A+ VERIFIED
NURSING · OBJECTIVE ASSESSMENT
NSG 6440 Predictor Final Exam — Complete
Questions and Answers with Explanation, Verified Revised Full Exam
Official Exam
150 Questions Full Rationales Verified Answers
150 5 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Advanced Health Assessment & Diagnostic Reasoning
02 Pharmacology & Prescriptive Practice
03 Chronic & Acute Disease Management
04 Health Promotion & Disease Prevention
05 Professional Role, Ethics & Practice Readiness
ABOUT THIS ASSESSMENT
Build mastery in advanced practice nursing — from health assessment and diagnostic reasoning to pharmacology, prescriptive practice, chronic and acute
disease management, health promotion, and professional practice readiness. This original study bank targets application and analysis skills for the NSG 6440
Predictor Final Exam, with full rationales for every answer. For review use only; not an institutional proctored assessment.
PASSING SCORE LEVEL FORMAT
80% Advanced (Graduate Nursing) Application / Analysis
STUVIA ACTUAL EXAM Page 1
, SECTION 1: Advanced Health Assessment & Diagnostic Reasoning
Q1. A 58-year-old man presents with progressive dyspnea, orthopnea, and bilateral ankle edema. Jugular venous distention is noted and
an S3 is heard at the apex. Which diagnostic finding would most strongly support a diagnosis of heart failure with reduced ejection
fraction?
A. Echocardiogram showing left-ventricular ejection fraction of 35%
B. Resting heart rate of 58 bpm without other findings
C. Clear lung fields on chest radiograph
D. Normal brain natriuretic peptide level
Correct Answer: A
Rationale: HFrEF is defined by reduced LVEF (typically ≤40%). Elevated BNP, pulmonary congestion, and tachycardia are supportive but the
echocardiogram quantifies systolic function and confirms the diagnosis.
Q2. A 34-year-old woman reports secondary amenorrhea for 6 months, hirsutism, and acne. BMI is 32. Which laboratory pattern is most
consistent with polycystic ovary syndrome?
A. Low TSH and elevated free T4
B. Elevated prolactin with normal androgens
C. Elevated LH:FSH ratio, elevated free testosterone, and insulin resistance markers
D. Low cortisol and elevated ACTH
Correct Answer: C
Rationale: PCOS typically shows androgen excess, oligo-anovulation, and often an elevated LH:FSH ratio plus metabolic features. Thyroid, prolactin,
and adrenal axes should be excluded but are not the primary pattern.
Q3. A 72-year-old with new cognitive complaints scores 22/30 on the Mini-Mental State Examination. Which additional assessment
finding would most increase concern for Alzheimer-type dementia rather than normal aging?
A. Progressive impairment in short-term memory and executive function interfering with medication management and finances
B. Subjective forgetfulness with normal performance on standardized testing
C. Occasional word-finding pauses that do not affect daily function
D. Mild slowing of gait with preserved instrumental ADLs
Correct Answer: A
Rationale: Functionally significant decline in memory and executive domains distinguishes dementia from age-related change or mild cognitive
impairment.
Q4. A 45-year-old man has a blood pressure of 168/102 mm Hg on two separate office visits. He has no known target-organ damage.
According to current guidelines, which classification and next step are most appropriate?
A. Elevated blood pressure only; recheck in one year
B. White-coat hypertension until proven otherwise; no treatment
C. Stage 2 hypertension; confirm with out-of-office measurement and initiate lifestyle plus pharmacologic therapy
D. Hypertensive emergency requiring immediate hospitalization
Correct Answer: C
Rationale: BP ≥140/90 on two occasions is Stage 2 hypertension. Out-of-office confirmation is preferred, and both lifestyle and medication are indicated.
Q5. A 29-year-old woman presents with fatigue, weight gain, and cold intolerance. Free T4 is low and TSH is markedly elevated. Which
physical finding is most consistent with primary hypothyroidism?
A. Tachycardia and lid lag
B. Warm moist skin and fine tremor
C. Delayed relaxation phase of deep-tendon reflexes and dry skin
D. Exophthalmos and pretibial myxedema
Correct Answer: C
Rationale: Primary hypothyroidism produces hypometabolic signs including delayed reflexes and dry skin. The other findings are more typical of
hyperthyroidism or Graves disease.
, Q6. A 61-year-old smoker reports a chronic productive cough and progressive dyspnea. Spirometry shows FEV1/FVC ratio of 0.62 and
post-bronchodilator FEV1 of 55% predicted. Which diagnosis is supported?
A. Restrictive lung disease only
B. COPD, moderate airflow obstruction
C. Asthma with complete reversibility
D. Normal spirometry for age
Correct Answer: B
Rationale: Post-bronchodilator FEV1/FVC <0.70 confirms obstruction; FEV1 50–79% predicted corresponds to moderate COPD (GOLD 2).
Q7. A 50-year-old woman has a new 1.2-cm irregularly pigmented lesion on her upper back with color variation and asymmetric borders.
Which action is most appropriate?
