1
NURS 6512 MIDTERM EXAM LATEST VERSION 1
/NURS6512 WEEK 6 MIDTERM EXAM ADVANCED
HEALTH A.
1. A 52-year-old patient presents for an annual health assessment and
reports that over the past several months they have experienced
intermittent headaches that are usually worse toward the end of the
workday and improve after resting, although they deny visual
changes, weakness, numbness, speech difficulty, fever, recent head
trauma, or loss of consciousness. During the interview, the nurse
practitioner determines that the patient has no previous history of
neurologic disease and is not currently taking prescription
medication. Which additional assessment finding would be most
important to obtain when characterizing this patient's headache
pattern and determining whether further neurologic evaluation is
warranted?
A. The patient's preferred sleeping position
B. The relationship between the headache and exertion, position, or
Valsalva maneuver
C. The patient's usual daily intake of dairy products
D. The patient's dominant hand
Answer: B
2. During a comprehensive health assessment of a 68-year-old
patient, the nurse practitioner asks the patient to describe their
current medications, including prescription drugs, over-the-counter
products, vitamins, herbal preparations, and medications obtained
from family members. The patient reports taking several
medications but cannot recall the names or dosages of two of them.
Which approach would provide the most accurate medication
history and help identify potential medication-related problems?
A. Document the medications as “unknown” and proceed with the
examination
B. Ask only about prescription medications because over-the-
counter products are generally clinically insignificant
,2
C. Ask the patient to bring medication containers or an updated
medication list for reconciliation
D. Assume that medications prescribed by different clinicians do
not require reconciliation
Answer: C
3. A 45-year-old patient presents with a complaint of intermittent
dizziness that has occurred several times over the previous month.
During the history, the patient uses the word “dizzy,” but further
questioning reveals that sometimes the sensation involves a
spinning environment while at other times it consists of feeling
faint when standing. Which interviewing strategy is most
appropriate for the nurse practitioner when attempting to
distinguish the underlying symptom characteristics?
A. Accept the word dizziness as a sufficient description
B. Ask the patient to describe exactly what the sensation feels like
and identify its timing, triggers, duration, and associated symptoms
C. Immediately diagnose benign positional vertigo
D. Focus exclusively on the patient's blood pressure measurement
Answer: B
4. A 34-year-old patient presents with abdominal discomfort that
began approximately two days ago. The patient describes the pain
as initially located near the umbilicus but now more pronounced in
the right lower quadrant and reports associated nausea and reduced
appetite. During the assessment, the nurse practitioner recognizes
that the sequence and migration of the pain may provide important
diagnostic information. Which additional historical finding would
most strongly increase concern for an acute intra-abdominal
inflammatory process?
A. Pain that improves after eating a large meal
B. Progressive localized pain associated with anorexia and nausea
C. Mild abdominal discomfort occurring once every few months
D. Abdominal discomfort associated exclusively with excessive
caffeine intake
Answer: B
,3
5. A 71-year-old patient presents for evaluation of progressive
difficulty hearing conversations, particularly when several people
are speaking simultaneously. The patient denies acute ear pain,
drainage, or recent trauma. During the health assessment, the nurse
practitioner recognizes that age-related changes may affect the
interpretation of the hearing examination. Which finding would be
most consistent with a sensorineural rather than conductive hearing
deficit?
A. Hearing loss associated with obstruction of the external auditory
canal
B. Hearing loss caused by impacted cerumen
C. Difficulty hearing high-frequency sounds associated with aging
D. Hearing loss caused by fluid in the middle ear
Answer: C
6. A 59-year-old patient with a history of tobacco use presents for a
routine examination and reports a persistent cough that has
recently changed in character. The patient denies having
experienced a similar change during previous respiratory
infections. During the assessment, the nurse practitioner recognizes
that certain features of a cough require additional investigation
rather than being attributed automatically to a benign respiratory
condition. Which finding would be most concerning?
