NSG 6998 PRACTICE EXAM
QUESTIONS AND DETAILED
SOLUTIONS 2026
▶ A 38-year-old multigravida who is at 32 weeks of gestation calls the
family nurse practitioner complaining of bright red vaginal bleeding. There
is no watery dis- charge. She complains that her uterus feels hard and is
very painful. Which of the following conditions is most likely?
A) Placenta previa
B) Placenta abruptio
C) A molar pregnancy
D) An ectopic pregnancy. Answer: B) Placenta abruptio
Abruptio placenta symptoms are bright red vaginal bleeding, board-like
uterus on palpation, and pain. However, there can be concealed
hemorrhage and the patient may not have vaginal bleeding. Placenta
previa is painless bleeding. Ectopic and molar pregnancy would not
progress to 32 weeks gestation
▶ The Jarisch-Herxheimer reaction is best described as:
A) An immune-mediated reaction precipitated by the destruction of a large
number of spirochetes due to an antibiotic injection
B) Severe chills and elevated blood pressure
C) Caused by infection with either Chlamydia trachomatis or gonorrheal
infection of the liver capsule
D) Associated with certain viral illnesses. Answer: A) An immune-mediated
reaction precipitated by the destruction of a large number of spirochetes
due to an antibiotic injection
The Jarisch-Herxheimer reaction is defined as an immune-mediated
reaction precipitated by the destruction of a large number of spirochetes
due to the antibiotic injection.
,▶ During a breast exam of a 30-year-old nulliparous female, the nurse
practitioner palpates several rubbery mobile areas of breast tissue. They
are slightly tender to palpation. Both breasts have symmetrical findings.
There are no skin changes or any nipple discharge. The patient is
expecting her menstrual period in 5 days. Which of the following would you
recommend?
A) Referral to a gynecologist for further evaluation
B) Tell her to return 1 week after her period so her breasts can be
rechecked
C) Advise the patient to return in 6 months to have her breasts rechecked
D) Schedule the patient for a mammogram. Answer: B)Tell her to return 1
week after her periods so her breasts can be rechecked
Prior to having menses, women will experience breast changes of
tenderness with palpation, with symmetrical soft, mobile areas of breast
tissue that are benign. Her symptoms should improve after her menses and
repeating the exam in 1 week would be recommended.
▶ When evaluating the blood pressure on both the arms and legs of an
infant who has a diagnosis of coarctation of the aorta, which of the
following is the correct finding?
A) The blood pressure is higher in the arms than in the legs
B) Only the diastolic blood pressure is higher in the legs than in the arms
C) The blood pressure is higher in the legs than the arms
D) The blood pressure is lower in both arms than in the legs. Answer: A)
The blood pressure is higher in the arms than in the legs
In coarctation of the aorta, blood pressure is higher in the arms than in the
legs due to the narrowing in the aorta. Blood pressure must rise to get
adequate blood flow to the lower extremities; therefore, the blood pressure
above the coarctation rises to compensate for this.
▶ Which of the following should you expect to find on a wet-mount slide of
a patient diagnosed with bacterial vaginosis?
A) Tzanck cells
B) A large amount of leukocytes and epithelial cells
,C) A large amount of bacteria coating the squamous cells and very few
leukocytes
D) Epithelial cells and a small amount of blood
108. Answer: C) A large amount of bacteria coating the squamous cells
and very few leukocytes
Results of the wet mount for bacterial vaginosis include bacteria coating the
squamous cells (clue cells) and very few leukocytes or RBCs
▶ A 40-year-old woman is in the office complaining of palpitations and
some light headedness for the past 6 months. These are random episodes.
The nurse practitioner notices a mid-systolic click with a late systolic
murmur that is best heard in the apical area during auscultation of the
chest. The NP would suspect:
A) Atrial fibrillation
B) Sinus arrhythmia
C) Mitral stenosis
D) Mitral valve prolapse. Answer: D) Mitral valve prolapse
Mitral valve prolapse occurs when the mitral valve does not close all the
way, causing a late systolic murmur heard best in the apical area during
auscultation of the chest. Symptoms patients may experience at times
include palpitations and dizziness.
