NURS 6512 Advanced Health Assessment
question and answers 2025-2026
Cardiovascular System
Question 1
A 58-year-old man presents with intermittent substernal chest discomfort that occurs while
climbing stairs and resolves after several minutes of rest. Which diagnosis is most consistent
with this presentation?
A. Acute pericarditis
B. Stable angina pectoris
C. Pulmonary embolism
D. Costochondritis
Correct Answer
B. Stable angina pectoris
Rationale
Stable angina is caused by transient myocardial ischemia during increased oxygen demand,
typically precipitated by exertion or emotional stress and relieved by rest or nitroglycerin.
A: Pericarditis pain is often sharp, pleuritic, and relieved by sitting forward.
C: Pulmonary embolism usually presents with sudden dyspnea and pleuritic chest pain.
D: Costochondritis causes reproducible chest wall tenderness.
Question 2
Which patient has the greatest risk for developing coronary artery disease?
A. 28-year-old woman with hypothyroidism
B. 62-year-old man with diabetes, hypertension, and tobacco use
C. 34-year-old marathon runner
,D. 45-year-old woman with seasonal allergies
Correct Answer
B. 62-year-old man with diabetes, hypertension, and tobacco use
Rationale
Major cardiovascular risk factors include:
Diabetes mellitus
Hypertension
Smoking
Hyperlipidemia
Increasing age
Family history
This patient possesses multiple major modifiable and nonmodifiable risk factors.
Question 3
The nurse practitioner auscultates an S3 heart sound in a 72-year-old patient complaining of
orthopnea and lower-extremity edema.
The S3 is most consistent with:
A. Normal finding
B. Left ventricular failure
C. Pulmonary hypertension
D. Aortic stenosis
Correct Answer
B. Left ventricular failure
Rationale
An S3 in older adults usually indicates ventricular volume overload and is strongly associated
with systolic heart failure.
Normal S3s may occur in:
, Children
Adolescents
Pregnancy
Young adults under approximately 40 years
Question 4
The point of maximal impulse (PMI) is normally palpated at:
A. Left second intercostal space
B. Right fifth intercostal space
C. Left fifth intercostal space, midclavicular line
D. Xiphoid process
Correct Answer
C. Left fifth intercostal space, midclavicular line
Rationale
The normal PMI represents the left ventricular apex.
Displacement laterally or inferiorly may indicate:
Cardiomegaly
Left ventricular hypertrophy
Dilated cardiomyopathy
Question 5
Which assessment finding is most consistent with left-sided heart failure?
A. Hepatomegaly
B. Ascites
C. Bibasilar crackles
D. Splenomegaly
, Correct Answer
C. Bibasilar crackles
Rationale
Left-sided failure causes pulmonary congestion leading to:
Crackles
Dyspnea
Orthopnea
Paroxysmal nocturnal dyspnea
Right-sided failure causes:
Peripheral edema
Jugular venous distention (JVD)
Hepatomegaly
Ascites
Question 6
A patient reports chest pain that improves when leaning forward.
Which diagnosis is most likely?
A. GERD
B. Stable angina
C. Acute pericarditis
D. Costochondritis
Correct Answer
C. Acute pericarditis
Rationale
Classic findings include:
Sharp pleuritic chest pain
question and answers 2025-2026
Cardiovascular System
Question 1
A 58-year-old man presents with intermittent substernal chest discomfort that occurs while
climbing stairs and resolves after several minutes of rest. Which diagnosis is most consistent
with this presentation?
A. Acute pericarditis
B. Stable angina pectoris
C. Pulmonary embolism
D. Costochondritis
Correct Answer
B. Stable angina pectoris
Rationale
Stable angina is caused by transient myocardial ischemia during increased oxygen demand,
typically precipitated by exertion or emotional stress and relieved by rest or nitroglycerin.
A: Pericarditis pain is often sharp, pleuritic, and relieved by sitting forward.
C: Pulmonary embolism usually presents with sudden dyspnea and pleuritic chest pain.
D: Costochondritis causes reproducible chest wall tenderness.
Question 2
Which patient has the greatest risk for developing coronary artery disease?
A. 28-year-old woman with hypothyroidism
B. 62-year-old man with diabetes, hypertension, and tobacco use
C. 34-year-old marathon runner
,D. 45-year-old woman with seasonal allergies
Correct Answer
B. 62-year-old man with diabetes, hypertension, and tobacco use
Rationale
Major cardiovascular risk factors include:
Diabetes mellitus
Hypertension
Smoking
Hyperlipidemia
Increasing age
Family history
This patient possesses multiple major modifiable and nonmodifiable risk factors.
Question 3
The nurse practitioner auscultates an S3 heart sound in a 72-year-old patient complaining of
orthopnea and lower-extremity edema.
The S3 is most consistent with:
A. Normal finding
B. Left ventricular failure
C. Pulmonary hypertension
D. Aortic stenosis
Correct Answer
B. Left ventricular failure
Rationale
An S3 in older adults usually indicates ventricular volume overload and is strongly associated
with systolic heart failure.
Normal S3s may occur in:
, Children
Adolescents
Pregnancy
Young adults under approximately 40 years
Question 4
The point of maximal impulse (PMI) is normally palpated at:
A. Left second intercostal space
B. Right fifth intercostal space
C. Left fifth intercostal space, midclavicular line
D. Xiphoid process
Correct Answer
C. Left fifth intercostal space, midclavicular line
Rationale
The normal PMI represents the left ventricular apex.
Displacement laterally or inferiorly may indicate:
Cardiomegaly
Left ventricular hypertrophy
Dilated cardiomyopathy
Question 5
Which assessment finding is most consistent with left-sided heart failure?
A. Hepatomegaly
B. Ascites
C. Bibasilar crackles
D. Splenomegaly
, Correct Answer
C. Bibasilar crackles
Rationale
Left-sided failure causes pulmonary congestion leading to:
Crackles
Dyspnea
Orthopnea
Paroxysmal nocturnal dyspnea
Right-sided failure causes:
Peripheral edema
Jugular venous distention (JVD)
Hepatomegaly
Ascites
Question 6
A patient reports chest pain that improves when leaning forward.
Which diagnosis is most likely?
A. GERD
B. Stable angina
C. Acute pericarditis
D. Costochondritis
Correct Answer
C. Acute pericarditis
Rationale
Classic findings include:
Sharp pleuritic chest pain
