NSG 6020 3P 2026/2027 | Advanced Nursing 3P Exam Study Guide,
Practice Questions & Answers, Pathophysiology, Pharmacology &
Physical Assessment Review
Question 1: During a comprehensive health history, a patient reports a
"crushing chest pressure that started one hour ago." This statement is
documented under which component of the history?
A. Past medical history
B. Review of systems
C. History of present illness
D. Family history
CORRECT ANSWER: C. History of present illness
Rationale: The history of present illness (HPI) captures the detailed
narrative of the patient's current chief complaint, including onset, location,
duration, character, aggravating and relieving factors, radiation, timing, and
severity using the OLDCARTS mnemonic. A spontaneous description of a
new acute symptom with its onset and character is classic HPI content .
Question 2: Which technique should the examiner always perform
FIRST during physical assessment of the abdomen?
A. Auscultation
B. Percussion
C. Palpation
D. Inspection
CORRECT ANSWER: D. Inspection
Rationale: Inspection is always the first technique for every body region.
For the abdomen, the standard sequence is inspection, auscultation,
percussion, then palpation. Auscultation is moved ahead of percussion
and palpation because touching the abdomen can stimulate bowel activity
and artificially alter bowel sounds .
Question 3: A nurse practitioner documents a patient's pain as 8/10,
throbbing, located in the right temple, and worse with light. Which
structured symptom framework organizes these elements?
A. CAGE
B. FAST
C. OLDCARTS
D. HEENT
,CORRECT ANSWER: C. OLDCARTS
Rationale: OLDCARTS stands for Onset, Location, Duration, Character,
Aggravating factors, Relieving factors, Timing, and Severity. Each
documented element in this scenario maps directly to that mnemonic,
ensuring a complete symptom history and supporting accurate differential
diagnosis .
Question 4: Which finding is considered a normal, expected variation
when palpating lymph nodes in a healthy adult?
A. Fixed, hard, nontender node
B. Small, mobile, discrete, nontender node under 1 cm
C. Tender, mobile, 2 cm node
D. Matted nodes fixed to surrounding tissue
CORRECT ANSWER: B. Small, mobile, discrete, nontender node under 1
cm
Rationale: In healthy adults, lymph nodes are normally nonpalpable,
although small, mobile, discrete, nontender nodes under 1 cm may be felt
in some people and are considered benign. Fixed, hard nodes raise
concern for malignancy; tender enlarged nodes suggest inflammation;
matted nodes are a red flag for lymphoma or metastatic disease .
Question 5: When percussing the lungs of a healthy adult, the nurse
practitioner expects to hear which sound over normal lung tissue?
A. Dullness
B. Tympany
C. Resonance
D. Hyperresonance
CORRECT ANSWER: C. Resonance
Rationale: Resonance is the low-pitched, hollow sound heard over normal
air-filled lung tissue. Dullness suggests fluid or consolidation such as
pneumonia or pleural effusion, hyperresonance indicates trapped air as in
emphysema or pneumothorax, and tympany is the drum-like sound over
air-filled abdominal organs .
Question 6: A 7-month-old infant is assessed with a loud noise. The
infant demonstrates abduction and flexion of arms and legs, fanning of
,fingers, and curling of the index finger and thumb in a C-position. This
response is known as:
A. Rooting reflex
B. Moro reflex
C. Palmar grasp
D. Babinski reflex
CORRECT ANSWER: B. Moro reflex
Rationale: The Moro reflex (startle reflex) is characterized by abduction and
flexion of the arms and legs, fanning of the fingers, and a C-shaped curling
of the thumb and index finger, followed by adduction. It is present at birth
and typically disappears by 4-6 months .
Question 7: When performing a respiratory examination, the correct
order of techniques is:
A. Auscultate, percuss, palpate, inspect
B. Inspect, palpate, percuss, auscultate
C. Palpate, inspect, auscultate, percuss
D. Percuss, auscultate, inspect, palpate
CORRECT ANSWER: B. Inspect, palpate, percuss, auscultate
Rationale: The correct order for respiratory examination is inspection,
palpation, percussion, and auscultation. This sequence prevents altering
breath sounds through manipulation before auscultation .
