Midterm Exam: NU 650/ NU650 Health Assessment (Latest 2025/ 2026 Update) | Questions and Verified Answers | GRADED A | 100% Correct – Regis

Midterm Exam: NU 650/ NU650 Health Assessment (Latest 2025/ 2026 Update) | Questions and Verified Answers | GRADED A | 100% Correct – Regis A patient is seen in the office for amenorrhea, for which you obtain a urine pregnancy test in the office that returns negative. You would document this finding in which of the following sections of the encounter? A. HPI B. CC C. Subjective Data D. Objective Data D: Objective data A patient you are seeing for the first time in your office, brings their previous medical records for the review. you would document a summer of the previous medical records in which of the following sections of the encounter note? A. HPI B. CC C. Subjective Data D. Objective Data C: Subjective data The most effective process to elicit the ROS is for the NP to: A. Limit the ROS to systems related to the CC B. Follow the patients lead regarding the order of symptoms C. incorporate the ROS during the physical exam, stopping to make notes as necessary D. Start with general questions on each of the different body systems D The NP can determine higher cognitive function by asking the patient to perform which of the following tasks? A. Explain the meaning of a proverb B. Identify the day of the week, month, season, date and year C. Recall details of historical events D. Spell a five-letter word such as WORLD backward A The NP will ask the patient which of the following questions to assess for depression? A. have you ever been annoyed by other criticizing your alcohol use? B. Over the past two weeks have you felt little interest or pleasure in doing things? C. Over the past two weeks have you been unable to stop or control worrying? D. How often do you have contact with those that you care about or care about you? B The NP will document the reason for visit in which of the following sections of the encounter? A. HPI B. CC C. Subjective Data D. Objective Data B The primary care provider will anticipate that what percent of outpatients have mental health disorders? A. 10% B. 15 % C. 20% D. 25% C Which of the following actions by the NP demonstrations patient-centered interviewing techniques? A. Determine the personal context of the patients symptoms B. Focus on symptoms to identify a disease or condition C. Offer his or her perspective to lead the patients response D. Solicit information from the patients significant others A Which of the following strategies is most effective when dealing with an angry or disruptive patient? A. Allow the patient to disrupt the setting as needed to alleviate their anger B. Ask the patient to lower their voice and remain calm throughout the interview C. Reinforce the patients criticisms of other clinicians or the facility D. Validate the patients feelings without agreeing with their reasons. D Which of the following variables should have the greatest affect as to how the NP will conduct the H & PE of a child? A. The child's developmental level B. the child's chronological age C. The expected head to toe format and order of examination techniques D. The child's birth history A Match the primary skin lesion to the description A. Macule 1. Lesion is raised B. Papule 2. Lesion is raised 1 cm & fluid filled C. Plaque 3. Lesion is flat D. Vesicle 4. Lesion is raised, 1cm but not fluid filled E. Bullae 5. Lesion is raised Macule -- Lesion is Flat Papule -- lesion is raised Plaque -- lesion is raised, 1 cm but not fluid filled Vesicle -- lesion is raised Bullae -- lesion is raised, 1 cm and fluid filled A linear arrangement along a nerve distribution is a description of which type of skin lesion? A. Annular B. Zosteriform C. Keratitis D. Linear B A wood's lamp is especially useful in diagnosing __________ A. tine versicolor B. herpes zoster C. contact dermatitis D. All of the above A. tine versicolor (woods lamp helps diagnosis yeast infections) Mr. P. has had a "terrible itch" for several months that he has been scratching continuously. Upon examination, the nurse might expect to find: A. a keloid B. a fissue C. keratosis D. Lichenification D The NP has identified a solid, elevated, circumscribed lesion that is less than 1 cm in diameter and palpable into the dermis. This NP will correctly document this finding as a _________ A. bulla B. wheal C. nodule D. papule D Which