NSG 6440 Predictor STUDY GUIDE QUESTIONS
WITH ANSWERS(SCORES 100%)
Course
Predictor
1. Question:
A 45-year-old woman presents with fatigue, cold intolerance, and weight gain. Labs show
elevated TSH and low free T4. What is the most appropriate initial treatment?
A. Levothyroxine
B. Methimazole
C. Propylthiouracil
D. Liothyronine
Answer: A. Levothyroxine
Explanation: Elevated TSH with low free T4 confirms primary hypothyroidism. Levothyroxine
is the standard first-line therapy.
2. Question:
A 62-year-old man with a 30-pack-year smoking history presents with hematuria but no pain.
What is the next best step?
A. Start antibiotics
B. Refer to nephrology
C. Order CT urogram and refer to urology
D. Order renal ultrasound
Answer: C. Order CT urogram and refer to urology
Explanation: Painless hematuria in a smoker is a red flag for bladder cancer. CT urogram is the
preferred imaging.
3. Question:
Which of the following vaccines is contraindicated during pregnancy?
A. Tdap
B. MMR
C. Hepatitis B
D. Influenza (inactivated)
,Answer: B. MMR
Explanation: MMR is a live attenuated vaccine and should not be administered during
pregnancy.
4. Question:
What is the first-line treatment for uncomplicated UTI in a healthy, non-pregnant female?
A. Levofloxacin for 10 days
B. Nitrofurantoin for 5 days
C. Amoxicillin for 10 days
D. Ceftriaxone IM once
Answer: B. Nitrofurantoin for 5 days
Explanation: Nitrofurantoin is effective, safe, and recommended for uncomplicated UTIs.
5. Question:
A 12-year-old boy presents with a sore throat, fever, and no cough. Rapid strep is positive. What
is the best treatment?
A. Penicillin VK
B. Azithromycin
C. Ciprofloxacin
D. Doxycycline
Answer: A. Penicillin VK
Explanation: Group A strep pharyngitis is best treated with penicillin or amoxicillin.
6. Question:
What lab test is most appropriate for evaluating long-term glycemic control?
A. Fasting blood glucose
B. Random blood glucose
C. Hemoglobin A1C
D. Oral glucose tolerance test
Answer: C. Hemoglobin A1C
Explanation: A1C reflects average blood glucose levels over the previous 2–3 months.
,7. Question:
Which of the following is most appropriate for the initial management of mild persistent asthma?
A. SABA PRN only
B. Low-dose inhaled corticosteroid (ICS)
C. Oral prednisone daily
D. LABA monotherapy
Answer: B. Low-dose inhaled corticosteroid (ICS)
Explanation: ICS is the preferred controller medication for persistent asthma.
8. Question:
A patient with atrial fibrillation and a CHA₂DS₂-VASc score of 3 should be started on:
A. Apixaban
B. ASA only
C. Metoprolol
D. No treatment
Answer: A. Apixaban
Explanation: CHA₂DS₂-VASc ≥2 in men or ≥3 in women indicates the need for oral
anticoagulation.
9. Question:
Which dermatologic condition presents with “herald patch” followed by a Christmas-tree pattern
rash?
A. Pityriasis rosea
B. Psoriasis
C. Tinea corporis
D. Contact dermatitis
Answer: A. Pityriasis rosea
Explanation: Classic presentation includes a single herald patch and a secondary rash on the
trunk.
, 10. Question:
Which medication requires renal dose adjustment in elderly patients?
A. Lisinopril
B. Atorvastatin
C. Metformin
D. Amlodipine
Answer: C. Metformin
Explanation: Metformin can cause lactic acidosis in renal impairment. Always assess eGFR
before initiation or continuation.
11. Question:
A 65-year-old male on lisinopril develops a persistent dry cough. What is the most appropriate
alternative medication?
A. Furosemide
B. Losartan
C. Metoprolol
D. Spironolactone
Answer: B. Losartan
Explanation: ACE inhibitors like lisinopril can cause a dry cough due to bradykinin
accumulation; switching to an ARB like losartan avoids this effect.
12. Question:
A 4-year-old presents with barking cough and inspiratory stridor. What is the most likely
diagnosis?
A. Croup (laryngotracheobronchitis)
B. Epiglottitis
C. Bronchiolitis
D. Asthma
Answer: A. Croup
Explanation: Croup presents with a characteristic “barking” cough, stridor, and often follows a
viral illness.