Question 8: A patient presents with a barking cough. This finding is
most suggestive of:
A. Asthma
B. Croup
C. Pneumonia
D. Bronchiolitis
CORRECT ANSWER: B. Croup
Rationale: A barking cough is a classic hallmark of croup
(laryngotracheobronchitis), which causes subglottic edema and a
distinctive seal-like cough .
, Question 9: Which lesion is dark, raised, and asymmetric with an
irregular border?
A. Nevus
B. Actinic keratosis
C. Keratoacanthoma
D. Melanoma
CORRECT ANSWER: D. Melanoma
Rationale: Melanoma is characterized by the ABCDE criteria: Asymmetry,
Border irregularity, Color variation, Diameter >6 mm, and Evolving. A dark,
raised, asymmetric lesion with irregular borders is highly suspicious for
melanoma .
Question 10: Heberden's nodes are commonly found in which disease?
A. Rheumatoid arthritis
B. Degenerative joint disease (osteoarthritis)
C. Gout
D. Psoriatic arthritis
CORRECT ANSWER: B. Degenerative joint disease (osteoarthritis)
Rationale: Heberden's nodes are bony enlargements of the distal
interphalangeal (DIP) joints, characteristic of osteoarthritis (degenerative
joint disease) .
Question 11: A 15-year-old patient is being evaluated for bipolar
disorder. Which behavior would raise HIGH suspicion for mania?
A. The patient blurts out answers inappropriately
B. The patient is quiet and withdrawn
C. The patient reports difficulty sleeping
D. The patient has a history of ADHD
CORRECT ANSWER: A. The patient blurts out answers inappropriately
Rationale: Blurting out answers inappropriately reflects pressured speech
and impulsivity, which are hallmark features of mania. Decreased need for
sleep with high energy is also a classic finding, but blurting out answers
specifically indicates the disinhibition and rapid thought processes seen in
mania .
Practice Questions & Answers, Pathophysiology, Pharmacology &
Physical Assessment Review
Question 1: During a comprehensive health history, a patient reports a
"crushing chest pressure that started one hour ago." This statement is
documented under which component of the history?
A. Past medical history
B. Review of systems
C. History of present illness
D. Family history
CORRECT ANSWER: C. History of present illness
Rationale: The history of present illness (HPI) captures the detailed
narrative of the patient's current chief complaint, including onset, location,
duration, character, aggravating and relieving factors, radiation, timing, and
severity using the OLDCARTS mnemonic. A spontaneous description of a
new acute symptom with its onset and character is classic HPI content .
Question 2: Which technique should the examiner always perform
FIRST during physical assessment of the abdomen?
A. Auscultation
B. Percussion
C. Palpation
D. Inspection
CORRECT ANSWER: D. Inspection
Rationale: Inspection is always the first technique for every body region.
For the abdomen, the standard sequence is inspection, auscultation,
percussion, then palpation. Auscultation is moved ahead of percussion
and palpation because touching the abdomen can stimulate bowel activity
and artificially alter bowel sounds .
Question 3: A nurse practitioner documents a patient's pain as 8/10,
throbbing, located in the right temple, and worse with light. Which
structured symptom framework organizes these elements?
A. CAGE
B. FAST
C. OLDCARTS
D. HEENT
,CORRECT ANSWER: C. OLDCARTS
Rationale: OLDCARTS stands for Onset, Location, Duration, Character,
Aggravating factors, Relieving factors, Timing, and Severity. Each
documented element in this scenario maps directly to that mnemonic,
ensuring a complete symptom history and supporting accurate differential
diagnosis .
Question 4: Which finding is considered a normal, expected variation
when palpating lymph nodes in a healthy adult?
