NUR 6001 Final Exam Actual Exam V1 | NUR 6001 Advanced Health
Assessment (NUR6001 Final Exam) | William Paterson University
1. A 55-year-old male presents with sudden onset of severe headache, described as the
‘worst headache of my life.’ Which physical examination finding is most critical to assess
immediately for this patient?
A. Visual acuity
B. Nuchal rigidity
C. Deep tendon reflexes
D. Temporal artery tenderness
Answer: B
Rationale: A sudden, ‘worst headache of life’ is a classic presentation of a subarachnoid
hemorrhage. Assessing for nuchal rigidity helps identify meningeal irritation which often
accompanies this condition. This finding, along with other signs of increased intracranial
pressure, requires emergent neurosurgical consultation.
2. During a cardiac assessment, the nurse practitioner identifies a medium-pitched, mid-
systolic murmur heard best at the second right intercostal space. This murmur radiates to the
neck. What is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Pulmonic Stenosis
D. Aortic Regurgitation
Answer: B
Rationale: Aortic stenosis typically presents as a mid-systolic ejection murmur at the right
second intercostal space. Radiation to the carotid arteries in the neck is a hallmark finding
of this valvular disorder. Identifying the location and radiation of murmurs is essential for
differentiating between cardiac pathologies.
3. A patient presents with right upper quadrant pain that increases with deep inspiration
during palpation under the right costal margin. This clinical finding is known as:
A. Murphy’s sign
B. McBurney’s sign
C. Rovsing’s sign
D. Psoas sign
,Answer: A
Rationale: Murphy’s sign is an indicator of acute cholecystitis. It is performed by palpating
the gallbladder area while the patient takes a deep breath. A positive sign occurs when the
patient abruptly stops inhaling due to pain when the gallbladder descends onto the
examiner’s hand.
4. When assessing a patient’s cranial nerves, the nurse practitioner asks the patient to stick
out their tongue. The tongue deviates to the left. Which cranial nerve is likely affected?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN VII (Facial)
D. CN XII (Hypoglossal)
Answer: D
Rationale: The hypoglossal nerve (CN XII) controls the motor movements of the tongue.
When there is a lesion, the tongue deviates toward the side of the affected nerve. This is
because the intact genioglossus muscle on the opposite side pushes the tongue toward the
weak side.
5. A 65-year-old female reports a ‘curtain-like’ shadow descending over her vision in her left
eye. There is no pain. What is the most urgent differential diagnosis?
A. Acute Angle-Closure Glaucoma
B. Retinal Detachment
C. Cataract
D. Macular Degeneration
Answer: B
Rationale: Retinal detachment is often described as a shadow or curtain being pulled over
the visual field. Unlike acute glaucoma, it is typically painless but represents a medical
emergency. Immediate ophthalmic evaluation is necessary to prevent permanent vision
loss.
6. While assessing the chest of a patient with suspected lobar pneumonia, the nurse
practitioner expects to find which of the following during percussion?
A. Hyperresonance
B. Dullness
C. Resonance
D. Tympany
, Answer: B
Rationale: Dullness on percussion occurs when fluid or solid tissue replaces air-filled lung
spaces. In lobar pneumonia, the alveoli are filled with exudate, leading to this change in
sound. In contrast, hyperresonance would suggest trapped air, such as in emphysema or
pneumothorax.
7. Which of the following is an example of an ‘open-ended’ question used during an advanced
health history interview?
A. Does the pain radiate to your back?
B. Are you taking your blood pressure medication every day?
C. How have you been feeling since your last visit?
D. Have you ever had surgery on your abdomen?
Answer: C
Rationale: Open-ended questions allow the patient to provide a narrative and express
their concerns in their own words. They are essential at the beginning of an interview to
build rapport and gather comprehensive data. Closed-ended questions are better for
clarifying specific details later in the assessment.
8. In the assessment of a patient with suspected carpal tunnel syndrome, the nurse
practitioner asks the patient to hold the backs of their hands together with wrists flexed at 90
degrees for 60 seconds. This test is called:
A. Tinel’s sign
B. Allen’s test
C. Finkelstein’s test
D. Phalen’s test
Answer: D
Rationale: Phalen’s test is used to assess for median nerve compression at the wrist.
Numbness or tingling in the distribution of the median nerve within 60 seconds is
considered a positive result. This clinical maneuver is a standard part of the
musculoskeletal and neurological exam for hand pain.
