Maryville NR 612 — Advanced Health
Assessment (Exam 3) With Actual 120
Questions & Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
Download Pdf
1. A 62-year-old man presents with exertional dyspnea and orthopnea. On exam you
hear a third heart sound (S3). This finding most likely indicates:
A. Left atrial hypertrophy
B. Increased systemic vascular resistance
C. Left ventricular systolic dysfunction
D. Mitral stenosis
Rationale: S3 commonly reflects increased left ventricular end-diastolic volume and
reduced systolic function (heart failure).
2. A 28-year-old woman reports episodic palpitations with anxiety and tremor. Her
vitals show tachycardia and warm, moist skin. Which test is most appropriate first?
A. ECG only
B. Chest X-ray
C. Thyroid function tests (TSH, free T4)
D. Echocardiogram
Rationale: Symptoms of palpitations, tremor, and warm skin suggest
hyperthyroidism; TSH and free T4 are appropriate initial tests.
3. Which lung sound is most consistent with fluid in the alveoli (pulmonary edema)?
A. Stridor
B. Wheeze
C. Fine crackles (rales) heard at bases
D. Pleural friction rub
, Rationale: Fine inspiratory crackles, especially basilar, are typical of alveolar fluid
as in pulmonary edema.
4. On abdominal exam, the presence of shifting dullness suggests:
A. Splenomegaly
B. Gastric dilation
C. Ascites
D. Intestinal obstruction
Rationale: Shifting dullness (change in percussion with position) indicates free
intraperitoneal fluid (ascites).
5. A 45-year-old male with sudden severe headache described as “worst ever.” Best
next test to evaluate for subarachnoid hemorrhage:
A. MRI brain without contrast
B. Noncontrast CT head
C. EEG
D. Lumbar puncture immediately
Rationale: Noncontrast CT head is the first-line rapid test to detect acute SAH; LP is
considered if CT is nondiagnostic and suspicion remains.
6. Which cranial nerve is responsible for shoulder shrug and head rotation?
A. CN V
B. CN IX
C. CN X
D. CN XI (spinal accessory)
Rationale: CN XI innervates trapezius and sternocleidomastoid for shoulder
elevation and head rotation.
7. In musculoskeletal exam, a positive McMurray test suggests injury to:
A. Anterior cruciate ligament
B. Medial or lateral meniscus
C. MCL
D. Patellar tendon
Rationale: McMurray maneuvers reproduce clicking or pain with
rotation/extension and suggest meniscal tear.
8. A 55-year-old smoker has a nontender, firm, fixed lymph node in the supraclavicular
area. The most concerning diagnosis is:
A. Reactive lymphadenopathy
B. Cat scratch disease
C. Metastatic malignancy
D. Tuberculosis only
, Rationale: A firm, non-tender, fixed supraclavicular node in an older smoker
strongly suggests metastatic cancer.
9. During cardiac auscultation you hear a harsh, crescendo-decrescendo systolic
murmur best at the right upper sternal border that radiates to the carotids. This is
most consistent with:
A. Mitral regurgitation
B. Tricuspid stenosis
C. Aortic stenosis
D. Ventricular septal defect
Rationale: A systolic ejection murmur at right 2nd ICS radiating to carotids is
characteristic of aortic stenosis.
10. On neurological exam, pronator drift indicates dysfunction of:
A. Brainstem
B. Corticospinal (upper motor neuron) pathways in the contralateral hemisphere
C. Cerebellum
D. Peripheral nerves
Rationale: Pronator drift indicates contralateral corticospinal (UMN) weakness,
often cortical lesion.
11. A 33-year-old woman has recurrent epistaxis. On anterior rhinoscopy you see friable
mucosa and telangiectasias. Next best step:
A. MRI sinus
B. Oral antibiotics
C. Evaluate for hereditary hemorrhagic telangiectasia and do ENT referral for local
control
D. Immediate nasal packing at home
Rationale: Telangiectasias and recurrent nosebleeds warrant evaluation for HHT
and ENT management for local control.
12. A 70-year-old patient presents with progressive memory loss and personality change.
On exam, you find primitive reflexes (grasp) and hyperreflexia. Most consistent with:
A. Major depressive disorder
B. Normal aging
C. Frontal lobe dementia (e.g., frontotemporal dementia)
D. Pure memory loss (normal pressure hydrocephalus)
Rationale: Behavioral changes and frontal release signs point to frontal lobe
dysfunction/FTD rather than typical Alzheimer’s.
