NURS6205
Advanced Health
Assessment
COMPLETED EXAM
2024
,1. A 65-year-old man presents with chest pain, dyspnea, diaphoresis and
nausea. He has a history of hypertension, diabetes and smoking. You
suspect he is having an acute myocardial infarction (AMI). What is the most
appropriate initial diagnostic test to confirm your suspicion?
a) Electrocardiogram (ECG)
b) Cardiac troponin
c) Chest X-ray
d) Coronary angiography
*Answer: a) Electrocardiogram (ECG)*
Rationale: An ECG is the most rapid and reliable test to diagnose an AMI, as
it can show characteristic changes in the electrical activity of the heart due
to ischemia or necrosis. Cardiac troponin is a biomarker that can also
confirm an AMI, but it may take several hours to rise after the onset of
symptoms. Chest X-ray can show signs of pulmonary edema or
cardiomegaly, but it is not specific for an AMI. Coronary angiography is an
invasive procedure that can visualize the coronary arteries and identify the
location and severity of the occlusion, but it is not usually done as the first
test.
2. A 45-year-old woman complains of fatigue, weight gain, constipation,
dry skin and hair loss. She has a family history of thyroid disease. You
suspect she has hypothyroidism. What is the most appropriate initial
diagnostic test to confirm your suspicion?
a) Thyroid-stimulating hormone (TSH)
b) Free thyroxine (FT4)
c) Thyroid peroxidase antibody (TPOAb)
d) Thyroid ultrasound
*Answer: a) Thyroid-stimulating hormone (TSH)*
Rationale: TSH is the most sensitive and specific test to diagnose
hypothyroidism, as it reflects the feedback mechanism between the
pituitary gland and the thyroid gland. A high TSH indicates primary
hypothyroidism, which is the most common type. FT4 measures the
amount of free or active thyroid hormone in the blood, but it may be
normal or low in hypothyroidism depending on the severity and duration
,of the condition. TPOAb is a marker of autoimmune thyroid disease, which
is a common cause of hypothyroidism, but it is not diagnostic by itself.
Thyroid ultrasound can show the size and shape of the thyroid gland, but it
cannot assess its function.
3. A 25-year-old man presents with fever, sore throat, swollen lymph nodes
and white patches on his tonsils. He has no history of allergies or chronic
diseases. You suspect he has streptococcal pharyngitis (strep throat). What
is the most appropriate initial diagnostic test to confirm your suspicion?
a) Rapid antigen detection test (RADT)
b) Throat culture
c) Complete blood count (CBC)
d) Monospot test
*Answer: a) Rapid antigen detection test (RADT)*
Rationale: RADT is a quick and easy test that can detect streptococcal
antigens from a throat swab within minutes. It has a high specificity,
meaning that a positive result is very likely to indicate a true infection.
Throat culture is the gold standard for diagnosing strep throat, but it takes
longer to obtain results and requires laboratory facilities. CBC can show
signs of inflammation or infection, such as elevated white blood cells or
neutrophils, but it is not specific for strep throat. Monospot test is used to
diagnose infectious mononucleosis (mono), which can cause similar
symptoms as strep throat, but it is less common and less likely in this case.
4. A 35-year-old woman presents with pelvic pain, dysmenorrhea,
dyspareunia and infertility. She has no history of sexually transmitted
infections or surgeries. You suspect she has endometriosis. What is the
most appropriate initial diagnostic test to confirm your suspicion?
a) Pelvic ultrasound
b) Pelvic magnetic resonance imaging (MRI)
c) Serum CA-125
d) Laparoscopy
*Answer: d) Laparoscopy*
Rationale: Laparoscopy is the only definitive way to diagnose
endometriosis, as it allows direct visualization and biopsy of the ectopic
endometrial tissue outside the uterus. Pelvic ultrasound and MRI can show
signs of endometriosis, such as ovarian cysts or adhesions, but they are not
, conclusive and may miss subtle lesions. Serum CA-125 is a tumor marker
that can be elevated in endometriosis, but it is also nonspecific and
influenced by other factors, such as the menstrual cycle or inflammation.
