NSG6020 / NSG 6020 Final Exam 2025 Questions
and Answers Updated () (Verified
Answers plus Rationales
1. A 55-year-old male presents with chest pain that radiates to his left arm.
What is the most appropriate initial diagnostic test?
ECG
An ECG is the first-line diagnostic test to assess for myocardial ischemia or
infarction.
2. Which antihypertensive is contraindicated in pregnancy?
Lisinopril
ACE inhibitors like lisinopril are teratogenic and should be avoided during
pregnancy.
3. What is the most likely cause of microcytic anemia?
Iron deficiency anemia
Iron deficiency is the most common cause of microcytic anemia, especially in
menstruating women or those with GI blood loss.
4. Which medication is first-line for type 2 diabetes?
Metformin
,Metformin is the recommended initial pharmacologic agent due to its efficacy,
safety, and low cost.
5. A patient on warfarin has an INR of 5.0 but is not bleeding. What is the
recommended action?
Hold warfarin and monitor INR
With an INR of 5.0 and no bleeding, warfarin should be held, and INR should be
closely monitored.
6. Which cranial nerve is responsible for facial symmetry?
CN VII
The facial nerve (CN VII) controls facial expression and symmetry.
7. A patient presents with sudden onset severe headache and neck stiffness.
What condition must be ruled out first?
Subarachnoid hemorrhage
These symptoms are classic for subarachnoid hemorrhage and require
immediate imaging.
8. What is the best test to confirm hypothyroidism?
TSH and Free T4
TSH is the most sensitive test, and Free T4 confirms the diagnosis.
9. Which heart sound is associated with heart failure?
S3
An S3 gallop indicates volume overload and is often heard in systolic heart
failure.
, 10.A diabetic patient has proteinuria. What class of drug should be started?
ACE inhibitor
ACE inhibitors reduce proteinuria and protect kidney function in diabetic
nephropathy.
11.What is the most common cause of secondary hypertension?
Renal artery stenosis
Renal artery stenosis is the leading reversible cause of secondary hypertension.
12.Which condition is associated with elevated TSH and low free T4?
Primary hypothyroidism
In primary hypothyroidism, the thyroid fails, causing elevated TSH and low T4.
13.What is the treatment of choice for acute otitis media?
Amoxicillin
Amoxicillin is first-line therapy for most uncomplicated cases.
14.What is a red flag symptom in a patient with low back pain?
Bowel or bladder incontinence
This suggests cauda equina syndrome, a surgical emergency.
15.Which medication should be avoided in asthmatics?
Non-selective beta blockers
These can provoke bronchospasm by blocking beta-2 receptors.
16.What lab value confirms a diagnosis of diabetes?
Fasting glucose ≥126 mg/dL
, A fasting glucose of 126 or more confirms diabetes per ADA criteria.
17.What is the hallmark sign of appendicitis?
RLQ tenderness (McBurney's point)
Pain at McBurney’s point is classic for appendicitis.
18.What is the most appropriate imaging for suspected pulmonary embolism?
CT pulmonary angiography
This is the gold standard for PE diagnosis.
19.A positive Phalen’s and Tinel’s test indicates:
Carpal tunnel syndrome
These maneuvers reproduce symptoms of median nerve compression.
20.What is the first-line treatment for generalized anxiety disorder?
SSRIs
SSRIs are first-line pharmacologic treatment for GAD due to their efficacy and
tolerability.
21.A patient has been diagnosed with GERD. Which class of medication is most
effective?
Proton pump inhibitors
PPIs provide superior acid suppression and symptom relief.
22.What is the first-line antibiotic for uncomplicated cystitis?
Nitrofurantoin
Nitrofurantoin is effective and has low resistance for uncomplicated UTIs.
and Answers Updated () (Verified
Answers plus Rationales
1. A 55-year-old male presents with chest pain that radiates to his left arm.
What is the most appropriate initial diagnostic test?
ECG
An ECG is the first-line diagnostic test to assess for myocardial ischemia or
infarction.
2. Which antihypertensive is contraindicated in pregnancy?
Lisinopril
ACE inhibitors like lisinopril are teratogenic and should be avoided during
pregnancy.
3. What is the most likely cause of microcytic anemia?
Iron deficiency anemia
Iron deficiency is the most common cause of microcytic anemia, especially in
menstruating women or those with GI blood loss.
4. Which medication is first-line for type 2 diabetes?
Metformin
,Metformin is the recommended initial pharmacologic agent due to its efficacy,
safety, and low cost.
5. A patient on warfarin has an INR of 5.0 but is not bleeding. What is the
recommended action?
Hold warfarin and monitor INR
With an INR of 5.0 and no bleeding, warfarin should be held, and INR should be
closely monitored.
6. Which cranial nerve is responsible for facial symmetry?
CN VII
The facial nerve (CN VII) controls facial expression and symmetry.
7. A patient presents with sudden onset severe headache and neck stiffness.
What condition must be ruled out first?
Subarachnoid hemorrhage
These symptoms are classic for subarachnoid hemorrhage and require
immediate imaging.
8. What is the best test to confirm hypothyroidism?
TSH and Free T4
TSH is the most sensitive test, and Free T4 confirms the diagnosis.
9. Which heart sound is associated with heart failure?
S3
An S3 gallop indicates volume overload and is often heard in systolic heart
failure.
, 10.A diabetic patient has proteinuria. What class of drug should be started?
ACE inhibitor
ACE inhibitors reduce proteinuria and protect kidney function in diabetic
nephropathy.
11.What is the most common cause of secondary hypertension?
Renal artery stenosis
Renal artery stenosis is the leading reversible cause of secondary hypertension.
12.Which condition is associated with elevated TSH and low free T4?
Primary hypothyroidism
In primary hypothyroidism, the thyroid fails, causing elevated TSH and low T4.
13.What is the treatment of choice for acute otitis media?
Amoxicillin
Amoxicillin is first-line therapy for most uncomplicated cases.
14.What is a red flag symptom in a patient with low back pain?
Bowel or bladder incontinence
This suggests cauda equina syndrome, a surgical emergency.
15.Which medication should be avoided in asthmatics?
Non-selective beta blockers
These can provoke bronchospasm by blocking beta-2 receptors.
16.What lab value confirms a diagnosis of diabetes?
Fasting glucose ≥126 mg/dL
, A fasting glucose of 126 or more confirms diabetes per ADA criteria.
17.What is the hallmark sign of appendicitis?
RLQ tenderness (McBurney's point)
Pain at McBurney’s point is classic for appendicitis.
18.What is the most appropriate imaging for suspected pulmonary embolism?
CT pulmonary angiography
This is the gold standard for PE diagnosis.
19.A positive Phalen’s and Tinel’s test indicates:
Carpal tunnel syndrome
These maneuvers reproduce symptoms of median nerve compression.
20.What is the first-line treatment for generalized anxiety disorder?
SSRIs
SSRIs are first-line pharmacologic treatment for GAD due to their efficacy and
tolerability.
21.A patient has been diagnosed with GERD. Which class of medication is most
effective?
Proton pump inhibitors
PPIs provide superior acid suppression and symptom relief.
22.What is the first-line antibiotic for uncomplicated cystitis?
Nitrofurantoin
Nitrofurantoin is effective and has low resistance for uncomplicated UTIs.
