NSG 6440 Predictor Test Prep – 2025–2026
Focus: Advanced nursing concepts, critical
thinking, clinical decision-making, and
preparation for final competency
assessment.
Focus: Advanced Health Assessment & Diagnosis
1. When percussing the posterior chest wall, a hyperresonant sound is noted. This finding is
most associated with:
A. Lobar pneumonia
B. Massive pleural effusion
C. Pulmonary fibrosis
D. Chronic obstructive pulmonary disease (COPD)
Answer: D ✓
2. A patient presents with acute shortness of breath and pleuritic chest pain. On exam, you
note decreased breath sounds and hyperresonance to percussion on the right side. Your initial
suspicion is:
A. Tension pneumothorax
B. Spontaneous pneumothorax
C. Acute asthma exacerbation
D. Pulmonary embolism
Answer: B ✓
3. The Babinski reflex in an adult is characterized by:
A. Flexion of the toes
B. Dorsiflexion of the great toe with fanning of the other toes
C. Inversion and plantar flexion of the foot
D. No response to plantar stimulation
Answer: B ✓
4. A patient with a history of heart failure presents with bilateral pitting edema up to the
knees, jugular venous distension (JVD) at 8 cm, and an S3 gallop. This constellation of findings
,suggests:
A. Isolated right-sided heart failure
B. Compensated heart failure
C. Biventricular heart failure
D. Pericardial tamponade
Answer: C ✓
5. McBurney's point tenderness is most indicative of:
A. Cholecystitis
B. Diverticulitis
C. Appendicitis
D. Pancreatitis
Answer: C ✓
6. The most specific clinical sign for diagnosing bacterial meningitis is:
A. Severe headache
B. Nuchal rigidity
C. Kernig's sign
D. Brudzinski's sign
Answer: C ✓
7. A patient with cirrhosis presents with asterixis. This is best described as:
A. A flapping tremor of the hands when wrists are extended
B. A fixed, dilated pupil
C. A shuffling gait
D. A waxing-and-waning level of consciousness
Answer: A ✓
8. When assessing a patient for deep vein thrombosis (DVT), Homan's sign is:
A. A reliable and definitive diagnostic tool
B. No longer recommended due to poor sensitivity and specificity
C. Positive if pain is elicited with passive dorsiflexion of the foot
D. Both B and C
Answer: D ✓
Focus: Pharmacology & Therapeutics
9. A patient on Lisinopril for hypertension develops a persistent, dry cough. The nurse
practitioner understands this is due to:
, A. Hyperkalemia
B. Accumulation of bradykinin
C. Acute renal failure
D. Angioedema of the airways
Answer: B ✓
10. The first-line pharmacologic treatment for uncomplicated hypertension in an African
American patient is typically:
A. ACE Inhibitor
B. Thiazide Diuretic or Calcium Channel Blocker
C. Beta-Blocker
D. Alpha-Blocker
Answer: B ✓
11. Metformin should be temporarily discontinued prior to procedures involving IV contrast
dye to prevent:
A. Hypoglycemia
B. Lactic Acidosis
C. Acute Hepatitis
D. Contrast-induced neuropathy
Answer: B ✓
12. Warfarin (Coumadin) therapy is monitored using the International Normalized Ratio (INR).
The therapeutic goal for most conditions (e.g., atrial fibrillation, DVT) is:
A. 1.0 - 1.5
B. 1.5 - 2.0
C. 2.0 - 3.0
D. 3.0 - 4.0
Answer: C ✓
13. A patient prescribed a Nitrate for angina should be counseled to avoid concomitant use of
Phosphodiesterase-5 inhibitors (e.g., Sildenafil) due to the risk of:
A. Severe hypertension
B. Profound hypotension
C. Cardiac arrhythmia
D. Priapism
Answer: B ✓
14. Which class of antibiotics is associated with tendon rupture and should be used with
caution in patients on corticosteroids?
Focus: Advanced nursing concepts, critical
thinking, clinical decision-making, and
preparation for final competency
assessment.
Focus: Advanced Health Assessment & Diagnosis
1. When percussing the posterior chest wall, a hyperresonant sound is noted. This finding is
most associated with:
A. Lobar pneumonia
B. Massive pleural effusion
C. Pulmonary fibrosis
D. Chronic obstructive pulmonary disease (COPD)
Answer: D ✓
2. A patient presents with acute shortness of breath and pleuritic chest pain. On exam, you
note decreased breath sounds and hyperresonance to percussion on the right side. Your initial
suspicion is:
A. Tension pneumothorax
B. Spontaneous pneumothorax
C. Acute asthma exacerbation
D. Pulmonary embolism
Answer: B ✓
3. The Babinski reflex in an adult is characterized by:
A. Flexion of the toes
B. Dorsiflexion of the great toe with fanning of the other toes
C. Inversion and plantar flexion of the foot
D. No response to plantar stimulation
Answer: B ✓
4. A patient with a history of heart failure presents with bilateral pitting edema up to the
knees, jugular venous distension (JVD) at 8 cm, and an S3 gallop. This constellation of findings
,suggests:
A. Isolated right-sided heart failure
B. Compensated heart failure
C. Biventricular heart failure
D. Pericardial tamponade
Answer: C ✓
5. McBurney's point tenderness is most indicative of:
A. Cholecystitis
B. Diverticulitis
C. Appendicitis
D. Pancreatitis
Answer: C ✓
6. The most specific clinical sign for diagnosing bacterial meningitis is:
A. Severe headache
B. Nuchal rigidity
C. Kernig's sign
D. Brudzinski's sign
Answer: C ✓
7. A patient with cirrhosis presents with asterixis. This is best described as:
A. A flapping tremor of the hands when wrists are extended
B. A fixed, dilated pupil
C. A shuffling gait
D. A waxing-and-waning level of consciousness
Answer: A ✓
8. When assessing a patient for deep vein thrombosis (DVT), Homan's sign is:
A. A reliable and definitive diagnostic tool
B. No longer recommended due to poor sensitivity and specificity
C. Positive if pain is elicited with passive dorsiflexion of the foot
D. Both B and C
Answer: D ✓
Focus: Pharmacology & Therapeutics
9. A patient on Lisinopril for hypertension develops a persistent, dry cough. The nurse
practitioner understands this is due to:
, A. Hyperkalemia
B. Accumulation of bradykinin
C. Acute renal failure
D. Angioedema of the airways
Answer: B ✓
10. The first-line pharmacologic treatment for uncomplicated hypertension in an African
American patient is typically:
A. ACE Inhibitor
B. Thiazide Diuretic or Calcium Channel Blocker
C. Beta-Blocker
D. Alpha-Blocker
Answer: B ✓
11. Metformin should be temporarily discontinued prior to procedures involving IV contrast
dye to prevent:
A. Hypoglycemia
B. Lactic Acidosis
C. Acute Hepatitis
D. Contrast-induced neuropathy
Answer: B ✓
12. Warfarin (Coumadin) therapy is monitored using the International Normalized Ratio (INR).
The therapeutic goal for most conditions (e.g., atrial fibrillation, DVT) is:
A. 1.0 - 1.5
B. 1.5 - 2.0
C. 2.0 - 3.0
D. 3.0 - 4.0
Answer: C ✓
13. A patient prescribed a Nitrate for angina should be counseled to avoid concomitant use of
Phosphodiesterase-5 inhibitors (e.g., Sildenafil) due to the risk of:
A. Severe hypertension
B. Profound hypotension
C. Cardiac arrhythmia
D. Priapism
Answer: B ✓
14. Which class of antibiotics is associated with tendon rupture and should be used with
caution in patients on corticosteroids?
