1
NSG 6998 FNP PREDICTOR EXAM 2026/2027 ACTUAL QUESTIONS AND
ANSWERS GRADED A+ SOUTH UNIVERSITY
1. A 58-year-old woman presents for an annual primary-care visit and reports
increasing fatigue, constipation, dry skin, and an unexplained 12-lb weight gain
over the past six months. She has no fever and reports that her menstrual periods
have become irregular. Physical examination demonstrates bradycardia and
delayed relaxation of the deep tendon reflexes. Which laboratory evaluation is
most appropriate to initially evaluate the suspected endocrine disorder?
A. Serum TSH and free T4
B. Serum cortisol and ACTH
C. Serum prolactin and FSH
D. Serum calcium and parathyroid hormone
Answer: A
2. A 67-year-old man with a 40-pack-year smoking history presents with
progressive exertional dyspnea and chronic productive cough. His oxygen
saturation is 92% on room air. Spirometry demonstrates a reduced FEV₁/FVC ratio
that remains abnormal after administration of a bronchodilator. Which diagnosis
best explains these findings?
A. Restrictive pulmonary disease
B. Chronic obstructive pulmonary disease
C. Interstitial pulmonary fibrosis
D. Neuromuscular respiratory weakness
Answer: B
3. A 46-year-old woman presents with sudden severe unilateral headache
accompanied by nausea, vomiting, photophobia, and neck stiffness. She describes
,2
the headache as the “worst headache of my life” and states that it began abruptly
while exercising. Which diagnosis should the FNP consider most urgently?
A. Migraine with aura
B. Tension-type headache
C. Cluster headache
D. Subarachnoid hemorrhage
Answer: D
4. A 72-year-old patient with hypertension and type 2 diabetes presents for
follow-up. Current medications include lisinopril, hydrochlorothiazide, metformin,
and atorvastatin. Laboratory testing shows an estimated GFR of 42 mL/min/1.73
m². The patient asks why kidney function is being monitored so closely. Which
explanation is most appropriate?
A. Reduced kidney function primarily increases absorption of oral medications
B. Reduced kidney function can decrease renal drug elimination and increase
medication exposure
C. Reduced kidney function prevents medications from binding to plasma proteins
D. Reduced kidney function consistently increases hepatic metabolism of
medications
Answer: B
5. A 34-year-old woman presents with episodic palpitations, tremulousness, heat
intolerance, increased sweating, anxiety, and unintentional weight loss.
Examination reveals a fine tremor and a diffusely enlarged thyroid gland. Which
laboratory pattern would most strongly support the suspected diagnosis?
A. Low TSH with elevated free T4
B. Elevated TSH with low free T4
C. Elevated TSH with elevated free T4
D. Low TSH with low free T4
,3
Answer: A
6. A 59-year-old man presents with substernal chest pressure that occurs when he
walks several blocks and resolves within several minutes after resting. He has
hypertension, hyperlipidemia, and a history of tobacco use. The symptoms have
remained stable for six months. Which clinical description best characterizes his
presentation?
A. Pleuritic chest pain
B. Stable exertional angina
C. Acute pericarditis
D. Aortic dissection
Answer: B
7. A 29-year-old woman presents with dysuria, urinary frequency, and urgency for
two days. She denies vaginal discharge, flank pain, fever, nausea, or vomiting.
Urinalysis demonstrates positive leukocyte esterase and nitrites. Which diagnosis
is most likely?
A. Acute pyelonephritis
B. Nephrolithiasis
C. Acute uncomplicated cystitis
D. Pelvic inflammatory disease
Answer: C
8. A 63-year-old patient reports progressive difficulty swallowing solid foods over
several months. Initially, meat and bread were difficult to swallow, but the patient
now has difficulty swallowing liquids as well. The patient has unintentionally lost
15 lb. Which finding requires the greatest concern?
, 4
A. Occasional heartburn after spicy meals
B. Dysphagia associated with progressive unintentional weight loss
C. Mild bloating after large meals
D. Intermittent belching after carbonated beverages
Answer: B
9. A 51-year-old woman presents with unilateral calf swelling, warmth,
tenderness, and erythema after returning from a 12-hour international flight. She
takes estrogen-containing oral contraceptives. Which condition should be
considered most strongly?
A. Deep venous thrombosis
B. Cellulitis
C. Baker cyst
D. Achilles tendinitis
Answer: A
10. A 24-year-old woman presents with recurrent episodes of wheezing, chest
tightness, and cough that occur after exposure to cats and during exercise.
Symptoms are absent between episodes. Which diagnostic study is most useful
for establishing variable airflow obstruction?