of the following objective findings would alert the NP to consider skin cancer in the list of differential diagnoses? A. Annular and symmetrical lesions B. Blurred edges to a raised lesion C. solid red raised lesion D. Diameter of 5 mm B Which of the following secondary lesions is usually the result of a self-inflicted abrasion? A. Excoriation B. Scale C. Lichenification D. Atrophy A You have just read in the patient's chart that she has a lesion that is confluent in nature. On exam, you would expect to find: A. lesions that run together B. Angular lesions that have grown together C. Lesions arranged in a line along a nerve route D. Lesions that are grouped or clustered together A Which of the following represents the proper position for the NP to assess the patient's abdomen? A. Stand at the patient's left side and proceed in a systematic fashion. B. Stand at the patient's left side and assess any problem areas first C. Stand at the patient's right side and process in a systemic fashion D. Stand at the patient's right side and assess any problem areas first C The NP will demonstrate the correct order of examination for the abdomen by using examination techniques that follows: 1. Auscultation 2. Inspection 3. Palpation 4. Percussion A. 1-2-3-4 B. 2-3-4-1 C. 3-4-1-2 D. 2-1-3-4 D A 36-year-old female patient is seen in the clinic for a reported fever and back pain. She complained of pain when the NP percussed over the left CVA angle. This finding supports which of the following differential diagnosis? A. Pyelonephritis B. Left lower lobe pneumonia C. Splenomegaly D. Cholecystitis A The liver border can be palpated normally below the costal margin at the: A. Left mid-clavicular line B. Right mid-axillary line C. Right mid-calvicular line D. Left mid-axillary line C The NP will recognize which of the following subjective or objective findings as worrisome for an abdominal aortic aneurysm? A. aortic width of 2.8 cm B. 25 pack-year smoking history C. age of 60 D. Female gender B The NP will use which of the following examination techniques to determine muscular resistance, superficial organs and masses in the abdomen A. inspection B. light palpation C. deep palpation D. percussion B The NP will use which of the following methods to help the patient relax during the abdominal exam? A. ask the patient to hold their breath B. Palpate the abdomen after inspiration C. palpate the abdomen after expiration D. Palpate the abdomen using quick short movements C The parents of a 4-month-old infant share concern about their child's umbilical hernia at a well-child visit. The NP will correctly inform them that: A. Most umbilical hernias disappear by 12 months of age B. The hernia can be surgically repaired before the child reaches adolescence C. This finding indicates that their child is at high risk for other hernias D. There is a strong familial history for umbilical hernias A When percussing the abdomen in a patient with constipation, which of the following sounds would you expect to find in the LLQ? A. Tympanic B. Dull C. Resonant D. Hyperresonant B When percussing the abdomen, you would document the normal finding of percussion over the intestines as: A. Tympanic B. Dull C. Resonant D. Hyperresonant A Which of the following abdominal exam findings would prompt the NP to consider cholecystitis as a differential diagnosis? A. Positive psoas sign B. Positive Rovsing's sign C. Positive Obturator sign D. Positive murphy's sign D Which of the following symptoms would you expect from a young adolescent in the early phase of appendicitis? A. Abdominal pain two hours after eating B. CVA tenderness C. Severe RLQ pain with pallor and sweating D. Constipation C A 40 year old male patient presents with sinus pain, pressure and yellow nasal discharge. Your exam would include palpation of: A. Ethmoid and frontal sinuses B. Maxillary and sphenoid sinuses C. Frontal and maxillary sinuses D. Sphenoid and ethmoid sinuses C A 60 y.o presents with a 3-day history of left eye irritation. Which of the following findings should be recorded in the ROS? A. Patient denies eye pain or change in vision B. Vision is 20/20 by Snellen Chary C. Yellow crust is visible at the inner canthus of the left eye D. all of the above A During a physical exam of the throat, which of the following structures of the mouth/throat should rise when the patient says "aah"? A. Hard palate B. Soft palate