NSG 6440 PREDICTOR FINAL EXAM 2026/2027 | Questions
and Answers with Explanations | Verified Revised Full Exam |
Pass Guaranteed - A+ Graded
Section 1: Health Promotion & Disease Prevention (Questions 1-25)
Q1: A 52-year-old female presents for her annual wellness exam. She has no personal or family
history of breast cancer. According to the 2026/2027 USPSTF guidelines, what is the most
appropriate recommendation regarding breast cancer screening?
A. Mammography every year starting now
B. Biennial mammography starting at age 55
C. Biennial mammography starting now [CORRECT]
D. No screening is recommended until age 60
Correct Answer: C
Rationale: The USPSTF recommends biennial screening mammography for women aged 40 to
74 years to reduce breast cancer mortality. Annual screening is not recommended by USPSTF,
and starting at age 55 is outdated based on recent updates lowering the age back to 40.
Q2: A 45-year-old African American male with a 20 pack-year smoking history asks about lung
cancer screening. He currently smokes and has no symptoms. What is the most appropriate
next step?
A. Order a chest X-ray immediately
B. Order a low-dose CT (LDCT) annually [CORRECT]
C. Order a sputum cytology
D. Reassure him that he does not need screening until age 50
Correct Answer: B
Rationale: The USPSTF recommends annual screening for lung cancer with LDCT in adults
aged 50 to 80 who have a 20 pack-year smoking history and currently smoke or have quit within
the past 15 years. Chest X-ray and sputum cytology are not recommended for screening as
they do not reduce mortality.
Q3: A 65-year-old female with no risk factors asks about colorectal cancer screening. She has
never been screened. Which of the following is an acceptable screening option according to
USPSTF?
,A. Annual fecal occult blood test (FOBT)
B. Colonoscopy every 10 years [CORRECT]
C. Barium enema every 5 years
D. Flexible sigmoidoscopy every 10 years
Correct Answer: B
Rationale: The USPSTF recommends screening for colorectal cancer starting at age 45.
Acceptable options include colonoscopy every 10 years, annual FIT, Cologuard every 3 years,
or flexible sigmoidoscopy every 5 years (with annual FIT). FOBT is outdated (replaced by FIT),
barium enema is not a preferred test, and flex sig alone is every 5 years.
Q4: A 28-year-old sexually active female with no history of cervical dysplasia presents for a
well-woman exam. According to USPSTF guidelines, how often should she receive cervical
cancer screening?
A. Annually
B. Every 3 years with a Pap smear alone [CORRECT]
C. Every 5 years with an HPV test alone
D. Every 6 months
Correct Answer: B
Rationale: For women aged 21 to 29 years, the USPSTF recommends screening with a Pap
smear every 3 years. HPV testing alone is not recommended in this age group due to high rates
of transient HPV infection. Annual screening is no longer recommended for average-risk
women.
Q5: A 70-year-old male with well-controlled hypertension and a BMI of 26 kg/m2 presents for a
routine visit. What is the USPSTF recommendation regarding abdominal aortic aneurysm (AAA)
screening for this patient?
A. One-time ultrasound screening
B. Annual ultrasound screening
C. No screening is recommended [CORRECT]
D. CT angiography
Correct Answer: C
Rationale: The USPSTF recommends one-time screening for AAA with ultrasonography in men
aged 65 to 75 who have ever smoked. This patient has no smoking history, so screening is not
indicated.
Q6: A 40-year-old patient is found to have a blood pressure of 135/85 mmHg during a routine
visit. According to the USPSTF, what is the recommended screening interval for hypertension?
,A. Every month
B. Every 6 months
C. Every 3 years [CORRECT]
D. Every year
Correct Answer: C
Rationale: The USPSTF recommends screening for hypertension in adults aged 18 years or
older. For adults 18 to 39 years with no risk factors, screening can be done every 3 to 5 years.
For adults 40 years and older, or those at increased risk, annual screening is recommended.
However, since his BP is elevated but not diagnostic of hypertension yet, the general 3-year rule
applies to baseline screening, though annual is better once elevated BP is noted. The specific
USPSTF text for low-risk adults is every 3 years.
Q7: A 55-year-old female with a BMI of 32 kg/m2 and no other risk factors asks about diabetes
screening. What should the nurse practitioner recommend?
A. Fasting plasma glucose now
B. No screening until age 60
C. HbA1c now [CORRECT]
D. Random blood glucose
Correct Answer: C
Rationale: The USPSTF recommends screening for abnormal blood glucose as part of
cardiovascular risk assessment in adults aged 35 to 70 years who are overweight or obese.
HbA1c, fasting plasma glucose, or oral glucose tolerance test are all appropriate, but HbA1c is
the most practical single test in this scenario.