A. Fixed, hard, nontender node
B. Small, mobile, discrete, nontender node under 1 cm
C. Tender, mobile, 2 cm node
D. Matted nodes fixed to surrounding tissue
CORRECT ANSWER: B. Small, mobile, discrete, nontender node under 1
cm
Rationale: In healthy adults, lymph nodes are normally nonpalpable,
although small, mobile, discrete, nontender nodes under 1 cm may be felt
in some people and are considered benign. Fixed, hard nodes raise
concern for malignancy; tender enlarged nodes suggest inflammation;
matted nodes are a red flag for lymphoma or metastatic disease .
Question 5: When percussing the lungs of a healthy adult, the nurse
practitioner expects to hear which sound over normal lung tissue?
A. Dullness
B. Tympany
C. Resonance
D. Hyperresonance
CORRECT ANSWER: C. Resonance
Rationale: Resonance is the low-pitched, hollow sound heard over normal
air-filled lung tissue. Dullness suggests fluid or consolidation such as
pneumonia or pleural effusion, hyperresonance indicates trapped air as in
emphysema or pneumothorax, and tympany is the drum-like sound over
air-filled abdominal organs .
Question 6: A 7-month-old infant is assessed with a loud noise. The
infant demonstrates abduction and flexion of arms and legs, fanning of
,fingers, and curling of the index finger and thumb in a C-position. This
response is known as:
A. Rooting reflex
B. Moro reflex
C. Palmar grasp
D. Babinski reflex
CORRECT ANSWER: B. Moro reflex
Rationale: The Moro reflex (startle reflex) is characterized by abduction and
flexion of the arms and legs, fanning of the fingers, and a C-shaped curling
of the thumb and index finger, followed by adduction. It is present at birth
and typically disappears by 4-6 months .
Question 7: When performing a respiratory examination, the correct
order of techniques is:
A. Auscultate, percuss, palpate, inspect
B. Inspect, palpate, percuss, auscultate
C. Palpate, inspect, auscultate, percuss
D. Percuss, auscultate, inspect, palpate
CORRECT ANSWER: B. Inspect, palpate, percuss, auscultate
Rationale: The correct order for respiratory examination is inspection,
palpation, percussion, and auscultation. This sequence prevents altering
breath sounds through manipulation before auscultation .
Question 8: A patient presents with a barking cough. This finding is
most suggestive of:
A. Asthma
B. Croup
C. Pneumonia
D. Bronchiolitis
CORRECT ANSWER: B. Croup
Rationale: A barking cough is a classic hallmark of croup
(laryngotracheobronchitis), which causes subglottic edema and a
distinctive seal-like cough .
, Question 9: Which lesion is dark, raised, and asymmetric with an
irregular border?
A. Nevus
B. Actinic keratosis
C. Keratoacanthoma
D. Melanoma
CORRECT ANSWER: D. Melanoma
Rationale: Melanoma is characterized by the ABCDE criteria: Asymmetry,
Border irregularity, Color variation, Diameter >6 mm, and Evolving. A dark,
raised, asymmetric lesion with irregular borders is highly suspicious for
melanoma .
Question 10: Heberden's nodes are commonly found in which disease?
A. Rheumatoid arthritis
B. Degenerative joint disease (osteoarthritis)
C. Gout
D. Psoriatic arthritis
CORRECT ANSWER: B. Degenerative joint disease (osteoarthritis)
Rationale: Heberden's nodes are bony enlargements of the distal
interphalangeal (DIP) joints, characteristic of osteoarthritis (degenerative
joint disease) .
Question 11: A 15-year-old patient is being evaluated for bipolar
disorder. Which behavior would raise HIGH suspicion for mania?
A. The patient blurts out answers inappropriately
B. The patient is quiet and withdrawn
C. The patient reports difficulty sleeping
D. The patient has a history of ADHD
CORRECT ANSWER: A. The patient blurts out answers inappropriately
Rationale: Blurting out answers inappropriately reflects pressured speech
and impulsivity, which are hallmark features of mania. Decreased need for
sleep with high energy is also a classic finding, but blurting out answers
specifically indicates the disinhibition and rapid thought processes seen in
mania .
