NURS 6512N MIDTERM EXAM 2025 — ALL 100
QUESTIONS AND ANSWERS (ALREADY GRADED)
1. During a health-history interview, the patient states, “I’ve been having chest
pain.” The FNP’s best immediate response is:
A. “Chest pain can be serious.”
B. “Does it hurt right now?”
C. “Can you describe the pain for me?”
C. Open-ended follow-up elicits the patient’s description, supporting a complete
PQRST assessment; closed questions limit data.
2. Which finding is a normal variant on inspection of adult skin?
A. Petechiae on forearms
B. Solar lentigines on dorsum of hands
C. Purpura on lower legs
D. Ecchymosis over scapula
B. Solar lentigines are benign age-related macules; the others indicate bleeding
disorders or trauma.
3. When assessing capillary refill, the FNP depresses the nail bed for 5 seconds and
observes return of color in 4 seconds. This finding is:
A. Brisk and normal
B. Slightly delayed, suggesting possible hypoperfusion
C. Rapid, indicating hyperthyroidism
D. Irrelevant in adults
B. Normal refill ≤ 2 seconds; 4 seconds can indicate early hypovolemia or
vasoconstriction.
4. A patient’s BP is 148/92 mmHg on two separate occasions. The FNP documents:
A. Normal BP
B. Hypertension, Stage 1
C. Elevated BP
D. Hypertensive crisis
B. ACC/AHA 2025: Stage 1 HTN = 130–139 systolic OR 80–89 diastolic; 148/92
meets criteria.
5. The FNP notes a respiratory rate of 26 breaths/min in a resting adult. This is:
A. Within normal limits
B. Tachypnea
C. Bradypnea
D. Hyperpnea
B. Adult normal 12–20 breaths/min; > 20 = tachypnea.
pg. 1
, 6. Which technique correctly tests cranial nerve II?
A. Whisper test
B. Snellen chart at 20 ft
C. Rinne test
D. Weber test
B. CN II = optic; Snellen assesses visual acuity.
7. On otoscopic exam, the tympanic membrane appears pearly gray, translucent,
and has a light reflex at 5 o’clock. This is:
A. Normal finding
B. Acute otitis media
C. Serous effusion
D. Perforation
A. Normal TM is pearly gray, translucent, with cone of light; other choices
describe pathology.
8. The FNP palpates a firm, non-tender 1 cm submandibular lymph node in an
adult. It is mobile and soft. This is:
A. Malignant until proven otherwise
B. Likely benign/reactive
C. Indicative of HIV infection
D. Always pathologic
B. Small (< 1 cm), soft, mobile nodes are usually reactive; hard, fixed, or > 1 cm
warrant further workup.
9. Which voice sound is used to assess for consolidation in the lungs?
A. Whispered pectoriloquy
B. Bronchophony
C. Egophony
D. All of the above
D. All are vocal resonance tests; increased clarity (bronchophony), nasal twang
(egophony), or distinct words (whispered pectoriloquy) suggest consolidation.
10. The point of maximal impulse (PMI) is normally located:
A. 2 cm right of sternum, 4th intercostal space
B. 5th intercostal space, mid-clavicular line
C. 3rd intercostal space, anterior axillary line
D. 2nd intercostal space, left sternal border
B. Normal PMI = 5th ICS, MCL; other locations suggest cardiac enlargement or
dextrocardia.
11. A grade 3/6 systolic murmur is:
A. Barely audible
B. Moderately loud, no thrill
C. Loud with palpable thrill
pg. 2
, D. Heard with stethoscope off chest
B. Levine scale: grade 3 moderate loudness without thrill; grade 4 adds thrill.
12. The FNP auscultates S3 gallop in a 70-year-old with dyspnea. This finding most
often indicates:
A. Normal aging
B. Ventricular dysfunction/heart failure
C. Mitral stenosis
D. Athletic heart
B. S3 in adults > 40 yrs is pathologic and reflects volume overload or systolic
dysfunction.
13. Which abdominal finding suggests ascites?
A. Tympany throughout
B. Shifting dullness on percussion
C. Hyperactive bowel sounds
D. Guarding
B. Shifting dullness = fluid (ascites); tympany is gas, guarding suggests
peritonitis.
14. Murphy’s sign is positive when:
A. Pain is felt with passive hip flexion
B. Patient stops inspiration during palpation of right upper quadrant
C. Rebound tenderness is present
D. Psoas sign is elicited
B. Murphy’s = inspiratory arrest on RUQ palpation → acute cholecystitis.
15. Which reflex is tested with a reflex hammer at the patellar tendon?
A. Achilles
B. Patellar (L3-L4)
C. Biceps
D. Triceps
B. Patellar reflex tests femoral nerve and L3-L4 segments.
16. A patient cannot identify a penny placed in the hand with eyes closed. This is:
A. Astereognosis
B. Stereognosis impairment
C. Graphesthesia
D. Extinction
B. Inability to recognize objects by touch = impaired stereognosis; astereognosis
is the term, but “impairment” best matches stem.