13. Which abdominal finding suggests acute cholecystitis?
A. Rovsing sign
B. Cullen sign
Assessment (Exam 3) With Actual 120
Questions & Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
Download Pdf
1. A 62-year-old man presents with exertional dyspnea and orthopnea. On exam you
hear a third heart sound (S3). This finding most likely indicates:
A. Left atrial hypertrophy
B. Increased systemic vascular resistance
C. Left ventricular systolic dysfunction
D. Mitral stenosis
Rationale: S3 commonly reflects increased left ventricular end-diastolic volume and
reduced systolic function (heart failure).
2. A 28-year-old woman reports episodic palpitations with anxiety and tremor. Her
vitals show tachycardia and warm, moist skin. Which test is most appropriate first?
A. ECG only
B. Chest X-ray
C. Thyroid function tests (TSH, free T4)
D. Echocardiogram
Rationale: Symptoms of palpitations, tremor, and warm skin suggest
hyperthyroidism; TSH and free T4 are appropriate initial tests.
3. Which lung sound is most consistent with fluid in the alveoli (pulmonary edema)?
A. Stridor
B. Wheeze
C. Fine crackles (rales) heard at bases
D. Pleural friction rub
, Rationale: Fine inspiratory crackles, especially basilar, are typical of alveolar fluid
as in pulmonary edema.
4. On abdominal exam, the presence of shifting dullness suggests:
A. Splenomegaly
B. Gastric dilation
C. Ascites
D. Intestinal obstruction
Rationale: Shifting dullness (change in percussion with position) indicates free
intraperitoneal fluid (ascites).
5. A 45-year-old male with sudden severe headache described as “worst ever.” Best
next test to evaluate for subarachnoid hemorrhage:
A. MRI brain without contrast
B. Noncontrast CT head
C. EEG
D. Lumbar puncture immediately
Rationale: Noncontrast CT head is the first-line rapid test to detect acute SAH; LP is
considered if CT is nondiagnostic and suspicion remains.
6. Which cranial nerve is responsible for shoulder shrug and head rotation?
A. CN V
B. CN IX
C. CN X
D. CN XI (spinal accessory)
Rationale: CN XI innervates trapezius and sternocleidomastoid for shoulder
elevation and head rotation.
7. In musculoskeletal exam, a positive McMurray test suggests injury to:
A. Anterior cruciate ligament
B. Medial or lateral meniscus
C. MCL
D. Patellar tendon
Rationale: McMurray maneuvers reproduce clicking or pain with
rotation/extension and suggest meniscal tear.
8. A 55-year-old smoker has a nontender, firm, fixed lymph node in the supraclavicular
area. The most concerning diagnosis is:
A. Reactive lymphadenopathy
B. Cat scratch disease
C. Metastatic malignancy
D. Tuberculosis only
, Rationale: A firm, non-tender, fixed supraclavicular node in an older smoker
strongly suggests metastatic cancer.
9. During cardiac auscultation you hear a harsh, crescendo-decrescendo systolic
murmur best at the right upper sternal border that radiates to the carotids. This is
most consistent with:
A. Mitral regurgitation
B. Tricuspid stenosis
C. Aortic stenosis
D. Ventricular septal defect
Rationale: A systolic ejection murmur at right 2nd ICS radiating to carotids is
characteristic of aortic stenosis.
10. On neurological exam, pronator drift indicates dysfunction of:
A. Brainstem
B. Corticospinal (upper motor neuron) pathways in the contralateral hemisphere
C. Cerebellum
D. Peripheral nerves
Rationale: Pronator drift indicates contralateral corticospinal (UMN) weakness,
often cortical lesion.
11. A 33-year-old woman has recurrent epistaxis. On anterior rhinoscopy you see friable
mucosa and telangiectasias. Next best step:
A. MRI sinus
B. Oral antibiotics
C. Evaluate for hereditary hemorrhagic telangiectasia and do ENT referral for local
control
D. Immediate nasal packing at home
Rationale: Telangiectasias and recurrent nosebleeds warrant evaluation for HHT
and ENT management for local control.
12. A 70-year-old patient presents with progressive memory loss and personality change.
On exam, you find primitive reflexes (grasp) and hyperreflexia. Most consistent with:
A. Major depressive disorder
B. Normal aging
C. Frontal lobe dementia (e.g., frontotemporal dementia)
D. Pure memory loss (normal pressure hydrocephalus)
Rationale: Behavioral changes and frontal release signs point to frontal lobe
dysfunction/FTD rather than typical Alzheimer’s.
13. Which abdominal finding suggests acute cholecystitis?
A. Rovsing sign
B. Cullen sign
