NURS 5220 Advanced Health Assessment | UTA NURS 5220 Study
Guide & Exam Prep 2026–2027 | Advanced Health Assessment and
Diagnostic Reasoning | Health History, Patient Interviewing, Physical
Examination, Vital Signs, Pain Assessment, Skin, HEENT,
Cardiovascular, Respiratory, Abdominal, Genitourinary,
Musculoskeletal, Neurological & Mental Status Assessment | Clinical
Reasoning, SOAP Documentation, Differential Diagnosis, Health
Promotion, Cultural Assessment, Lifespan Assessment | Practice
Questions, Case Studies & Detailed Rationales
Question 1: A nurse practitioner is assessing a patient with suspected
hypothyroidism. Which physical examination finding is most consistent with this
diagnosis?
A. Exophthalmos and lid lag
B. Warm, moist skin with fine tremors
C. Delayed relaxation phase of deep tendon reflexes
D. Tachycardia with a bounding pulse
CORRECT ANSWER: C. Delayed relaxation phase of deep tendon reflexes
Rationale: Hypothyroidism classically presents with a delayed relaxation phase of
deep tendon reflexes (often called "hung-up" reflexes), along with fatigue, weight
gain, cold intolerance, dry skin, and periorbital puffiness. Exophthalmos, warm
moist skin, tremors, and tachycardia are findings associated with
hyperthyroidism, not hypothyroidism.
Question 2: During an abdominal examination, the nurse practitioner
auscultates a bruit in the epigastric region. This finding is most suggestive of
which condition?
A. Abdominal aortic aneurysm
B. Renal artery stenosis
C. Portal hypertension
D. Gastric ulcer
CORRECT ANSWER: B. Renal artery stenosis
,Rationale: A bruit heard in the epigastric region or just above the umbilicus using
the bell of the stethoscope is a classic finding in renal artery stenosis, resulting
from turbulent blood flow through a narrowed renal artery. While an abdominal
aortic aneurysm may also produce a bruit, renal artery stenosis is specifically
associated with an epigastric bruit.
Question 3: A patient presents with a sudden onset of severe tearing chest pain
radiating to the back, with a 25 mm Hg blood pressure difference between the
right and left arms. Which physical examination finding is most specific for
aortic dissection?
A. A widened mediastinum on chest radiograph
B. A new diastolic murmur at the right sternal border
C. A pulse deficit in one extremity
D. Jugular venous distension
CORRECT ANSWER: C. A pulse deficit in one extremity
Rationale: A pulse deficit—an absent or diminished pulse in one extremity
compared to the contralateral side—is a highly specific physical finding for aortic
dissection, indicating obstruction of a major branch vessel by the dissection flap.
Blood pressure differences and widened mediastinum are suggestive but less
specific. A diastolic murmur may indicate aortic regurgitation from dissection but
is not as specific as a pulse deficit.
Question 4: A patient presents with a unilateral, painful vesicular rash in a
dermatomal distribution on the trunk. Which finding most strongly supports a
diagnosis of herpes zoster rather than a bacterial skin infection?
A. The rash crosses the midline
B. The rash is preceded by prodromal pain and paresthesia
C. The rash is associated with fever and lymphadenopathy
D. The rash is confluent and covered with honey-colored crusts
CORRECT ANSWER: B. The rash is preceded by prodromal pain and paresthesia
Rationale: Herpes zoster (shingles) characteristically presents with a painful,
unilateral vesicular rash in a dermatomal distribution. A hallmark feature is the
presence of prodromal pain, burning, or paresthesia in the affected dermatome
,that precedes the eruption by several days. The rash does not cross the midline.
Honey-colored crusts are more consistent with bacterial infections such as
impetigo.
Question 5: Which of the following findings in a newborn's tympanic membrane
is considered a normal variant during the first few days of life?
A. Immobility of the drum
B. A cone-shaped light reflex
C. A membrane that appears thick and opaque due to vernix caseosa
D. A bulging, red membrane with loss of landmarks
CORRECT ANSWER: C. A membrane that appears thick and opaque due to vernix
caseosa
Rationale: During the first few days of life, the newborn's tympanic membrane
often appears thickened and opaque because vernix caseosa obscures the
membrane. This is a normal, temporary finding. Immobility, a cone-shaped light
reflex, and a bulging red membrane with loss of landmarks are abnormal findings.
Question 6: A nurse practitioner is preparing to perform an otoscopic
examination. Which statement is true regarding the anatomy of the nasal
cavity?
