NURS 5220 Advanced Health
Assessment Exam Practice Questions
And Correct Answers (Verified Answers)
Plus Rationale 2027 Q&A| Instant
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1. A 45-year-old patient presents for evaluation of progressive fatigue
and shortness of breath. Which component of the health history is
most useful for determining whether the dyspnea is acute or chronic?
A. Family history
B. Occupational history
C. Onset and duration of symptoms
D. Review of childhood illnesses
Rationale: Determining when symptoms began and how they have
progressed helps distinguish acute processes from chronic
cardiopulmonary conditions and guides subsequent diagnostic reasoning.
2. A patient reports shortness of breath that occurs when lying flat but
improves when sitting upright. Which symptom is being described?
A. Paroxysmal nocturnal dyspnea
B. Orthopnea
C. Pleuritic dyspnea
D. Exertional tachypnea
,Rationale: Orthopnea is dyspnea that occurs in the supine position and
improves when the patient sits or stands, commonly occurring with left-
sided heart failure.
3. A patient awakens several hours after falling asleep with severe
shortness of breath and must sit upright to breathe comfortably.
Which symptom is most consistent with this history?
A. Orthostatic dyspnea
B. Exertional dyspnea
C. Paroxysmal nocturnal dyspnea
D. Pleuritic chest pain
Rationale: Paroxysmal nocturnal dyspnea causes sudden episodes of
breathlessness that awaken a patient from sleep and are relieved by
sitting or standing.
4. Which characteristic of chest pain most strongly suggests myocardial
ischemia?
A. Brief localized pain reproducible by palpation
B. Sharp pain occurring only with deep inspiration
C. Pressure or squeezing discomfort precipitated by exertion
D. Burning pain confined to the skin
Rationale: Myocardial ischemia classically produces pressure, squeezing, or
heaviness that may be triggered by exertion and relieved by rest or
treatment.
5. A patient reports sharp chest pain that worsens with deep inspiration
and coughing. Which description best characterizes this pain?
A. Visceral ischemic pain
B. Pleuritic pain
C. Neuropathic pain
D. Referred gastrointestinal pain
,Rationale: Pleuritic pain arises from irritation of the pleural surfaces and
characteristically worsens with deep breathing or coughing.
6. Which history finding is most concerning for pulmonary embolism?
A. Chronic productive cough for five years
B. Gradual dyspnea occurring only during strenuous exercise
C. Sudden unexplained dyspnea with pleuritic chest pain and tachycardia
D. Seasonal sneezing and rhinorrhea
Rationale: Pulmonary embolism may present abruptly with dyspnea,
pleuritic chest pain, tachycardia, hypoxemia, and sometimes hemoptysis.
7. A patient with chronic obstructive pulmonary disease is being
assessed. Which physical finding is most consistent with significant
hyperinflation?
A. Dullness to percussion
B. Decreased anterior-posterior chest diameter
C. Increased anterior-posterior chest diameter
D. Bronchial breath sounds over the peripheral lung fields
Rationale: Chronic hyperinflation can increase the anterior-posterior
diameter of the chest, producing the characteristic barrel-shaped
appearance.
8. Which percussion note is normally expected over most healthy lung
tissue?
A. Dullness
B. Flatness
C. Resonance
D. Tympany
Rationale: Air-filled normal lung tissue produces a resonant percussion
note, whereas dullness may indicate fluid or consolidation.
, 9. A patient has unilateral dullness to percussion at the lung base with
decreased breath sounds and reduced tactile fremitus. Which
condition is most likely?
A. Lobar consolidation
B. Pleural effusion
C. Pneumothorax
D. Asthma
Rationale: Pleural fluid dampens transmission of sound and vibration,
producing dullness, decreased breath sounds, and decreased tactile
fremitus.
10. A patient has sudden dyspnea with unilateral absent breath
sounds and hyperresonance on percussion. Which diagnosis should be
suspected?
A. Pleural effusion
B. Pulmonary edema
C. Pneumothorax
D. Lobar pneumonia
Rationale: Pneumothorax introduces air into the pleural space, producing
hyperresonance and diminished or absent breath sounds on the affected
side.
11. Which auscultatory finding is most characteristic of
bronchospasm?
A. Fine crackles
B. Expiratory wheezing
C. Pleural friction rub
D. Bronchial breathing over peripheral lung fields
Rationale: Wheezing is a musical sound produced by airflow through
narrowed airways and is commonly associated with asthma and
obstructive airway disease.