C. Lingual frenulum D. Buccal mucosa B In conductive type hearing loss, you would expect: A. sound lateralizes to the good ear when the weber test is used B. sound lateralizes to the affected (bad) ear when the weber test is used C. The weber test remains unaltered with conductive type hearing loss and sound will be heard equally in both ears D. The weber test can cause discomfort in a patient with conductive type hearing loss and should not be used in this situation B On exam of the posterior pharynx, you are able to visualize the tonsils bilaterally extending just past the anterior and posterior pillars. According to the Friedman Scale, how would you document this finding in your note? A. tonsils noted to be normal B. Tonsils visualized grade 3 C. Tonsils visualized grade 1 D. Tonsils visualized grade 2 C The NP will assess visual acuity using which of the following tests? A. Snellen test B. Cover test C. Accommodation test D. Confrontation test A The NP will recognize which of the following findings when assessing the lymph nodes in the head and neck as worrisome, warranting further workup? A. Tender tonsillar and submandibular nodes in the presence of a streptococcal infection B. Any lymph node that the NP is able to roll in two directions: up and down, side to side C. Enlarged supraclavicular nodes D. Deep cervical chain nodes that are inaccessible to exam C When conducting an ophthalmoscopic exam, the NP will differentiate arteries from veins by noting: A. Larger size of arteries B. Bright light reflection of arteries C. Dark red color of arteries D. location of the vessel to the optic disc B When examining a 3 y.o presenting to your office with right ear pain, which would be the appropriate order for the assessment? A. Right ear, left ear, mouth, nose, neck, lungs, heart B. Neck, lungs, heart, mouth, nose, left ear, right ear C. Left ear, right ear, neck, lungs, heart and nose D. Lungs, heart, mouth, nose, and right ear. B Which of the following describes the proper technique for examination of the ear canal and drum for a 5 year old? A. Use the smallest ear speculum, position the pt. head so that you see comfortable, straighten the ear canal by grasping the auricle firmly and pulling it upward and backward, slightly away from the head. B. use the largest ear speculum that inserts easily in the canal, position the patients head so that you see comfortable, straighten the ear canal by grasping the auricle firmly and pulling it downward and backward, slightly away from the head B Which of the following findings on exam of the nasal mucosa and septum would most likely indicate allergic rhinitis? A. Reddened nasal mucosa with purulent drainage B. pale or bluish nasal mucosa with clear drainage C. fresh blood or crusting of the nasal mucosa D. Asymmetry in appearance between the right and left sides B Which of the following is/are normal in the examination of the oral cavity? A. a midline lingual frenulum extending from the tongue to the floor of the mouth B. papillae covering the dorsum of the tongue C. Pink buccal mucosa lining the cheeks D. All of the above are normal D Which of the following techniques identifies the correct way to use an ophthalmascope to inspect the optic disc and retina in the patients left eye? The NP will hold the ophthalmoscope: A. in their left hand and examine the patients left eye with his or hear left eye B. in the right hand and examine the patients left eye with her or her right eye. C. In their dominant hand and examine both of the patients eyes with his/her dominant eye D. According to personal preference and experience A You are examining a 4 y.o boy who presents to the office with his mother who complains that he gets bloody noses frequently. You know that the most common cause of epitaxis in the age group is: A. Chronic rhinitis B. Foreign body C. picking their nose D. Allergic rhinitis C You are examining a 9-month-old in your office and do not see a red reflex on the fundoscopic exam. This finding would cause concern as it can indicate which of the following? A. Glaucoma B. Dacryostenosis C. Cararacts D. Retinoblastoma D A newborn is in the office with cold symptoms. you go into the room to see a distressed mom who is very concerned about her baby. She expresses to you that something is wrong. Your initial thought that comes to mind is that this could be RSV. You must look for signs of respiratory