NUR 612
EXAM 4
Health Assessment & Diagnostic
Reasoning
Questions And Answers Plus Rationales 2026
Instant Pdf Download
CHAMBERLAIN
This exam consists of 100 NCLEX-style multiple-
choice questions, each with one correct Answer
and a detailed rationale.
,1. The nurse is assessing a patient with a history of chronic kidney
disease. Which skin finding is most commonly associated with
uremia?
A. Uremic frost (urine crystal deposits on skin)
B. Bruising (ecchymosis)
C. Yellowish discoloration (carotenemia)
D. Hyperpigmentation (bronze color)
Answer: A. Uremic frost (urine crystal deposits on skin)
Rationale: Uremic frost is seen in severe untreated uremia; urea crystals
precipitate on the skin, especially in areas of sweating. It is rare now with
dialysis. Yellow skin occurs with jaundice or carotenemia.
2. A patient presents with fatigue, pallor, and a smooth, red, painful
tongue (glossitis). These findings suggest:
A. Iron deficiency anemia
B. Vitamin B12 deficiency (pernicious anemia)
C. Folic acid deficiency
D. All of the above
Answer: D. All of the above
Rationale: Glossitis (atrophic, smooth, red tongue) can occur with
deficiencies of iron, B12, folate, or niacin. B12 deficiency also causes
neurologic symptoms. Pallor and fatigue are common to all anemias.
,3. The nurse is assessing a patient’s abdomen and notes a palpable,
tender, sausage-shaped mass in the right lower quadrant. This is
most suggestive of:
A. Appendiceal abscess
B. Intussusception in a child (sausage-shaped mass)
C. Crohn’s disease (thickened bowel)
D. Ovarian cyst
Answer: B. Intussusception in a child (sausage-shaped mass)
Rationale: In a child, a palpable sausage-shaped mass in the RLQ with
colicky pain and red currant jelly stool is classic for intussusception. In
adults, consider malignancy.
4. The nurse is assessing a patient’s cranial nerve VI (abducens).
Which eye movement is impaired if CN VI is damaged?
A. Abduction (lateral gaze)
B. Adduction (medial gaze)
C. Upward gaze
D. Downward gaze
Answer: A. Abduction (lateral gaze)
Rationale: CN VI innervates the lateral rectus muscle, which abducts the
, eye. Damage causes inability to abduct, resulting in esotropia (cross-eye)
at rest.
5. A patient with a history of heavy smoking presents with a new,
unilateral wheeze that does not change with cough or position. This
finding suggests:
A. Bronchial obstruction (e.g., tumor)
B. Asthma
C. COPD
D. Pulmonary embolism
Answer: A. Bronchial obstruction (e.g., tumor)
Rationale: A fixed, unilateral wheeze (monophonic) suggests a fixed
obstruction (foreign body, bronchogenic carcinoma). Asthma and COPD
produce bilateral, polyphonic wheezes.
6. The nurse is performing a cardiac assessment. The S2 heart sound
is best heard at which auscultatory area?
A. Aortic and pulmonic areas (left and right 2nd ICS)
B. Apex (5th ICS MCL)
C. Left lower sternal border
D. Epigastrium
EXAM 4
Health Assessment & Diagnostic
Reasoning
Questions And Answers Plus Rationales 2026
Instant Pdf Download
CHAMBERLAIN
This exam consists of 100 NCLEX-style multiple-
choice questions, each with one correct Answer
and a detailed rationale.
,1. The nurse is assessing a patient with a history of chronic kidney
disease. Which skin finding is most commonly associated with
uremia?
A. Uremic frost (urine crystal deposits on skin)
B. Bruising (ecchymosis)
C. Yellowish discoloration (carotenemia)
D. Hyperpigmentation (bronze color)
Answer: A. Uremic frost (urine crystal deposits on skin)
Rationale: Uremic frost is seen in severe untreated uremia; urea crystals
precipitate on the skin, especially in areas of sweating. It is rare now with
dialysis. Yellow skin occurs with jaundice or carotenemia.
2. A patient presents with fatigue, pallor, and a smooth, red, painful
tongue (glossitis). These findings suggest:
A. Iron deficiency anemia
B. Vitamin B12 deficiency (pernicious anemia)
C. Folic acid deficiency
D. All of the above
Answer: D. All of the above
Rationale: Glossitis (atrophic, smooth, red tongue) can occur with
deficiencies of iron, B12, folate, or niacin. B12 deficiency also causes
neurologic symptoms. Pallor and fatigue are common to all anemias.
,3. The nurse is assessing a patient’s abdomen and notes a palpable,
tender, sausage-shaped mass in the right lower quadrant. This is
most suggestive of:
A. Appendiceal abscess
B. Intussusception in a child (sausage-shaped mass)
C. Crohn’s disease (thickened bowel)
D. Ovarian cyst
Answer: B. Intussusception in a child (sausage-shaped mass)
Rationale: In a child, a palpable sausage-shaped mass in the RLQ with
colicky pain and red currant jelly stool is classic for intussusception. In
adults, consider malignancy.
4. The nurse is assessing a patient’s cranial nerve VI (abducens).
Which eye movement is impaired if CN VI is damaged?
A. Abduction (lateral gaze)
B. Adduction (medial gaze)
C. Upward gaze
D. Downward gaze
Answer: A. Abduction (lateral gaze)
Rationale: CN VI innervates the lateral rectus muscle, which abducts the
, eye. Damage causes inability to abduct, resulting in esotropia (cross-eye)
at rest.
5. A patient with a history of heavy smoking presents with a new,
unilateral wheeze that does not change with cough or position. This
finding suggests:
A. Bronchial obstruction (e.g., tumor)
B. Asthma
C. COPD
D. Pulmonary embolism
Answer: A. Bronchial obstruction (e.g., tumor)
Rationale: A fixed, unilateral wheeze (monophonic) suggests a fixed
obstruction (foreign body, bronchogenic carcinoma). Asthma and COPD
produce bilateral, polyphonic wheezes.
6. The nurse is performing a cardiac assessment. The S2 heart sound
is best heard at which auscultatory area?
A. Aortic and pulmonic areas (left and right 2nd ICS)
B. Apex (5th ICS MCL)
C. Left lower sternal border
D. Epigastrium
