NSG 6440 Final Exam : Complete Test Bank with 220 Q&A – Primary Care of the Adult (FNP, AGNP, PA)

Pass the NSG 6440 Final Exam on your first attempt with this comprehensive test bank featuring 220 practice questions and detailed clinical rationales. Designed for Family Nurse Practitioner (FNP), Adult-Gerontology Nurse Practitioner (AGNP), and Physician Assistant (PA) students, this resource covers every high-yield topic in primary care of the adult. Sections covered include: Cardiovascular disorders – hypertension (ACC/AHA 2017 guidelines, stage 1/stage 2, first-line agents: ACEi, ARB, CCB, thiazide; Black patients: thiazide or CCB), heart failure with reduced ejection fraction (HFrEF) – GDMT (ACEi/ARB/ARNI, beta-blocker, diuretic, aldosterone antagonist, SGLT2i); HFpEF (diuretics, SGLT2i), atrial fibrillation (CHA₂DS₂-VASc anticoagulation, warfarin/DOAC), dyslipidemia (high-intensity statin for LDL ≥190 or diabetes with ASCVD), stable angina (nitroglycerin), peripheral artery disease (cilostazol + exercise), DVT (apixaban, DOAC), aortic stenosis (surgical valve replacement for symptoms), pericarditis (NSAIDs + colchicine) Respiratory disorders – asthma (GINA classification, low-dose ICS), COPD (GOLD Group E: LABA+LAMA, add ICS if eosinophils ≥300), community-acquired pneumonia (amoxicillin-clavulanate + macrolide), pulmonary embolism (Wells score, CTPA), obstructive sleep apnea (CPAP), tuberculosis (LTBI: 3HP, 4R, 9H; active TB: RIPE), COVID-19 (hypoxia: admit, remdesivir, dexamethasone) Endocrine disorders – diabetes mellitus (diagnosis: fasting glucose ≥126, HbA1c ≥6.5%; type 2: metformin first-line; add SGLT2i or GLP-1 RA for ASCVD/CKD; avoid TZD in heart failure), DKA (IV fluids, insulin, potassium), thyroid disorders (primary hypothyroidism: levothyroxine; hyperthyroidism: methimazole; methimazole agranulocytosis – stop, CBC), adrenal disorders (Addison's crisis: IV hydrocortisone + NS), hyperaldosteronism (ARR screen, spironolactone/eplerenone), hyperparathyroidism (PTH + hypercalcemia), hypocalcemia post-thyroidectomy (IV calcium gluconate), SIADH (fluid restriction, hypertonic saline if severe), central DI (desmopressin), prolactinoma (cabergoline), acromegaly (surgery, octreotide), osteoporosis (bisphosphonate or denosumab), gout (acute: NSAIDs, colchicine, prednisone; allopurinol start low, monitor rash) Renal & genitourinary disorders – uncomplicated cystitis (nitrofurantoin 100 mg BID x5 days), pyelonephritis (admit if severe, IV antibiotics), BPH (alpha-blocker or 5-ARI), CKD anemia (iron repletion, ESA target Hb 10-11), hyperkalemia (calcium gluconate, insulin+glucose, albuterol, kayexalate), nephrolithiasis (hydration 2.5 L/day, low sodium, normal calcium), stress incontinence (pelvic floor exercises, sling), urge incontinence/OAB (bladder training, anticholinergic or mirabegron) Gastrointestinal disorders – GERD (lifestyle + PPI), peptic ulcer disease (H. pylori: triple or quadruple therapy), IBS-D (rifaximin, eluxadoline), IBS-C (linaclotide, lubiprostone), diverticulitis (uncomplicated: oral antibiotics, clear liquid diet), Crohn's disease (infliximab for fistulizing), ulcerative colitis (mesalamine oral + topical), alcoholic liver disease (AST:ALT 2:1), hepatitis C (DAA: glecaprevir/pibrentasvir 8 weeks), cirrhosis ascites (sodium restriction, spironolactone + furosemide, paracentesis), hepatic encephalopathy (lactulose + rifaximin), acute pancreatitis (IV fluids, NPO), chronic pancreatitis (pancreatic enzymes), C. difficile (oral vancomycin or fidaxomicin), cholelithiasis (cholecystectomy if symptomatic), acute cholecystitis (admit, IV antibiotics, cholecystectomy), celiac disease (lifelong gluten-free diet) Neurological disorders – acute ischemic stroke (stat CT, tPA if within 4.5 hours), TIA (DAPT, statin, workup), migraine (acute: triptan + NSAID; chronic prevention: propranolol, topiramate, amitriptyline, CGRP mAbs), epilepsy (AED after second seizure), phenytoin toxicity (nystagmus, ataxia, confusion – hold dose), Parkinson's disease (carbidopa/levodopa; dyskinesias: amantadine or reduce dose), multiple sclerosis relapse (IV methylprednisolone), trigeminal neuralgia (carbamazepine), myasthenia gravis (pyridostigmine + immunotherapy), Alzheimer's dementia (donepezil – monitor bradycardia), Guillain-Barré (admit, IVIG or