NUR 631 ADVANCED HEALTH ASSESSMENT EXAM 4 LATEST 2026 WITH 100 EXAM PREP
QUESTIONS AND CORRECT VERIFIED ANSWERS/ (BRAND NEW!)
Question 1
Which of the following describes the correct order of assessment for the abdominal physical
examination?
A) Inspection, Palpation, Percussion, Auscultation
B) Auscultation, Inspection, Palpation, Percussion
C) Inspection, Auscultation, Percussion, Palpation
D) Percussion, Inspection, Auscultation, Palpation
E) Inspection, Percussion, Palpation, Auscultation
Correct Answer: C) Inspection, Auscultation, Percussion, Palpation
Rationale: In the abdominal exam, auscultation is performed before percussion and
palpation. This is because manipulation of the bowel through percussion or palpation can
alter the frequency and character of bowel sounds, potentially leading to inaccurate
findings.
Question 2
A 46-year-old male with a history of cirrhosis presents with black, tarry stools (melena), spider
angiomas, jaundice, and dilated veins around the umbilicus (caput medusae). Palpation reveals a
small, hard liver. What is the most likely cause of his black stools?
A) Infectious diarrhea
B) Mallory-Weiss tear
C) Peptic ulcer disease
D) Esophageal varices
E) Acute diverticulitis
Correct Answer: D) Esophageal varices
Rationale: In the setting of cirrhosis and portal hypertension, blood flow is diverted from
the liver to collateral vessels. Esophageal varices are dilated submucosal veins in the lower
esophagus that can rupture and bleed profusely. This blood is then digested as it moves
through the GI tract, presenting as melena (black stools). The presence of caput medusae
and spider angiomas further confirms portal hypertension.
Question 3
Which of the following physiological changes is considered normal during a healthy pregnancy?
A) Increased systemic vascular resistance (SVR)
B) Decreased glomerular filtration rate (GFR)
C) Decreased heart rate
D) Increased blood volume
E) Respiratory acidosis
Correct Answer: D) Increased blood volume
Rationale: During pregnancy, maternal blood volume increases by 40-50% to provide for
fetal needs and protect against hemorrhage during delivery. Other normal changes include
, 2
increased GFR, increased heart rate, decreased SVR (leading to lower BP in the second
trimester), and a compensatory respiratory alkalosis due to increased minute ventilation.
Question 4
Using Naegele’s Rule, calculate the Estimated Due Date (EDD) for a patient whose Last
Menstrual Period (LMP) began on July 10, 2024.
A) April 10, 2025
B) April 17, 2025
C) May 17, 2025
D) March 17, 2025
E) April 3, 2025
Correct Answer: B) April 17, 2025
Rationale: Naegele’s Rule is a standard method to calculate the EDD: Add 7 days to the first
day of the LMP, subtract 3 months, and add 1 year. July 10 + 7 days = July 17. July minus
3 months = April. Thus, the EDD is April 17, 2025.
Question 5
A 21-year-old female complains of frequent loose stools and cramping that has occurred
intermittently since high school. She notes the symptoms worsen when she is nervous. Her
physical exam and rectal exam are unremarkable. What is the most likely etiology?
A) Secretory infection
B) Inflammatory bowel disease
C) Irritable bowel syndrome
D) Malabsorption syndrome
E) Celiac disease
Correct Answer: C) Irritable bowel syndrome
Rationale: Irritable bowel syndrome (IBS) is a functional GI disorder characterized by
chronic abdominal pain and altered bowel habits (diarrhea, constipation, or both) without
an organic cause. It often presents in young adulthood and is frequently triggered or
exacerbated by psychological stress. An unremarkable physical exam is classic for IBS.
Question 6
During a pelvic exam of a pregnant patient, the Nurse Practitioner observes a bluish-purple
discoloration of the cervix and vaginal mucosa. This finding is known as:
A) Goodell’s sign
B) Hegar’s sign
C) Chadwick’s sign
D) Murphy’s sign
E) Rovsing’s sign
Correct Answer: C) Chadwick’s sign
Rationale: Chadwick’s sign is a bluish discoloration of the cervix, vagina, and labia
QUESTIONS AND CORRECT VERIFIED ANSWERS/ (BRAND NEW!)