5. A 55-year-old man presents with hematuria, flank pain, weight loss and
night sweats. He has a history of smoking and occupational exposure to
asbestos. You suspect he has renal cell carcinoma (RCC). What is the most
appropriate initial diagnostic test to confirm your suspicion?
a) Urinalysis
b) Urine cytology
c) Renal ultrasound
d) Computed tomography (CT) scan
*Answer: d) Computed tomography (CT) scan*
Rationale: CT scan is the best imaging modality to diagnose RCC, as it can
show the size, shape and location of the renal mass, as well as any
involvement of the renal vein, inferior vena cava or lymph nodes. It can
also detect any metastases to other organs, such as the lungs, liver or
bones. Urinalysis can show blood or protein in the urine, but it is not
specific for RCC. Urine cytology can detect abnormal cells in the urine, but
it has a low sensitivity and specificity for RCC. Renal ultrasound can show a
renal mass, but it cannot differentiate between benign and malignant
tumors or assess the extent of the disease.
6. A 75-year-old woman presents with memory loss, confusion,
disorientation and personality changes. She has a history of hypertension,
hyperlipidemia and diabetes. You suspect she has Alzheimer's disease (AD).
What is the most appropriate initial diagnostic test to confirm your
suspicion?
a) Mini-Mental State Examination (MMSE)
b) Montreal Cognitive Assessment (MoCA)
c) Cerebrospinal fluid (CSF) analysis
d) Positron emission tomography (PET) scan
*Answer: b) Montreal Cognitive Assessment (MoCA)*
Rationale: MoCA is a brief and validated cognitive screening tool that can
detect mild cognitive impairment (MCI), which is a prodromal stage of AD.
It assesses various domains of cognition, such as attention, memory,
language, executive function and visuospatial skills. It has a higher
Advanced Health
Assessment
COMPLETED EXAM
2024
,1. A 65-year-old man presents with chest pain, dyspnea, diaphoresis and
nausea. He has a history of hypertension, diabetes and smoking. You
suspect he is having an acute myocardial infarction (AMI). What is the most
appropriate initial diagnostic test to confirm your suspicion?
a) Electrocardiogram (ECG)
b) Cardiac troponin
c) Chest X-ray
d) Coronary angiography
*Answer: a) Electrocardiogram (ECG)*
Rationale: An ECG is the most rapid and reliable test to diagnose an AMI, as
it can show characteristic changes in the electrical activity of the heart due
to ischemia or necrosis. Cardiac troponin is a biomarker that can also
confirm an AMI, but it may take several hours to rise after the onset of
symptoms. Chest X-ray can show signs of pulmonary edema or
cardiomegaly, but it is not specific for an AMI. Coronary angiography is an
invasive procedure that can visualize the coronary arteries and identify the
location and severity of the occlusion, but it is not usually done as the first
test.
2. A 45-year-old woman complains of fatigue, weight gain, constipation,
dry skin and hair loss. She has a family history of thyroid disease. You
suspect she has hypothyroidism. What is the most appropriate initial
diagnostic test to confirm your suspicion?
a) Thyroid-stimulating hormone (TSH)
b) Free thyroxine (FT4)
c) Thyroid peroxidase antibody (TPOAb)
d) Thyroid ultrasound
*Answer: a) Thyroid-stimulating hormone (TSH)*
Rationale: TSH is the most sensitive and specific test to diagnose
hypothyroidism, as it reflects the feedback mechanism between the
pituitary gland and the thyroid gland. A high TSH indicates primary
hypothyroidism, which is the most common type. FT4 measures the
amount of free or active thyroid hormone in the blood, but it may be
normal or low in hypothyroidism depending on the severity and duration
,of the condition. TPOAb is a marker of autoimmune thyroid disease, which
is a common cause of hypothyroidism, but it is not diagnostic by itself.