A. The Kiesselbach plexus is located in the posterior nasal cavity
B. The turbinates are bony projections that increase the surface area for air
processing
C. The meatus is the central dividing structure of the nose
D. The septum contains the superior, middle, and inferior conchae
CORRECT ANSWER: B. The turbinates are bony projections that increase the
surface area for air processing
Rationale: The lateral walls of each nasal cavity contain three parallel bony
projections called the superior, middle, and inferior turbinates (conchae). These
increase the surface area so that more blood vessels and mucous membrane are
available to warm, humidify, and filter inhaled air. The Kiesselbach plexus is
located in the anterior septum, and the septum is the central dividing structure.
, Question 7: A 72-year-old patient with a 30-pack-year smoking history who quit
10 years ago asks about lung cancer screening. Which recommendation is most
appropriate?
A. No screening is indicated because the patient quit smoking
B. Annual low-dose computed tomography (LDCT) screening is recommended
C. Chest radiograph every 6 months is recommended
D. Sputum cytology annually is recommended
CORRECT ANSWER: B. Annual low-dose computed tomography (LDCT) screening
is recommended
Rationale: Annual LDCT screening is recommended for patients aged 55-74 years
with a 30-pack-year smoking history who are current smokers or have quit within
the past 15 years. This patient meets all criteria, including the 30-pack-year
history and having quit 10 years ago (within the 15-year window).
Question 8: A patient with limited English proficiency needs to discuss complex
symptoms. What is the most appropriate approach for the nurse practitioner?
A. Ask a young family member to interpret
B. Speak louder and repeat every question
C. Use a qualified medical interpreter and communicate directly with the patient
D. Avoid detailed questions to prevent misunderstanding
CORRECT ANSWER: C. Use a qualified medical interpreter and communicate
directly with the patient
Rationale: A qualified medical interpreter supports accurate communication,
confidentiality, and informed decision-making. The clinician should continue
addressing the patient rather than speaking primarily to the interpreter. Using
family members as interpreters is inappropriate due to confidentiality concerns
and potential for inaccurate interpretation. Speaking louder does not address
language barriers.
Question 9: Which statement best describes cultural humility in advanced
nursing practice?
A. Learning every belief associated with each cultural group
B. Applying identical communication techniques to every patient
Guide & Exam Prep 2026–2027 | Advanced Health Assessment and
Diagnostic Reasoning | Health History, Patient Interviewing, Physical
Examination, Vital Signs, Pain Assessment, Skin, HEENT,
Cardiovascular, Respiratory, Abdominal, Genitourinary,
Musculoskeletal, Neurological & Mental Status Assessment | Clinical
Reasoning, SOAP Documentation, Differential Diagnosis, Health
Promotion, Cultural Assessment, Lifespan Assessment | Practice
Questions, Case Studies & Detailed Rationales
Question 1: A nurse practitioner is assessing a patient with suspected
hypothyroidism. Which physical examination finding is most consistent with this
diagnosis?
A. Exophthalmos and lid lag
B. Warm, moist skin with fine tremors
C. Delayed relaxation phase of deep tendon reflexes
D. Tachycardia with a bounding pulse
CORRECT ANSWER: C. Delayed relaxation phase of deep tendon reflexes
Rationale: Hypothyroidism classically presents with a delayed relaxation phase of
deep tendon reflexes (often called "hung-up" reflexes), along with fatigue, weight
gain, cold intolerance, dry skin, and periorbital puffiness. Exophthalmos, warm
moist skin, tremors, and tachycardia are findings associated with
hyperthyroidism, not hypothyroidism.
Question 2: During an abdominal examination, the nurse practitioner
auscultates a bruit in the epigastric region. This finding is most suggestive of
which condition?
A. Abdominal aortic aneurysm
B. Renal artery stenosis
C. Portal hypertension
D. Gastric ulcer
CORRECT ANSWER: B. Renal artery stenosis
,Rationale: A bruit heard in the epigastric region or just above the umbilicus using
the bell of the stethoscope is a classic finding in renal artery stenosis, resulting
from turbulent blood flow through a narrowed renal artery. While an abdominal
aortic aneurysm may also produce a bruit, renal artery stenosis is specifically
associated with an epigastric bruit.
Question 3: A patient presents with a sudden onset of severe tearing chest pain
radiating to the back, with a 25 mm Hg blood pressure difference between the
right and left arms. Which physical examination finding is most specific for
aortic dissection?
