South University NSG 6998 FNP PrePredictor Exam
| Latest Update 2026/2027 | 200 Practice
Questions & Detailed Answers | Real Exam Q&A
with Rationales | A+ Graded
1. A 58yearold male presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea
for 45 minutes. ECG shows ST elevation in leads II, III, and aVF. Which artery is most likely occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Left main coronary artery
Correct Answer: C) Right coronary artery
Rationale: ST elevation in leads II, III, and aVF indicates an inferior wall myocardial infarction. The right
coronary artery (RCA) supplies the inferior wall of the left ventricle in approximately 80% of patients,
making RCA occlusion the most likely cause.
2. A 34yearold female presents with fatigue, weight gain, cold intolerance, constipation, and dry skin.
TSH is 9.2 mIU/L and free T4 is low. What is the most appropriate initial treatment?
A) Methimazole 10 mg daily
B) Propylthiouracil 100 mg three times daily
C) Levothyroxine 25–50 mcg daily
D) Radioactive iodine ablation
Correct Answer: C) Levothyroxine 25–50 mcg daily
,Rationale: The presentation is consistent with primary hypothyroidism. Levothyroxine is the drug of
choice. Lower starting doses are used in elderly or cardiac patients; otherwise, 1.6 mcg/kg/day is
standard, starting low and titrating based on TSH levels.
3. A 4yearold presents with a barking cough, inspiratory stridor, and lowgrade fever. The child appears
anxious but is maintaining oxygen saturation at 97%. What is the most likely diagnosis?
A) Epiglottitis
B) Bacterial tracheitis
C) Foreign body aspiration
D) Croup (laryngotracheobronchitis)
Correct Answer: D) Croup (laryngotracheobronchitis)
Rationale: The classic triad of barking cough, inspiratory stridor, and lowgrade fever in a toddler
describes croup, most commonly caused by parainfluenza virus. Treatment includes corticosteroids and
nebulized racemic epinephrine for moderatetosevere cases.
4. Which of the following findings is most consistent with bacterial vaginosis?
A) Thick, white, cottage cheeselike discharge with vulvar pruritus
B) Frothy, yellowgreen discharge with strawberry cervix
C) Thin, graywhite discharge with fishy odor and positive whiff test
D) Mucopurulent cervical discharge with dyspareunia
Correct Answer: C) Thin, graywhite discharge with fishy odor and positive whiff test
Rationale: Bacterial vaginosis is diagnosed using Amsel criteria: thin graywhite discharge, pH >4.5,
positive whiff test with KOH, and clue cells on wet prep. The fishy odor results from volatile amines
produced by anaerobic bacteria.
,5. A 72yearold male with a history of hypertension and diabetes presents with sudden onset of severe
tearing chest pain radiating to the back. Blood pressure is 180/100 mmHg in the right arm and 140/80
mmHg in the left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Correct Answer: B) Aortic dissection
Rationale: Sudden tearing chest pain radiating to the back with a blood pressure differential between
arms is classic for aortic dissection. Immediate imaging (CT angiography) and blood pressure control are
critical.
6. A 28yearold female presents with a 3day history of dysuria, frequency, and urgency. Urinalysis shows
positive leukocyte esterase and nitrites. What is the most appropriate firstline treatment?
A) Amoxicillin 500 mg TID for 7 days
B) Nitrofurantoin 100 mg BID for 5 days
C) Ciprofloxacin 500 mg BID for 3 days
D) Azithromycin 1 g single dose
Correct Answer: B) Nitrofurantoin 100 mg BID for 5 days
Rationale: Nitrofurantoin is a firstline agent for uncomplicated cystitis. Fluoroquinolones are reserved
for complicated infections due to collateral damage concerns.
, 7. A 6monthold infant is brought to the clinic with a 2day history of fever, runny nose, and a persistent
cough. On examination, the infant has tachypnea, intercostal retractions, and wheezing. What is the
most likely diagnosis?
A) Bronchiolitis
B) Asthma
C) Pneumonia
D) Croup
Correct Answer: A) Bronchiolitis
Rationale: Bronchiolitis, most commonly caused by respiratory syncytial virus (RSV), presents in infants
under 2 years with fever, cough, tachypnea, retractions, and wheezing. Treatment is supportive.
8. Which screening tool is MOST appropriate for initial depression screening in an older adult?
A) PHQ9
B) PHQ2
C) Geriatric Depression Scale
D) Beck Depression Inventory
Correct Answer: B) PHQ2
Rationale: The PHQ2 is the recommended initial screening tool for depression in primary care due to its
brevity and validated sensitivity. Positive screens are followed by the PHQ9.
9. A 45yearold male presents with a 2week history of epigastric pain that worsens with eating. He
reports NSAID use for back pain. What is the most likely diagnosis?