distress. Those signs include________________ A. Vomiting and diarrhea B. coughing, pulling legs up C. retractions, nasal flaring, tachypnea, grunting D. fever of 100.4 or higher, tachypnea, vomiting C An 85 y.o. woman is brought to the urgent care center for possible aspiration pneumonia. The NP understands that, based on normal anatomy adventitious lung sounds will most likely be heard in which of the following areas? A. left upper lobe B. left middle & lower lobes C. right upper lobe D. Right middle and lower lobes D Barrel chest is an abnormal chest configuration that may occur in which of the following disorders? A. COPD B. Pneumonia C. Pneumothorax D. TBA A Bronchovesticular sounds are heard normally at which location? A. second intercostal space anteriorly bilaterally B. base of lungs bilaterally, posteriorly C. laterally at the midaxillary line, bilaterally D. Bilaterally at the mid-clabicular line, 5th intercostal space A Normally when the lung fields are percussed the resulting sound is described as _______: A. hyperresonant B. resonant C. tympanic D. Dull B The clinic has extended hours to provide flu vaccines and preventative teaching for the community. Based on current CDC influenza vaccine recommendations, the NP understands which of the following patients has a contraindication and cannot receive the vaccine? A. healthy 2 month baby girl B. primagravida at 32 weeks C. 60 y.o male with hx CHF D. 45 y.o female with BMI of 42 A The NP will nose a history of chronic cough based on the patients report of symptoms lasting for: A. 1 week B. 4 weeks C. 6 weeks D. 10 weeks D When compared to wheezes and rhonchi, the NP notes that on auscultation, crackles are: A. musical in quality B. prolonged sounds, typically persisting throughout the respiratory cycle C. intermittent and discontinuous sounds D. Relatively low-pitched with a snoring quality C Which breath sound is normally heard over the sternal notch? A. Bronchial B. Bronchovesicular C. Vesicular D. Tracheal A Which of the following findings will alert the NP to include pneumonia as a differential diagnosis? A. decreased tactile fremitus B. symmetrical chest expansion/lung excursion C. hyperresonance with percussion D. positive bronchophony D Which of the following is an expected change of aging? A. supraclavicular retractions with inspiration B. Kyphosis C. There is a decrease of the elastic properties within lungs D. Pectus excavatum C Cultural Humility: A process that requires humility as individuals continually engage in self-reflection and self-critique as lifelong learners and reflective practitioners. 3 Dimensions of cultural humility 1) Self-awareness: learn about your own biases; we all have them. 2) Respectful communication: work to eliminate assumptions about what is "normal". Learn directly from your patients; they are the experts on their culture and illness. 3) Collaborative partnerships: build your patient relationships on respect and mutually acceptable plans. True or False: The beginning NP should focus on interpreting the findings of the physical examination. False Which of the following statements represents a general goal for the comprehensive or focused physical examination? a. Avoid unnecessary changes in position b. Maximize patient comfort c. Enhance clinical efficiency d. all of the above D Chronic pain definition Pain that persists one month beyond the course of an acute injury Crackles auscultated sound description: Discontinuous Non-musical Like dots in time Wheezes auscultated sound description: High pitched with hissing or shrill quality Continuous Rhonchi auscultated sound description: Continuous Low pitched with snoring quality Vesicular breath sound characteristics: Inspiration longer than expiration Heard over most lung tissue Tracheal breath sound characteristics: Inspiration & expiration almost equal Relatively high pitched Intensity of expiration very loud Bronchovesicular breath sound characteristics: Inspiration and expiration almost equal, and heard in the first and second interspaces anteriorly and between the scapulae Bronchial breath sound characteristics: Expiration longer than inspiration Heard over large proximal airways You are performing a thorough cardiac examination. Which of the following chambers of the heart can you assess by palpation? A) Left atrium B) Right atrium C) Right ventricle D) Sinus node C ./ What is responsible for