A. Reassure that all moles are benign after age 50
B. Apply topical corticosteroid for two weeks and reassess
C. Refer for dermatologic evaluation and possible biopsy using ABCDE criteria
D. Order a serum tumor marker panel before any further evaluation
Correct Answer: C
Rationale: Asymmetry, border irregularity, color variation, and diameter >6 mm warrant prompt specialist evaluation for possible melanoma.
Q8. A 38-year-old man presents with acute right flank pain radiating to the groin, nausea, and microscopic hematuria. Which imaging
study is preferred for initial diagnosis of suspected urolithiasis when radiation exposure is a concern?
A. Non-contrast CT of the abdomen and pelvis is most sensitive, but ultrasound may be used first in selected patients
B. MRI is the first-line study for all patients
C. Plain abdominal radiograph alone is definitive
D. Contrast-enhanced CT exclusively
Correct Answer: A
Rationale: Non-contrast CT is the most sensitive test; ultrasound avoids radiation and is reasonable in younger patients or pregnancy.
Q9. A 67-year-old with atrial fibrillation is found to have a CHA2DS2-VASc score of 4. Which recommendation follows from this score?
A. Aspirin alone is sufficient
B. Dual antiplatelet therapy is preferred over anticoagulation
C. Oral anticoagulation is indicated for stroke prevention unless contraindicated
D. No antithrombotic therapy is needed
Correct Answer: C
Rationale: CHA2DS2-VASc ≥2 in men (or ≥3 in women) warrants anticoagulation for stroke risk reduction.
Q10. A 42-year-old woman reports episodic palpitations, heat intolerance, and unexplained weight loss. TSH is suppressed and free T4
is elevated. Which additional finding supports Graves disease over other causes of hyperthyroidism?
A. Single toxic nodule on uptake scan
B. Painful thyroid with elevated ESR only
C. Recent iodine contrast exposure as the sole trigger
D. Diffuse thyroid enlargement, ophthalmopathy, and positive TSH-receptor antibodies
Correct Answer: D
Rationale: Graves disease features diffuse goiter, orbitopathy, and TSH-receptor antibodies; other etiologies lack these findings.
Q11. A 55-year-old man has a fasting glucose of 126 mg/dL and A1C of 6.7% on repeat testing. Which diagnosis is confirmed?
A. Diabetes mellitus
B. Prediabetes only
C. Stress hyperglycemia exclusively
D. Normal glucose tolerance
Correct Answer: A
Rationale: A1C ≥6.5% or fasting glucose ≥126 mg/dL on two occasions confirms diabetes.
STUVIA ACTUAL EXAM · Page 3
NURSING · OBJECTIVE ASSESSMENT
NSG 6440 Predictor Final Exam — Complete
Questions and Answers with Explanation, Verified Revised Full Exam
Official Exam
150 Questions Full Rationales Verified Answers
150 5 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Advanced Health Assessment & Diagnostic Reasoning
02 Pharmacology & Prescriptive Practice
03 Chronic & Acute Disease Management
04 Health Promotion & Disease Prevention
05 Professional Role, Ethics & Practice Readiness
ABOUT THIS ASSESSMENT
Build mastery in advanced practice nursing — from health assessment and diagnostic reasoning to pharmacology, prescriptive practice, chronic and acute
disease management, health promotion, and professional practice readiness. This original study bank targets application and analysis skills for the NSG 6440
Predictor Final Exam, with full rationales for every answer. For review use only; not an institutional proctored assessment.
PASSING SCORE LEVEL FORMAT
80% Advanced (Graduate Nursing) Application / Analysis
STUVIA ACTUAL EXAM Page 1
, SECTION 1: Advanced Health Assessment & Diagnostic Reasoning
Q1. A 58-year-old man presents with progressive dyspnea, orthopnea, and bilateral ankle edema. Jugular venous distention is noted and
an S3 is heard at the apex. Which diagnostic finding would most strongly support a diagnosis of heart failure with reduced ejection
fraction?
A. Echocardiogram showing left-ventricular ejection fraction of 35%
B. Resting heart rate of 58 bpm without other findings
C. Clear lung fields on chest radiograph
D. Normal brain natriuretic peptide level
Correct Answer: A
Rationale: HFrEF is defined by reduced LVEF (typically ≤40%). Elevated BNP, pulmonary congestion, and tachycardia are supportive but the
echocardiogram quantifies systolic function and confirms the diagnosis.
Q2. A 34-year-old woman reports secondary amenorrhea for 6 months, hirsutism, and acne. BMI is 32. Which laboratory pattern is most
consistent with polycystic ovary syndrome?
A. Low TSH and elevated free T4
B. Elevated prolactin with normal androgens
C. Elevated LH:FSH ratio, elevated free testosterone, and insulin resistance markers
D. Low cortisol and elevated ACTH
Correct Answer: C
Rationale: PCOS typically shows androgen excess, oligo-anovulation, and often an elevated LH:FSH ratio plus metabolic features. Thyroid, prolactin,
and adrenal axes should be excluded but are not the primary pattern.
