NSG6440 TEST SCRIPT
UPDATED ACTUAL Exam Questions and CORRECT Answers
Question 1.
Which of the following class of drugs is preferred treatment for a diabetic with stage II
hypertension?
a. Calcium channel blockers
b. Alpha blockers
c. Angiotensin converting enzyme inhibitor
d. Loop diuretics
Correct Answer: Angiotensin converting enzyme inhibitor
Question 2.
You are caring for a 30-year-old white male in your office with a BP of 144/90. He has
never had a diagnosis of hypertension. He doesn't check his blood pressure at home. He
has a family history of hypertension. What are your recommendations?
a. Start HCTZ 12.5mg daily, purchase a blood pressure cuff, and return to your office in
1 mth
b. Instruct to purchase a BP cuff, record blood pressures, call if over 140's over 90's, low
salt diet, return in 2 weeks.
c. Order EKG, CMP, CBC, and lipid panel, and refer to cardiology.
d. Order a cardiac stress test and lipid panel.
Correct Answer: Instruct to purchase a BP cuff, record blood pressures, call if
over 140's over 90's, low salt diet, return in 2 weeks
Question 3.
You are treating a young adult female with HTN and migraine headaches. Which class of
medications could you choose to treat both?
Ace inhibitors Calcium channel blockers Beta blockers Angiotensin receptor blockers
Correct Answer: Beta blockers
• A 42-year-old male presents with the following lipid profile. He is not on any
medications for cholesterol or herbal supplements. Total: 210 LDL: 145 TG 162
HDL 52 What medication would you recommend?
a. Low dose statin
b. Low dose bile acid sequestrant
c. Low dose fibrate
d. Fish oil -✓✓Low dose statin
Question 4.
You are caring for a 68-year-old male who has been taking atorvastain (Lipitor) for 8
weeks. He complains of fatigue, muscle aches, and dark-colored urine. Which of the
following is the most appropriate treatment plan?
a. Order a CBC and CMP.
,b. Order lipid level and serum creatine phosphokinase (CPK, creatine kinase)
c. Order a 24 hr urine
d. Recommend increasing his fluids and rest.
Correct Answer: Order lipid level and serum creatine phosphokinase (CPK,
creatine kinase).
Question 5.
What would you advise this patient regarding taking his atrovastatin (Lipitor)?
Continuing taking the medication until the labs are available Take atorvastatin every
other day until labs are available Take half of the atorvastatin every other day until labs
are available Stop taking the atorvastatin until the labs are available
Correct Answer: Stop taking atorvastatin until the labs are available.
• A 58 year old male presents to your office with an episode of chest tightness
in his substernal area that radiated to his back while he was jogging. It was
relieved with rest. Which of the following does this best describe?
Acute myocardial infarction Gastroesophageal reflux disease Angina pectoris
Acute costochondritis -✓✓Angina pectoris
Question 6.
What is the most common cause of left ventricular hypertrophy in the United States?
Mitral valve prolapse Chronic atrial fibrillation Pulmonary hypertension Chronic
hypertension
Correct Answer: Chronic hypertension
Question 7.
Which of the following heart sounds is associated with heart failure?
Still's murmer and S4 S3 S1, S2, and S4 S1, S2, and S3
Correct Answer: S3
Question 8.
While performing a routine physical exam on a 60-year-old hypertensive male, you
notice a bruit over the carotid area on the left side of the neck. There is no induration of
the skin. This patient is at higher risk for:
Stroke and coronary heart disease Temporal arteritis and brain aneurysms Abdominal
aneurysm and congestive heart gailure Dizziness and headaches
Correct Answer: Stroke and coronary heart disease
Question 9.
A 72-year-old female presents to your office with gradual difficulty breathing,
non-productive cough, bilateral swelling of her feet, and a 10 pound weight gain. Upon
,examination you hear crackles and rhonchi with an S3 heart sound. What is the most
likely diagnosis? COPD Renal hypertension Congestive heart hailure Asthma
Correct Answer: Congestive heart failure
Question 10.
