NUR 504
EXAM 5
Advanced Health Assessment
Questions And Answers Plus Rationales
Instant Pdf Download | 2026
THIS DOCUMENT CONTAINS :
➢ Printable + Tablet-friendly Pdf
➢ Latest Qs & Ans 2026/27 Update
➢ Qs & Answers Plus Rationales
,1. A 58-year-old male with a history of hypertension presents with a
sudden onset of severe, tearing chest pain radiating to the
interscapular region. His blood pressure is 160/50 mmHg in the
right arm and 110/60 mmHg in the left arm. Which physical exam
finding is most likely also present?
a) Pulsus paradoxus
b) Aortic regurgitation murmur
c) Fixed splitting of S2
d) Pericardial friction rub
Answer: b (Aortic dissection extending into the aortic root can cause
acute aortic regurgitation – a decrescendo diastolic murmur at left
sternal border.)
2. A 45-year-old female presents with progressive dyspnea on
exertion and a dry cough. On auscultation, you hear bilateral fine,
late-inspiratory crackles that sound like “Velcro.” The most likely
diagnosis is:
a) Heart failure
b) Idiopathic pulmonary fibrosis
c) Pneumonia
d) Bronchiectasis
Answer: b (Bilateral fine, late-inspiratory crackles (“Velcro”) are classic for
interstitial lung disease, especially idiopathic pulmonary fibrosis.)
,3. A 32-year-old G2P1 woman at 34 weeks gestation reports a
painless, bright red vaginal bleeding episode that resolved. She
denies contractions. On abdominal exam, the uterus is soft and non-
tender. Fetal heart rate is normal. What is the most appropriate next
step?
a) Digital cervical exam
b) Sterile speculum exam followed by bedside ultrasound
c) Immediate cesarean section
d) Administer betamethasone
Answer: b (Painless third-trimester bleeding suggests placenta previa.
Digital exam is contraindicated. Sterile speculum and ultrasound confirm
diagnosis.)
4. A 68-year-old male with a 50-pack-year smoking history reports a
2-month history of a hoarse voice. Direct laryngoscopy reveals a
unilateral, immobile vocal cord. The most likely underlying etiology
is:
a) Laryngeal papilloma
b) Recurrent laryngeal nerve invasion by lung cancer
c) Vocal cord nodule
d) Laryngitis
Answer: b (Unilateral vocal cord paralysis in a smoker is highly
suspicious for mediastinal malignancy, especially lung cancer,
compressing the recurrent laryngeal nerve.)
, 5. During a mental status exam, a patient is unable to copy a simple
figure (e.g., intersecting pentagons) and struggles to draw a clock.
This suggests impairment in which cognitive domain?
a) Attention
b) Visuospatial/executive function
c) Language
d) Memory
Answer: b (Clock drawing and figure copying assess visuospatial skills
and executive function; deficits are seen in dementia, especially
Alzheimer’s or frontotemporal.)
6. A 22-year-old male presents with acute scrotal pain and swelling.
On exam, the left testis is tender, and the cremasteric reflex is
present. Prehn sign (pain relief with elevation) is positive. The most
likely diagnosis is:
a) Testicular torsion
b) Epididymitis
c) Varicocele
d) Hydrocele
Answer: b (Epididymitis: gradual onset, fever, intact cremasteric reflex,
positive Prehn sign. Torsion has sudden pain, absent reflex, negative
Prehn.)
7. A 55-year-old female with a history of rheumatoid arthritis
presents with a new, painless, red eye. On slit-lamp exam, you see a
EXAM 5
Advanced Health Assessment
Questions And Answers Plus Rationales
Instant Pdf Download | 2026
THIS DOCUMENT CONTAINS :
➢ Printable + Tablet-friendly Pdf
➢ Latest Qs & Ans 2026/27 Update
➢ Qs & Answers Plus Rationales
,1. A 58-year-old male with a history of hypertension presents with a
sudden onset of severe, tearing chest pain radiating to the
interscapular region. His blood pressure is 160/50 mmHg in the
right arm and 110/60 mmHg in the left arm. Which physical exam
finding is most likely also present?
a) Pulsus paradoxus
b) Aortic regurgitation murmur
c) Fixed splitting of S2
d) Pericardial friction rub
Answer: b (Aortic dissection extending into the aortic root can cause
acute aortic regurgitation – a decrescendo diastolic murmur at left
sternal border.)
2. A 45-year-old female presents with progressive dyspnea on
exertion and a dry cough. On auscultation, you hear bilateral fine,
late-inspiratory crackles that sound like “Velcro.” The most likely
diagnosis is:
a) Heart failure
b) Idiopathic pulmonary fibrosis
c) Pneumonia
d) Bronchiectasis
Answer: b (Bilateral fine, late-inspiratory crackles (“Velcro”) are classic for
interstitial lung disease, especially idiopathic pulmonary fibrosis.)
,3. A 32-year-old G2P1 woman at 34 weeks gestation reports a
painless, bright red vaginal bleeding episode that resolved. She
denies contractions. On abdominal exam, the uterus is soft and non-
tender. Fetal heart rate is normal. What is the most appropriate next
step?
a) Digital cervical exam
b) Sterile speculum exam followed by bedside ultrasound
c) Immediate cesarean section
d) Administer betamethasone
Answer: b (Painless third-trimester bleeding suggests placenta previa.
Digital exam is contraindicated. Sterile speculum and ultrasound confirm
diagnosis.)
4. A 68-year-old male with a 50-pack-year smoking history reports a
2-month history of a hoarse voice. Direct laryngoscopy reveals a
unilateral, immobile vocal cord. The most likely underlying etiology
is:
a) Laryngeal papilloma
b) Recurrent laryngeal nerve invasion by lung cancer
c) Vocal cord nodule
d) Laryngitis
Answer: b (Unilateral vocal cord paralysis in a smoker is highly
suspicious for mediastinal malignancy, especially lung cancer,
compressing the recurrent laryngeal nerve.)
, 5. During a mental status exam, a patient is unable to copy a simple
figure (e.g., intersecting pentagons) and struggles to draw a clock.
This suggests impairment in which cognitive domain?
a) Attention
b) Visuospatial/executive function
c) Language
d) Memory
Answer: b (Clock drawing and figure copying assess visuospatial skills
and executive function; deficits are seen in dementia, especially
Alzheimer’s or frontotemporal.)
6. A 22-year-old male presents with acute scrotal pain and swelling.
On exam, the left testis is tender, and the cremasteric reflex is
present. Prehn sign (pain relief with elevation) is positive. The most
likely diagnosis is:
a) Testicular torsion
b) Epididymitis
c) Varicocele
d) Hydrocele
Answer: b (Epididymitis: gradual onset, fever, intact cremasteric reflex,
positive Prehn sign. Torsion has sudden pain, absent reflex, negative
Prehn.)
7. A 55-year-old female with a history of rheumatoid arthritis
presents with a new, painless, red eye. On slit-lamp exam, you see a
