D’YOUVILLE COLLEGE NUR 631/NUR631 – ADVANCED HEALTH
ASSESSMENT EXAM 2 (V2) QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
Core Domains:
Health History and Interviewing Techniques
Physical Examination Skills and Techniques
Cardiovascular System Assessment
Respiratory System Assessment
Neurological System Assessment
Abdominal and Gastrointestinal Assessment
Musculoskeletal System Assessment
Ethics and Professional Standards
Introduction
This examination assesses the graduate nursing student’s
competence in obtaining a comprehensive health history and
performing a systematic physical examination across the lifespan.
The test evaluates foundational theory, applied professional
knowledge, and clinical decision-making skills essential for the
advanced practice role. Questions are structured as multiple-choice
and scenario-based items that require real-world application,
critical thinking, and integration of regulatory, legal, and ethical
standards. Emphasis is placed on accurate interpretation of findings
and the development of appropriate differential diagnoses.
SECTION ONE: QUESTIONS 1–100
1. A patient presents with a complaint of “feeling tired all the
time.” During the history, the nurse practitioner asks, “When did
you first notice this fatigue?” This question is an example of
which component of the health history?
,A. Review of systems
B. Present illness
C. Past medical history
D. Functional assessment
🟢 B. Present illness
🔴 RATIONALE: The Present Illness section explores the chief
complaint in detail, including onset, duration, and characteristics.
Asking when the fatigue began is part of the seven attributes of a
symptom within the Present Illness. The Review of Systems is a
systematic survey of body systems, Past Medical History covers
prior illnesses and conditions, and Functional Assessment
evaluates the patient’s ability to perform activities of daily living.
2. Which of the following best describes the purpose of the
Review of Systems (ROS)?
A. To document the patient’s family health history
B. To identify the patient’s chief complaint in the patient’s own
words
C. To systematically survey each body system for relevant
symptoms
D. To assess the patient’s level of education and health literacy
🟢 C. To systematically survey each body system for relevant
symptoms
🔴 RATIONALE: The Review of Systems is a head-to-toe survey of
patient-reported symptoms organized by body system. It serves
to uncover symptoms the patient may not have volunteered
during the Present Illness. Family history is documented
separately, the chief complaint is the patient’s primary reason for
seeking care, and health literacy is part of the social history.
,3. A 68-year-old patient with a history of hypertension and
diabetes presents for a routine visit. The nurse practitioner
notes that the patient’s blood pressure is 158/92 mmHg. The
patient reports taking all medications as prescribed. Which of
the following is the most appropriate next step?
A. Diagnose uncontrolled hypertension and double the
medication dose
B. Assess for adherence barriers, medication side effects, and
home blood pressure readings
C. Refer the patient to cardiology immediately
D. Document the finding and recheck at the next annual visit
🟢 B. Assess for adherence barriers, medication side effects, and
home blood pressure readings
🔴 RATIONALE: Before intensifying therapy, the nurse practitioner
must evaluate whether the elevated reading reflects true
uncontrolled hypertension. Factors such as white-coat effect,
improper technique, medication adherence barriers, and home
readings must be assessed. Doubling medication without this
assessment is unsafe, immediate cardiology referral is premature,
and deferring to an annual visit would allow ongoing end-organ
damage.
4. During an interview, a patient becomes tearful and states, “I
don’t know how much longer I can handle all of this.” Which
response by the nurse practitioner is most therapeutic?
A. “I’m sure things will get better soon.”
B. “Let’s focus on your physical symptoms right now.”
C. “Tell me more about what you’re feeling.”
D. “You have so much to be grateful for.”
🟢 C. “Tell me more about what you’re feeling.”
, 🔴 RATIONALE: This response uses active listening and open-
ended exploration, allowing the patient to express distress
without judgment. Offering false reassurance, redirecting to
physical symptoms, or minimizing feelings with gratitude
statements blocks communication and fails to address the
patient’s emotional state.
5. When performing an otoscopic examination on an adult, which
direction should the nurse practitioner pull the auricle to
straighten the ear canal?
A. Down and forward
B. Up and back
C. Down and back
D. Up and forward
🟢 B. Up and back
🔴 RATIONALE: In adults, the external auditory canal curves
upward and forward. Pulling the auricle up and back straightens
this curvature, facilitating visualization of the tympanic membrane.
In children under three years, the canal curves downward and
forward, requiring the auricle to be pulled down and back.