What is your treatment plan for this patient with difficulty breathing, cough, weight gain,
edema, and S3 heart sounds?
Rest and increase fluids Diuretics, digoxin, and anti-hypertensive medications Nebulized
albuterol and prednisone Anti-coagulation and cardiology evaluation
Correct Answer: Diuretics, digoxin, and anti- hypertensive medications
Question 11.
You are treating a 49-year-old female who presents with fatigue and palpitations. You
check her apical pulse and she is irregular and tachycardic. You obtain an EKG and it
reveals afib with rapid ventricular response. What is your treatment plan?
You order a 2D echo. You admit her to the hospital for new onset afib. You perform
cardiac massage and have her relax. You order a cardiology consult.
Correct Answer: You admit her to the hospital for new onset afib.
Question 12.
Upon examination of a 17-year-old during a sports physical, you hear a split S2 during
inspiration that disappears during expiration. The patient denies chest pain and
dyspnea. What will you tell the mother and patient regarding your findings?
You advise the patient to avoid strenuous physical activity until further investigation
You recommend a referral to cardiology.
Due to the patient being an athlete, you recommend a stress echo Educate the mother
and patient that this is a benign finding
Correct Answer: Educate the mother and patient that this is a benign finding.
Question 13.
The first sign of an asthma exacerbation is:
Cough Wheeze Dyspnea Chest tightness
Correct Answer: Cough
Question 14.
According to the NAEPP-3 Guidelines for the Treatment and Management of Asthma,
what is the gold standard for daily treatment of mild-persistent asthma?
Inhaled steroids Long-acting bronchodliators Short-acting bronchodilators Combination
therapies
Correct Answer: Inhaled steroids
, Question 15.
You are treating an adult asthma patient and reviewing her metered dose inhaler (MDI)
technique. She demonstrates her MDI technique by shaking the inhaler, placing the
inhaler in her mouth, pressing the canister, and inhaling quickly. What is your response?
You praise the patient for demonstrating the correct MDI technique
You educate the patient taht, first, she should exhale fully, then shake the inhale, and
finally, as she presses the canister, inhale slowly and fully
You instruct the patient to take a faster, even inspiratory effort
You educate the patient that she should always use a spacer or holding chamber with all
MDI's
Correct Answer: You educate the patient that, first, she should exhale fully,
then shake the inhaler, and finally, as she presses the canister, inhale slowly
and fully.
Question 16.
An adult patient with a history of chronic obstructive lung disease (COPD) presents to
your office with 1 day of worsening shortness of breath, wheezing, and non-productive
cough. You determine he has a COPD exacerbation. What is your treatment plan?
Chest x-ray
Levaquin 500 mg QD for 7 days, Prednisone spurt, Albuterol/Atrovent inhaler 2 puffs QID
7 - 10 day prednisone spurt, Albuterol/Atrovent inhaler 2 puffs QID
Z-pak, 7 - 10 day prednisone spurt, Atrovent inhaler 2 puffs QID
Correct Answer: 7-10 days prednisone spurt, Albuterol/Atrovent inhaler 2
puffs QID
Question 17.
All of the following are useful in treating patients with COPD except:
Antihistamines Anticholinergics Oral steroids Short-acting beta2-agonists
Correct Answer: Antihistamines
Question 18.
Which of the following is less likely to be found in a patient with emphysema dominant
COPD?
A cough that is productive with large amounts of sputum Prolonged expiration Exertional
dyspnea Weight loss
Correct Answer: A cough that is productive with large amounts of purulent
sputum
• You are treating a patient in your office whom you suspect has chronic lung
disease, but you are unsure if you should start treatment today. What do you
consider ordering first?