the inspiratory splitting of S2? A) Closure of aortic, then pulmonic valves B) Closure of mitral, then tricuspid valves C) Closure of aortic, then tricuspid valves D) Closure of mitral, then pulmonic valves A ./ A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your physical examination, you listen to her heart and hear a murmur only at the cardiac apex. Which valve is most likely to be involved, based on the location of the murmur? A) Mitral B) Tricuspid C) Aortic D) Pulmonic A ./ A 58-year-old teacher presents to your clinic complaining of breathlessness with activity. The patient has no chronic conditions and takes no medications, herbs, or supplements. Which of the following symptoms is appropriate to ask about in the cardiovascular review of systems? A) Abdominal pain B) Orthopnea C) Hematochezia D) Tenesmus B You are screening people at the mall as part of a health fair. The first person who comes for screening has a blood pressure of 132/85. How would you categorize this? A) Normal B) Prehypertension C) Stage 1 hypertension D) Stage 2 hypertension B Prehypertension = 120-139/80-89 You are participating in a health fair and performing cholesterol screens. One person has a cholesterol of 225. She is concerned about her risk for developing heart disease. Which of the following factors is used to estimate the 10-year risk of developing coronary heart disease? A) Ethnicity B) Alcohol intake C) Gender D) Asthma C You are evaluating a 40-year-old banker for coronary heart disease risk factors. He has a history of hypertension, which is well-controlled on his current medications. He does not smoke; he does 45 minutes of aerobic exercise five times weekly. You are calculating his 10-year coronary heart disease risk. Which of the following conditions is considered to be a coronary heart disease risk equivalent? A) Hypertension B) Peripheral arterial disease C) Systemic lupus erythematosus D) Chronic obstructive pulmonary disease (COPD) B ./ You are conducting a workshop on the measurement of jugular venous pulsation. As part of your instruction, you tell the students to make sure they can distinguish between the jugular venous pulsation and the carotid pulse. Which one of the following characteristics is typical of the carotid pulse? A) Palpable B) Soft, rapid, undulating quality C) Pulsation eliminated by light pressure on the vessel D) Level of pulsation changes with changes in position A A 68-year-old mechanic presents to the emergency room for shortness of breath. You are concerned about a cardiac cause and measure his jugular venous pressure (JVP). It is elevated. Which one of the following conditions is a potential cause of elevated JVP? A) Left-sided heart failure B) Mitral stenosis C) Constrictive pericarditis D) Aortic aneurysm C You are palpating the apical impulse in a patient with heart disease and find that the amplitude is diffuse and increased. Which of the following conditions could be a potential cause of an increase in the amplitude of the impulse? A) Hypothyroidism B) Aortic stenosis, with pressure overload of the left ventricle C) Mitral stenosis, with volume overload of the left atrium D) Cardiomyopathy B You are performing a cardiac examination on a patient with shortness of breath and palpitations. You listen to the heart with the patient sitting upright, then have him change to a supine position, and finally have him turn onto his left side in the left lateral decubitus position. Which of the following valvular defects is best heard in this position? A) Aortic B) Pulmonic C) Mitral D) Tricuspid C You are concerned that a patient has an aortic regurgitation murmur. Which is the best position to accentuate the murmur? A) Upright B) Upright, but leaning forward C) Supine D) Left lateral decubitus B A 68-year-old retired waiter comes to your clinic for evaluation of fatigue. You perform a cardiac examination and find his pulse rate is less than 60. Which of the following conditions could be responsible for this heart rate? A) Second-degree A-V block B) Atrial flutter C) Sinus arrhythmia D) Atrial fibrillation A Where is the point of maximal impulse (PMI) normally located? A) In the left 5th intercostal space, 7 to 9 cm lateral to the sternum B) In the left 5th intercostal space, 10 to 12 cm lateral to the sternum C) In the left 5th intercostal space, in the anterior axillary line D) In the left 5th intercostal space, in