NURS 6531 ADVANCED PRACTICE
EXAM 2026/2027 QUESTIONS AND
VERIFIED ANSWERS| GRADE
A+|WALDEN UNIVERSITY
1. A 68-year-old patient presents with an S4 heart sound on auscultation. Which condition is
most likely associated with this finding?
A. Acute myocardial infarction
B. Atrial fibrillation
C. Mitral valve prolapse
D. Left ventricular hypertrophy
Answer: D
Conceptual Explanation: An S4 heart sound (atrial gallop) occurs during atrial
contraction and is associated with a non-compliant or ‘stiff’ ventricle, frequently seen in left
ventricular hypertrophy due to hypertension.
2. During a physical exam, a patient is asked to stick out their tongue. It deviates to the right.
Which cranial nerve is likely affected?
A. Cranial Nerve XII (Hypoglossal)
,B. Cranial Nerve X (Vagus)
C. Cranial Nerve IX (Glossopharyngeal)
D. Cranial Nerve VII (Facial)
Answer: A
Conceptual Explanation: Cranial Nerve XII (Hypoglossal) controls the muscles of the
tongue. In a lower motor neuron lesion, the tongue deviates toward the affected side.
3. A clinician performs the Murphy’s sign on a patient with right upper quadrant pain. A
positive result most strongly suggests:
A. Acute cholecystitis
B. Acute appendicitis
C. Splenic rupture
D. Nephrolithiasis
Answer: A
Conceptual Explanation: Murphy’s sign is performed by palpating the gallbladder area
while the patient inspires; a sharp halt in inspiration due to pain is highly indicative of
acute cholecystitis.
4. When assessing for a meniscus tear in the knee, which special test is most appropriate?
A. Lachman test
B. McMurray test
, C. Valgus stress test
D. Drawer test
Answer: B
Conceptual Explanation: The McMurray test involves rotating the knee with internal and
external stress to identify clicks or pain indicative of a meniscal tear.
5. Which physical exam finding is most consistent with lobar pneumonia?
A. Decreased tactile fremitus
B. Hyperresonance on percussion
C. Tracheal deviation to the opposite side
D. Increased tactile fremitus
Answer: D
Conceptual Explanation: Consolidation, as seen in pneumonia, increases the transmission
of vibrations, resulting in increased tactile fremitus.
6. A 55-year-old male presents with a suspected melanoma. Which feature is part of the
‘ABCDE’ criteria for assessment?
A. Bilateral symmetry
B. Color uniformity
C. Evolution or change over time
EXAM 2026/2027 QUESTIONS AND
VERIFIED ANSWERS| GRADE
A+|WALDEN UNIVERSITY
1. A 68-year-old patient presents with an S4 heart sound on auscultation. Which condition is
most likely associated with this finding?
A. Acute myocardial infarction
B. Atrial fibrillation
C. Mitral valve prolapse
D. Left ventricular hypertrophy
Answer: D
Conceptual Explanation: An S4 heart sound (atrial gallop) occurs during atrial
contraction and is associated with a non-compliant or ‘stiff’ ventricle, frequently seen in left
ventricular hypertrophy due to hypertension.
2. During a physical exam, a patient is asked to stick out their tongue. It deviates to the right.
Which cranial nerve is likely affected?
A. Cranial Nerve XII (Hypoglossal)
,B. Cranial Nerve X (Vagus)
C. Cranial Nerve IX (Glossopharyngeal)
D. Cranial Nerve VII (Facial)
Answer: A
Conceptual Explanation: Cranial Nerve XII (Hypoglossal) controls the muscles of the
tongue. In a lower motor neuron lesion, the tongue deviates toward the affected side.
3. A clinician performs the Murphy’s sign on a patient with right upper quadrant pain. A
positive result most strongly suggests:
A. Acute cholecystitis
B. Acute appendicitis
C. Splenic rupture
D. Nephrolithiasis
Answer: A
Conceptual Explanation: Murphy’s sign is performed by palpating the gallbladder area
while the patient inspires; a sharp halt in inspiration due to pain is highly indicative of
acute cholecystitis.
4. When assessing for a meniscus tear in the knee, which special test is most appropriate?
A. Lachman test
B. McMurray test
, C. Valgus stress test
D. Drawer test
Answer: B
Conceptual Explanation: The McMurray test involves rotating the knee with internal and
external stress to identify clicks or pain indicative of a meniscal tear.
5. Which physical exam finding is most consistent with lobar pneumonia?
A. Decreased tactile fremitus
B. Hyperresonance on percussion
C. Tracheal deviation to the opposite side
D. Increased tactile fremitus
Answer: D
Conceptual Explanation: Consolidation, as seen in pneumonia, increases the transmission
of vibrations, resulting in increased tactile fremitus.
6. A 55-year-old male presents with a suspected melanoma. Which feature is part of the
‘ABCDE’ criteria for assessment?
A. Bilateral symmetry
B. Color uniformity
C. Evolution or change over time