plasmapheresis) Musculoskeletal disorders – osteoarthritis (acetaminophen, NSAIDs, exercise, weight loss), rheumatoid arthritis (methotrexate + folic acid – monitor CBC, LFTs, Cr), gout (acute: NSAIDs, colchicine, prednisone; allopurinol titration), osteoporosis (bisphosphonate or denosumab), low back pain (NSAIDs, activity, PT), spinal stenosis (PT, epidural steroids, laminectomy), fibromyalgia (duloxetine, pregabalin, milnacipran), polymyalgia rheumatica (prednisone 15-20 mg daily), pseudogout (NSAIDs, colchicine, steroids), septic arthritis (stat arthrocentesis, IV antibiotics, orthopedics), carpal tunnel syndrome (night splints, injection, surgery) Infectious diseases – cellulitis (oral cephalexin, clindamycin, or TMP-SMX), abscess (I&D ± antibiotics), septic shock (broad-spectrum IV antibiotics within 1 hour, fluids, norepinephrine), chlamydia (doxycycline 100 mg BID x7 days or azithromycin 1 g), gonorrhea (ceftriaxone 500 mg IM + azithromycin 1 g), syphilis (benzathine penicillin G 2.4 million units IM), HIV (ART: integrase inhibitor + 2 NRTIs – BIC/FTC/TAF or DTG/3TC), latent TB (3HP, 4R, or 9H), Lyme disease (doxycycline 100 mg BID x10-14 days), CA-MRSA (I&D + TMP-SMX, doxycycline, or clindamycin), influenza (oseltamivir if high risk and within 48 hours), shingles (valacyclovir 1 g TID x7 days within 72 hours), bacterial vaginosis (metronidazole 500 mg BID x7 days) Dermatologic disorders – acne (comedonal: topical retinoid; inflammatory: topical BP + antibiotic, oral doxycycline, isotretinoin for severe), psoriasis (topical steroids + vitamin D analog), rosacea (topical metronidazole, azelaic acid, low-dose doxycycline), atopic dermatitis (emollients + topical steroids), basal cell carcinoma (excisional biopsy, Mohs surgery), actinic keratosis (cryotherapy, topical 5-FU), tinea corporis (topical antifungal), onychomycosis (oral terbinafine 250 mg daily x12 weeks), scabies (permethrin 5% cream) Mental health in primary care – MDD (SSRI/SNRI + CBT; full effect 4-8 weeks), GAD (SSRI/SNRI first-line), panic disorder (SSRI/SNRI), social anxiety (propranolol PRN for performance), PTSD (SSRI/SNRI first-line; prazosin for nightmares), OCD (high-dose SSRI + ERP), ADHD (stimulants first-line), insomnia (CBT-I first-line), alcohol use disorder (naltrexone, acamprosate, disulfiram), opioid use disorder (buprenorphine, methadone, clonidine for withdrawal; naloxone for overdose), bulimia nervosa (hypokalemia, metabolic alkalosis), anorexia nervosa (medical admission if bradycardia/hypotension), somatic symptom disorder (validate distress, avoid unnecessary tests, SSRI/CBT) Geriatric syndromes & special populations – falls (multifactorial risk assessment), Beers criteria (avoid anticholinergics – diphenhydramine), polypharmacy (adverse drug reactions, falls, cognitive impairment), overtreatment of hypertension in elderly (reduce antihypertensives if symptomatic hypotension), delirium (sudden change in dementia patient – treat underlying infection), NSAID risks in elderly (GI bleeding, AKI), urge incontinence (bladder training, pelvic floor exercises, avoid anticholinergics), diabetes in elderly (relaxed HbA1c target 7.5-8.0% to avoid hypoglycemia), advanced dementia (hand feeding, avoid tube feeding) Preventive care & health maintenance – mammography (age 40-49 shared decision, age 50-74 biennial), colorectal cancer screening (start age 45 – colonoscopy q10y, FIT annually), lung cancer screening (LDCT annually for age 50-80, ≥20 pack-years, current smoker or quit ≤15 years), osteoporosis screening (DEXA age 65), vaccines (influenza annual, pneumococcal PCV13 then PPSV23 or PCV20 alone, Tdap q10y, zoster recombinant (Shingrix) age 50, RSV age 60-75 shared decision, COVID-19, hepatitis B for diabetics age 19-59), smoking cessation (counseling + pharmacotherapy – varenicline, NRT, bupropion), diabetes screening (age 35-70 with overweight/obesity q3y), lipid screening (every 4-6 years for age 40-75), family history high-risk colorectal cancer screening (start age 40 or 10 years before youngest affected relative) High-yield clinical case questions (10 cases) Each question includes the correct answer and a clear, high-yield clinical rationale. Updated for . A+ verified. Perfect for NSG 6440 final exam, FNP/AGNP/PA primary care certification (AANP, ANCC, NCCPA), and clinical practice.