NSG 554 Exam 3 – Nurse Practitioners in Primary Care I
| 65 Actual Questions and Answers + Expert Rationales |
2026/27 Updates | 100% correct
1. Pelvic Inflammatory Disease (PID): Definition
· A) An infection of the female reproductive organs, including the uterus, fallopian
tubes, and ovaries, often resulting from the ascent of bacteria from the lower
genital tract
· B) A viral infection of the cervix
· C) A fungal infection of the vagina
· D) A bacterial infection of the urinary bladder
Correct Answer: A) An infection of the female reproductive organs, including the
uterus, fallopian tubes, and ovaries, often resulting from the ascent of bacteria from
the lower genital tract
Expert Rationale: PID is a polymicrobial infection that ascends from the cervix
and vagina to involve the endometrium, fallopian tubes, and ovaries. It is most
commonly caused by sexually transmitted organisms (Chlamydia trachomatis and
Neisseria gonorrhoeae), though other bacteria can also be involved. If untreated, it
can lead to serious complications including infertility, ectopic pregnancy, and
chronic pelvic pain.
, 2. PID: Most Common Causes
· A) Escherichia coli and Staphylococcus aureus
· B) Candida albicans and Trichomonas vaginalis
· C) Human papillomavirus and herpes simplex virus
· D) Chlamydia trachomatis and Neisseria gonorrhoeae
Correct Answer: D) Chlamydia trachomatis and Neisseria gonorrhoeae
Expert Rationale: The most common pathogens associated with PID are
Chlamydia trachomatis and Neisseria gonorrhoeae, which ascend from the lower
genital tract. Other organisms such as bacterial vaginosis-associated bacteria
(Gardnerella vaginalis, Mycoplasma genitalium) can also contribute.
3. Exercise Stress Test: Indications
· A) Used for detection of ischemia in asymptomatic patients with no history of
revascularization
· B) Used only in patients with known coronary artery disease
· C) Used as a screening test for all patients over 50
· D) Used to assess CAD in patients with chest pain or dyspnea with intermediate
risk of ACS; also shows functional capacity which is a predictor of future cardiac
events
,Correct Answer: D) Used to assess CAD in patients with chest pain or dyspnea
with intermediate risk of ACS; also shows functional capacity which is a predictor
of future cardiac events
Expert Rationale: Exercise stress testing is indicated for patients with symptoms
suggestive of coronary artery disease (CAD), such as chest pain or dyspnea on
exertion, particularly those with intermediate pretest probability. It is NOT
recommended for routine screening in asymptomatic patients without risk factors
or history of revascularization. The test provides important prognostic information
about functional capacity.
4. Exercise Stress Test: Positive vs. Negative Results
· A) Positive if development of horizontal or downsloping ST depression of ≥1
mm; Negative if patient exercises to at least 85% of age-predicted max heart rate
without evidence of inducible ischemia
· B) Positive if ST elevation occurs; Negative if any ST changes occur
· C) Positive if patient cannot reach target heart rate; Negative if patient reaches
target heart rate
· D) Positive only if chest pain occurs during the test
Correct Answer: A) Positive if development of horizontal or downsloping ST
depression of ≥1 mm; Negative if patient exercises to at least 85% of age-predicted
max heart rate without evidence of inducible ischemia
, Expert Rationale: An exercise stress test is considered positive (abnormal) when
there is ≥1 mm horizontal or downsloping ST-segment depression measured 60-80
ms after the J point. A negative test requires the patient to achieve at least 85% of
their maximum predicted heart rate (220 – age) without ECG changes or
symptoms, providing good prognostic value.
5. Medications That Reduce Exercise Test Diagnostic Accuracy
· A) Statins and aspirin
· B) Beta-blockers, digoxin, calcium channel blockers, antihypertensives
· C) ACE inhibitors and ARBs
· D) Diuretics and nitrates
Correct Answer: B) Beta-blockers, digoxin, calcium channel blockers,
antihypertensives.
Expert Rationale: Medications that lower heart rate or alter myocardial oxygen
demand reduce the diagnostic accuracy of exercise stress testing. Beta-blockers,
calcium channel blockers, and digoxin prevent achieving target heart rate.
Antihypertensives may affect blood pressure response. Consultation with
cardiology is recommended before withholding these medications.