Q8: A 60-year-old male with a history of depression presents for a wellness exam. Which
screening tool is recommended by the USPSTF for this patient?
A. PHQ-9 [CORRECT]
B. GAD-7
C. MMSE
D. MoCA
Correct Answer: A
Rationale: The USPSTF recommends screening for depression in the adult population,
including pregnant and postpartum women. The PHQ-9 is the standard validated tool for
depression screening in primary care. GAD-7 is for anxiety, MMSE/MoCA are for cognitive
impairment.
, Q9: A 22-year-old female presents for a preconception visit. She reports no chronic illnesses.
Which immunization should she receive today if she has no documentation of prior vaccination?
A. HPV vaccine
B. Tdap vaccine [CORRECT]
C. Zoster vaccine
D. Pneumococcal vaccine
Correct Answer: B
Rationale: The CDC recommends that all pregnant women receive a dose of Tdap during each
pregnancy, preferably in the early part of gestation (27-36 weeks). If she is not currently
pregnant but planning, it is safe to give now, or wait until she is pregnant. HPV is typically given
up to age 26 (though now approved to 45), zoster is for 50+, and pneumococcal is for 65+ or
high risk.
Q10: A 68-year-old patient received the 13-valent pneumococcal conjugate vaccine (PCV13) at
age 60 due to an underlying chronic lung condition. She is back today for her wellness exam.
What pneumococcal vaccine is indicated now?
A. Another PCV13
B. 23-valent pneumococcal polysaccharide vaccine (PPSV23) [CORRECT]
C. PCV20
D. No further pneumococcal vaccines
Correct Answer: B
Rationale: Under current CDC guidelines, if a patient received PCV13 before age 65 due to a
chronic condition, they should receive PPSV23 at least one year later. PCV20 is used for naive
patients or as a standalone option, but since she already had PCV13, completing the series with
PPSV23 is the standard historical protocol.
Q11: A 72-year-old male with well-controlled hypertension reports falling twice in the past month
but has not sustained an injury. What is the most appropriate initial action?
A. Refer to a neurologist
B. Order a brain MRI
C. Perform a multifactorial fall risk assessment [CORRECT]
D. Prescribe physical therapy without further evaluation
Correct Answer: C
Rationale: The USPSTF recommends exercise interventions to prevent falls in
community-dwelling adults 65 years or older at increased risk for falls. The first step is a
multifactorial assessment (gait, balance, medications, vision, home environment) to identify
modifiable risk factors.
and Answers with Explanations | Verified Revised Full Exam |
Pass Guaranteed - A+ Graded
Section 1: Health Promotion & Disease Prevention (Questions 1-25)
Q1: A 52-year-old female presents for her annual wellness exam. She has no personal or family
history of breast cancer. According to the 2026/2027 USPSTF guidelines, what is the most
appropriate recommendation regarding breast cancer screening?
A. Mammography every year starting now
B. Biennial mammography starting at age 55
C. Biennial mammography starting now [CORRECT]
D. No screening is recommended until age 60
Correct Answer: C
Rationale: The USPSTF recommends biennial screening mammography for women aged 40 to
74 years to reduce breast cancer mortality. Annual screening is not recommended by USPSTF,
and starting at age 55 is outdated based on recent updates lowering the age back to 40.
Q2: A 45-year-old African American male with a 20 pack-year smoking history asks about lung
cancer screening. He currently smokes and has no symptoms. What is the most appropriate
next step?
A. Order a chest X-ray immediately
B. Order a low-dose CT (LDCT) annually [CORRECT]
C. Order a sputum cytology
D. Reassure him that he does not need screening until age 50
Correct Answer: B
Rationale: The USPSTF recommends annual screening for lung cancer with LDCT in adults
aged 50 to 80 who have a 20 pack-year smoking history and currently smoke or have quit within
the past 15 years. Chest X-ray and sputum cytology are not recommended for screening as
they do not reduce mortality.
Q3: A 65-year-old female with no risk factors asks about colorectal cancer screening. She has
never been screened. Which of the following is an acceptable screening option according to
USPSTF?
,A. Annual fecal occult blood test (FOBT)
B. Colonoscopy every 10 years [CORRECT]
C. Barium enema every 5 years
D. Flexible sigmoidoscopy every 10 years
Correct Answer: B
Rationale: The USPSTF recommends screening for colorectal cancer starting at age 45.
Acceptable options include colonoscopy every 10 years, annual FIT, Cologuard every 3 years,
or flexible sigmoidoscopy every 5 years (with annual FIT). FOBT is outdated (replaced by FIT),
barium enema is not a preferred test, and flex sig alone is every 5 years.
Q4: A 28-year-old sexually active female with no history of cervical dysplasia presents for a
well-woman exam. According to USPSTF guidelines, how often should she receive cervical
cancer screening?