9. A 72-year-old patient presents with symptoms of heart failure. On auscultation, the nurse
practitioner hears a low-pitched sound in early diastole, immediately following S2. This sound
is most likely:
A. Systolic Click
B. S4 (Atrial Gallop)
C. S3 (Ventricular Gallop)
Assessment (NUR6001 Final Exam) | William Paterson University
1. A 55-year-old male presents with sudden onset of severe headache, described as the
‘worst headache of my life.’ Which physical examination finding is most critical to assess
immediately for this patient?
A. Visual acuity
B. Nuchal rigidity
C. Deep tendon reflexes
D. Temporal artery tenderness
Answer: B
Rationale: A sudden, ‘worst headache of life’ is a classic presentation of a subarachnoid
hemorrhage. Assessing for nuchal rigidity helps identify meningeal irritation which often
accompanies this condition. This finding, along with other signs of increased intracranial
pressure, requires emergent neurosurgical consultation.
2. During a cardiac assessment, the nurse practitioner identifies a medium-pitched, mid-
systolic murmur heard best at the second right intercostal space. This murmur radiates to the
neck. What is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Pulmonic Stenosis
D. Aortic Regurgitation
Answer: B
Rationale: Aortic stenosis typically presents as a mid-systolic ejection murmur at the right
second intercostal space. Radiation to the carotid arteries in the neck is a hallmark finding
of this valvular disorder. Identifying the location and radiation of murmurs is essential for
differentiating between cardiac pathologies.
3. A patient presents with right upper quadrant pain that increases with deep inspiration
during palpation under the right costal margin. This clinical finding is known as:
A. Murphy’s sign
B. McBurney’s sign
C. Rovsing’s sign
D. Psoas sign
,Answer: A
Rationale: Murphy’s sign is an indicator of acute cholecystitis. It is performed by palpating
the gallbladder area while the patient takes a deep breath. A positive sign occurs when the
patient abruptly stops inhaling due to pain when the gallbladder descends onto the
examiner’s hand.
4. When assessing a patient’s cranial nerves, the nurse practitioner asks the patient to stick
out their tongue. The tongue deviates to the left. Which cranial nerve is likely affected?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN VII (Facial)
D. CN XII (Hypoglossal)
Answer: D
Rationale: The hypoglossal nerve (CN XII) controls the motor movements of the tongue.
When there is a lesion, the tongue deviates toward the side of the affected nerve. This is
because the intact genioglossus muscle on the opposite side pushes the tongue toward the
weak side.
5. A 65-year-old female reports a ‘curtain-like’ shadow descending over her vision in her left
eye. There is no pain. What is the most urgent differential diagnosis?
A. Acute Angle-Closure Glaucoma
B. Retinal Detachment
C. Cataract
D. Macular Degeneration
Answer: B
Rationale: Retinal detachment is often described as a shadow or curtain being pulled over
the visual field. Unlike acute glaucoma, it is typically painless but represents a medical
emergency. Immediate ophthalmic evaluation is necessary to prevent permanent vision
loss.
6. While assessing the chest of a patient with suspected lobar pneumonia, the nurse
practitioner expects to find which of the following during percussion?
A. Hyperresonance
B. Dullness
C. Resonance
D. Tympany
, Answer: B
Rationale: Dullness on percussion occurs when fluid or solid tissue replaces air-filled lung
spaces. In lobar pneumonia, the alveoli are filled with exudate, leading to this change in
sound. In contrast, hyperresonance would suggest trapped air, such as in emphysema or
pneumothorax.
7. Which of the following is an example of an ‘open-ended’ question used during an advanced
health history interview?
A. Does the pain radiate to your back?
B. Are you taking your blood pressure medication every day?
C. How have you been feeling since your last visit?
D. Have you ever had surgery on your abdomen?
Answer: C
Rationale: Open-ended questions allow the patient to provide a narrative and express
their concerns in their own words. They are essential at the beginning of an interview to
build rapport and gather comprehensive data. Closed-ended questions are better for
clarifying specific details later in the assessment.
8. In the assessment of a patient with suspected carpal tunnel syndrome, the nurse
practitioner asks the patient to hold the backs of their hands together with wrists flexed at 90
degrees for 60 seconds. This test is called:
A. Tinel’s sign
B. Allen’s test
C. Finkelstein’s test
D. Phalen’s test
Answer: D
Rationale: Phalen’s test is used to assess for median nerve compression at the wrist.
Numbness or tingling in the distribution of the median nerve within 60 seconds is
considered a positive result. This clinical maneuver is a standard part of the
musculoskeletal and neurological exam for hand pain.
9. A 72-year-old patient presents with symptoms of heart failure. On auscultation, the nurse
practitioner hears a low-pitched sound in early diastole, immediately following S2. This sound
is most likely:
A. Systolic Click
B. S4 (Atrial Gallop)
C. S3 (Ventricular Gallop)