Question 1
Which of the following describes the correct order of assessment for the abdominal physical
examination?
A) Inspection, Palpation, Percussion, Auscultation
B) Auscultation, Inspection, Palpation, Percussion
C) Inspection, Auscultation, Percussion, Palpation
D) Percussion, Inspection, Auscultation, Palpation
E) Inspection, Percussion, Palpation, Auscultation
Correct Answer: C) Inspection, Auscultation, Percussion, Palpation
Rationale: In the abdominal exam, auscultation is performed before percussion and
palpation. This is because manipulation of the bowel through percussion or palpation can
alter the frequency and character of bowel sounds, potentially leading to inaccurate
findings.
Question 2
A 46-year-old male with a history of cirrhosis presents with black, tarry stools (melena), spider
angiomas, jaundice, and dilated veins around the umbilicus (caput medusae). Palpation reveals a
small, hard liver. What is the most likely cause of his black stools?
A) Infectious diarrhea
B) Mallory-Weiss tear
C) Peptic ulcer disease
D) Esophageal varices
E) Acute diverticulitis
Correct Answer: D) Esophageal varices
Rationale: In the setting of cirrhosis and portal hypertension, blood flow is diverted from
the liver to collateral vessels. Esophageal varices are dilated submucosal veins in the lower
esophagus that can rupture and bleed profusely. This blood is then digested as it moves
through the GI tract, presenting as melena (black stools). The presence of caput medusae
and spider angiomas further confirms portal hypertension.
Question 3
Which of the following physiological changes is considered normal during a healthy pregnancy?
A) Increased systemic vascular resistance (SVR)
B) Decreased glomerular filtration rate (GFR)
C) Decreased heart rate
D) Increased blood volume
E) Respiratory acidosis
Correct Answer: D) Increased blood volume
Rationale: During pregnancy, maternal blood volume increases by 40-50% to provide for
fetal needs and protect against hemorrhage during delivery. Other normal changes include
, 2
increased GFR, increased heart rate, decreased SVR (leading to lower BP in the second
trimester), and a compensatory respiratory alkalosis due to increased minute ventilation.
Question 4
Using Naegele’s Rule, calculate the Estimated Due Date (EDD) for a patient whose Last
Menstrual Period (LMP) began on July 10, 2024.
A) April 10, 2025
B) April 17, 2025
C) May 17, 2025
D) March 17, 2025
E) April 3, 2025
Correct Answer: B) April 17, 2025
Rationale: Naegele’s Rule is a standard method to calculate the EDD: Add 7 days to the first
day of the LMP, subtract 3 months, and add 1 year. July 10 + 7 days = July 17. July minus
3 months = April. Thus, the EDD is April 17, 2025.
Question 5
A 21-year-old female complains of frequent loose stools and cramping that has occurred
intermittently since high school. She notes the symptoms worsen when she is nervous. Her
physical exam and rectal exam are unremarkable. What is the most likely etiology?
A) Secretory infection
B) Inflammatory bowel disease
C) Irritable bowel syndrome
D) Malabsorption syndrome
E) Celiac disease
Correct Answer: C) Irritable bowel syndrome
Rationale: Irritable bowel syndrome (IBS) is a functional GI disorder characterized by
chronic abdominal pain and altered bowel habits (diarrhea, constipation, or both) without
an organic cause. It often presents in young adulthood and is frequently triggered or
exacerbated by psychological stress. An unremarkable physical exam is classic for IBS.
Question 6
During a pelvic exam of a pregnant patient, the Nurse Practitioner observes a bluish-purple
discoloration of the cervix and vaginal mucosa. This finding is known as:
A) Goodell’s sign
B) Hegar’s sign
C) Chadwick’s sign
D) Murphy’s sign
E) Rovsing’s sign
Correct Answer: C) Chadwick’s sign
Rationale: Chadwick’s sign is a bluish discoloration of the cervix, vagina, and labia