▶ Your 35-year-old patient is being worked up for microscopic hematuria.
All of the following are differential diagnoses of microscopic hematuria
except:
A) Kidney stones
B) Bladder cancer
C) Acute pyelonephritis
D) Renal stenosis. Answer: D) Renal stenosis
Renal stenosis is a narrowing of the renal artery. No blood would be noted
on exam. Evidence of blood in the urine can be seen with kidney stones,
bladder cancer, and acute pyelonephritis.
▶ During a routine physical exam of an elderly woman, a triangular
thickening of the bulbar conjunctiva on the temporal side is noted to be
, encroaching on the cornea. She denies any eye pain or visual changes.
Which of the following is most likely?
A) Corneal arcus
B) Pterygium
C) Pinguecula
D) Chalazion. Answer: B) Pterygium
Pterygium is a triangular growth on the white part of the eye that also
extends onto the cornea. Corneal arcus is a ring around the edge of the
cornea. Chalazion is a stye in the eye that may cause pain and swelling.
Pinguecula is a benign growth on the conjuctiva caused by the
degeneration of its collagen fibers. Thick, yellow fibers may be seen.
▶ Mr. Jones, who has been on pravastatin (Pravachol) 20 mg at bedtime
for the past few months, complains of lately feeling extremely fatigued. The
patient also noticed that his urine has been a darker color during the past 2
weeks. Which of the following is the best treatment plan to follow?
A) Discontinue his pravastatin and order a liver function profile
B) Continue the pravastatin but on half the dose
C) Schedule him for a complete physical exam
D) Schedule him for a liver function profile. Answer: A) Discontinue his
pravastatin and order a liver function profile
Side effects of statin drugs include myalgia, fatigue, and elevated liver
enzymes. Routine labs should include liver enzymes to assess the effects
on the liver.
▶ Jane, a young primigravida, reports to you that she is starting to feel the
baby's movements in her uterus. This is considered to be which of the
following?
A) Presumptive sign
B) Probable sign
C) Positive sign
D) Possible sign. Answer: B) Probable sign
Probable signs of pregnancy are symptoms of pregnancy that are felt by
the woman.
QUESTIONS AND DETAILED
SOLUTIONS 2026
▶ A 38-year-old multigravida who is at 32 weeks of gestation calls the
family nurse practitioner complaining of bright red vaginal bleeding. There
is no watery dis- charge. She complains that her uterus feels hard and is
very painful. Which of the following conditions is most likely?
A) Placenta previa
B) Placenta abruptio
C) A molar pregnancy
D) An ectopic pregnancy. Answer: B) Placenta abruptio
Abruptio placenta symptoms are bright red vaginal bleeding, board-like
uterus on palpation, and pain. However, there can be concealed
hemorrhage and the patient may not have vaginal bleeding. Placenta
previa is painless bleeding. Ectopic and molar pregnancy would not
progress to 32 weeks gestation
▶ The Jarisch-Herxheimer reaction is best described as:
A) An immune-mediated reaction precipitated by the destruction of a large
number of spirochetes due to an antibiotic injection
B) Severe chills and elevated blood pressure
C) Caused by infection with either Chlamydia trachomatis or gonorrheal
infection of the liver capsule
D) Associated with certain viral illnesses. Answer: A) An immune-mediated
reaction precipitated by the destruction of a large number of spirochetes
due to an antibiotic injection
The Jarisch-Herxheimer reaction is defined as an immune-mediated
reaction precipitated by the destruction of a large number of spirochetes
due to the antibiotic injection.
,▶ During a breast exam of a 30-year-old nulliparous female, the nurse
practitioner palpates several rubbery mobile areas of breast tissue. They
are slightly tender to palpation. Both breasts have symmetrical findings.
There are no skin changes or any nipple discharge. The patient is
expecting her menstrual period in 5 days. Which of the following would you
recommend?
A) Referral to a gynecologist for further evaluation
B) Tell her to return 1 week after her period so her breasts can be
rechecked
C) Advise the patient to return in 6 months to have her breasts rechecked
D) Schedule the patient for a mammogram. Answer: B)Tell her to return 1
week after her periods so her breasts can be rechecked
Prior to having menses, women will experience breast changes of
tenderness with palpation, with symmetrical soft, mobile areas of breast
tissue that are benign. Her symptoms should improve after her menses and
repeating the exam in 1 week would be recommended.