Q3. A 72-year-old with new cognitive complaints scores 22/30 on the Mini-Mental State Examination. Which additional assessment
finding would most increase concern for Alzheimer-type dementia rather than normal aging?
A. Progressive impairment in short-term memory and executive function interfering with medication management and finances
B. Subjective forgetfulness with normal performance on standardized testing
C. Occasional word-finding pauses that do not affect daily function
D. Mild slowing of gait with preserved instrumental ADLs
Correct Answer: A
Rationale: Functionally significant decline in memory and executive domains distinguishes dementia from age-related change or mild cognitive
impairment.
Q4. A 45-year-old man has a blood pressure of 168/102 mm Hg on two separate office visits. He has no known target-organ damage.
According to current guidelines, which classification and next step are most appropriate?
A. Elevated blood pressure only; recheck in one year
B. White-coat hypertension until proven otherwise; no treatment
C. Stage 2 hypertension; confirm with out-of-office measurement and initiate lifestyle plus pharmacologic therapy
D. Hypertensive emergency requiring immediate hospitalization
Correct Answer: C
Rationale: BP ≥140/90 on two occasions is Stage 2 hypertension. Out-of-office confirmation is preferred, and both lifestyle and medication are indicated.
Q5. A 29-year-old woman presents with fatigue, weight gain, and cold intolerance. Free T4 is low and TSH is markedly elevated. Which
physical finding is most consistent with primary hypothyroidism?
A. Tachycardia and lid lag
B. Warm moist skin and fine tremor
C. Delayed relaxation phase of deep-tendon reflexes and dry skin
D. Exophthalmos and pretibial myxedema
Correct Answer: C
Rationale: Primary hypothyroidism produces hypometabolic signs including delayed reflexes and dry skin. The other findings are more typical of
hyperthyroidism or Graves disease.
, Q6. A 61-year-old smoker reports a chronic productive cough and progressive dyspnea. Spirometry shows FEV1/FVC ratio of 0.62 and
post-bronchodilator FEV1 of 55% predicted. Which diagnosis is supported?
A. Restrictive lung disease only
B. COPD, moderate airflow obstruction
C. Asthma with complete reversibility
D. Normal spirometry for age
Correct Answer: B
Rationale: Post-bronchodilator FEV1/FVC <0.70 confirms obstruction; FEV1 50–79% predicted corresponds to moderate COPD (GOLD 2).
Q7. A 50-year-old woman has a new 1.2-cm irregularly pigmented lesion on her upper back with color variation and asymmetric borders.
Which action is most appropriate?
A. Reassure that all moles are benign after age 50
B. Apply topical corticosteroid for two weeks and reassess
C. Refer for dermatologic evaluation and possible biopsy using ABCDE criteria
D. Order a serum tumor marker panel before any further evaluation
Correct Answer: C
Rationale: Asymmetry, border irregularity, color variation, and diameter >6 mm warrant prompt specialist evaluation for possible melanoma.
Q8. A 38-year-old man presents with acute right flank pain radiating to the groin, nausea, and microscopic hematuria. Which imaging
study is preferred for initial diagnosis of suspected urolithiasis when radiation exposure is a concern?
A. Non-contrast CT of the abdomen and pelvis is most sensitive, but ultrasound may be used first in selected patients
B. MRI is the first-line study for all patients
C. Plain abdominal radiograph alone is definitive
D. Contrast-enhanced CT exclusively
Correct Answer: A
Rationale: Non-contrast CT is the most sensitive test; ultrasound avoids radiation and is reasonable in younger patients or pregnancy.
Q9. A 67-year-old with atrial fibrillation is found to have a CHA2DS2-VASc score of 4. Which recommendation follows from this score?
A. Aspirin alone is sufficient
B. Dual antiplatelet therapy is preferred over anticoagulation
C. Oral anticoagulation is indicated for stroke prevention unless contraindicated
D. No antithrombotic therapy is needed
Correct Answer: C
Rationale: CHA2DS2-VASc ≥2 in men (or ≥3 in women) warrants anticoagulation for stroke risk reduction.
Q10. A 42-year-old woman reports episodic palpitations, heat intolerance, and unexplained weight loss. TSH is suppressed and free T4
is elevated. Which additional finding supports Graves disease over other causes of hyperthyroidism?
A. Single toxic nodule on uptake scan
B. Painful thyroid with elevated ESR only
C. Recent iodine contrast exposure as the sole trigger
D. Diffuse thyroid enlargement, ophthalmopathy, and positive TSH-receptor antibodies
Correct Answer: D
Rationale: Graves disease features diffuse goiter, orbitopathy, and TSH-receptor antibodies; other etiologies lack these findings.
Q11. A 55-year-old man has a fasting glucose of 126 mg/dL and A1C of 6.7% on repeat testing. Which diagnosis is confirmed?
A. Diabetes mellitus
B. Prediabetes only
C. Stress hyperglycemia exclusively
D. Normal glucose tolerance
Correct Answer: A
Rationale: A1C ≥6.5% or fasting glucose ≥126 mg/dL on two occasions confirms diabetes.
STUVIA ACTUAL EXAM · Page 3