17. The FNP notes a positive Romberg test. This indicates:
A. Cerebellar ataxia
B. Proprioceptive or vestibular dysfunction
C. Parkinsonian rigidity
pg. 3
QUESTIONS AND ANSWERS (ALREADY GRADED)
1. During a health-history interview, the patient states, “I’ve been having chest
pain.” The FNP’s best immediate response is:
A. “Chest pain can be serious.”
B. “Does it hurt right now?”
C. “Can you describe the pain for me?”
C. Open-ended follow-up elicits the patient’s description, supporting a complete
PQRST assessment; closed questions limit data.
2. Which finding is a normal variant on inspection of adult skin?
A. Petechiae on forearms
B. Solar lentigines on dorsum of hands
C. Purpura on lower legs
D. Ecchymosis over scapula
B. Solar lentigines are benign age-related macules; the others indicate bleeding
disorders or trauma.
3. When assessing capillary refill, the FNP depresses the nail bed for 5 seconds and
observes return of color in 4 seconds. This finding is:
A. Brisk and normal
B. Slightly delayed, suggesting possible hypoperfusion
C. Rapid, indicating hyperthyroidism
D. Irrelevant in adults
B. Normal refill ≤ 2 seconds; 4 seconds can indicate early hypovolemia or
vasoconstriction.
4. A patient’s BP is 148/92 mmHg on two separate occasions. The FNP documents:
A. Normal BP
B. Hypertension, Stage 1
C. Elevated BP
D. Hypertensive crisis
B. ACC/AHA 2025: Stage 1 HTN = 130–139 systolic OR 80–89 diastolic; 148/92
meets criteria.
5. The FNP notes a respiratory rate of 26 breaths/min in a resting adult. This is:
A. Within normal limits
B. Tachypnea
C. Bradypnea
D. Hyperpnea
B. Adult normal 12–20 breaths/min; > 20 = tachypnea.
pg. 1
, 6. Which technique correctly tests cranial nerve II?
A. Whisper test
B. Snellen chart at 20 ft
C. Rinne test
D. Weber test
B. CN II = optic; Snellen assesses visual acuity.
7. On otoscopic exam, the tympanic membrane appears pearly gray, translucent,
and has a light reflex at 5 o’clock. This is:
A. Normal finding
B. Acute otitis media
C. Serous effusion
D. Perforation
A. Normal TM is pearly gray, translucent, with cone of light; other choices
describe pathology.
8. The FNP palpates a firm, non-tender 1 cm submandibular lymph node in an
adult. It is mobile and soft. This is:
A. Malignant until proven otherwise
B. Likely benign/reactive
C. Indicative of HIV infection
D. Always pathologic
B. Small (< 1 cm), soft, mobile nodes are usually reactive; hard, fixed, or > 1 cm
warrant further workup.
9. Which voice sound is used to assess for consolidation in the lungs?
A. Whispered pectoriloquy
B. Bronchophony
C. Egophony
D. All of the above
D. All are vocal resonance tests; increased clarity (bronchophony), nasal twang
(egophony), or distinct words (whispered pectoriloquy) suggest consolidation.
10. The point of maximal impulse (PMI) is normally located:
A. 2 cm right of sternum, 4th intercostal space
B. 5th intercostal space, mid-clavicular line
C. 3rd intercostal space, anterior axillary line
D. 2nd intercostal space, left sternal border
B. Normal PMI = 5th ICS, MCL; other locations suggest cardiac enlargement or
dextrocardia.
11. A grade 3/6 systolic murmur is:
A. Barely audible
B. Moderately loud, no thrill
C. Loud with palpable thrill
pg. 2
, D. Heard with stethoscope off chest
B. Levine scale: grade 3 moderate loudness without thrill; grade 4 adds thrill.
12. The FNP auscultates S3 gallop in a 70-year-old with dyspnea. This finding most
often indicates:
A. Normal aging
B. Ventricular dysfunction/heart failure
C. Mitral stenosis
D. Athletic heart
B. S3 in adults > 40 yrs is pathologic and reflects volume overload or systolic
dysfunction.
13. Which abdominal finding suggests ascites?
A. Tympany throughout
B. Shifting dullness on percussion
C. Hyperactive bowel sounds
D. Guarding
B. Shifting dullness = fluid (ascites); tympany is gas, guarding suggests
peritonitis.
14. Murphy’s sign is positive when:
A. Pain is felt with passive hip flexion
B. Patient stops inspiration during palpation of right upper quadrant
C. Rebound tenderness is present
D. Psoas sign is elicited
B. Murphy’s = inspiratory arrest on RUQ palpation → acute cholecystitis.
15. Which reflex is tested with a reflex hammer at the patellar tendon?
A. Achilles
B. Patellar (L3-L4)
C. Biceps
D. Triceps
B. Patellar reflex tests femoral nerve and L3-L4 segments.
16. A patient cannot identify a penny placed in the hand with eyes closed. This is:
A. Astereognosis
B. Stereognosis impairment
C. Graphesthesia
D. Extinction
B. Inability to recognize objects by touch = impaired stereognosis; astereognosis
is the term, but “impairment” best matches stem.
17. The FNP notes a positive Romberg test. This indicates:
A. Cerebellar ataxia
B. Proprioceptive or vestibular dysfunction
C. Parkinsonian rigidity
pg. 3
