GUA RA N T EED
CHAMBERLAIN UNIVERSITY · COLLEGE OF NURSING PASS.
NR 304 Final Exam
Complete Practice Question Bank
Health Assessment — Cardiovascular, Respiratory, GU, Musculoskeletal & More
COMPLETE FINAL EXAM COVERAGE:
90+ NCLEX-Style Questions with Answers & Rationales
All Body Systems, Failure to Rescue, Reproductive Health
Complete Edition · July 2026
EXAM FOCUSED DETAILED HIGH-YIELD CONFIDENCE
Final exam content RATIONALES Tested concepts BUILDER
Evidence-based Pass with confidence
P r e p a r e · P r a c t i c e · Pa s s
Excellence in Nursing Education
,NR 304 · CHAMBERLAIN UNIVERSITY FINAL EXAM COMPLETE QUESTION BANK
Questions 1–22: Cardiac, Urinary, Musculoskeletal & Equipment
1 At which anatomical landmark should the nurse listen to best evaluate closure of the mitral valve?
A Left midclavicular line, 5th intercostal space
B Right 2nd intercostal space
C Left 2nd intercostal space
D Right 5th intercostal space
Why A is correct: The mitral valve is best auscultated at the apex — left midclavicular line, 5th intercostal space (point of maximal
impulse). The aortic valve is at the right 2nd ICS; pulmonic at left 2nd ICS; tricuspid at left lower sternal border.
2 Which muscle strength grades indicate the ability to move against resistance?
A Grade 4, Grade 5
B Grade 2, Grade 3
C Grade 1, Grade 2
D Grade 0, Grade 1
Why A is correct: Grade 4 = full ROM against gravity with some resistance (Good). Grade 5 = full ROM against gravity with full
resistance (Normal). Grade 3 = against gravity only (Fair); Grade 2 = gravity eliminated (Poor).
3 Which piece of equipment allows visualization of the retina and internal eye structures?
A Ophthalmoscope
B Otoscope
C Stethoscope
D Sphygmomanometer
Why A is correct: The ophthalmoscope visualizes the retina, optic disc, macula, and retinal vessels. The otoscope examines the ear
canal and tympanic membrane.
4 Which diagnostic procedure provides the most definitive confirmation of bladder malignancy?
A Tissue biopsy obtained via cystoscopy
B Urine cytology
C CT scan
D Ultrasound
Why A is correct: Tissue biopsy is the gold standard for definitively diagnosing malignancy. Cystoscopy allows direct visualization
and tissue sampling. Urine cytology, CT, and ultrasound are screening/diagnostic adjuncts.
,5 Which factor most commonly contributes to failure to rescue in hospitalized clients?
A Missed recognition of progressive clinical decline
B Equipment malfunction
C Staffing ratios
D Medication errors
Why A is correct: The most common cause of failure to rescue is failure to recognize early, subtle signs of clinical deterioration.
Early recognition is the single most important factor in preventing adverse outcomes.
6 Which client history places an individual at the highest risk for developing testicular cancer?
A Congenital undescended testes (cryptorchidism)
B Family history of prostate cancer
C History of UTIs
D Circumcision status
Why A is correct: Cryptorchidism is the strongest risk factor for testicular cancer, increasing risk 3–10 times. Testicular cancer is
most common in young men aged 15–35.
7 Which disorder best explains a client's inability to actively straighten the ring and little fingers?
A Dupuytren contracture
B Carpal tunnel syndrome
C Trigger finger
D Rheumatoid arthritis
Why A is correct: Dupuytren contracture causes progressive flexion deformity of the ring and little fingers due to thickening of
the palmar fascia. Carpal tunnel affects the thumb/index/middle fingers.
8 What finding should the nurse expect when comparing bilateral muscle strength in a healthy adult?
A Equal strength on both sides
B Dominant side significantly stronger
C Non-dominant side stronger
D Variable strength depending on time of day
Why A is correct: Bilateral muscle strength should be symmetric (equal) in healthy adults. Significant asymmetry may indicate
neurological or musculoskeletal pathology.
, 9 Which new symptom in a client being treated for a UTI suggests ascending infection?
A Flank pain
B Urinary frequency
C Dysuria
D Cloudy urine
Why A is correct: Flank pain suggests the infection has ascended from the bladder to the kidneys (pyelonephritis). Frequency,
dysuria, and cloudy urine are lower UTI symptoms.
10 Approximately how many men over age 50 experience prostate enlargement?
A One in two (50%)
B One in ten (10%)
C One in four (25%)
D One in one hundred (1%)
Why A is correct: BPH affects approximately 50% of men over 50 and up to 90% of men over 70. It is the most common benign
neoplasm in aging men.
11 Which condition should the nurse suspect with blood in urine and sharp flank pain?
A Renal calculi
B Urinary tract infection
C Bladder cancer
D Prostatitis
Why A is correct: Hematuria + sharp flank pain is the classic presentation of renal calculi (kidney stones) as the stone moves
through the ureter. UTI presents with dysuria/frequency; bladder cancer is often painless hematuria.
12 Which recommendation should be included when teaching a client with low testosterone about managing fatigue?
A Engage in routine physical exercise
B Avoid all physical activity
C Increase caffeine intake
D Take frequent naps
Why A is correct: Regular exercise improves energy levels, mood, and muscle mass in men with low testosterone. It is a first-line
lifestyle intervention alongside adequate sleep and nutrition.
