NURS 5220 Advanced Health
Assessment Exam Practice Questions
And Correct Answers (Verified Answers)
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1. A 58-year-old patient presents for an annual examination and reports
increasing fatigue, constipation, dry skin, and a 7-kg weight gain over
the past year. Which additional finding would most strongly support a
diagnosis of hypothyroidism?
A. Warm, moist skin with fine tremors
B. Hyperreflexia with brisk ankle jerks
C. Bradycardia with delayed relaxation of deep tendon reflexes
D. Exophthalmos with lid retraction
Rationale: Hypothyroidism decreases metabolic activity and commonly
causes bradycardia, dry skin, weight gain, fatigue, cold intolerance, and
delayed relaxation of deep tendon reflexes.
2. During examination of a patient with suspected hyperthyroidism,
which finding is most characteristic?
A. Coarse skin and hypothermia
B. Fine tremor and hyperreflexia
C. Bradycardia and constipation
D. Periorbital edema and dry skin
,Rationale: Hyperthyroidism increases sympathetic activity and metabolic
rate, producing findings such as fine tremor, tachycardia, warm moist skin,
weight loss, and hyperreflexia.
3. A patient reports difficulty swallowing solid foods but has no difficulty
swallowing liquids. Which condition should the examiner consider
most strongly?
A. Achalasia
B. Esophageal motility disorder
C. Mechanical obstruction of the esophagus
D. Oropharyngeal neuromuscular weakness
Rationale: Dysphagia that initially affects solids more than liquids suggests
a structural narrowing or mechanical obstruction, whereas motility
disorders often affect solids and liquids.
4. A patient reports difficulty initiating swallowing, coughing during
meals, and nasal regurgitation. Which problem is most likely?
A. Esophageal stricture
B. Gastroesophageal reflux disease
C. Achalasia
D. Oropharyngeal dysphagia
Rationale: Difficulty initiating swallowing with coughing, choking, or nasal
regurgitation indicates impaired transfer of food through the
oropharyngeal phase of swallowing.
5. During abdominal examination, the nurse palpates a painful, rigid
abdomen with involuntary guarding. What does this finding most
strongly suggest?
A. Functional constipation
B. Irritable bowel syndrome
C. Peritoneal inflammation
D. Uncomplicated gastroesophageal reflux
,Rationale: Involuntary guarding and abdominal rigidity are concerning for
peritoneal irritation, which may occur with conditions such as perforation,
severe inflammation, or peritonitis.
6. Which abdominal finding is most concerning for a possible abdominal
aortic aneurysm?
A. Hyperactive bowel sounds
B. Mild epigastric tenderness
C. Pulsatile abdominal mass
D. Tympany over the stomach
Rationale: A pulsatile abdominal mass, particularly in an older patient with
vascular risk factors, should raise concern for an abdominal aortic
aneurysm.
7. A patient reports right upper quadrant pain that occurs after eating
fatty foods and radiates toward the right shoulder. Which condition is
most consistent with these findings?
A. Acute appendicitis
B. Gallbladder disease
C. Pancreatic insufficiency
D. Diverticulitis
Rationale: Right upper quadrant pain precipitated by fatty meals and
radiating to the right shoulder is characteristic of biliary or gallbladder
disease.
8. Which abdominal examination finding is most consistent with ascites?
A. Hyperresonance throughout the abdomen
B. Absent bowel sounds only
C. Fixed dullness in the epigastrium
D. Shifting dullness with changes in position
, Rationale: Free fluid within the peritoneal cavity can shift with position,
producing shifting areas of dullness during percussion.
9. A patient has severe right lower quadrant abdominal pain that began
near the umbilicus and later localized to the right lower quadrant.
Which diagnosis should be considered?
A. Cholecystitis
B. Pancreatitis
C. Acute appendicitis
D. Acute cystitis
Rationale: Pain that initially occurs near the umbilicus and then localizes to
the right lower quadrant is a classic presentation of acute appendicitis.
10. Which finding is most characteristic of an inguinal hernia?
A. Diffuse abdominal rigidity
B. Left upper quadrant tenderness
C. Groin bulge that may increase with coughing or straining
D. Absent bowel sounds
Rationale: An inguinal hernia often presents as a groin or scrotal bulge
that becomes more prominent with increased intra-abdominal pressure
such as coughing or straining.
11. A patient reports black, tarry stools. Which condition should the
examiner suspect?
A. Lower urinary tract bleeding
B. Upper gastrointestinal bleeding
C. Hemorrhoidal bleeding only
D. Malabsorption without bleeding
Rationale: Melena results from digestion of blood and is classically
associated with bleeding from the upper gastrointestinal tract.