A pulmonary consult A chest x-ray An office spirometry A pulmonary function
test -✓✓An office spirometry
UPDATED ACTUAL Exam Questions and CORRECT Answers
Question 1.
Which of the following class of drugs is preferred treatment for a diabetic with stage II
hypertension?
a. Calcium channel blockers
b. Alpha blockers
c. Angiotensin converting enzyme inhibitor
d. Loop diuretics
Correct Answer: Angiotensin converting enzyme inhibitor
Question 2.
You are caring for a 30-year-old white male in your office with a BP of 144/90. He has
never had a diagnosis of hypertension. He doesn't check his blood pressure at home. He
has a family history of hypertension. What are your recommendations?
a. Start HCTZ 12.5mg daily, purchase a blood pressure cuff, and return to your office in
1 mth
b. Instruct to purchase a BP cuff, record blood pressures, call if over 140's over 90's, low
salt diet, return in 2 weeks.
c. Order EKG, CMP, CBC, and lipid panel, and refer to cardiology.
d. Order a cardiac stress test and lipid panel.
Correct Answer: Instruct to purchase a BP cuff, record blood pressures, call if
over 140's over 90's, low salt diet, return in 2 weeks
Question 3.
You are treating a young adult female with HTN and migraine headaches. Which class of
medications could you choose to treat both?
Ace inhibitors Calcium channel blockers Beta blockers Angiotensin receptor blockers
Correct Answer: Beta blockers
• A 42-year-old male presents with the following lipid profile. He is not on any
medications for cholesterol or herbal supplements. Total: 210 LDL: 145 TG 162
HDL 52 What medication would you recommend?
a. Low dose statin
b. Low dose bile acid sequestrant
c. Low dose fibrate
d. Fish oil -✓✓Low dose statin
Question 4.
You are caring for a 68-year-old male who has been taking atorvastain (Lipitor) for 8
weeks. He complains of fatigue, muscle aches, and dark-colored urine. Which of the
following is the most appropriate treatment plan?
a. Order a CBC and CMP.
,b. Order lipid level and serum creatine phosphokinase (CPK, creatine kinase)
c. Order a 24 hr urine
d. Recommend increasing his fluids and rest.
Correct Answer: Order lipid level and serum creatine phosphokinase (CPK,
creatine kinase).
Question 5.
What would you advise this patient regarding taking his atrovastatin (Lipitor)?
Continuing taking the medication until the labs are available Take atorvastatin every
other day until labs are available Take half of the atorvastatin every other day until labs
are available Stop taking the atorvastatin until the labs are available
Correct Answer: Stop taking atorvastatin until the labs are available.
• A 58 year old male presents to your office with an episode of chest tightness
in his substernal area that radiated to his back while he was jogging. It was
relieved with rest. Which of the following does this best describe?
Acute myocardial infarction Gastroesophageal reflux disease Angina pectoris
Acute costochondritis -✓✓Angina pectoris
Question 6.
What is the most common cause of left ventricular hypertrophy in the United States?
Mitral valve prolapse Chronic atrial fibrillation Pulmonary hypertension Chronic
hypertension
Correct Answer: Chronic hypertension
Question 7.
Which of the following heart sounds is associated with heart failure?
Still's murmer and S4 S3 S1, S2, and S4 S1, S2, and S3
Correct Answer: S3
Question 8.
While performing a routine physical exam on a 60-year-old hypertensive male, you
notice a bruit over the carotid area on the left side of the neck. There is no induration of
the skin. This patient is at higher risk for:
Stroke and coronary heart disease Temporal arteritis and brain aneurysms Abdominal
aneurysm and congestive heart gailure Dizziness and headaches
Correct Answer: Stroke and coronary heart disease
Question 9.
A 72-year-old female presents to your office with gradual difficulty breathing,
non-productive cough, bilateral swelling of her feet, and a 10 pound weight gain. Upon
,examination you hear crackles and rhonchi with an S3 heart sound. What is the most
likely diagnosis? COPD Renal hypertension Congestive heart hailure Asthma
Correct Answer: Congestive heart failure
Question 10.
