NURS 5220 Advanced Health
Assessment Final Exam Practice
Questions And Correct Answers
(Verified Answers) Plus Rationale 2027
Q&A| Instant Download Pdf.
1. A 68-year-old patient presents with fatigue, exertional dyspnea, and
intermittent chest pressure. Which component of the health history is most
important to clarify first regarding the chest discomfort?
A. Usual dietary intake
B. Family history of arthritis
C. Onset, provoking factors, quality, location, radiation, severity, and
associated symptoms
D. Previous childhood illnesses
Rationale: A structured assessment of chest pain characteristics helps
distinguish potentially life-threatening cardiovascular causes from
pulmonary, gastrointestinal, musculoskeletal, and other etiologies.
2. During an interview, a patient states, “I have several problems I want
to discuss.” What is the best initial response by the advanced practice
nurse?
A. “Which problem is the most serious?”
B. “Tell me about everything that has been concerning you.”
C. “We only have time to discuss one problem.”
D. “You should schedule another appointment for the other symptoms.”
,Rationale: An open-ended response encourages the patient to identify
concerns in their own words and helps establish the agenda before focused
questioning begins.
3. Which component of the history identifies the patient's perception of
the primary reason for seeking medical attention?
A. Chief complaint
B. Review of systems
C. Family history
D. Social history
Rationale: The chief complaint identifies the primary concern or reason for
the encounter and is ideally documented using the patient's own words.
4. A patient reports abdominal pain that began suddenly three hours
ago. Which question best assesses the onset of the symptom?
A. “Does the pain radiate anywhere?”
B. “What makes the pain better?”
C. “How would you describe the pain?”
D. “What were you doing when the pain began?”
Rationale: Questions about when and under what circumstances a
symptom began establish its onset and help distinguish acute from chronic
or recurrent conditions.
5. A patient reports severe abdominal pain that started around the
umbilicus and subsequently moved to the right lower quadrant. Which
condition should be suspected?
A. Acute cholecystitis
B. Acute appendicitis
C. Acute pancreatitis
D. Diverticulitis
,Rationale: Pain that begins periumbilically and migrates to the right lower
quadrant is a classic presentation of acute appendicitis.
6. Which abdominal finding is most concerning for peritoneal irritation?
A. Mild tympany
B. Voluntary guarding
C. Involuntary guarding and abdominal rigidity
D. Hyperactive bowel sounds
Rationale: Involuntary guarding and rigidity reflect reflex contraction of
abdominal muscles and may indicate inflammation of the peritoneum.
7. During an abdominal examination, what is the correct sequence of
techniques?
A. Palpation, percussion, auscultation, inspection
B. Auscultation, inspection, palpation, percussion
C. Inspection, auscultation, percussion, palpation
D. Percussion, palpation, inspection, auscultation
Rationale: Auscultation is performed before percussion and palpation
because manipulating the abdomen can alter bowel sounds.
8. A patient has right upper-quadrant pain, fever, nausea, and pain
during inspiration when the examiner palpates beneath the right
costal margin. Which condition is most likely?
A. Acute appendicitis
B. Acute cholecystitis
C. Acute pancreatitis
D. Peptic ulcer disease
Rationale: Right upper-quadrant tenderness with inspiratory arrest, known
as a positive Murphy sign, supports acute cholecystitis.
, 9. A patient with chronic liver disease has abdominal distention.
Percussion demonstrates shifting dullness. What does this finding
indicate?
A. Intestinal obstruction
B. Splenomegaly
C. Ascites
D. Abdominal aortic aneurysm
Rationale: Shifting dullness occurs when free intraperitoneal fluid changes
position with movement and is a classic physical finding of ascites.
10. A patient has a palpable pulsatile abdominal mass. What is the
most appropriate clinical concern?
A. Gastric ulcer
B. Splenic rupture
C. Abdominal aortic aneurysm
D. Acute pancreatitis
Rationale: A pulsatile abdominal mass, particularly in an older patient,
may represent an abdominal aortic aneurysm and warrants appropriate
diagnostic evaluation.
11. Which symptom pattern is most characteristic of
gastroesophageal reflux disease?
A. Severe pain after physical exertion
B. Burning retrosternal discomfort with regurgitation that worsens when
lying down
C. Sudden unilateral pleuritic chest pain
D. Colicky right lower-quadrant pain
Rationale: GERD commonly causes heartburn and acid regurgitation that
are aggravated after meals or when the patient lies down.