Assessment Exam Practice Questions
And Correct Answers (Verified Answers)
Plus Rationale 2027 Q&A| Instant
Download Pdf.
1. A 45-year-old patient presents for evaluation of progressive fatigue
and shortness of breath. Which component of the health history is
most useful for determining whether the dyspnea is acute or chronic?
A. Family history
B. Occupational history
C. Onset and duration of symptoms
D. Review of childhood illnesses
Rationale: Determining when symptoms began and how they have
progressed helps distinguish acute processes from chronic
cardiopulmonary conditions and guides subsequent diagnostic reasoning.
2. A patient reports shortness of breath that occurs when lying flat but
improves when sitting upright. Which symptom is being described?
A. Paroxysmal nocturnal dyspnea
B. Orthopnea
C. Pleuritic dyspnea
D. Exertional tachypnea
,Rationale: Orthopnea is dyspnea that occurs in the supine position and
improves when the patient sits or stands, commonly occurring with left-
sided heart failure.
3. A patient awakens several hours after falling asleep with severe
shortness of breath and must sit upright to breathe comfortably.
Which symptom is most consistent with this history?
A. Orthostatic dyspnea
B. Exertional dyspnea
C. Paroxysmal nocturnal dyspnea
D. Pleuritic chest pain
Rationale: Paroxysmal nocturnal dyspnea causes sudden episodes of
breathlessness that awaken a patient from sleep and are relieved by
sitting or standing.
4. Which characteristic of chest pain most strongly suggests myocardial
ischemia?
A. Brief localized pain reproducible by palpation
B. Sharp pain occurring only with deep inspiration
C. Pressure or squeezing discomfort precipitated by exertion
D. Burning pain confined to the skin
Rationale: Myocardial ischemia classically produces pressure, squeezing, or
heaviness that may be triggered by exertion and relieved by rest or
treatment.
5. A patient reports sharp chest pain that worsens with deep inspiration
and coughing. Which description best characterizes this pain?
A. Visceral ischemic pain
B. Pleuritic pain
C. Neuropathic pain
D. Referred gastrointestinal pain
,Rationale: Pleuritic pain arises from irritation of the pleural surfaces and
characteristically worsens with deep breathing or coughing.
6. Which history finding is most concerning for pulmonary embolism?
A. Chronic productive cough for five years
B. Gradual dyspnea occurring only during strenuous exercise
C. Sudden unexplained dyspnea with pleuritic chest pain and tachycardia
D. Seasonal sneezing and rhinorrhea
Rationale: Pulmonary embolism may present abruptly with dyspnea,
pleuritic chest pain, tachycardia, hypoxemia, and sometimes hemoptysis.
7. A patient with chronic obstructive pulmonary disease is being
assessed. Which physical finding is most consistent with significant
hyperinflation?
A. Dullness to percussion
B. Decreased anterior-posterior chest diameter
C. Increased anterior-posterior chest diameter
D. Bronchial breath sounds over the peripheral lung fields
Rationale: Chronic hyperinflation can increase the anterior-posterior
diameter of the chest, producing the characteristic barrel-shaped
appearance.
8. Which percussion note is normally expected over most healthy lung
tissue?
A. Dullness
B. Flatness
C. Resonance
D. Tympany
Rationale: Air-filled normal lung tissue produces a resonant percussion
note, whereas dullness may indicate fluid or consolidation.
, 9. A patient has unilateral dullness to percussion at the lung base with
decreased breath sounds and reduced tactile fremitus. Which
condition is most likely?
A. Lobar consolidation
B. Pleural effusion
C. Pneumothorax
D. Asthma
Rationale: Pleural fluid dampens transmission of sound and vibration,
producing dullness, decreased breath sounds, and decreased tactile
fremitus.
10. A patient has sudden dyspnea with unilateral absent breath
sounds and hyperresonance on percussion. Which diagnosis should be
suspected?
A. Pleural effusion
B. Pulmonary edema
C. Pneumothorax
D. Lobar pneumonia
Rationale: Pneumothorax introduces air into the pleural space, producing
hyperresonance and diminished or absent breath sounds on the affected
side.
11. Which auscultatory finding is most characteristic of
bronchospasm?
A. Fine crackles
B. Expiratory wheezing
C. Pleural friction rub
D. Bronchial breathing over peripheral lung fields
Rationale: Wheezing is a musical sound produced by airflow through
narrowed airways and is commonly associated with asthma and
obstructive airway disease.
