NSG 6440 Predictor Final Exam Study Guide (2025-2026) | 300+ Verified Q&A with
Rationales | South University
Crush your Practicum IV predictor exam with this elite study script featuring over 300
verified questions and detailed rationales updated for the 2026 curriculum. This guide
masters high-yield clinical topics including HIV management trends, geriatric
pharmacology, and advanced dermatology diagnostics like erythema migrans and
actinic keratosis. Designed for students aiming for an A+, it provides clear explanations
for complex decision-making scenarios to ensure you pass your South University final on
the first attempt.
1. A 55-year-old male presents with "tearing" chest pain radiating to the back and
a blood pressure differential of 30 mmHg between arms. What is the most likely
diagnosis?
A) Myocardial Infarction
B) Acute Aortic Dissection
C) Pulmonary Embolism
D) Tension Pneumothorax
*Answer: B) Acute Aortic Dissection *
Rationale: Tearing pain radiating to the back and asymmetric blood pressure readings
between arms are hallmark signs of an aortic dissection.
2. A positive Lachman test indicates an injury to which knee structure?
A) Medial Meniscus
B) Posterior Cruciate Ligament (PCL)
C) Anterior Cruciate Ligament (ACL)
D) Medial Collateral Ligament (MCL)
*Answer: C) Anterior Cruciate Ligament (ACL) *
Rationale: The Lachman test is the most sensitive clinical maneuver for detecting an
ACL tear.
,3. A "curtain-like" shadow over the field of vision accompanied by flashes of light
is characteristic of:
A) Glaucoma
B) Retinal Detachment
C) Macular Degeneration
D) Cataracts
*Answer: B) Retinal Detachment *
Rationale: This is a painless ocular emergency where the retina peels away from its
underlying support tissue.
4. Dullness on percussion and decreased breath sounds over the lung base
suggest:
A) Pneumothorax
B) Pleural Effusion
C) Pneumonia with consolidation
D) Asthma
*Answer: B) Pleural Effusion *
Rationale: Fluid in the pleural space muffle sound transmission and creates a "dull" note
on percussion.
5. An "olive-shaped" mass in the epigastrium of a 3-week-old infant with projectile
vomiting suggests:
A) Intussusception
B) Pyloric Stenosis
C) GERD
D) Hirschsprung Disease
*Answer: B) Pyloric Stenosis *
Rationale: Hypertrophic pyloric stenosis causes a palpable mass and prevents food from
entering the small intestine.
6. An S3 heart sound in a 50-year-old patient is most likely a sign of:
A) Normal athletic heart
B) Heart Failure (Fluid Overload)
,C) Aortic Stenosis
D) Mitral Valve Prolapse
*Answer: B) Heart Failure (Fluid Overload) *
Rationale: S3 is often an early sign of ventricular failure and fluid volume excess in older
adults.
7. The "gold standard" for confirming a diagnosis of Gout is:
A) Serum Uric Acid levels
B) X-ray of the joint
C) Joint aspiration (synovial fluid analysis)
D) Trial of Ibuprofen
*Answer: C) Joint aspiration (synovial fluid analysis) *
Rationale: Identifying needle-shaped, negatively birefringent urate crystals in synovial
fluid is the definitive test.
8. Which cranial nerve is tested by asking a patient to smile, frown, and puff out
their cheeks?
A) CN V (Trigeminal)
B) CN VII (Facial)
C) CN IX (Glossopharyngeal)
D) CN X (Vagus)
*Answer: B) CN VII (Facial) *
Rationale: CN VII controls the muscles of facial expression.
9. A positive Murphy’s sign is suggestive of:
A) Acute Appendicitis
B) Acute Cholecystitis
C) Splenic Rupture
D) Renal Calculi
*Answer: B) Acute Cholecystitis *
Rationale: Sharp pain and a halt in inspiration during gallbladder palpation indicate
inflammation.
, 10. A malar "butterfly" rash that spares the nasolabial folds is a classic sign of:
A) Rosacea
B) Systemic Lupus Erythematosus (SLE)
C) Psoriasis
D) Seborrheic Dermatitis
*Answer: B) Systemic Lupus Erythematosus (SLE) *
Rationale: The distribution of the rash across the cheeks and bridge of the nose is a
primary diagnostic criteria for SLE.
11. Spurling’s maneuver is used to evaluate for:
A) Rotator cuff tears
B) Cervical Radiculopathy
C) Carpal Tunnel Syndrome
D) Meniscal tears
*Answer: B) Cervical Radiculopathy *
Rationale: Compressing the head down while tilted to the side reproduces radicular pain
if a nerve root is compressed.
12. Pill-rolling tremors and cogwheel rigidity are associated with:
A) Multiple Sclerosis
B) Parkinson’s Disease
C) Alzheimer’s Disease
D) Huntington’s Chorea
*Answer: B) Parkinson’s Disease *
Rationale: These are classic motor signs of dopamine depletion in the basal ganglia.