6. Pharmacologic Stress Testing: Indications
| 65 Actual Questions and Answers + Expert Rationales |
2026/27 Updates | 100% correct
1. Pelvic Inflammatory Disease (PID): Definition
· A) An infection of the female reproductive organs, including the uterus, fallopian
tubes, and ovaries, often resulting from the ascent of bacteria from the lower
genital tract
· B) A viral infection of the cervix
· C) A fungal infection of the vagina
· D) A bacterial infection of the urinary bladder
Correct Answer: A) An infection of the female reproductive organs, including the
uterus, fallopian tubes, and ovaries, often resulting from the ascent of bacteria from
the lower genital tract
Expert Rationale: PID is a polymicrobial infection that ascends from the cervix
and vagina to involve the endometrium, fallopian tubes, and ovaries. It is most
commonly caused by sexually transmitted organisms (Chlamydia trachomatis and
Neisseria gonorrhoeae), though other bacteria can also be involved. If untreated, it
can lead to serious complications including infertility, ectopic pregnancy, and
chronic pelvic pain.
, 2. PID: Most Common Causes
· A) Escherichia coli and Staphylococcus aureus
· B) Candida albicans and Trichomonas vaginalis
· C) Human papillomavirus and herpes simplex virus
· D) Chlamydia trachomatis and Neisseria gonorrhoeae
Correct Answer: D) Chlamydia trachomatis and Neisseria gonorrhoeae
Expert Rationale: The most common pathogens associated with PID are
Chlamydia trachomatis and Neisseria gonorrhoeae, which ascend from the lower
genital tract. Other organisms such as bacterial vaginosis-associated bacteria
(Gardnerella vaginalis, Mycoplasma genitalium) can also contribute.
3. Exercise Stress Test: Indications
· A) Used for detection of ischemia in asymptomatic patients with no history of
revascularization
· B) Used only in patients with known coronary artery disease
· C) Used as a screening test for all patients over 50
· D) Used to assess CAD in patients with chest pain or dyspnea with intermediate
risk of ACS; also shows functional capacity which is a predictor of future cardiac
events
,Correct Answer: D) Used to assess CAD in patients with chest pain or dyspnea
with intermediate risk of ACS; also shows functional capacity which is a predictor
of future cardiac events
Expert Rationale: Exercise stress testing is indicated for patients with symptoms
suggestive of coronary artery disease (CAD), such as chest pain or dyspnea on
exertion, particularly those with intermediate pretest probability. It is NOT
recommended for routine screening in asymptomatic patients without risk factors
or history of revascularization. The test provides important prognostic information
about functional capacity.
4. Exercise Stress Test: Positive vs. Negative Results
· A) Positive if development of horizontal or downsloping ST depression of ≥1
mm; Negative if patient exercises to at least 85% of age-predicted max heart rate
without evidence of inducible ischemia
· B) Positive if ST elevation occurs; Negative if any ST changes occur
· C) Positive if patient cannot reach target heart rate; Negative if patient reaches
target heart rate
· D) Positive only if chest pain occurs during the test
Correct Answer: A) Positive if development of horizontal or downsloping ST
depression of ≥1 mm; Negative if patient exercises to at least 85% of age-predicted
max heart rate without evidence of inducible ischemia
, Expert Rationale: An exercise stress test is considered positive (abnormal) when
there is ≥1 mm horizontal or downsloping ST-segment depression measured 60-80
ms after the J point. A negative test requires the patient to achieve at least 85% of
their maximum predicted heart rate (220 – age) without ECG changes or
symptoms, providing good prognostic value.
5. Medications That Reduce Exercise Test Diagnostic Accuracy
· A) Statins and aspirin
· B) Beta-blockers, digoxin, calcium channel blockers, antihypertensives
· C) ACE inhibitors and ARBs
· D) Diuretics and nitrates
Correct Answer: B) Beta-blockers, digoxin, calcium channel blockers,
antihypertensives.
Expert Rationale: Medications that lower heart rate or alter myocardial oxygen
demand reduce the diagnostic accuracy of exercise stress testing. Beta-blockers,
calcium channel blockers, and digoxin prevent achieving target heart rate.
Antihypertensives may affect blood pressure response. Consultation with
cardiology is recommended before withholding these medications.
6. Pharmacologic Stress Testing: Indications