6. A patient is diagnosed with presbyopia. The nurse practitioner
understands that this condition results from:
A. Increased intraocular pressure
B. Degeneration of the optic nerve
C. Loss of lens elasticity
D. Opacification of the lens
🟢 C. Loss of lens elasticity
🔴 RATIONALE: Presbyopia is an age-related change in which the
lens loses elasticity, progressively reducing its ability to
ASSESSMENT EXAM 2 (V2) QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
Core Domains:
Health History and Interviewing Techniques
Physical Examination Skills and Techniques
Cardiovascular System Assessment
Respiratory System Assessment
Neurological System Assessment
Abdominal and Gastrointestinal Assessment
Musculoskeletal System Assessment
Ethics and Professional Standards
Introduction
This examination assesses the graduate nursing student’s
competence in obtaining a comprehensive health history and
performing a systematic physical examination across the lifespan.
The test evaluates foundational theory, applied professional
knowledge, and clinical decision-making skills essential for the
advanced practice role. Questions are structured as multiple-choice
and scenario-based items that require real-world application,
critical thinking, and integration of regulatory, legal, and ethical
standards. Emphasis is placed on accurate interpretation of findings
and the development of appropriate differential diagnoses.
SECTION ONE: QUESTIONS 1–100
1. A patient presents with a complaint of “feeling tired all the
time.” During the history, the nurse practitioner asks, “When did
you first notice this fatigue?” This question is an example of
which component of the health history?
,A. Review of systems
B. Present illness
C. Past medical history
D. Functional assessment
🟢 B. Present illness
🔴 RATIONALE: The Present Illness section explores the chief
complaint in detail, including onset, duration, and characteristics.
Asking when the fatigue began is part of the seven attributes of a
symptom within the Present Illness. The Review of Systems is a
systematic survey of body systems, Past Medical History covers
prior illnesses and conditions, and Functional Assessment
evaluates the patient’s ability to perform activities of daily living.
2. Which of the following best describes the purpose of the
Review of Systems (ROS)?
A. To document the patient’s family health history
B. To identify the patient’s chief complaint in the patient’s own
words
C. To systematically survey each body system for relevant
symptoms
D. To assess the patient’s level of education and health literacy
🟢 C. To systematically survey each body system for relevant
symptoms
🔴 RATIONALE: The Review of Systems is a head-to-toe survey of
patient-reported symptoms organized by body system. It serves
to uncover symptoms the patient may not have volunteered
during the Present Illness. Family history is documented
separately, the chief complaint is the patient’s primary reason for
seeking care, and health literacy is part of the social history.
,3. A 68-year-old patient with a history of hypertension and
diabetes presents for a routine visit. The nurse practitioner
notes that the patient’s blood pressure is 158/92 mmHg. The
patient reports taking all medications as prescribed. Which of
the following is the most appropriate next step?
A. Diagnose uncontrolled hypertension and double the
medication dose
B. Assess for adherence barriers, medication side effects, and
home blood pressure readings
C. Refer the patient to cardiology immediately
D. Document the finding and recheck at the next annual visit
🟢 B. Assess for adherence barriers, medication side effects, and
home blood pressure readings
🔴 RATIONALE: Before intensifying therapy, the nurse practitioner
must evaluate whether the elevated reading reflects true
uncontrolled hypertension. Factors such as white-coat effect,
improper technique, medication adherence barriers, and home
readings must be assessed. Doubling medication without this
assessment is unsafe, immediate cardiology referral is premature,
and deferring to an annual visit would allow ongoing end-organ
damage.
4. During an interview, a patient becomes tearful and states, “I
don’t know how much longer I can handle all of this.” Which
response by the nurse practitioner is most therapeutic?
A. “I’m sure things will get better soon.”
B. “Let’s focus on your physical symptoms right now.”
C. “Tell me more about what you’re feeling.”
D. “You have so much to be grateful for.”
🟢 C. “Tell me more about what you’re feeling.”
, 🔴 RATIONALE: This response uses active listening and open-
ended exploration, allowing the patient to express distress
without judgment. Offering false reassurance, redirecting to
physical symptoms, or minimizing feelings with gratitude
statements blocks communication and fails to address the
patient’s emotional state.
5. When performing an otoscopic examination on an adult, which
direction should the nurse practitioner pull the auricle to
straighten the ear canal?
A. Down and forward
B. Up and back
C. Down and back
D. Up and forward
🟢 B. Up and back
🔴 RATIONALE: In adults, the external auditory canal curves
upward and forward. Pulling the auricle up and back straightens
this curvature, facilitating visualization of the tympanic membrane.
In children under three years, the canal curves downward and
forward, requiring the auricle to be pulled down and back.
6. A patient is diagnosed with presbyopia. The nurse practitioner
understands that this condition results from:
A. Increased intraocular pressure
B. Degeneration of the optic nerve
C. Loss of lens elasticity
D. Opacification of the lens
🟢 C. Loss of lens elasticity
🔴 RATIONALE: Presbyopia is an age-related change in which the
lens loses elasticity, progressively reducing its ability to