A. Annually
B. Every 3 years with a Pap smear alone [CORRECT]
C. Every 5 years with an HPV test alone
D. Every 6 months
Correct Answer: B
Rationale: For women aged 21 to 29 years, the USPSTF recommends screening with a Pap
smear every 3 years. HPV testing alone is not recommended in this age group due to high rates
of transient HPV infection. Annual screening is no longer recommended for average-risk
women.
Q5: A 70-year-old male with well-controlled hypertension and a BMI of 26 kg/m2 presents for a
routine visit. What is the USPSTF recommendation regarding abdominal aortic aneurysm (AAA)
screening for this patient?
A. One-time ultrasound screening
B. Annual ultrasound screening
C. No screening is recommended [CORRECT]
D. CT angiography
Correct Answer: C
Rationale: The USPSTF recommends one-time screening for AAA with ultrasonography in men
aged 65 to 75 who have ever smoked. This patient has no smoking history, so screening is not
indicated.
Q6: A 40-year-old patient is found to have a blood pressure of 135/85 mmHg during a routine
visit. According to the USPSTF, what is the recommended screening interval for hypertension?
,A. Every month
B. Every 6 months
C. Every 3 years [CORRECT]
D. Every year
Correct Answer: C
Rationale: The USPSTF recommends screening for hypertension in adults aged 18 years or
older. For adults 18 to 39 years with no risk factors, screening can be done every 3 to 5 years.
For adults 40 years and older, or those at increased risk, annual screening is recommended.
However, since his BP is elevated but not diagnostic of hypertension yet, the general 3-year rule
applies to baseline screening, though annual is better once elevated BP is noted. The specific
USPSTF text for low-risk adults is every 3 years.
Q7: A 55-year-old female with a BMI of 32 kg/m2 and no other risk factors asks about diabetes
screening. What should the nurse practitioner recommend?
A. Fasting plasma glucose now
B. No screening until age 60
C. HbA1c now [CORRECT]
D. Random blood glucose
Correct Answer: C
Rationale: The USPSTF recommends screening for abnormal blood glucose as part of
cardiovascular risk assessment in adults aged 35 to 70 years who are overweight or obese.
HbA1c, fasting plasma glucose, or oral glucose tolerance test are all appropriate, but HbA1c is
the most practical single test in this scenario.
Q8: A 60-year-old male with a history of depression presents for a wellness exam. Which
screening tool is recommended by the USPSTF for this patient?
A. PHQ-9 [CORRECT]
B. GAD-7
C. MMSE
D. MoCA
Correct Answer: A
Rationale: The USPSTF recommends screening for depression in the adult population,
including pregnant and postpartum women. The PHQ-9 is the standard validated tool for
depression screening in primary care. GAD-7 is for anxiety, MMSE/MoCA are for cognitive
impairment.
, Q9: A 22-year-old female presents for a preconception visit. She reports no chronic illnesses.
Which immunization should she receive today if she has no documentation of prior vaccination?
A. HPV vaccine
B. Tdap vaccine [CORRECT]
C. Zoster vaccine
D. Pneumococcal vaccine
Correct Answer: B
Rationale: The CDC recommends that all pregnant women receive a dose of Tdap during each
pregnancy, preferably in the early part of gestation (27-36 weeks). If she is not currently
pregnant but planning, it is safe to give now, or wait until she is pregnant. HPV is typically given
up to age 26 (though now approved to 45), zoster is for 50+, and pneumococcal is for 65+ or
high risk.
Q10: A 68-year-old patient received the 13-valent pneumococcal conjugate vaccine (PCV13) at
age 60 due to an underlying chronic lung condition. She is back today for her wellness exam.
What pneumococcal vaccine is indicated now?
A. Another PCV13
B. 23-valent pneumococcal polysaccharide vaccine (PPSV23) [CORRECT]
C. PCV20
D. No further pneumococcal vaccines
Correct Answer: B
Rationale: Under current CDC guidelines, if a patient received PCV13 before age 65 due to a
chronic condition, they should receive PPSV23 at least one year later. PCV20 is used for naive
patients or as a standalone option, but since she already had PCV13, completing the series with
PPSV23 is the standard historical protocol.
Q11: A 72-year-old male with well-controlled hypertension reports falling twice in the past month
but has not sustained an injury. What is the most appropriate initial action?
A. Refer to a neurologist
B. Order a brain MRI
C. Perform a multifactorial fall risk assessment [CORRECT]
D. Prescribe physical therapy without further evaluation
Correct Answer: C
Rationale: The USPSTF recommends exercise interventions to prevent falls in
community-dwelling adults 65 years or older at increased risk for falls. The first step is a
multifactorial assessment (gait, balance, medications, vision, home environment) to identify
modifiable risk factors.