Assessment Exam Practice Questions
And Correct Answers (Verified Answers)
Plus Rationale 2027 Q&A| Instant
Download Pdf.
1. A 58-year-old patient presents for an annual examination and reports
increasing fatigue, constipation, dry skin, and a 7-kg weight gain over
the past year. Which additional finding would most strongly support a
diagnosis of hypothyroidism?
A. Warm, moist skin with fine tremors
B. Hyperreflexia with brisk ankle jerks
C. Bradycardia with delayed relaxation of deep tendon reflexes
D. Exophthalmos with lid retraction
Rationale: Hypothyroidism decreases metabolic activity and commonly
causes bradycardia, dry skin, weight gain, fatigue, cold intolerance, and
delayed relaxation of deep tendon reflexes.
2. During examination of a patient with suspected hyperthyroidism,
which finding is most characteristic?
A. Coarse skin and hypothermia
B. Fine tremor and hyperreflexia
C. Bradycardia and constipation
D. Periorbital edema and dry skin
,Rationale: Hyperthyroidism increases sympathetic activity and metabolic
rate, producing findings such as fine tremor, tachycardia, warm moist skin,
weight loss, and hyperreflexia.
3. A patient reports difficulty swallowing solid foods but has no difficulty
swallowing liquids. Which condition should the examiner consider
most strongly?
A. Achalasia
B. Esophageal motility disorder
C. Mechanical obstruction of the esophagus
D. Oropharyngeal neuromuscular weakness
Rationale: Dysphagia that initially affects solids more than liquids suggests
a structural narrowing or mechanical obstruction, whereas motility
disorders often affect solids and liquids.
4. A patient reports difficulty initiating swallowing, coughing during
meals, and nasal regurgitation. Which problem is most likely?
A. Esophageal stricture
B. Gastroesophageal reflux disease
C. Achalasia
D. Oropharyngeal dysphagia
Rationale: Difficulty initiating swallowing with coughing, choking, or nasal
regurgitation indicates impaired transfer of food through the
oropharyngeal phase of swallowing.
5. During abdominal examination, the nurse palpates a painful, rigid
abdomen with involuntary guarding. What does this finding most
strongly suggest?
A. Functional constipation
B. Irritable bowel syndrome
C. Peritoneal inflammation
D. Uncomplicated gastroesophageal reflux
,Rationale: Involuntary guarding and abdominal rigidity are concerning for
peritoneal irritation, which may occur with conditions such as perforation,
severe inflammation, or peritonitis.
6. Which abdominal finding is most concerning for a possible abdominal
aortic aneurysm?
A. Hyperactive bowel sounds
B. Mild epigastric tenderness
C. Pulsatile abdominal mass
D. Tympany over the stomach
Rationale: A pulsatile abdominal mass, particularly in an older patient with
vascular risk factors, should raise concern for an abdominal aortic
aneurysm.
7. A patient reports right upper quadrant pain that occurs after eating
fatty foods and radiates toward the right shoulder. Which condition is
most consistent with these findings?
A. Acute appendicitis
B. Gallbladder disease
C. Pancreatic insufficiency
D. Diverticulitis
Rationale: Right upper quadrant pain precipitated by fatty meals and
radiating to the right shoulder is characteristic of biliary or gallbladder
disease.
8. Which abdominal examination finding is most consistent with ascites?
A. Hyperresonance throughout the abdomen
B. Absent bowel sounds only
C. Fixed dullness in the epigastrium
D. Shifting dullness with changes in position
, Rationale: Free fluid within the peritoneal cavity can shift with position,
producing shifting areas of dullness during percussion.
9. A patient has severe right lower quadrant abdominal pain that began
near the umbilicus and later localized to the right lower quadrant.
Which diagnosis should be considered?
A. Cholecystitis
B. Pancreatitis
C. Acute appendicitis
D. Acute cystitis
Rationale: Pain that initially occurs near the umbilicus and then localizes to
the right lower quadrant is a classic presentation of acute appendicitis.
10. Which finding is most characteristic of an inguinal hernia?
A. Diffuse abdominal rigidity
B. Left upper quadrant tenderness
C. Groin bulge that may increase with coughing or straining
D. Absent bowel sounds
Rationale: An inguinal hernia often presents as a groin or scrotal bulge
that becomes more prominent with increased intra-abdominal pressure
such as coughing or straining.
11. A patient reports black, tarry stools. Which condition should the
examiner suspect?
A. Lower urinary tract bleeding
B. Upper gastrointestinal bleeding
C. Hemorrhoidal bleeding only
D. Malabsorption without bleeding
Rationale: Melena results from digestion of blood and is classically
associated with bleeding from the upper gastrointestinal tract.