Thyroid ultrasound can show the size and shape of the thyroid gland, but it
cannot assess its function.
3. A 25-year-old man presents with fever, sore throat, swollen lymph nodes
and white patches on his tonsils. He has no history of allergies or chronic
diseases. You suspect he has streptococcal pharyngitis (strep throat). What
is the most appropriate initial diagnostic test to confirm your suspicion?
a) Rapid antigen detection test (RADT)
b) Throat culture
c) Complete blood count (CBC)
d) Monospot test
*Answer: a) Rapid antigen detection test (RADT)*
Rationale: RADT is a quick and easy test that can detect streptococcal
antigens from a throat swab within minutes. It has a high specificity,
meaning that a positive result is very likely to indicate a true infection.
Throat culture is the gold standard for diagnosing strep throat, but it takes
longer to obtain results and requires laboratory facilities. CBC can show
signs of inflammation or infection, such as elevated white blood cells or
neutrophils, but it is not specific for strep throat. Monospot test is used to
diagnose infectious mononucleosis (mono), which can cause similar
symptoms as strep throat, but it is less common and less likely in this case.
4. A 35-year-old woman presents with pelvic pain, dysmenorrhea,
dyspareunia and infertility. She has no history of sexually transmitted
infections or surgeries. You suspect she has endometriosis. What is the
most appropriate initial diagnostic test to confirm your suspicion?
a) Pelvic ultrasound
b) Pelvic magnetic resonance imaging (MRI)
c) Serum CA-125
d) Laparoscopy
*Answer: d) Laparoscopy*
Rationale: Laparoscopy is the only definitive way to diagnose
endometriosis, as it allows direct visualization and biopsy of the ectopic
endometrial tissue outside the uterus. Pelvic ultrasound and MRI can show
signs of endometriosis, such as ovarian cysts or adhesions, but they are not
, conclusive and may miss subtle lesions. Serum CA-125 is a tumor marker
that can be elevated in endometriosis, but it is also nonspecific and
influenced by other factors, such as the menstrual cycle or inflammation.
5. A 55-year-old man presents with hematuria, flank pain, weight loss and
night sweats. He has a history of smoking and occupational exposure to
asbestos. You suspect he has renal cell carcinoma (RCC). What is the most
appropriate initial diagnostic test to confirm your suspicion?
a) Urinalysis
b) Urine cytology
c) Renal ultrasound
d) Computed tomography (CT) scan
*Answer: d) Computed tomography (CT) scan*
Rationale: CT scan is the best imaging modality to diagnose RCC, as it can
show the size, shape and location of the renal mass, as well as any
involvement of the renal vein, inferior vena cava or lymph nodes. It can
also detect any metastases to other organs, such as the lungs, liver or
bones. Urinalysis can show blood or protein in the urine, but it is not
specific for RCC. Urine cytology can detect abnormal cells in the urine, but
it has a low sensitivity and specificity for RCC. Renal ultrasound can show a
renal mass, but it cannot differentiate between benign and malignant
tumors or assess the extent of the disease.
6. A 75-year-old woman presents with memory loss, confusion,
disorientation and personality changes. She has a history of hypertension,
hyperlipidemia and diabetes. You suspect she has Alzheimer's disease (AD).
What is the most appropriate initial diagnostic test to confirm your
suspicion?
a) Mini-Mental State Examination (MMSE)
b) Montreal Cognitive Assessment (MoCA)
c) Cerebrospinal fluid (CSF) analysis
d) Positron emission tomography (PET) scan
*Answer: b) Montreal Cognitive Assessment (MoCA)*
Rationale: MoCA is a brief and validated cognitive screening tool that can
detect mild cognitive impairment (MCI), which is a prodromal stage of AD.
It assesses various domains of cognition, such as attention, memory,
language, executive function and visuospatial skills. It has a higher
