NUR 600 Module 5 Exam Actual Exam 2026/2027:
Complete Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
TABLE OF CONTENTS
Section 1 | Advanced Health Assessment | Q1 – Q10
Section 2 | Differential Diagnosis | Q11 – Q20
Section 3 | Pharmacology for Advanced Practice | Q21 – Q30
Section 4 | Evidence-Based Clinical Guidelines | Q31 – Q40
Section 5 | Patient Management and Follow-Up | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: ADVANCED HEALTH ASSESSMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 72-year-old woman with a history of hypertension reports progressive dyspnea on
exertion over the past year. On cardiac auscultation, you detect a blowing holosystolic
murmur best heard at the cardiac apex that radiates toward the axilla. The murmur
intensifies when you ask the patient to squeeze your hands. Which additional finding on
examination would best support the suspected diagnosis?
A. A displaced, laterally displaced point of maximal impulse
B. A fixed, widely split S2 sound
C. A rumbling diastolic murmur at the apex
D. A systolic ejection click at the left upper sternal border
Correct Answer: A
,Rationale: The holosystolic apical murmur radiating to the axilla that intensifies with
handgrip is classic for mitral regurgitation, and a displaced PMI reflects the left
ventricular enlargement that accompanies chronic severe disease. A fixed, widely split
S2 is characteristic of an atrial septal defect, not valvular disease. Chronic mitral
regurgitation often develops gradually in older adults with long-standing hypertension.
Question 2 of 50
A 45-year-old woman presents with a 3-month history of palpitations, heat intolerance,
and a 10-pound weight loss. On neck examination, you palpate a single, firm, non-tender
nodule in the right lobe of the thyroid that moves with swallowing. There is no cervical
lymphadenopathy. Which examination technique would best help determine if this
nodule is suspicious for malignancy?
A. Measuring the nodule with ultrasound calipers during the office visit
B. Assessing the nodule's consistency and checking for fixation to surrounding tissues
C. Performing the Trousseau sign to evaluate for hypocalcemia
D. Auscultating for a bruit over the anterior neck bilaterally
Correct Answer: B
Rationale: A thyroid nodule that is firm and fixed to surrounding tissues raises concern
for malignancy, whereas mobile, soft nodules more often suggest benign etiologies. The
Trousseau sign tests for hypocalcemia and is unrelated to thyroid nodule
characterization. All palpable thyroid nodules in adults require dedicated ultrasound
evaluation regardless of physical examination texture.
Question 3 of 50
A 62-year-old man with a 40 pack-year smoking history presents with worsening cough
and increased sputum production. On chest percussion, you note hyperresonance over
the anterior and lateral chest bilaterally, and the diaphragmatic excursion is decreased
,to 1 cm. Which additional physical finding would be most consistent with the suspected
underlying condition?
A. Dullness to percussion over the lung bases with increased tactile fremitus
B. Crackles auscultated at the posterior lung bases that do not clear with cough
C. Decreased breath sounds with prolonged expiratory phase
D. Egophony and whispered pectoriloquy over the right lower lobe
Correct Answer: C
Rationale: Hyperresonance and reduced diaphragmatic excursion are hallmark
percussion findings in COPD and emphysema, and decreased breath sounds with a
prolonged expiratory phase reflect obstructive air trapping. Dullness to percussion with
increased fremitus suggests lobar pneumonia or consolidation, not obstructive disease.
These findings often worsen during acute exacerbations in long-term smokers.
Question 4 of 50
A 28-year-old runner twisted her ankle during a trail race 2 hours ago. She reports
hearing a pop and is unable to bear weight. On examination, there is marked swelling
over the lateral malleolus and anterior ankle. You perform the anterior drawer test and
note significant laxity compared with the unaffected side. Which structure is most likely
injured?
A. The deltoid ligament complex on the medial ankle
B. The syndesmotic ligaments between the tibia and fibula
C. The Achilles tendon at its insertion on the calcaneus
D. The anterior talofibular ligament of the lateral collateral complex
Correct Answer: D
Rationale: A positive anterior drawer test demonstrates excessive anterior translation of
the talus, indicating disruption of the anterior talofibular ligament, the most commonly
injured lateral ankle ligament. Injury to the deltoid ligament would cause medial, not
lateral, swelling and would not produce anterior drawer laxity. Immediate swelling and
, inability to bear weight after an inversion mechanism strongly suggest a Grade II or III
lateral ankle sprain.
Question 5 of 50
A 55-year-old man presents with steady, severe epigastric pain that began 6 hours after
eating a large fatty meal. He is febrile to 101.2°F and has significant right upper
quadrant tenderness. When you press deeply in the right upper quadrant and ask him to
take a deep breath, he abruptly stops inhaling due to pain. Which physical examination
finding would further support the suspected diagnosis?
A. A palpable, tender gallbladder in the right subcostal region
B. Rebound tenderness with maximal pain in the left lower quadrant
C. A succussion splash audible in the epigastrium
D. Psoas sign positivity on the left side
Correct Answer: A
Rationale: Murphy sign with postprandial right upper quadrant pain and fever is classic
for acute cholecystitis, and a palpable, tender gallbladder in the right subcostal region
further supports the diagnosis. Rebound tenderness localized to the left lower quadrant
would suggest diverticulitis rather than biliary pathology. This presentation is most
common in middle-aged men with risk factors such as obesity or hemolytic disease.
Question 6 of 50
A 38-year-old accountant reports severe, throbbing headaches that occur two to three
times per month, usually in the afternoon. The pain is bifrontal, worsens with bending
forward, and is associated with photophobia and nausea. Her neurological examination
is entirely normal, including fundoscopy. Which finding on physical examination would
be most helpful to distinguish the likely headache type?