13. Question:
WITH ANSWERS(SCORES 100%)
Course
Predictor
1. Question:
A 45-year-old woman presents with fatigue, cold intolerance, and weight gain. Labs show
elevated TSH and low free T4. What is the most appropriate initial treatment?
A. Levothyroxine
B. Methimazole
C. Propylthiouracil
D. Liothyronine
Answer: A. Levothyroxine
Explanation: Elevated TSH with low free T4 confirms primary hypothyroidism. Levothyroxine
is the standard first-line therapy.
2. Question:
A 62-year-old man with a 30-pack-year smoking history presents with hematuria but no pain.
What is the next best step?
A. Start antibiotics
B. Refer to nephrology
C. Order CT urogram and refer to urology
D. Order renal ultrasound
Answer: C. Order CT urogram and refer to urology
Explanation: Painless hematuria in a smoker is a red flag for bladder cancer. CT urogram is the
preferred imaging.
3. Question:
Which of the following vaccines is contraindicated during pregnancy?
A. Tdap
B. MMR
C. Hepatitis B
D. Influenza (inactivated)
,Answer: B. MMR
Explanation: MMR is a live attenuated vaccine and should not be administered during
pregnancy.
4. Question:
What is the first-line treatment for uncomplicated UTI in a healthy, non-pregnant female?
A. Levofloxacin for 10 days
B. Nitrofurantoin for 5 days
C. Amoxicillin for 10 days
D. Ceftriaxone IM once
Answer: B. Nitrofurantoin for 5 days
Explanation: Nitrofurantoin is effective, safe, and recommended for uncomplicated UTIs.
5. Question:
A 12-year-old boy presents with a sore throat, fever, and no cough. Rapid strep is positive. What
is the best treatment?
A. Penicillin VK
B. Azithromycin
C. Ciprofloxacin
D. Doxycycline
Answer: A. Penicillin VK
Explanation: Group A strep pharyngitis is best treated with penicillin or amoxicillin.
6. Question:
What lab test is most appropriate for evaluating long-term glycemic control?
A. Fasting blood glucose
B. Random blood glucose
C. Hemoglobin A1C
D. Oral glucose tolerance test
Answer: C. Hemoglobin A1C
Explanation: A1C reflects average blood glucose levels over the previous 2–3 months.
,7. Question:
Which of the following is most appropriate for the initial management of mild persistent asthma?
A. SABA PRN only
B. Low-dose inhaled corticosteroid (ICS)
C. Oral prednisone daily
D. LABA monotherapy
Answer: B. Low-dose inhaled corticosteroid (ICS)
Explanation: ICS is the preferred controller medication for persistent asthma.
8. Question:
A patient with atrial fibrillation and a CHA₂DS₂-VASc score of 3 should be started on:
A. Apixaban
B. ASA only
C. Metoprolol
D. No treatment
Answer: A. Apixaban
Explanation: CHA₂DS₂-VASc ≥2 in men or ≥3 in women indicates the need for oral
anticoagulation.
9. Question:
Which dermatologic condition presents with “herald patch” followed by a Christmas-tree pattern
rash?
A. Pityriasis rosea
B. Psoriasis
C. Tinea corporis
D. Contact dermatitis
Answer: A. Pityriasis rosea
Explanation: Classic presentation includes a single herald patch and a secondary rash on the
trunk.
, 10. Question:
Which medication requires renal dose adjustment in elderly patients?
A. Lisinopril
B. Atorvastatin
C. Metformin
D. Amlodipine
Answer: C. Metformin
Explanation: Metformin can cause lactic acidosis in renal impairment. Always assess eGFR
before initiation or continuation.
11. Question:
A 65-year-old male on lisinopril develops a persistent dry cough. What is the most appropriate
alternative medication?
A. Furosemide
B. Losartan
C. Metoprolol
D. Spironolactone
Answer: B. Losartan
Explanation: ACE inhibitors like lisinopril can cause a dry cough due to bradykinin
accumulation; switching to an ARB like losartan avoids this effect.
12. Question:
A 4-year-old presents with barking cough and inspiratory stridor. What is the most likely
diagnosis?
A. Croup (laryngotracheobronchitis)
B. Epiglottitis
C. Bronchiolitis
D. Asthma
Answer: A. Croup
Explanation: Croup presents with a characteristic “barking” cough, stridor, and often follows a
viral illness.
13. Question:
