NRP 571 ADVANCED HEALTH
ASSESSMENT AND DIFFERENTIAL
DIAGNOSIS EXAM PREP QUESTIONS
AND ANSWERS | 2026/2027 UPDATE |
100% CORRECT
1. A 65-year-old patient presents with a holosystolic murmur heard best at the apex and
radiating to the left axilla. What is the most likely diagnosis?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: B
Conceptual Explanation: Mitral Regurgitation is typically characterized by a holosystolic
murmur heard best at the apex that radiates to the axilla.
2. During a cranial nerve assessment, the patient is unable to shrug their shoulders against
resistance. Which cranial nerve is likely affected?
A. CN XI (Spinal Accessory)
B. CN XII (Hypoglossal)
,C. CN X (Vagus)
D. CN IX (Glossopharyngeal)
Answer: A
Conceptual Explanation: Cranial Nerve XI (Spinal Accessory) innervates the trapezius and
sternocleidomastoid muscles; dysfunction leads to difficulty shrugging shoulders.
3. A 45-year-old male complains of sudden, severe pain in the first metatarsophalangeal joint.
Arthrocentesis shows negatively birefringent needle-shaped crystals. What is the diagnosis?
A. Pseudogout
B. Rheumatoid Arthritis
C. Gout
D. Osteoarthritis
Answer: C
Conceptual Explanation: Gout is confirmed by the presence of negatively birefringent
needle-shaped crystals (monosodium urate) in the synovial fluid.
4. Which physical exam maneuver is most sensitive for detecting a meniscus tear?
A. Lachman Test
B. Posterior Drawer Test
C. Valgus Stress Test
, D. McMurray Test
Answer: D
Conceptual Explanation: The McMurray test is used specifically to evaluate for meniscal
tears by rotating the knee with applied pressure.
5. A patient presents with a TSH of 12.5 mU/L and a low Free T4. Which condition does this
lab profile indicate?
A. Primary Hyperthyroidism
B. Primary Hypothyroidism
C. Subclinical Hypothyroidism
D. Secondary Hyperthyroidism
Answer: B
Conceptual Explanation: Elevated TSH combined with a low Free T4 is the classic lab
finding for primary hypothyroidism.
6. Which of the following is a classic clinical finding in a patient with Carbon Monoxide
poisoning?
A. Cyanosis
B. Jaundice
C. Cherry-red skin color
D. Pallor
ASSESSMENT AND DIFFERENTIAL
DIAGNOSIS EXAM PREP QUESTIONS
AND ANSWERS | 2026/2027 UPDATE |
100% CORRECT
1. A 65-year-old patient presents with a holosystolic murmur heard best at the apex and
radiating to the left axilla. What is the most likely diagnosis?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: B
Conceptual Explanation: Mitral Regurgitation is typically characterized by a holosystolic
murmur heard best at the apex that radiates to the axilla.
2. During a cranial nerve assessment, the patient is unable to shrug their shoulders against
resistance. Which cranial nerve is likely affected?
A. CN XI (Spinal Accessory)
B. CN XII (Hypoglossal)
,C. CN X (Vagus)
D. CN IX (Glossopharyngeal)
Answer: A
Conceptual Explanation: Cranial Nerve XI (Spinal Accessory) innervates the trapezius and
sternocleidomastoid muscles; dysfunction leads to difficulty shrugging shoulders.
3. A 45-year-old male complains of sudden, severe pain in the first metatarsophalangeal joint.
Arthrocentesis shows negatively birefringent needle-shaped crystals. What is the diagnosis?
A. Pseudogout
B. Rheumatoid Arthritis
C. Gout
D. Osteoarthritis
Answer: C
Conceptual Explanation: Gout is confirmed by the presence of negatively birefringent
needle-shaped crystals (monosodium urate) in the synovial fluid.
4. Which physical exam maneuver is most sensitive for detecting a meniscus tear?
A. Lachman Test
B. Posterior Drawer Test
C. Valgus Stress Test
, D. McMurray Test
Answer: D
Conceptual Explanation: The McMurray test is used specifically to evaluate for meniscal
tears by rotating the knee with applied pressure.
5. A patient presents with a TSH of 12.5 mU/L and a low Free T4. Which condition does this
lab profile indicate?
A. Primary Hyperthyroidism
B. Primary Hypothyroidism
C. Subclinical Hypothyroidism
D. Secondary Hyperthyroidism
Answer: B
Conceptual Explanation: Elevated TSH combined with a low Free T4 is the classic lab
finding for primary hypothyroidism.
6. Which of the following is a classic clinical finding in a patient with Carbon Monoxide
poisoning?
A. Cyanosis
B. Jaundice
C. Cherry-red skin color
D. Pallor