Assessment Final Exam Practice
Questions And Correct Answers
(Verified Answers) Plus Rationale 2027
Q&A| Instant Download Pdf.
1. A 68-year-old patient presents with fatigue, exertional dyspnea, and
intermittent chest pressure. Which component of the health history is most
important to clarify first regarding the chest discomfort?
A. Usual dietary intake
B. Family history of arthritis
C. Onset, provoking factors, quality, location, radiation, severity, and
associated symptoms
D. Previous childhood illnesses
Rationale: A structured assessment of chest pain characteristics helps
distinguish potentially life-threatening cardiovascular causes from
pulmonary, gastrointestinal, musculoskeletal, and other etiologies.
2. During an interview, a patient states, “I have several problems I want
to discuss.” What is the best initial response by the advanced practice
nurse?
A. “Which problem is the most serious?”
B. “Tell me about everything that has been concerning you.”
C. “We only have time to discuss one problem.”
D. “You should schedule another appointment for the other symptoms.”
,Rationale: An open-ended response encourages the patient to identify
concerns in their own words and helps establish the agenda before focused
questioning begins.
3. Which component of the history identifies the patient's perception of
the primary reason for seeking medical attention?
A. Chief complaint
B. Review of systems
C. Family history
D. Social history
Rationale: The chief complaint identifies the primary concern or reason for
the encounter and is ideally documented using the patient's own words.
4. A patient reports abdominal pain that began suddenly three hours
ago. Which question best assesses the onset of the symptom?
A. “Does the pain radiate anywhere?”
B. “What makes the pain better?”
C. “How would you describe the pain?”
D. “What were you doing when the pain began?”
Rationale: Questions about when and under what circumstances a
symptom began establish its onset and help distinguish acute from chronic
or recurrent conditions.
5. A patient reports severe abdominal pain that started around the
umbilicus and subsequently moved to the right lower quadrant. Which
condition should be suspected?
A. Acute cholecystitis
B. Acute appendicitis
C. Acute pancreatitis
D. Diverticulitis
,Rationale: Pain that begins periumbilically and migrates to the right lower
quadrant is a classic presentation of acute appendicitis.
6. Which abdominal finding is most concerning for peritoneal irritation?
A. Mild tympany
B. Voluntary guarding
C. Involuntary guarding and abdominal rigidity
D. Hyperactive bowel sounds
Rationale: Involuntary guarding and rigidity reflect reflex contraction of
abdominal muscles and may indicate inflammation of the peritoneum.
7. During an abdominal examination, what is the correct sequence of
techniques?
A. Palpation, percussion, auscultation, inspection
B. Auscultation, inspection, palpation, percussion
C. Inspection, auscultation, percussion, palpation
D. Percussion, palpation, inspection, auscultation
Rationale: Auscultation is performed before percussion and palpation
because manipulating the abdomen can alter bowel sounds.
8. A patient has right upper-quadrant pain, fever, nausea, and pain
during inspiration when the examiner palpates beneath the right
costal margin. Which condition is most likely?
A. Acute appendicitis
B. Acute cholecystitis
C. Acute pancreatitis
D. Peptic ulcer disease
Rationale: Right upper-quadrant tenderness with inspiratory arrest, known
as a positive Murphy sign, supports acute cholecystitis.
, 9. A patient with chronic liver disease has abdominal distention.
Percussion demonstrates shifting dullness. What does this finding
indicate?
A. Intestinal obstruction
B. Splenomegaly
C. Ascites
D. Abdominal aortic aneurysm
Rationale: Shifting dullness occurs when free intraperitoneal fluid changes
position with movement and is a classic physical finding of ascites.
10. A patient has a palpable pulsatile abdominal mass. What is the
most appropriate clinical concern?
A. Gastric ulcer
B. Splenic rupture
C. Abdominal aortic aneurysm
D. Acute pancreatitis
Rationale: A pulsatile abdominal mass, particularly in an older patient,
may represent an abdominal aortic aneurysm and warrants appropriate
diagnostic evaluation.
11. Which symptom pattern is most characteristic of
gastroesophageal reflux disease?
A. Severe pain after physical exertion
B. Burning retrosternal discomfort with regurgitation that worsens when
lying down
C. Sudden unilateral pleuritic chest pain
D. Colicky right lower-quadrant pain
Rationale: GERD commonly causes heartburn and acid regurgitation that
are aggravated after meals or when the patient lies down.