13. A mid-systolic click heard at the apex is diagnostic for:
A) Mitral Stenosis
B) Mitral Valve Prolapse (MVP)
C) Aortic Regurgitation
D) Tricuspid Stenosis
*Answer: B) Mitral Valve Prolapse (MVP) *
Rationales | South University
Crush your Practicum IV predictor exam with this elite study script featuring over 300
verified questions and detailed rationales updated for the 2026 curriculum. This guide
masters high-yield clinical topics including HIV management trends, geriatric
pharmacology, and advanced dermatology diagnostics like erythema migrans and
actinic keratosis. Designed for students aiming for an A+, it provides clear explanations
for complex decision-making scenarios to ensure you pass your South University final on
the first attempt.
1. A 55-year-old male presents with "tearing" chest pain radiating to the back and
a blood pressure differential of 30 mmHg between arms. What is the most likely
diagnosis?
A) Myocardial Infarction
B) Acute Aortic Dissection
C) Pulmonary Embolism
D) Tension Pneumothorax
*Answer: B) Acute Aortic Dissection *
Rationale: Tearing pain radiating to the back and asymmetric blood pressure readings
between arms are hallmark signs of an aortic dissection.
2. A positive Lachman test indicates an injury to which knee structure?
A) Medial Meniscus
B) Posterior Cruciate Ligament (PCL)
C) Anterior Cruciate Ligament (ACL)
D) Medial Collateral Ligament (MCL)
*Answer: C) Anterior Cruciate Ligament (ACL) *
Rationale: The Lachman test is the most sensitive clinical maneuver for detecting an
ACL tear.
,3. A "curtain-like" shadow over the field of vision accompanied by flashes of light
is characteristic of:
A) Glaucoma
B) Retinal Detachment
C) Macular Degeneration
D) Cataracts
*Answer: B) Retinal Detachment *
Rationale: This is a painless ocular emergency where the retina peels away from its
underlying support tissue.
4. Dullness on percussion and decreased breath sounds over the lung base
suggest:
A) Pneumothorax
B) Pleural Effusion
C) Pneumonia with consolidation
D) Asthma
*Answer: B) Pleural Effusion *
Rationale: Fluid in the pleural space muffle sound transmission and creates a "dull" note
on percussion.
5. An "olive-shaped" mass in the epigastrium of a 3-week-old infant with projectile
vomiting suggests:
A) Intussusception
B) Pyloric Stenosis
C) GERD
D) Hirschsprung Disease
*Answer: B) Pyloric Stenosis *
Rationale: Hypertrophic pyloric stenosis causes a palpable mass and prevents food from
entering the small intestine.
6. An S3 heart sound in a 50-year-old patient is most likely a sign of:
A) Normal athletic heart
B) Heart Failure (Fluid Overload)
,C) Aortic Stenosis
D) Mitral Valve Prolapse
*Answer: B) Heart Failure (Fluid Overload) *
Rationale: S3 is often an early sign of ventricular failure and fluid volume excess in older
adults.
7. The "gold standard" for confirming a diagnosis of Gout is:
A) Serum Uric Acid levels
B) X-ray of the joint
C) Joint aspiration (synovial fluid analysis)
D) Trial of Ibuprofen
*Answer: C) Joint aspiration (synovial fluid analysis) *
Rationale: Identifying needle-shaped, negatively birefringent urate crystals in synovial
fluid is the definitive test.
8. Which cranial nerve is tested by asking a patient to smile, frown, and puff out
their cheeks?
A) CN V (Trigeminal)
B) CN VII (Facial)
C) CN IX (Glossopharyngeal)
D) CN X (Vagus)
*Answer: B) CN VII (Facial) *
Rationale: CN VII controls the muscles of facial expression.
9. A positive Murphy’s sign is suggestive of:
A) Acute Appendicitis
B) Acute Cholecystitis
C) Splenic Rupture
D) Renal Calculi
*Answer: B) Acute Cholecystitis *
Rationale: Sharp pain and a halt in inspiration during gallbladder palpation indicate
inflammation.
, 10. A malar "butterfly" rash that spares the nasolabial folds is a classic sign of:
A) Rosacea
B) Systemic Lupus Erythematosus (SLE)
C) Psoriasis
D) Seborrheic Dermatitis
*Answer: B) Systemic Lupus Erythematosus (SLE) *
Rationale: The distribution of the rash across the cheeks and bridge of the nose is a
primary diagnostic criteria for SLE.
11. Spurling’s maneuver is used to evaluate for:
A) Rotator cuff tears
B) Cervical Radiculopathy
C) Carpal Tunnel Syndrome
D) Meniscal tears
*Answer: B) Cervical Radiculopathy *
Rationale: Compressing the head down while tilted to the side reproduces radicular pain
if a nerve root is compressed.
12. Pill-rolling tremors and cogwheel rigidity are associated with:
A) Multiple Sclerosis
B) Parkinson’s Disease
C) Alzheimer’s Disease
D) Huntington’s Chorea
*Answer: B) Parkinson’s Disease *
Rationale: These are classic motor signs of dopamine depletion in the basal ganglia.
13. A mid-systolic click heard at the apex is diagnostic for:
A) Mitral Stenosis
B) Mitral Valve Prolapse (MVP)
C) Aortic Regurgitation
D) Tricuspid Stenosis
*Answer: B) Mitral Valve Prolapse (MVP) *