A. Chest radiograph
B. Spirometry with bronchodilator assessment
C. Complete blood count
D. D-dimer testing
Answer: B
11. A 75-year-old woman presents with new-onset unilateral temporal headache
and scalp tenderness. She reports jaw pain when chewing and transient episodes
NSG 6998 FNP PREDICTOR EXAM 2026/2027 ACTUAL QUESTIONS AND
ANSWERS GRADED A+ SOUTH UNIVERSITY
1. A 58-year-old woman presents for an annual primary-care visit and reports
increasing fatigue, constipation, dry skin, and an unexplained 12-lb weight gain
over the past six months. She has no fever and reports that her menstrual periods
have become irregular. Physical examination demonstrates bradycardia and
delayed relaxation of the deep tendon reflexes. Which laboratory evaluation is
most appropriate to initially evaluate the suspected endocrine disorder?
A. Serum TSH and free T4
B. Serum cortisol and ACTH
C. Serum prolactin and FSH
D. Serum calcium and parathyroid hormone
Answer: A
2. A 67-year-old man with a 40-pack-year smoking history presents with
progressive exertional dyspnea and chronic productive cough. His oxygen
saturation is 92% on room air. Spirometry demonstrates a reduced FEV₁/FVC ratio
that remains abnormal after administration of a bronchodilator. Which diagnosis
best explains these findings?
A. Restrictive pulmonary disease
B. Chronic obstructive pulmonary disease
C. Interstitial pulmonary fibrosis
D. Neuromuscular respiratory weakness
Answer: B
3. A 46-year-old woman presents with sudden severe unilateral headache
accompanied by nausea, vomiting, photophobia, and neck stiffness. She describes
,2
the headache as the “worst headache of my life” and states that it began abruptly
while exercising. Which diagnosis should the FNP consider most urgently?
A. Migraine with aura
B. Tension-type headache
C. Cluster headache
D. Subarachnoid hemorrhage
Answer: D
4. A 72-year-old patient with hypertension and type 2 diabetes presents for
follow-up. Current medications include lisinopril, hydrochlorothiazide, metformin,
and atorvastatin. Laboratory testing shows an estimated GFR of 42 mL/min/1.73
m². The patient asks why kidney function is being monitored so closely. Which
explanation is most appropriate?
A. Reduced kidney function primarily increases absorption of oral medications
B. Reduced kidney function can decrease renal drug elimination and increase
medication exposure
C. Reduced kidney function prevents medications from binding to plasma proteins
D. Reduced kidney function consistently increases hepatic metabolism of
medications
Answer: B
5. A 34-year-old woman presents with episodic palpitations, tremulousness, heat
intolerance, increased sweating, anxiety, and unintentional weight loss.
Examination reveals a fine tremor and a diffusely enlarged thyroid gland. Which
laboratory pattern would most strongly support the suspected diagnosis?
A. Low TSH with elevated free T4
B. Elevated TSH with low free T4
C. Elevated TSH with elevated free T4
D. Low TSH with low free T4
,3
Answer: A
6. A 59-year-old man presents with substernal chest pressure that occurs when he
walks several blocks and resolves within several minutes after resting. He has
hypertension, hyperlipidemia, and a history of tobacco use. The symptoms have
remained stable for six months. Which clinical description best characterizes his
presentation?
A. Pleuritic chest pain
B. Stable exertional angina
C. Acute pericarditis
D. Aortic dissection
Answer: B
7. A 29-year-old woman presents with dysuria, urinary frequency, and urgency for
two days. She denies vaginal discharge, flank pain, fever, nausea, or vomiting.
Urinalysis demonstrates positive leukocyte esterase and nitrites. Which diagnosis
is most likely?
A. Acute pyelonephritis
B. Nephrolithiasis
C. Acute uncomplicated cystitis
D. Pelvic inflammatory disease
Answer: C
8. A 63-year-old patient reports progressive difficulty swallowing solid foods over
several months. Initially, meat and bread were difficult to swallow, but the patient
now has difficulty swallowing liquids as well. The patient has unintentionally lost
15 lb. Which finding requires the greatest concern?
, 4
A. Occasional heartburn after spicy meals
B. Dysphagia associated with progressive unintentional weight loss
C. Mild bloating after large meals
D. Intermittent belching after carbonated beverages
Answer: B
9. A 51-year-old woman presents with unilateral calf swelling, warmth,
tenderness, and erythema after returning from a 12-hour international flight. She
takes estrogen-containing oral contraceptives. Which condition should be
considered most strongly?
A. Deep venous thrombosis
B. Cellulitis
C. Baker cyst
D. Achilles tendinitis
Answer: A
10. A 24-year-old woman presents with recurrent episodes of wheezing, chest
tightness, and cough that occur after exposure to cats and during exercise.
Symptoms are absent between episodes. Which diagnostic study is most useful
for establishing variable airflow obstruction?
A. Chest radiograph
B. Spirometry with bronchodilator assessment
C. Complete blood count
D. D-dimer testing
Answer: B
11. A 75-year-old woman presents with new-onset unilateral temporal headache
and scalp tenderness. She reports jaw pain when chewing and transient episodes
