A patient with asthma reports nighttime wheezing several times each week
despite using a short-acting bronchodilator frequently. Which finding suggests
that the patient's asthma is inadequately controlled?
A. Increasing reliance on a rescue inhaler
B. Occasional sneezing during spring
C. Normal oxygen saturation at rest
D. Absence of fever
Answer: A
10.
A patient with diabetes mellitus presents with polyuria, polydipsia, abdominal
discomfort, nausea, and deep rapid respirations. Laboratory results reveal marked
hyperglycemia, metabolic acidosis, and elevated serum ketones. Which diagnosis
is most likely?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis
C. Syndrome of inappropriate antidiuretic hormone secretion
D. Primary respiratory alkalosis
Answer: B
11.
A patient with chronic kidney disease reports increasing fatigue, pruritus,
anorexia, and nausea. Laboratory testing shows elevated serum creatinine and
decreased estimated glomerular filtration rate. Which complication of chronic
kidney disease is most directly associated with the patient's fatigue?
A. Iron overload
B. Hyperthyroidism
NSG 6020 3P EXAM QUESTIONS AND ANSWERS
1.
A 67-year-old patient presents to the primary care clinic reporting progressive
fatigue, decreased appetite, and an unintended 12-pound weight loss over four
months. During the interview, the patient states that the symptoms began
gradually and denies fever or acute pain. Which additional assessment question
would provide the most clinically useful information when evaluating this patient's
unexplained weight loss?
A. “How many hours do you sleep each night?”
B. “Have you recently changed your favorite foods?”
C. “Have you noticed changes in your bowel habits, appetite, swallowing, or ability
to obtain and prepare food?”
D. “Do you prefer taking medications in the morning or evening?”
Answer: C
2.
A patient reports experiencing intermittent substernal chest discomfort when
climbing stairs that resolves after several minutes of rest. The patient has
hypertension, diabetes, and a history of cigarette smoking. Which interpretation is
most appropriate?
A. The symptom pattern is concerning for stable exertional angina and warrants
cardiovascular evaluation.
B. The symptoms are most consistent with acute pericarditis.
C. The symptoms are characteristic of pleuritic chest pain from pneumonia.
D. The symptoms are diagnostic of gastroesophageal reflux disease.
Answer: A
3.
A 54-year-old patient reports severe epigastric pain that radiates to the back and
began after several days of heavy alcohol consumption. The patient is vomiting
,2
and appears uncomfortable. Which laboratory finding would most strongly
support the suspected diagnosis?
A. Decreased serum sodium
B. Elevated serum lipase
C. Decreased hemoglobin A1c
D. Elevated thyroid-stimulating hormone
Answer: B
4.
A patient with a history of hypertension presents with sudden severe headache
described as “the worst headache of my life,” accompanied by vomiting and neck
stiffness. Which condition should the advanced practice nurse consider most
urgently?
A. Tension headache
B. Sinus headache
C. Migraine without aura
D. Subarachnoid hemorrhage
Answer: D
5.
A 72-year-old patient reports gradually worsening difficulty hearing conversations,
particularly when several people are speaking simultaneously. Otoscopic
examination reveals no cerumen obstruction or acute infection. Which age-related
process is most consistent with these findings?
A. Presbycusis
B. Acute otitis media
C. Conductive hearing loss from cerumen
D. Otitis externa
Answer: A
6.
,3
A patient presents with unilateral facial weakness involving the forehead, inability
to close the affected eye completely, and drooping of the corner of the mouth.
Which cranial nerve is primarily involved?
A. Cranial nerve V
B. Cranial nerve VIII
C. Cranial nerve VII
D. Cranial nerve XII
Answer: C
7.
A 45-year-old patient complains of progressive difficulty swallowing both liquids
and solids. The patient denies odynophagia but reports that food sometimes
seems to “stick” behind the sternum. Which finding requires further evaluation for
an esophageal motility or structural disorder?
A. Difficulty swallowing only cold liquids
B. Dysphagia involving both solids and liquids
C. Occasional belching after meals
D. Mild thirst during exercise
Answer: B
8.
A patient with a long history of smoking presents with chronic cough, sputum
production, and exertional dyspnea. Pulmonary function testing demonstrates
persistent airflow limitation that is not completely reversible. Which
pathophysiologic process best explains the patient's condition?
A. Reversible bronchial smooth-muscle contraction only
B. Acute alveolar hemorrhage
C. Pulmonary edema caused by left-sided heart failure
D. Chronic airway inflammation and structural changes producing persistent
airflow limitation
, 4
Answer: D
9.
A patient with asthma reports nighttime wheezing several times each week
despite using a short-acting bronchodilator frequently. Which finding suggests
that the patient's asthma is inadequately controlled?
A. Increasing reliance on a rescue inhaler
B. Occasional sneezing during spring
C. Normal oxygen saturation at rest
D. Absence of fever
Answer: A
10.
A patient with diabetes mellitus presents with polyuria, polydipsia, abdominal
discomfort, nausea, and deep rapid respirations. Laboratory results reveal marked
hyperglycemia, metabolic acidosis, and elevated serum ketones. Which diagnosis
is most likely?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis
C. Syndrome of inappropriate antidiuretic hormone secretion
D. Primary respiratory alkalosis
Answer: B
11.
A patient with chronic kidney disease reports increasing fatigue, pruritus,
anorexia, and nausea. Laboratory testing shows elevated serum creatinine and
decreased estimated glomerular filtration rate. Which complication of chronic
kidney disease is most directly associated with the patient's fatigue?
A. Iron overload
B. Hyperthyroidism