What is your treatment plan for this patient with difficulty breathing, cough, weight gain,
edema, and S3 heart sounds?
Rest and increase fluids Diuretics, digoxin, and anti-hypertensive medications Nebulized
albuterol and prednisone Anti-coagulation and cardiology evaluation
Correct Answer: Diuretics, digoxin, and anti- hypertensive medications
Question 11.
You are treating a 49-year-old female who presents with fatigue and palpitations. You
check her apical pulse and she is irregular and tachycardic. You obtain an EKG and it
reveals afib with rapid ventricular response. What is your treatment plan?
You order a 2D echo. You admit her to the hospital for new onset afib. You perform
cardiac massage and have her relax. You order a cardiology consult.
Correct Answer: You admit her to the hospital for new onset afib.
Question 12.
Upon examination of a 17-year-old during a sports physical, you hear a split S2 during
inspiration that disappears during expiration. The patient denies chest pain and
dyspnea. What will you tell the mother and patient regarding your findings?
You advise the patient to avoid strenuous physical activity until further investigation
You recommend a referral to cardiology.
Due to the patient being an athlete, you recommend a stress echo Educate the mother
and patient that this is a benign finding
Correct Answer: Educate the mother and patient that this is a benign finding.
Question 13.
The first sign of an asthma exacerbation is:
Cough Wheeze Dyspnea Chest tightness
Correct Answer: Cough
Question 14.
According to the NAEPP-3 Guidelines for the Treatment and Management of Asthma,
what is the gold standard for daily treatment of mild-persistent asthma?
Inhaled steroids Long-acting bronchodliators Short-acting bronchodilators Combination
therapies
Correct Answer: Inhaled steroids
, Question 15.
You are treating an adult asthma patient and reviewing her metered dose inhaler (MDI)
technique. She demonstrates her MDI technique by shaking the inhaler, placing the
inhaler in her mouth, pressing the canister, and inhaling quickly. What is your response?
You praise the patient for demonstrating the correct MDI technique
You educate the patient taht, first, she should exhale fully, then shake the inhale, and
finally, as she presses the canister, inhale slowly and fully
You instruct the patient to take a faster, even inspiratory effort
You educate the patient that she should always use a spacer or holding chamber with all
MDI's
Correct Answer: You educate the patient that, first, she should exhale fully,
then shake the inhaler, and finally, as she presses the canister, inhale slowly
and fully.
Question 16.
An adult patient with a history of chronic obstructive lung disease (COPD) presents to
your office with 1 day of worsening shortness of breath, wheezing, and non-productive
cough. You determine he has a COPD exacerbation. What is your treatment plan?
Chest x-ray
Levaquin 500 mg QD for 7 days, Prednisone spurt, Albuterol/Atrovent inhaler 2 puffs QID
7 - 10 day prednisone spurt, Albuterol/Atrovent inhaler 2 puffs QID
Z-pak, 7 - 10 day prednisone spurt, Atrovent inhaler 2 puffs QID
Correct Answer: 7-10 days prednisone spurt, Albuterol/Atrovent inhaler 2
puffs QID
Question 17.
All of the following are useful in treating patients with COPD except:
Antihistamines Anticholinergics Oral steroids Short-acting beta2-agonists
Correct Answer: Antihistamines
Question 18.
Which of the following is less likely to be found in a patient with emphysema dominant
COPD?
A cough that is productive with large amounts of sputum Prolonged expiration Exertional
dyspnea Weight loss
Correct Answer: A cough that is productive with large amounts of purulent
sputum
• You are treating a patient in your office whom you suspect has chronic lung
disease, but you are unsure if you should start treatment today. What do you
consider ordering first?
A pulmonary consult A chest x-ray An office spirometry A pulmonary function
test -✓✓An office spirometry
