NURS 5220 EXAM 4: ADVANCED
HEALTH ASSESSMENT AND
DIAGNOSTIC REASONING QUESTIONS
AND VERIFIED ANSWERS. JUST
RELEASED
1. During a cardiac examination, the clinician notes a mid-systolic click followed by a late
systolic murmur at the apex. Which valvular condition is most likely?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Valve Prolapse
D. Tricuspid Stenosis
Answer: C
Conceptual Explanation: Mitral Valve Prolapse is characteristically associated with a mid-
systolic click and a late systolic murmur caused by the leaflets bowing into the left atrium.
,2. When assessing a patient for meningeal irritation, the clinician flexes the patient’s neck
and observes for involuntary flexion of the hips and knees. This is known as:
A. Kernig’s sign
B. Murphy’s sign
C. Rovsing’s sign
D. Brudzinski’s sign
Answer: D
Conceptual Explanation: Brudzinski’s sign is positive when neck flexion causes
spontaneous hip and knee flexion, indicating meningeal inflammation.
3. A 65-year-old male presents with sudden onset of ‘the worst headache of my life.’ Physical
exam reveals neck stiffness. Which diagnostic step is most urgent?
A. Lumbar puncture
B. MRI of the brain
C. CT scan of the head without contrast
D. Temporal artery biopsy
Answer: C
Conceptual Explanation: A ‘thunderclap’ headache suggests subarachnoid hemorrhage. A
non-contrast CT is the gold standard for initial emergent diagnosis.
, 4. Which of the following physical findings is most indicative of pleural effusion during a
pulmonary examination?
A. Increased tactile fremitus and hyperresonance
B. Decreased tactile fremitus and hyperresonance
C. Increased tactile fremitus and dullness to percussion
D. Decreased tactile fremitus and dullness to percussion
Answer: D
Conceptual Explanation: Fluid in the pleural space (effusion) blocks the transmission of
sound (decreased fremitus) and replaces air with liquid (dullness to percussion).
5. A patient presents with unilateral ptosis, miosis, and anhidrosis. This triad is characteristic
of which condition?
A. Bell’s Palsy
B. Horner’s Syndrome
C. Trigeminal Neuralgia
D. Myasthenia Gravis
Answer: B
Conceptual Explanation: Horner’s Syndrome results from a sympathetic nerve pathway
interruption and presents with ptosis (drooping eyelid), miosis (constricted pupil), and
anhidrosis (lack of sweating).
HEALTH ASSESSMENT AND
DIAGNOSTIC REASONING QUESTIONS
AND VERIFIED ANSWERS. JUST
RELEASED
1. During a cardiac examination, the clinician notes a mid-systolic click followed by a late
systolic murmur at the apex. Which valvular condition is most likely?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Valve Prolapse
D. Tricuspid Stenosis
Answer: C
Conceptual Explanation: Mitral Valve Prolapse is characteristically associated with a mid-
systolic click and a late systolic murmur caused by the leaflets bowing into the left atrium.
,2. When assessing a patient for meningeal irritation, the clinician flexes the patient’s neck
and observes for involuntary flexion of the hips and knees. This is known as:
A. Kernig’s sign
B. Murphy’s sign
C. Rovsing’s sign
D. Brudzinski’s sign
Answer: D
Conceptual Explanation: Brudzinski’s sign is positive when neck flexion causes
spontaneous hip and knee flexion, indicating meningeal inflammation.
3. A 65-year-old male presents with sudden onset of ‘the worst headache of my life.’ Physical
exam reveals neck stiffness. Which diagnostic step is most urgent?
A. Lumbar puncture
B. MRI of the brain
C. CT scan of the head without contrast
D. Temporal artery biopsy
Answer: C
Conceptual Explanation: A ‘thunderclap’ headache suggests subarachnoid hemorrhage. A
non-contrast CT is the gold standard for initial emergent diagnosis.
, 4. Which of the following physical findings is most indicative of pleural effusion during a
pulmonary examination?
A. Increased tactile fremitus and hyperresonance
B. Decreased tactile fremitus and hyperresonance
C. Increased tactile fremitus and dullness to percussion
D. Decreased tactile fremitus and dullness to percussion
Answer: D
Conceptual Explanation: Fluid in the pleural space (effusion) blocks the transmission of
sound (decreased fremitus) and replaces air with liquid (dullness to percussion).
5. A patient presents with unilateral ptosis, miosis, and anhidrosis. This triad is characteristic
of which condition?
A. Bell’s Palsy
B. Horner’s Syndrome
C. Trigeminal Neuralgia
D. Myasthenia Gravis
Answer: B
Conceptual Explanation: Horner’s Syndrome results from a sympathetic nerve pathway
interruption and presents with ptosis (drooping eyelid), miosis (constricted pupil), and
anhidrosis (lack of sweating).
