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NUR-631 Advanced Health Assessment
Exam Review 2025 – 100 Practice
Questions with Answers & Rationales”
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Q1. Which of the following findings is most consistent with left-sided heart failure?
A. Jugular vein distention
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B. Dyspnea on exertion ✓✓✓
C. Peripheral edema
D. Hepatomegaly
Rationale: Dyspnea on exertion occurs in left-sided heart failure due to pulmonary
congestion. Right-sided failure typically causes peripheral edema and jugular vein distention.
Q2. What is the most reliable sign of dehydration in an elderly patient?
A. Dry mucous membranes
B. Decreased skin turgor
C. Orthostatic hypotension ✓✓✓
D. Tachycardia
Rationale: Orthostatic hypotension is a sensitive indicator of volume depletion in the elderly,
as skin turgor and mucosal moisture may not be reliable due to age-related changes.
Q3. Which physical exam finding is most suggestive of appendicitis?
A. Positive Murphy's sign
B. Rebound tenderness at McBurney's point ✓✓✓
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C. Positive Cullen's sign
D. Left lower quadrant pain
Page | 3 Rationale: Rebound tenderness at McBurney's point is a classic sign of appendicitis.
Murphy's sign is associated with cholecystitis, and Cullen's with pancreatitis or ectopic
pregnancy.
Q4. Which of the following best characterizes an S3 heart sound?
A. Occurs during atrial contraction
B. Heard early in diastole, often in heart failure ✓✓✓
C. Represents aortic valve opening
D. Associated with pericarditis
Rationale: The S3 sound is heard early in diastole and is associated with increased
ventricular filling pressures, commonly in heart failure.
Q5. A positive Phalen's test suggests:
A. Ulnar nerve entrapment
B. Carpal tunnel syndrome ✓✓✓
C. De Quervain's tenosynovitis
D. Rheumatoid arthritis
Rationale: Phalen's test elicits symptoms of carpal tunnel syndrome by compressing the
median nerve.
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Q6. Which of the following breath sounds is most commonly associated with asthma?
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A. Crackles
B. Expiratory wheezes ✓✓✓
C. Stridor
D. Pleural friction rub
Rationale: Expiratory wheezes result from narrowed airways and are characteristic of asthma
exacerbations.
Q7. A patient presents with bradykinesia, resting tremor, and shuffling gait. What is the most
likely diagnosis?
A. Alzheimer’s disease
B. Parkinson’s disease ✓✓✓
C. Multiple sclerosis
D. Myasthenia gravis
Rationale: These are hallmark signs of Parkinson's disease, a progressive neurological
disorder affecting movement.
Q8. A diastolic murmur best heard at the apex with the bell of the stethoscope in the left
lateral decubitus position suggests:
Page | 1
NUR-631 Advanced Health Assessment
Exam Review 2025 – 100 Practice
Questions with Answers & Rationales”
, 2
Q1. Which of the following findings is most consistent with left-sided heart failure?
A. Jugular vein distention
Page | 2
B. Dyspnea on exertion ✓✓✓
C. Peripheral edema
D. Hepatomegaly
Rationale: Dyspnea on exertion occurs in left-sided heart failure due to pulmonary
congestion. Right-sided failure typically causes peripheral edema and jugular vein distention.
Q2. What is the most reliable sign of dehydration in an elderly patient?
A. Dry mucous membranes
B. Decreased skin turgor
C. Orthostatic hypotension ✓✓✓
D. Tachycardia
Rationale: Orthostatic hypotension is a sensitive indicator of volume depletion in the elderly,
as skin turgor and mucosal moisture may not be reliable due to age-related changes.
Q3. Which physical exam finding is most suggestive of appendicitis?
A. Positive Murphy's sign
B. Rebound tenderness at McBurney's point ✓✓✓
, 3
C. Positive Cullen's sign
D. Left lower quadrant pain
Page | 3 Rationale: Rebound tenderness at McBurney's point is a classic sign of appendicitis.
Murphy's sign is associated with cholecystitis, and Cullen's with pancreatitis or ectopic
pregnancy.
Q4. Which of the following best characterizes an S3 heart sound?
A. Occurs during atrial contraction
B. Heard early in diastole, often in heart failure ✓✓✓
C. Represents aortic valve opening
D. Associated with pericarditis
Rationale: The S3 sound is heard early in diastole and is associated with increased
ventricular filling pressures, commonly in heart failure.
Q5. A positive Phalen's test suggests:
A. Ulnar nerve entrapment
B. Carpal tunnel syndrome ✓✓✓
C. De Quervain's tenosynovitis
D. Rheumatoid arthritis
Rationale: Phalen's test elicits symptoms of carpal tunnel syndrome by compressing the
median nerve.
, 4
Q6. Which of the following breath sounds is most commonly associated with asthma?
Page | 4
A. Crackles
B. Expiratory wheezes ✓✓✓
C. Stridor
D. Pleural friction rub
Rationale: Expiratory wheezes result from narrowed airways and are characteristic of asthma
exacerbations.
Q7. A patient presents with bradykinesia, resting tremor, and shuffling gait. What is the most
likely diagnosis?
A. Alzheimer’s disease
B. Parkinson’s disease ✓✓✓
C. Multiple sclerosis
D. Myasthenia gravis
Rationale: These are hallmark signs of Parkinson's disease, a progressive neurological
disorder affecting movement.
Q8. A diastolic murmur best heard at the apex with the bell of the stethoscope in the left
lateral decubitus position suggests:
