NSG 6020 ADVANCED HEALTH
ASSESSMENT MIDTERM EXAM
QUESTIONS AND ANSWERS
1. During a cardiac assessment, the nurse practitioner notes a low-pitched, mid-diastolic
murmur at the apex, heard best with the bell in the left lateral decubitus position. This
finding is most consistent with:
A. Aortic Regurgitation
B. Mitral Valve Prolapse
C. Mitral Stenosis
D. Aortic Stenosis
Answer: C
Conceptual Explanation: Mitral stenosis is a diastolic murmur heard best at the apex with
the bell. Aortic regurgitation is also diastolic but heard at the base. Stenosis of the mitral
valve restricts flow from the left atrium to the left ventricle during diastole.
,2. When performing a respiratory assessment on a patient with suspected lobar pneumonia,
which finding is expected during tactile fremitus?
A. Decreased fremitus over the affected area
B. Increased fremitus over the affected area
C. Absent fremitus over the affected area
D. Normal fremitus throughout all lung fields
Answer: B
Conceptual Explanation: Tactile fremitus increases with lung consolidation, such as in
lobar pneumonia, because sound travels better through solid/fluid-filled tissue than
through air.
3. A 65-year-old patient presents with sudden, painless loss of vision in the right eye. Upon
funduscopic exam, you note a ‘cherry-red spot’ at the macula. What is the most likely
diagnosis?
A. Retinal Detachment
B. Central Retinal Artery Occlusion
C. Acute Angle-Closure Glaucoma
D. Diabetic Retinopathy
Answer: B
, Conceptual Explanation: A cherry-red spot at the macula is a hallmark sign of Central
Retinal Artery Occlusion (CRAO), an ocular emergency.
4. Which of the following maneuvers is most sensitive for detecting a small amount of pleural
effusion?
A. Tactile fremitus
B. Percussion of the lung bases
C. Chest expansion
D. Diaphragmatic excursion
Answer: D
Conceptual Explanation: Diaphragmatic excursion measures the movement of the
diaphragm. A decreased or absent excursion can indicate pleural effusion or atelectasis.
5. In an elderly patient, which of the following is considered a normal age-related change in
the cardiovascular system?
A. Decrease in systolic blood pressure
B. Decrease in arterial stiffness
C. Increase in maximum heart rate
D. Increase in left ventricular wall thickness
Answer: D
ASSESSMENT MIDTERM EXAM
QUESTIONS AND ANSWERS
1. During a cardiac assessment, the nurse practitioner notes a low-pitched, mid-diastolic
murmur at the apex, heard best with the bell in the left lateral decubitus position. This
finding is most consistent with:
A. Aortic Regurgitation
B. Mitral Valve Prolapse
C. Mitral Stenosis
D. Aortic Stenosis
Answer: C
Conceptual Explanation: Mitral stenosis is a diastolic murmur heard best at the apex with
the bell. Aortic regurgitation is also diastolic but heard at the base. Stenosis of the mitral
valve restricts flow from the left atrium to the left ventricle during diastole.
,2. When performing a respiratory assessment on a patient with suspected lobar pneumonia,
which finding is expected during tactile fremitus?
A. Decreased fremitus over the affected area
B. Increased fremitus over the affected area
C. Absent fremitus over the affected area
D. Normal fremitus throughout all lung fields
Answer: B
Conceptual Explanation: Tactile fremitus increases with lung consolidation, such as in
lobar pneumonia, because sound travels better through solid/fluid-filled tissue than
through air.
3. A 65-year-old patient presents with sudden, painless loss of vision in the right eye. Upon
funduscopic exam, you note a ‘cherry-red spot’ at the macula. What is the most likely
diagnosis?
A. Retinal Detachment
B. Central Retinal Artery Occlusion
C. Acute Angle-Closure Glaucoma
D. Diabetic Retinopathy
Answer: B
, Conceptual Explanation: A cherry-red spot at the macula is a hallmark sign of Central
Retinal Artery Occlusion (CRAO), an ocular emergency.
4. Which of the following maneuvers is most sensitive for detecting a small amount of pleural
effusion?
A. Tactile fremitus
B. Percussion of the lung bases
C. Chest expansion
D. Diaphragmatic excursion
Answer: D
Conceptual Explanation: Diaphragmatic excursion measures the movement of the
diaphragm. A decreased or absent excursion can indicate pleural effusion or atelectasis.
5. In an elderly patient, which of the following is considered a normal age-related change in
the cardiovascular system?
A. Decrease in systolic blood pressure
B. Decrease in arterial stiffness
C. Increase in maximum heart rate
D. Increase in left ventricular wall thickness
Answer: D