CHAMBERLAIN UNIVERSITY · COLLEGE OF NURSING PASS.
NR 304 Final Exam
Complete Practice Question Bank
Health Assessment — Cardiovascular, Respiratory, GU, Musculoskeletal & More
COMPLETE FINAL EXAM COVERAGE:
90+ NCLEX-Style Questions with Answers & Rationales
All Body Systems, Failure to Rescue, Reproductive Health
Complete Edition · July 2026
EXAM FOCUSED DETAILED HIGH-YIELD CONFIDENCE
Final exam content RATIONALES Tested concepts BUILDER
Evidence-based Pass with confidence
P r e p a r e · P r a c t i c e · Pa s s
Excellence in Nursing Education
,NR 304 · CHAMBERLAIN UNIVERSITY FINAL EXAM COMPLETE QUESTION BANK
Questions 1–22: Cardiac, Urinary, Musculoskeletal & Equipment
1 At which anatomical landmark should the nurse listen to best evaluate closure of the mitral valve?
A Left midclavicular line, 5th intercostal space
B Right 2nd intercostal space
C Left 2nd intercostal space
D Right 5th intercostal space
Why A is correct: The mitral valve is best auscultated at the apex — left midclavicular line, 5th intercostal space (point of maximal
impulse). The aortic valve is at the right 2nd ICS; pulmonic at left 2nd ICS; tricuspid at left lower sternal border.
2 Which muscle strength grades indicate the ability to move against resistance?
A Grade 4, Grade 5
B Grade 2, Grade 3
C Grade 1, Grade 2
D Grade 0, Grade 1
Why A is correct: Grade 4 = full ROM against gravity with some resistance (Good). Grade 5 = full ROM against gravity with full
resistance (Normal). Grade 3 = against gravity only (Fair); Grade 2 = gravity eliminated (Poor).
3 Which piece of equipment allows visualization of the retina and internal eye structures?
A Ophthalmoscope
B Otoscope
C Stethoscope
D Sphygmomanometer
Why A is correct: The ophthalmoscope visualizes the retina, optic disc, macula, and retinal vessels. The otoscope examines the ear
canal and tympanic membrane.
4 Which diagnostic procedure provides the most definitive confirmation of bladder malignancy?
A Tissue biopsy obtained via cystoscopy
B Urine cytology
C CT scan
D Ultrasound
Why A is correct: Tissue biopsy is the gold standard for definitively diagnosing malignancy. Cystoscopy allows direct visualization
and tissue sampling. Urine cytology, CT, and ultrasound are screening/diagnostic adjuncts.
,5 Which factor most commonly contributes to failure to rescue in hospitalized clients?
A Missed recognition of progressive clinical decline
B Equipment malfunction
C Staffing ratios
D Medication errors
Why A is correct: The most common cause of failure to rescue is failure to recognize early, subtle signs of clinical deterioration.
Early recognition is the single most important factor in preventing adverse outcomes.
6 Which client history places an individual at the highest risk for developing testicular cancer?
A Congenital undescended testes (cryptorchidism)
B Family history of prostate cancer
C History of UTIs
D Circumcision status
Why A is correct: Cryptorchidism is the strongest risk factor for testicular cancer, increasing risk 3–10 times. Testicular cancer is
most common in young men aged 15–35.
7 Which disorder best explains a client's inability to actively straighten the ring and little fingers?
A Dupuytren contracture
B Carpal tunnel syndrome
C Trigger finger
D Rheumatoid arthritis
Why A is correct: Dupuytren contracture causes progressive flexion deformity of the ring and little fingers due to thickening of
the palmar fascia. Carpal tunnel affects the thumb/index/middle fingers.
8 What finding should the nurse expect when comparing bilateral muscle strength in a healthy adult?
A Equal strength on both sides
B Dominant side significantly stronger
C Non-dominant side stronger
D Variable strength depending on time of day
Why A is correct: Bilateral muscle strength should be symmetric (equal) in healthy adults. Significant asymmetry may indicate
neurological or musculoskeletal pathology.
, 9 Which new symptom in a client being treated for a UTI suggests ascending infection?
A Flank pain
B Urinary frequency
C Dysuria
D Cloudy urine
Why A is correct: Flank pain suggests the infection has ascended from the bladder to the kidneys (pyelonephritis). Frequency,
dysuria, and cloudy urine are lower UTI symptoms.
10 Approximately how many men over age 50 experience prostate enlargement?
A One in two (50%)
B One in ten (10%)
C One in four (25%)
D One in one hundred (1%)
Why A is correct: BPH affects approximately 50% of men over 50 and up to 90% of men over 70. It is the most common benign
neoplasm in aging men.
11 Which condition should the nurse suspect with blood in urine and sharp flank pain?
A Renal calculi
B Urinary tract infection
C Bladder cancer
D Prostatitis
Why A is correct: Hematuria + sharp flank pain is the classic presentation of renal calculi (kidney stones) as the stone moves
through the ureter. UTI presents with dysuria/frequency; bladder cancer is often painless hematuria.
12 Which recommendation should be included when teaching a client with low testosterone about managing fatigue?
A Engage in routine physical exercise
B Avoid all physical activity
C Increase caffeine intake
D Take frequent naps
Why A is correct: Regular exercise improves energy levels, mood, and muscle mass in men with low testosterone. It is a first-line
lifestyle intervention alongside adequate sleep and nutrition.