A. A cough occurring only after exposure to cold air
B. A chronic cough with recent change in pattern accompanied by
hemoptysis
C. An occasional cough immediately after drinking water
D. A cough that occurs briefly after vigorous exercise
Answer: B
7. During a cardiovascular assessment of a 64-year-old patient, the
nurse practitioner observes that the patient reports shortness of
breath when climbing stairs and states that the symptom has
gradually worsened over the previous year. The patient denies
acute chest pain but reports occasional ankle swelling at the end of
the day. Which additional assessment finding would be particularly
important when evaluating the possibility of cardiovascular
, 4
dysfunction?
A. Presence of jugular venous distention
B. Ability to identify common household odors
C. Presence of mild cerumen in the external auditory canal
D. Patient's preferred type of breakfast
Answer: A
8. A 27-year-old patient presents with recurrent episodes of
palpitations that begin suddenly and terminate spontaneously after
several minutes. The patient reports feeling anxious during the
episodes but denies that anxiety consistently precedes the
palpitations. Which component of the health history would be most
useful in differentiating a cardiac rhythm disturbance from
nonspecific anxiety-related awareness of the heartbeat?
A. Asking whether the episodes have a sudden onset and sudden
termination and determining their regularity
B. Asking whether the patient prefers morning or evening
appointments
C. Asking whether the patient has a family history of seasonal
allergies
D. Asking whether the patient regularly consumes dairy products
Answer: A
9. A 73-year-old patient is being assessed for recent fatigue and
decreased exercise tolerance. The patient reports having noticed
dark, tarry stools several times during the previous week but
initially did not consider this significant. The nurse practitioner
recognizes that stool characteristics can provide important clues
regarding gastrointestinal bleeding. Which interpretation is most
appropriate?
A. Black, tarry stool may indicate upper gastrointestinal bleeding
B. Black stool always indicates dietary iron intake and requires no
further evaluation
C. Tarry stool is characteristic of lower urinary tract bleeding
D. Stool color is not clinically useful when evaluating
gastrointestinal symptoms
Answer: A
NURS 6512 MIDTERM EXAM LATEST VERSION 1
/NURS6512 WEEK 6 MIDTERM EXAM ADVANCED
HEALTH A.
1. A 52-year-old patient presents for an annual health assessment and
reports that over the past several months they have experienced
intermittent headaches that are usually worse toward the end of the
workday and improve after resting, although they deny visual
changes, weakness, numbness, speech difficulty, fever, recent head
trauma, or loss of consciousness. During the interview, the nurse
practitioner determines that the patient has no previous history of
neurologic disease and is not currently taking prescription
medication. Which additional assessment finding would be most
important to obtain when characterizing this patient's headache
pattern and determining whether further neurologic evaluation is
warranted?
A. The patient's preferred sleeping position
B. The relationship between the headache and exertion, position, or
Valsalva maneuver
C. The patient's usual daily intake of dairy products
D. The patient's dominant hand
Answer: B
2. During a comprehensive health assessment of a 68-year-old
patient, the nurse practitioner asks the patient to describe their
current medications, including prescription drugs, over-the-counter
products, vitamins, herbal preparations, and medications obtained
from family members. The patient reports taking several
medications but cannot recall the names or dosages of two of them.
Which approach would provide the most accurate medication
history and help identify potential medication-related problems?
A. Document the medications as “unknown” and proceed with the
examination
B. Ask only about prescription medications because over-the-
counter products are generally clinically insignificant
,2
C. Ask the patient to bring medication containers or an updated
medication list for reconciliation
D. Assume that medications prescribed by different clinicians do
not require reconciliation
Answer: C
3. A 45-year-old patient presents with a complaint of intermittent
dizziness that has occurred several times over the previous month.
During the history, the patient uses the word “dizzy,” but further
questioning reveals that sometimes the sensation involves a
spinning environment while at other times it consists of feeling
faint when standing. Which interviewing strategy is most
appropriate for the nurse practitioner when attempting to
distinguish the underlying symptom characteristics?
