NURS 5220: ADVANCED PHYSICAL
ASSESSMENT AND DIAGNOSTIC
REASONING EXAM PREP QUESTIONS
AND VERIFIED ANSWERS. JUST
RELEASED
1. When assessing for Mitral Regurgitation, which physical finding is most characteristic
during auscultation?
A. A mid-systolic click followed by a late systolic murmur
B. A holosystolic murmur at the apex radiating to the axilla
C. A crescendo-decrescendo murmur at the second right intercostal space
D. An early diastolic decrescendo murmur at the left sternal border
Answer: B
Conceptual Explanation: Mitral regurgitation is characterized by a holosystolic
(pansystolic) murmur heard best at the apex, which typically radiates to the left axilla due
to the backflow of blood from the left ventricle into the left atrium.
,2. In a patient with suspected lobar pneumonia, what would the clinician expect to find
during the assessment of tactile fremitus?
A. Decreased fremitus over the affected area
B. Increased fremitus over the area of consolidation
C. Absent fremitus throughout the lung fields
D. Normal fremitus with hyperresonance on percussion
Answer: B
Conceptual Explanation: Tactile fremitus is increased over areas of lung consolidation
(like pneumonia) because solid tissue conducts sound vibrations more effectively than air-
filled lung tissue.
3. A patient presents with sudden onset of facial drooping. To differentiate between a Bell’s
Palsy and an acute stroke, which assessment finding is most significant?
A. Sparing of the forehead muscles on the affected side
B. Presence of a facial twitch on the contralateral side
C. Inability to close the eye on the affected side
D. Involvement of the lower facial muscles only
Answer: A
, Conceptual Explanation: In an upper motor neuron lesion (like a stroke), the forehead is
often spared due to bilateral innervation. In a lower motor neuron lesion (like Bell’s Palsy),
the entire side of the face, including the forehead, is affected.
4. Which of the following maneuvers is specifically used to assess for a torn meniscus in the
knee?
A. McMurray test
B. Anterior Drawer test
C. Lachman test
D. Valgus stress test
Answer: A
Conceptual Explanation: The McMurray test involves rotating the lower leg while
extending the knee to check for clicks or pain indicative of a meniscal tear. Lachman and
Anterior Drawer tests assess the ACL.
5. While performing an abdominal exam, you elicit pain in the right lower quadrant when
palpating the left lower quadrant. This is known as:
A. Rovsing’s sign
B. Murphy’s sign
C. Psoas sign
D. Obturator sign
ASSESSMENT AND DIAGNOSTIC
REASONING EXAM PREP QUESTIONS
AND VERIFIED ANSWERS. JUST
RELEASED
1. When assessing for Mitral Regurgitation, which physical finding is most characteristic
during auscultation?
A. A mid-systolic click followed by a late systolic murmur
B. A holosystolic murmur at the apex radiating to the axilla
C. A crescendo-decrescendo murmur at the second right intercostal space
D. An early diastolic decrescendo murmur at the left sternal border
Answer: B
Conceptual Explanation: Mitral regurgitation is characterized by a holosystolic
(pansystolic) murmur heard best at the apex, which typically radiates to the left axilla due
to the backflow of blood from the left ventricle into the left atrium.
,2. In a patient with suspected lobar pneumonia, what would the clinician expect to find
during the assessment of tactile fremitus?
A. Decreased fremitus over the affected area
B. Increased fremitus over the area of consolidation
C. Absent fremitus throughout the lung fields
D. Normal fremitus with hyperresonance on percussion
Answer: B
Conceptual Explanation: Tactile fremitus is increased over areas of lung consolidation
(like pneumonia) because solid tissue conducts sound vibrations more effectively than air-
filled lung tissue.
3. A patient presents with sudden onset of facial drooping. To differentiate between a Bell’s
Palsy and an acute stroke, which assessment finding is most significant?
A. Sparing of the forehead muscles on the affected side
B. Presence of a facial twitch on the contralateral side
C. Inability to close the eye on the affected side
D. Involvement of the lower facial muscles only
Answer: A
, Conceptual Explanation: In an upper motor neuron lesion (like a stroke), the forehead is
often spared due to bilateral innervation. In a lower motor neuron lesion (like Bell’s Palsy),
the entire side of the face, including the forehead, is affected.
4. Which of the following maneuvers is specifically used to assess for a torn meniscus in the
knee?
A. McMurray test
B. Anterior Drawer test
C. Lachman test
D. Valgus stress test
Answer: A
Conceptual Explanation: The McMurray test involves rotating the lower leg while
extending the knee to check for clicks or pain indicative of a meniscal tear. Lachman and
Anterior Drawer tests assess the ACL.
5. While performing an abdominal exam, you elicit pain in the right lower quadrant when
palpating the left lower quadrant. This is known as:
A. Rovsing’s sign
B. Murphy’s sign
C. Psoas sign
D. Obturator sign