A. Nuchal rigidity and Kernig sign positivity
Complete Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
TABLE OF CONTENTS
Section 1 | Advanced Health Assessment | Q1 – Q10
Section 2 | Differential Diagnosis | Q11 – Q20
Section 3 | Pharmacology for Advanced Practice | Q21 – Q30
Section 4 | Evidence-Based Clinical Guidelines | Q31 – Q40
Section 5 | Patient Management and Follow-Up | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: ADVANCED HEALTH ASSESSMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 72-year-old woman with a history of hypertension reports progressive dyspnea on
exertion over the past year. On cardiac auscultation, you detect a blowing holosystolic
murmur best heard at the cardiac apex that radiates toward the axilla. The murmur
intensifies when you ask the patient to squeeze your hands. Which additional finding on
examination would best support the suspected diagnosis?
A. A displaced, laterally displaced point of maximal impulse
B. A fixed, widely split S2 sound
C. A rumbling diastolic murmur at the apex
D. A systolic ejection click at the left upper sternal border
Correct Answer: A
,Rationale: The holosystolic apical murmur radiating to the axilla that intensifies with
handgrip is classic for mitral regurgitation, and a displaced PMI reflects the left
ventricular enlargement that accompanies chronic severe disease. A fixed, widely split
S2 is characteristic of an atrial septal defect, not valvular disease. Chronic mitral
regurgitation often develops gradually in older adults with long-standing hypertension.
Question 2 of 50
A 45-year-old woman presents with a 3-month history of palpitations, heat intolerance,
and a 10-pound weight loss. On neck examination, you palpate a single, firm, non-tender
nodule in the right lobe of the thyroid that moves with swallowing. There is no cervical
lymphadenopathy. Which examination technique would best help determine if this
nodule is suspicious for malignancy?
A. Measuring the nodule with ultrasound calipers during the office visit
B. Assessing the nodule's consistency and checking for fixation to surrounding tissues
C. Performing the Trousseau sign to evaluate for hypocalcemia
D. Auscultating for a bruit over the anterior neck bilaterally
Correct Answer: B
Rationale: A thyroid nodule that is firm and fixed to surrounding tissues raises concern
for malignancy, whereas mobile, soft nodules more often suggest benign etiologies. The
Trousseau sign tests for hypocalcemia and is unrelated to thyroid nodule
characterization. All palpable thyroid nodules in adults require dedicated ultrasound
evaluation regardless of physical examination texture.
Question 3 of 50
A 62-year-old man with a 40 pack-year smoking history presents with worsening cough
and increased sputum production. On chest percussion, you note hyperresonance over
the anterior and lateral chest bilaterally, and the diaphragmatic excursion is decreased
,to 1 cm. Which additional physical finding would be most consistent with the suspected
underlying condition?
A. Dullness to percussion over the lung bases with increased tactile fremitus
B. Crackles auscultated at the posterior lung bases that do not clear with cough
C. Decreased breath sounds with prolonged expiratory phase
D. Egophony and whispered pectoriloquy over the right lower lobe
Correct Answer: C
Rationale: Hyperresonance and reduced diaphragmatic excursion are hallmark
percussion findings in COPD and emphysema, and decreased breath sounds with a
prolonged expiratory phase reflect obstructive air trapping. Dullness to percussion with
increased fremitus suggests lobar pneumonia or consolidation, not obstructive disease.
These findings often worsen during acute exacerbations in long-term smokers.
Question 4 of 50
A 28-year-old runner twisted her ankle during a trail race 2 hours ago. She reports
hearing a pop and is unable to bear weight. On examination, there is marked swelling
over the lateral malleolus and anterior ankle. You perform the anterior drawer test and
note significant laxity compared with the unaffected side. Which structure is most likely
injured?
A. The deltoid ligament complex on the medial ankle
B. The syndesmotic ligaments between the tibia and fibula
C. The Achilles tendon at its insertion on the calcaneus
D. The anterior talofibular ligament of the lateral collateral complex
Correct Answer: D
Rationale: A positive anterior drawer test demonstrates excessive anterior translation of
the talus, indicating disruption of the anterior talofibular ligament, the most commonly
injured lateral ankle ligament. Injury to the deltoid ligament would cause medial, not
lateral, swelling and would not produce anterior drawer laxity. Immediate swelling and
, inability to bear weight after an inversion mechanism strongly suggest a Grade II or III
lateral ankle sprain.
Question 5 of 50
A 55-year-old man presents with steady, severe epigastric pain that began 6 hours after
eating a large fatty meal. He is febrile to 101.2°F and has significant right upper
quadrant tenderness. When you press deeply in the right upper quadrant and ask him to
take a deep breath, he abruptly stops inhaling due to pain. Which physical examination
finding would further support the suspected diagnosis?
A. A palpable, tender gallbladder in the right subcostal region
B. Rebound tenderness with maximal pain in the left lower quadrant
C. A succussion splash audible in the epigastrium
D. Psoas sign positivity on the left side
Correct Answer: A
Rationale: Murphy sign with postprandial right upper quadrant pain and fever is classic
for acute cholecystitis, and a palpable, tender gallbladder in the right subcostal region
further supports the diagnosis. Rebound tenderness localized to the left lower quadrant
would suggest diverticulitis rather than biliary pathology. This presentation is most
common in middle-aged men with risk factors such as obesity or hemolytic disease.
Question 6 of 50
A 38-year-old accountant reports severe, throbbing headaches that occur two to three
times per month, usually in the afternoon. The pain is bifrontal, worsens with bending
forward, and is associated with photophobia and nausea. Her neurological examination
is entirely normal, including fundoscopy. Which finding on physical examination would
be most helpful to distinguish the likely headache type?
A. Nuchal rigidity and Kernig sign positivity