A) Gastroesophageal reflux disease (GERD)
B) Peptic ulcer disease
| Latest Update 2026/2027 | 200 Practice
Questions & Detailed Answers | Real Exam Q&A
with Rationales | A+ Graded
1. A 58yearold male presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea
for 45 minutes. ECG shows ST elevation in leads II, III, and aVF. Which artery is most likely occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Left main coronary artery
Correct Answer: C) Right coronary artery
Rationale: ST elevation in leads II, III, and aVF indicates an inferior wall myocardial infarction. The right
coronary artery (RCA) supplies the inferior wall of the left ventricle in approximately 80% of patients,
making RCA occlusion the most likely cause.
2. A 34yearold female presents with fatigue, weight gain, cold intolerance, constipation, and dry skin.
TSH is 9.2 mIU/L and free T4 is low. What is the most appropriate initial treatment?
A) Methimazole 10 mg daily
B) Propylthiouracil 100 mg three times daily
C) Levothyroxine 25–50 mcg daily
D) Radioactive iodine ablation
Correct Answer: C) Levothyroxine 25–50 mcg daily
,Rationale: The presentation is consistent with primary hypothyroidism. Levothyroxine is the drug of
choice. Lower starting doses are used in elderly or cardiac patients; otherwise, 1.6 mcg/kg/day is
standard, starting low and titrating based on TSH levels.
3. A 4yearold presents with a barking cough, inspiratory stridor, and lowgrade fever. The child appears
anxious but is maintaining oxygen saturation at 97%. What is the most likely diagnosis?
A) Epiglottitis
B) Bacterial tracheitis
C) Foreign body aspiration
D) Croup (laryngotracheobronchitis)
Correct Answer: D) Croup (laryngotracheobronchitis)
Rationale: The classic triad of barking cough, inspiratory stridor, and lowgrade fever in a toddler
describes croup, most commonly caused by parainfluenza virus. Treatment includes corticosteroids and
nebulized racemic epinephrine for moderatetosevere cases.
4. Which of the following findings is most consistent with bacterial vaginosis?
A) Thick, white, cottage cheeselike discharge with vulvar pruritus
B) Frothy, yellowgreen discharge with strawberry cervix
C) Thin, graywhite discharge with fishy odor and positive whiff test
D) Mucopurulent cervical discharge with dyspareunia
Correct Answer: C) Thin, graywhite discharge with fishy odor and positive whiff test
Rationale: Bacterial vaginosis is diagnosed using Amsel criteria: thin graywhite discharge, pH >4.5,
positive whiff test with KOH, and clue cells on wet prep. The fishy odor results from volatile amines
produced by anaerobic bacteria.
,5. A 72yearold male with a history of hypertension and diabetes presents with sudden onset of severe
tearing chest pain radiating to the back. Blood pressure is 180/100 mmHg in the right arm and 140/80
mmHg in the left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Correct Answer: B) Aortic dissection
Rationale: Sudden tearing chest pain radiating to the back with a blood pressure differential between
arms is classic for aortic dissection. Immediate imaging (CT angiography) and blood pressure control are
critical.
6. A 28yearold female presents with a 3day history of dysuria, frequency, and urgency. Urinalysis shows
positive leukocyte esterase and nitrites. What is the most appropriate firstline treatment?
A) Amoxicillin 500 mg TID for 7 days
B) Nitrofurantoin 100 mg BID for 5 days
C) Ciprofloxacin 500 mg BID for 3 days
D) Azithromycin 1 g single dose
Correct Answer: B) Nitrofurantoin 100 mg BID for 5 days
Rationale: Nitrofurantoin is a firstline agent for uncomplicated cystitis. Fluoroquinolones are reserved
for complicated infections due to collateral damage concerns.
, 7. A 6monthold infant is brought to the clinic with a 2day history of fever, runny nose, and a persistent
cough. On examination, the infant has tachypnea, intercostal retractions, and wheezing. What is the
most likely diagnosis?
A) Bronchiolitis
B) Asthma
C) Pneumonia
D) Croup
Correct Answer: A) Bronchiolitis
Rationale: Bronchiolitis, most commonly caused by respiratory syncytial virus (RSV), presents in infants
under 2 years with fever, cough, tachypnea, retractions, and wheezing. Treatment is supportive.
8. Which screening tool is MOST appropriate for initial depression screening in an older adult?
A) PHQ9
B) PHQ2
C) Geriatric Depression Scale
D) Beck Depression Inventory
Correct Answer: B) PHQ2
Rationale: The PHQ2 is the recommended initial screening tool for depression in primary care due to its
brevity and validated sensitivity. Positive screens are followed by the PHQ9.
9. A 45yearold male presents with a 2week history of epigastric pain that worsens with eating. He
reports NSAID use for back pain. What is the most likely diagnosis?
A) Gastroesophageal reflux disease (GERD)
B) Peptic ulcer disease
