NU 650 ADVANCED HEALTH
ASSESSMENT COMPREHENSIVE EXAM
2026/2027
1. A 65-year-old male presents with a harsh systolic crescendo-decrescendo murmur heard
best at the second right intercostal space, radiating to the carotid arteries. Which condition is
most likely?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Pulmonary Stenosis
D. Aortic Regurgitation
Answer: B
Conceptual Explanation: Aortic Stenosis is characterized by a systolic crescendo-
decrescendo murmur at the right second intercostal space that typically radiates to the
carotids.
,2. When assessing a patient for a suspected tension pneumothorax, which clinical finding is
most pathognomonic?
A. Increased tactile fremitus
B. Vesicular breath sounds
C. Dullness to percussion
D. Tracheal deviation to the contralateral side
Answer: D
Conceptual Explanation: In tension pneumothorax, the buildup of pressure causes the
mediastinum and trachea to shift away (contralateral) from the affected side.
3. During a neurological exam, the provider asks the patient to puff out their cheeks and
smile. Which cranial nerve is being evaluated?
A. CN VII (Facial)
B. CN V (Trigeminal)
C. CN IX (Glossopharyngeal)
D. CN XII (Hypoglossal)
Answer: A
Conceptual Explanation: Cranial Nerve VII, the facial nerve, controls the muscles of facial
expression, including smiling and puffing out cheeks.
, 4. A patient presents with acute abdominal pain. Upon palpation of the left lower quadrant,
the patient experiences pain in the right lower quadrant. This is known as:
A. Murphy’s sign
B. McBurney’s sign
C. Psoas sign
D. Rovsing’s sign
Answer: D
Conceptual Explanation: Rovsing’s sign is positive when pressure on the LLQ causes pain
in the RLQ, suggesting peritoneal irritation or appendicitis.
5. Which physical examination finding is most indicative of chronic obstructive pulmonary
disease (COPD)?
A. Pectus excavatum
B. Increased AP diameter of the chest (Barrel chest)
C. Increased tactile fremitus
D. Resonant percussion throughout
Answer: B
Conceptual Explanation: Chronic air trapping in COPD leads to an increase in the
anterior-posterior diameter of the chest, commonly called a barrel chest.
ASSESSMENT COMPREHENSIVE EXAM
2026/2027
1. A 65-year-old male presents with a harsh systolic crescendo-decrescendo murmur heard
best at the second right intercostal space, radiating to the carotid arteries. Which condition is
most likely?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Pulmonary Stenosis
D. Aortic Regurgitation
Answer: B
Conceptual Explanation: Aortic Stenosis is characterized by a systolic crescendo-
decrescendo murmur at the right second intercostal space that typically radiates to the
carotids.
,2. When assessing a patient for a suspected tension pneumothorax, which clinical finding is
most pathognomonic?
A. Increased tactile fremitus
B. Vesicular breath sounds
C. Dullness to percussion
D. Tracheal deviation to the contralateral side
Answer: D
Conceptual Explanation: In tension pneumothorax, the buildup of pressure causes the
mediastinum and trachea to shift away (contralateral) from the affected side.
3. During a neurological exam, the provider asks the patient to puff out their cheeks and
smile. Which cranial nerve is being evaluated?
A. CN VII (Facial)
B. CN V (Trigeminal)
C. CN IX (Glossopharyngeal)
D. CN XII (Hypoglossal)
Answer: A
Conceptual Explanation: Cranial Nerve VII, the facial nerve, controls the muscles of facial
expression, including smiling and puffing out cheeks.
, 4. A patient presents with acute abdominal pain. Upon palpation of the left lower quadrant,
the patient experiences pain in the right lower quadrant. This is known as:
A. Murphy’s sign
B. McBurney’s sign
C. Psoas sign
D. Rovsing’s sign
Answer: D
Conceptual Explanation: Rovsing’s sign is positive when pressure on the LLQ causes pain
in the RLQ, suggesting peritoneal irritation or appendicitis.
5. Which physical examination finding is most indicative of chronic obstructive pulmonary
disease (COPD)?
A. Pectus excavatum
B. Increased AP diameter of the chest (Barrel chest)
C. Increased tactile fremitus
D. Resonant percussion throughout
Answer: B
Conceptual Explanation: Chronic air trapping in COPD leads to an increase in the
anterior-posterior diameter of the chest, commonly called a barrel chest.