the midaxillary line A ./ Which of the following events occurs at the start of diastole? A) Closure of the tricuspid valve B) Opening of the pulmonic valve C) Closure of the aortic valve D) Production of the first heart sound (S1) C ./ Which is true of a third heart sound (S3)? A) It marks atrial contraction. B) It reflects normal compliance of the left ventricle. C) It is caused by rapid deceleration of blood against the ventricular wall. D) It is not heard in atrial fibrillation. C ./ Which is true of splitting of the second heart sound? A) It is best heard over the pulmonic area with the bell of the stethoscope. B) It normally increases with exhalation. C) It is best heard over the apex. D) It does not vary with respiration. A ./ Which of the following is true of jugular venous pressure (JVP) measurement? A) It is measured with the patient at a 45-degree angle. B) The vertical height of the blood column in centimeters, plus 5 cm, is the JVP. C) A JVP below 9 cm is abnormal. D) It is measured above the sternal notch. B Which of the following regarding jugular venous pulsations is a systolic phenomenon? A) The "y" descent B) The "x" descent C) The upstroke of the "a" wave D) The downstroke of the "v" wave B How much does cardiovascular risk increase for each increment of 20 mm Hg systolic and 10 mm Hg diastolic in blood pressure? A) 25% B) 50% C) 75% D) 100% D In healthy adults over 20, how often should blood pressure, body mass index, waist circumference, and pulse be assessed, according to American Heart Association guidelines? A) Every 6 months B) Every year C) Every 2 years D) Every 5 years C Which of the following is a clinical identifier of metabolic syndrome? A) Waist circumference of 38 inches for a male B) Waist circumference of 34 inches for a female C) BP of 134/88 for a male D) BP of 128/84 for a female C ./ Mrs. Adams would like to begin an exercise program and was told to exercise as intensely as necessary to obtain a heart rate 60% or greater of her maximum heart rate. She is 52. What heart rate should she achieve? A) 80 B) 100 C) 120 D) 140 B In measuring the jugular venous pressure (JVP), which of the following is important? A) Keep the patient's torso at a 45-degree angle. B) Measure the highest visible pressure, usually at end expiration. C) Add the vertical height over the sternal notch to a 5-cm constant. D) Realize that a total value of over 12 cm is abnormal. B You find a bounding carotid pulse on a 62-year-old patient. Which murmur should you search out? A) Mitral valve prolapse B) Pulmonic stenosis C) Tricuspid insufficiency D) Aortic insufficiency D To hear a soft murmur or bruit, which of the following may be necessary? A) Asking the patient to hold her breath B) Asking the patient in the next bed to turn down the TV C) Checking your stethoscope for air leaks D) All of the above D Which of the following may be missed unless the patient is placed in the left lateral decubitus position and auscultated with the bell? A) Mitral stenosis murmur B) Opening snap of the mitral valve C) S3 and S4 gallops D) All of the above D How should you determine whether a murmur is systolic or diastolic? A) Palpate the carotid pulse. B) Palpate the radial pulse. C) Judge the relative length of systole and diastole by auscultation. D) Correlate the murmur with a bedside heart monitor. A Which of the following correlates with a sustained, high-amplitude PMI? A) Hyperthyroidism B) Anemia C) Fever D) Hypertension D You are examining a patient with emphysema in exacerbation and are having difficulty hearing his heart sounds. What should you do to obtain a good exam? A) Listen in the epigastrium. B) Listen to the patient in the left lateral decubitus position. C) Ask the patient to hold his breath for 30 seconds. D) Listen posteriorly. A You are listening carefully for S2 splitting. Which of the following will help? A) Using the diaphragm with light pressure over the 2nd right intercostal space B) Using the bell with light pressure over the 2nd left intercostal space C) Using the diaphragm with firm pressure over the apex D) Using the bell with firm pressure over the lower left sternal border B Which of the following is true of a grade 4-intensity murmur? A) It is moderately loud. B) It can be heard with the stethoscope off the chest. C) It can be heard with the stethoscope partially off the chest. D) It is associated with a "thrill." D