NURS 5220 ADVANCED HEALTH
ASSESSMENT AND DIAGNOSTIC
REASONING QUESTIONS AND
CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. When assessing for increased tactile fremitus, which clinical condition should the advanced
practice nurse most likely suspect?
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Chronic obstructive pulmonary disease
Answer: A
Conceptual Explanation: Tactile fremitus is increased in conditions where lung tissue is
consolidated, such as lobar pneumonia, because sound travels better through solid/liquid
media than air.
2. A patient presents with a grade IV/VI systolic murmur heard best at the 2nd intercostal
space, right sternal border, radiating to the neck. What is the most likely diagnosis?
A. Mitral regurgitation
,B. Aortic regurgitation
C. Aortic stenosis
D. Mitral stenosis
Answer: C
Conceptual Explanation: Aortic stenosis is characterized by a harsh systolic crescendo-
decrescendo murmur at the right upper sternal border radiating to the carotids.
3. During a neurological exam, the patient is unable to differentiate between two points
touched simultaneously on the skin 2cm apart on the fingertip. This indicates a deficit in:
A. Stereognosis
B. Proprioception
C. Graphesthesia
D. Two-point discrimination
Answer: D
Conceptual Explanation: Two-point discrimination is the ability to discern that two
nearby objects touching the skin are truly two distinct points, testing the sensory cortex.
4. In diagnostic reasoning, a test with high sensitivity is most useful for which of the following
purposes?
A. Confirming a suspected diagnosis
B. Ruling in a rare disease
, C. Determining the severity of a condition
D. Screening to rule out a disease
Answer: D
Conceptual Explanation: Sensitivity (SnNout) means a Negative result in a highly
Sensitive test helps rule out the disease.
5. While performing a musculoskeletal exam, the NP uses the Lachman test. A positive result
indicates an injury to which structure?
A. Medial collateral ligament
B. Anterior cruciate ligament
C. Posterior cruciate ligament
D. Lateral meniscus
Answer: B
Conceptual Explanation: The Lachman test is the most sensitive clinical test for detecting
an ACL tear.
6. A 65-year-old patient reports a sudden, painless loss of vision in one eye described as a
‘curtain’ being pulled down. This is a classic presentation of:
A. Acute angle-closure glaucoma
B. Cataracts
C. Macular degeneration
ASSESSMENT AND DIAGNOSTIC
REASONING QUESTIONS AND
CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. When assessing for increased tactile fremitus, which clinical condition should the advanced
practice nurse most likely suspect?
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Chronic obstructive pulmonary disease
Answer: A
Conceptual Explanation: Tactile fremitus is increased in conditions where lung tissue is
consolidated, such as lobar pneumonia, because sound travels better through solid/liquid
media than air.
2. A patient presents with a grade IV/VI systolic murmur heard best at the 2nd intercostal
space, right sternal border, radiating to the neck. What is the most likely diagnosis?
A. Mitral regurgitation
,B. Aortic regurgitation
C. Aortic stenosis
D. Mitral stenosis
Answer: C
Conceptual Explanation: Aortic stenosis is characterized by a harsh systolic crescendo-
decrescendo murmur at the right upper sternal border radiating to the carotids.
3. During a neurological exam, the patient is unable to differentiate between two points
touched simultaneously on the skin 2cm apart on the fingertip. This indicates a deficit in:
A. Stereognosis
B. Proprioception
C. Graphesthesia
D. Two-point discrimination
Answer: D
Conceptual Explanation: Two-point discrimination is the ability to discern that two
nearby objects touching the skin are truly two distinct points, testing the sensory cortex.
4. In diagnostic reasoning, a test with high sensitivity is most useful for which of the following
purposes?
A. Confirming a suspected diagnosis
B. Ruling in a rare disease
, C. Determining the severity of a condition
D. Screening to rule out a disease
Answer: D
Conceptual Explanation: Sensitivity (SnNout) means a Negative result in a highly
Sensitive test helps rule out the disease.
5. While performing a musculoskeletal exam, the NP uses the Lachman test. A positive result
indicates an injury to which structure?
A. Medial collateral ligament
B. Anterior cruciate ligament
C. Posterior cruciate ligament
D. Lateral meniscus
Answer: B
Conceptual Explanation: The Lachman test is the most sensitive clinical test for detecting
an ACL tear.
6. A 65-year-old patient reports a sudden, painless loss of vision in one eye described as a
‘curtain’ being pulled down. This is a classic presentation of:
A. Acute angle-closure glaucoma
B. Cataracts
C. Macular degeneration