A. A widened mediastinum on chest radiograph
B. A new diastolic murmur at the right sternal border
C. A pulse deficit in one extremity
D. Jugular venous distension
CORRECT ANSWER: C. A pulse deficit in one extremity
Rationale: A pulse deficit—an absent or diminished pulse in one extremity
compared to the contralateral side—is a highly specific physical finding for aortic
dissection, indicating obstruction of a major branch vessel by the dissection flap.
Blood pressure differences and widened mediastinum are suggestive but less
specific. A diastolic murmur may indicate aortic regurgitation from dissection but
is not as specific as a pulse deficit.
Question 4: A patient presents with a unilateral, painful vesicular rash in a
dermatomal distribution on the trunk. Which finding most strongly supports a
diagnosis of herpes zoster rather than a bacterial skin infection?
A. The rash crosses the midline
B. The rash is preceded by prodromal pain and paresthesia
C. The rash is associated with fever and lymphadenopathy
D. The rash is confluent and covered with honey-colored crusts
CORRECT ANSWER: B. The rash is preceded by prodromal pain and paresthesia
Rationale: Herpes zoster (shingles) characteristically presents with a painful,
unilateral vesicular rash in a dermatomal distribution. A hallmark feature is the
presence of prodromal pain, burning, or paresthesia in the affected dermatome
,that precedes the eruption by several days. The rash does not cross the midline.
Honey-colored crusts are more consistent with bacterial infections such as
impetigo.
Question 5: Which of the following findings in a newborn's tympanic membrane
is considered a normal variant during the first few days of life?
A. Immobility of the drum
B. A cone-shaped light reflex
C. A membrane that appears thick and opaque due to vernix caseosa
D. A bulging, red membrane with loss of landmarks
CORRECT ANSWER: C. A membrane that appears thick and opaque due to vernix
caseosa
Rationale: During the first few days of life, the newborn's tympanic membrane
often appears thickened and opaque because vernix caseosa obscures the
membrane. This is a normal, temporary finding. Immobility, a cone-shaped light
reflex, and a bulging red membrane with loss of landmarks are abnormal findings.
Question 6: A nurse practitioner is preparing to perform an otoscopic
examination. Which statement is true regarding the anatomy of the nasal
cavity?
A. The Kiesselbach plexus is located in the posterior nasal cavity
B. The turbinates are bony projections that increase the surface area for air
processing
C. The meatus is the central dividing structure of the nose
D. The septum contains the superior, middle, and inferior conchae
CORRECT ANSWER: B. The turbinates are bony projections that increase the
surface area for air processing
Rationale: The lateral walls of each nasal cavity contain three parallel bony
projections called the superior, middle, and inferior turbinates (conchae). These
increase the surface area so that more blood vessels and mucous membrane are
available to warm, humidify, and filter inhaled air. The Kiesselbach plexus is
located in the anterior septum, and the septum is the central dividing structure.
, Question 7: A 72-year-old patient with a 30-pack-year smoking history who quit
10 years ago asks about lung cancer screening. Which recommendation is most
appropriate?
A. No screening is indicated because the patient quit smoking
B. Annual low-dose computed tomography (LDCT) screening is recommended
C. Chest radiograph every 6 months is recommended
D. Sputum cytology annually is recommended
CORRECT ANSWER: B. Annual low-dose computed tomography (LDCT) screening
is recommended
Rationale: Annual LDCT screening is recommended for patients aged 55-74 years
with a 30-pack-year smoking history who are current smokers or have quit within
the past 15 years. This patient meets all criteria, including the 30-pack-year
history and having quit 10 years ago (within the 15-year window).
Question 8: A patient with limited English proficiency needs to discuss complex
symptoms. What is the most appropriate approach for the nurse practitioner?
A. Ask a young family member to interpret
B. Speak louder and repeat every question
C. Use a qualified medical interpreter and communicate directly with the patient
D. Avoid detailed questions to prevent misunderstanding
CORRECT ANSWER: C. Use a qualified medical interpreter and communicate
directly with the patient
Rationale: A qualified medical interpreter supports accurate communication,
confidentiality, and informed decision-making. The clinician should continue
addressing the patient rather than speaking primarily to the interpreter. Using
family members as interpreters is inappropriate due to confidentiality concerns
and potential for inaccurate interpretation. Speaking louder does not address
language barriers.
Question 9: Which statement best describes cultural humility in advanced
nursing practice?
A. Learning every belief associated with each cultural group
B. Applying identical communication techniques to every patient
