NUR 643E Advanced Health Assessment
Final Exam 2025 – Actual Exam, 2
Verified Versions (A & B), Questions with
100% Correct Answers and Detailed
Rationales | Graded A+
This comprehensive final exam for NUR 643E Advanced Health Assessment (2025 edition)
includes two verified versions (A & B) with 50 questions each, covering head-to-toe assessment,
differential diagnosis, physical exam techniques, and clinical reasoning across lifespan.
Questions are scenario-based, with four options, correct answer in RED, and detailed rationales
with evidence-based reasoning, clinical implications, and assessment tips for A+ success.
Version A
Question 1: A 45-year-old woman presents with a 2-month history of fatigue, weight gain,
and cold intolerance. On exam, she has dry skin and delayed reflexes. What is the priority
diagnostic test?
A. Thyroid-stimulating hormone (TSH) level
B. Complete blood count (CBC)
C. Fasting glucose
D. Lipid panel
Correct Answer: A. Thyroid-stimulating hormone (TSH) level
Rationale: Symptoms and findings suggest hypothyroidism; elevated TSH confirms (USPSTF
guidelines). CBC (B) for anemia; glucose (C) for diabetes; lipids (D) for dyslipidemia. Clinical
implication: Early diagnosis prevents cardiovascular complications. Assessment tip: Screen for
goiter.
Question 2: During a physical exam, the nurse notes a 60-year-old man's BP 150/90 mmHg
in the right arm and 140/85 mmHg in the left. What is the next step?
A. Repeat BP in 1 week
B. Obtain bilateral brachial and radial pulses
C. Order ECG
D. Start antihypertensive
Correct Answer: B. Obtain bilateral brachial and radial pulses
Rationale: Discrepancy >10 mmHg suggests subclavian stenosis or aortic dissection; pulse
assessment differentiates. Repeat (A) if isolated; ECG (C) for arrhythmia; antihypertensive (D)
after evaluation. Clinical implication: Detect vascular disease. Assessment tip: Compare bilateral
BP.
, Question 3: A 25-year-old woman has a BMI of 18 and irregular menses. What is the
priority exam finding to assess?
A. Thyroid enlargement
B. Abdominal tenderness
C. Breast discharge
D. Pelvic tenderness
Correct Answer: D. Pelvic tenderness
Rationale: Low BMI and amenorrhea suggest PCOS; pelvic exam assesses for ovarian cysts.
Thyroid (A) for hypo; abdominal (B) GI; breast (C) prolactinoma. Clinical implication:
Hormonal imbalance. Assessment tip: Include bimanual exam.
Question 4: A 70-year-old man has a painless lump in his neck. What is the priority
diagnostic test?
A. Fine-needle aspiration (FNA)
B. CT scan neck
C. Ultrasound
D. Both A and C
Correct Answer: D. Both A and C
Rationale: Ultrasound guides FNA for lymph node evaluation in elderly (NCCN guidelines). CT
(B) for staging later. Clinical implication: Rule out malignancy. Assessment tip: Palpate lymph
nodes systematically.
Question 5: During abdominal exam, the nurse notes shifting dullness. What does this
indicate?
A. Gas
B. Ascites
C. Constipation
D. Muscle rigidity
Correct Answer: B. Ascites
Rationale: Shifting dullness suggests free fluid in peritoneum (liver disease). Gas (A) tympany;
constipation (C) mass; rigidity (D) peritonitis. Clinical implication: Liver function tests.
Assessment tip: Percuss flanks.
Question 6: A 30-year-old man has unilateral knee swelling after trauma. What is the
priority test?
A. X-ray
B. MRI
C. Aspiration
Final Exam 2025 – Actual Exam, 2
Verified Versions (A & B), Questions with
100% Correct Answers and Detailed
Rationales | Graded A+
This comprehensive final exam for NUR 643E Advanced Health Assessment (2025 edition)
includes two verified versions (A & B) with 50 questions each, covering head-to-toe assessment,
differential diagnosis, physical exam techniques, and clinical reasoning across lifespan.
Questions are scenario-based, with four options, correct answer in RED, and detailed rationales
with evidence-based reasoning, clinical implications, and assessment tips for A+ success.
Version A
Question 1: A 45-year-old woman presents with a 2-month history of fatigue, weight gain,
and cold intolerance. On exam, she has dry skin and delayed reflexes. What is the priority
diagnostic test?
A. Thyroid-stimulating hormone (TSH) level
B. Complete blood count (CBC)
C. Fasting glucose
D. Lipid panel
Correct Answer: A. Thyroid-stimulating hormone (TSH) level
Rationale: Symptoms and findings suggest hypothyroidism; elevated TSH confirms (USPSTF
guidelines). CBC (B) for anemia; glucose (C) for diabetes; lipids (D) for dyslipidemia. Clinical
implication: Early diagnosis prevents cardiovascular complications. Assessment tip: Screen for
goiter.
Question 2: During a physical exam, the nurse notes a 60-year-old man's BP 150/90 mmHg
in the right arm and 140/85 mmHg in the left. What is the next step?
A. Repeat BP in 1 week
B. Obtain bilateral brachial and radial pulses
C. Order ECG
D. Start antihypertensive
Correct Answer: B. Obtain bilateral brachial and radial pulses
Rationale: Discrepancy >10 mmHg suggests subclavian stenosis or aortic dissection; pulse
assessment differentiates. Repeat (A) if isolated; ECG (C) for arrhythmia; antihypertensive (D)
after evaluation. Clinical implication: Detect vascular disease. Assessment tip: Compare bilateral
BP.
, Question 3: A 25-year-old woman has a BMI of 18 and irregular menses. What is the
priority exam finding to assess?
A. Thyroid enlargement
B. Abdominal tenderness
C. Breast discharge
D. Pelvic tenderness
Correct Answer: D. Pelvic tenderness
Rationale: Low BMI and amenorrhea suggest PCOS; pelvic exam assesses for ovarian cysts.
Thyroid (A) for hypo; abdominal (B) GI; breast (C) prolactinoma. Clinical implication:
Hormonal imbalance. Assessment tip: Include bimanual exam.
Question 4: A 70-year-old man has a painless lump in his neck. What is the priority
diagnostic test?
A. Fine-needle aspiration (FNA)
B. CT scan neck
C. Ultrasound
D. Both A and C
Correct Answer: D. Both A and C
Rationale: Ultrasound guides FNA for lymph node evaluation in elderly (NCCN guidelines). CT
(B) for staging later. Clinical implication: Rule out malignancy. Assessment tip: Palpate lymph
nodes systematically.
Question 5: During abdominal exam, the nurse notes shifting dullness. What does this
indicate?
A. Gas
B. Ascites
C. Constipation
D. Muscle rigidity
Correct Answer: B. Ascites
Rationale: Shifting dullness suggests free fluid in peritoneum (liver disease). Gas (A) tympany;
constipation (C) mass; rigidity (D) peritonitis. Clinical implication: Liver function tests.
Assessment tip: Percuss flanks.
Question 6: A 30-year-old man has unilateral knee swelling after trauma. What is the
priority test?
A. X-ray
B. MRI
C. Aspiration