▶ When evaluating the blood pressure on both the arms and legs of an
infant who has a diagnosis of coarctation of the aorta, which of the
following is the correct finding?
A) The blood pressure is higher in the arms than in the legs
B) Only the diastolic blood pressure is higher in the legs than in the arms
C) The blood pressure is higher in the legs than the arms
D) The blood pressure is lower in both arms than in the legs. Answer: A)
The blood pressure is higher in the arms than in the legs
In coarctation of the aorta, blood pressure is higher in the arms than in the
legs due to the narrowing in the aorta. Blood pressure must rise to get
adequate blood flow to the lower extremities; therefore, the blood pressure
above the coarctation rises to compensate for this.
▶ Which of the following should you expect to find on a wet-mount slide of
a patient diagnosed with bacterial vaginosis?
A) Tzanck cells
B) A large amount of leukocytes and epithelial cells
,C) A large amount of bacteria coating the squamous cells and very few
leukocytes
D) Epithelial cells and a small amount of blood
108. Answer: C) A large amount of bacteria coating the squamous cells
and very few leukocytes
Results of the wet mount for bacterial vaginosis include bacteria coating the
squamous cells (clue cells) and very few leukocytes or RBCs
▶ A 40-year-old woman is in the office complaining of palpitations and
some light headedness for the past 6 months. These are random episodes.
The nurse practitioner notices a mid-systolic click with a late systolic
murmur that is best heard in the apical area during auscultation of the
chest. The NP would suspect:
A) Atrial fibrillation
B) Sinus arrhythmia
C) Mitral stenosis
D) Mitral valve prolapse. Answer: D) Mitral valve prolapse
Mitral valve prolapse occurs when the mitral valve does not close all the
way, causing a late systolic murmur heard best in the apical area during
auscultation of the chest. Symptoms patients may experience at times
include palpitations and dizziness.
▶ Your 35-year-old patient is being worked up for microscopic hematuria.
All of the following are differential diagnoses of microscopic hematuria
except:
A) Kidney stones
B) Bladder cancer
C) Acute pyelonephritis
D) Renal stenosis. Answer: D) Renal stenosis
Renal stenosis is a narrowing of the renal artery. No blood would be noted
on exam. Evidence of blood in the urine can be seen with kidney stones,
bladder cancer, and acute pyelonephritis.
▶ During a routine physical exam of an elderly woman, a triangular
thickening of the bulbar conjunctiva on the temporal side is noted to be
, encroaching on the cornea. She denies any eye pain or visual changes.
Which of the following is most likely?
A) Corneal arcus
B) Pterygium
C) Pinguecula
D) Chalazion. Answer: B) Pterygium
Pterygium is a triangular growth on the white part of the eye that also
extends onto the cornea. Corneal arcus is a ring around the edge of the
cornea. Chalazion is a stye in the eye that may cause pain and swelling.
Pinguecula is a benign growth on the conjuctiva caused by the
degeneration of its collagen fibers. Thick, yellow fibers may be seen.
▶ Mr. Jones, who has been on pravastatin (Pravachol) 20 mg at bedtime
for the past few months, complains of lately feeling extremely fatigued. The
patient also noticed that his urine has been a darker color during the past 2
weeks. Which of the following is the best treatment plan to follow?
A) Discontinue his pravastatin and order a liver function profile
B) Continue the pravastatin but on half the dose
C) Schedule him for a complete physical exam
D) Schedule him for a liver function profile. Answer: A) Discontinue his
pravastatin and order a liver function profile
Side effects of statin drugs include myalgia, fatigue, and elevated liver
enzymes. Routine labs should include liver enzymes to assess the effects
on the liver.
▶ Jane, a young primigravida, reports to you that she is starting to feel the
baby's movements in her uterus. This is considered to be which of the
following?
A) Presumptive sign
B) Probable sign
C) Positive sign
D) Possible sign. Answer: B) Probable sign
Probable signs of pregnancy are symptoms of pregnancy that are felt by
the woman.