A. Accept the word dizziness as a sufficient description
B. Ask the patient to describe exactly what the sensation feels like
and identify its timing, triggers, duration, and associated symptoms
C. Immediately diagnose benign positional vertigo
D. Focus exclusively on the patient's blood pressure measurement
Answer: B
4. A 34-year-old patient presents with abdominal discomfort that
began approximately two days ago. The patient describes the pain
as initially located near the umbilicus but now more pronounced in
the right lower quadrant and reports associated nausea and reduced
appetite. During the assessment, the nurse practitioner recognizes
that the sequence and migration of the pain may provide important
diagnostic information. Which additional historical finding would
most strongly increase concern for an acute intra-abdominal
inflammatory process?
A. Pain that improves after eating a large meal
B. Progressive localized pain associated with anorexia and nausea
C. Mild abdominal discomfort occurring once every few months
D. Abdominal discomfort associated exclusively with excessive
caffeine intake
Answer: B
,3
5. A 71-year-old patient presents for evaluation of progressive
difficulty hearing conversations, particularly when several people
are speaking simultaneously. The patient denies acute ear pain,
drainage, or recent trauma. During the health assessment, the nurse
practitioner recognizes that age-related changes may affect the
interpretation of the hearing examination. Which finding would be
most consistent with a sensorineural rather than conductive hearing
deficit?
A. Hearing loss associated with obstruction of the external auditory
canal
B. Hearing loss caused by impacted cerumen
C. Difficulty hearing high-frequency sounds associated with aging
D. Hearing loss caused by fluid in the middle ear
Answer: C
6. A 59-year-old patient with a history of tobacco use presents for a
routine examination and reports a persistent cough that has
recently changed in character. The patient denies having
experienced a similar change during previous respiratory
infections. During the assessment, the nurse practitioner recognizes
that certain features of a cough require additional investigation
rather than being attributed automatically to a benign respiratory
condition. Which finding would be most concerning?
A. A cough occurring only after exposure to cold air
B. A chronic cough with recent change in pattern accompanied by
hemoptysis
C. An occasional cough immediately after drinking water
D. A cough that occurs briefly after vigorous exercise
Answer: B
7. During a cardiovascular assessment of a 64-year-old patient, the
nurse practitioner observes that the patient reports shortness of
breath when climbing stairs and states that the symptom has
gradually worsened over the previous year. The patient denies
acute chest pain but reports occasional ankle swelling at the end of
the day. Which additional assessment finding would be particularly
important when evaluating the possibility of cardiovascular
, 4
dysfunction?
A. Presence of jugular venous distention
B. Ability to identify common household odors
C. Presence of mild cerumen in the external auditory canal
D. Patient's preferred type of breakfast
Answer: A
8. A 27-year-old patient presents with recurrent episodes of
palpitations that begin suddenly and terminate spontaneously after
several minutes. The patient reports feeling anxious during the
episodes but denies that anxiety consistently precedes the
palpitations. Which component of the health history would be most
useful in differentiating a cardiac rhythm disturbance from
nonspecific anxiety-related awareness of the heartbeat?
A. Asking whether the episodes have a sudden onset and sudden
termination and determining their regularity
B. Asking whether the patient prefers morning or evening
appointments
C. Asking whether the patient has a family history of seasonal
allergies
D. Asking whether the patient regularly consumes dairy products
Answer: A
9. A 73-year-old patient is being assessed for recent fatigue and
decreased exercise tolerance. The patient reports having noticed
dark, tarry stools several times during the previous week but
initially did not consider this significant. The nurse practitioner
recognizes that stool characteristics can provide important clues
regarding gastrointestinal bleeding. Which interpretation is most
appropriate?
A. Black, tarry stool may indicate upper gastrointestinal bleeding
B. Black stool always indicates dietary iron intake and requires no
further evaluation
C. Tarry stool is characteristic of lower urinary tract bleeding
D. Stool color is not clinically useful when evaluating
gastrointestinal symptoms
Answer: A
