MARYVILLE NURS 612 EXAM 2 ADVANCED
HEALTH ASSESSMENT OA ACTUAL EXAM
STUDY GUIDE 2025/2026 COMPLETE
QUESTION BANK AND CORRECT DETAILED
ANSWERS WITH RATIONALES || 100%
GUARANTEED PASS <LATEST VERSION>
NURS 612 Advanced Health Assessment: Exam 2 Question Bank
1. A 65-year-old patient with a history of hypertension presents for a routine
physical. During auscultation of the carotid arteries, you note a medium-
pitched, harsh sound heard throughout systole. This is most consistent with:
A. A carotid bruit
B. A venous hum
C. A transmitted cardiac murmur
D. A normal finding in an older adult
Answer: A. A carotid bruit
Rationale: A bruit is a blowing, swooshing sound caused by turbulent blood flow
through a narrowed or irregular artery. A carotid bruit is specifically heard over the
carotid artery and indicates atherosclerotic plaque, which is a risk factor for stroke.
A venous hum (B) is a continuous sound heard in the neck, often in children or
anemic patients. A transmitted cardiac murmur (C) would be loudest over the
precordium, not the neck. While atherosclerosis is more common with age, a
carotid bruit is never a normal finding (D).
2. When assessing the precordium of a patient, you palpate a pulsation at the
5th intercostal space, left midclavicular line. You document this as the:
A. Aortic area
B. Pulmonic area
C. Point of Maximal Impulse (PMI)
D. Tricuspid area
,Answer: C. Point of Maximal Impulse (PMI)
Rationale: The PMI is the location where the apical pulse is palpated most
strongly, typically at the 5th intercostal space at or just medial to the left
midclavicular line. It corresponds to the apex of the heart. The aortic area (A) is at
the 2nd right intercostal space, the pulmonic (B) at the 2nd left, and the tricuspid
(D) at the 4th or 5th left lower sternal border.
3. During a cardiovascular exam, you auscultate a high-pitched, blowing,
decrescendo diastolic murmur at the 2nd right intercostal space. This finding
is most suggestive of:
A. Aortic Stenosis
B. Mitral Regurgitation
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: C. Aortic Regurgitation
Rationale: Aortic regurgitation produces a diastolic murmur as blood flows back
from the aorta into the left ventricle during diastole. It is best heard at the 2nd right
intercostal space (aortic area) with the patient leaning forward. Aortic stenosis (A)
is a systolic murmur. Mitral regurgitation (B) is a holosystolic murmur. Mitral
stenosis (D) is a diastolic murmur but is low-pitched and rumbling, heard best at
the apex.
4. The Allen test is performed to assess:
A. Patency of the radial and ulnar arteries
B. Deep vein thrombosis in the lower extremities
C. Capillary refill in the fingertips
D. Carotid artery blood flow
Answer: A. Patency of the radial and ulnar arteries
Rationale: The Allen test is used to evaluate the adequacy of collateral circulation
(via the ulnar artery) before performing a radial artery puncture. The patient makes
a fist, the examiner occludes both radial and ulnar arteries, the patient opens their
hand, pressure on the ulnar artery is released, and color should return to the palm
within 5-6 seconds, indicating patent ulnar artery.
,5. A 55-year-old patient presents with unilateral leg swelling, warmth, and
tenderness along the calf. The Homan's sign is positive. The most appropriate
initial action is to:
A. Order a Doppler ultrasound to rule out Deep Vein Thrombosis (DVT)
B. Massage the calf to relieve the spasm
C. Apply warm compresses and advise rest
D. Instruct the patient to ambulate frequently to promote circulation
Answer: A. Order a Doppler ultrasound to rule out Deep Vein Thrombosis
(DVT)
Rationale: Unilateral leg swelling, warmth, tenderness, and a positive Homan's
sign (pain in the calf on dorsiflexion of the foot) are classic signs of a DVT. The
Homan's sign is unreliable, but the clinical presentation is highly suspicious. The
initial action is diagnostic confirmation with a Doppler ultrasound to prevent a
potentially fatal pulmonary embolism. Massaging (B) or ambulating (D) could
dislodge the clot.
6. When percussing the abdomen, a tympanitic sound is heard over most of
the abdomen. This is expected because tympany is the sound produced by:
A. A solid organ like the liver
B. A fluid-filled structure
C. Air-filled viscera like the stomach and intestines
D. Dense fecal matter
Answer: C. Air-filled viscera like the stomach and intestines
Rationale: Tympany is a high-pitched, drum-like sound produced when percussing
over an air-filled cavity. Since the stomach and intestines contain air, tympany is
the predominant sound during abdominal percussion. Dullness (A & B) is heard
over solid or fluid-filled structures.
7. A patient complains of sharp, right upper quadrant pain that radiates to the
right scapula. This pattern of pain is most commonly associated with:
A. Acute pancreatitis
B. Acute cholecystitis
C. Appendicitis
D. Peptic ulcer disease
, Answer: B. Acute cholecystitis
Rationale: Pain from cholecystitis (inflammation of the gallbladder) often
localizes to the right upper quadrant and can refer to the right scapular region due
to shared nerve pathways (phrenic nerve irritation). Pancreatitis (A) pain is
typically epigastric and may radiate to the back. Appendicitis (C) pain starts
periumbilical and migrates to the right lower quadrant. Peptic ulcer disease (D)
pain is often epigastric and burning.
8. During a musculoskeletal exam, you ask the patient to "rotate the forearm
so that the palm is facing down." You document this movement as:
A. Supination
B. Pronation
C. Eversion
D. Inversion
Answer: B. Pronation
Rationale: Pronation is the rotation of the forearm that turns the palm posteriorly
or downward. Supination (A) is the opposite movement (palm up). Eversion (C)
and inversion (D) are movements of the ankle.
9. The Glasgow Coma Scale (GCS) is used to assess a patient's level of
consciousness. The three components scored are:
A. Memory, Orientation, Calculation
B. Eye Opening, Verbal Response, Motor Response
C. Cranial Nerves, Reflexes, Sensation
D. Affect, Behavior, Speech
Answer: B. Eye Opening, Verbal Response, Motor Response
Rationale: The GCS is a standardized tool for assessing impaired consciousness. It
scores three categories: Eye Opening (1-4), Verbal Response (1-5), and Motor
Response (1-6), with a total score ranging from 3 (deeply comatose) to 15 (fully
alert).
10. To test the function of Cranial Nerve VIII (Acoustic), the nurse
practitioner should:
A. Test for air and bone conduction (Rinne test) and check for lateralization
(Weber test)
HEALTH ASSESSMENT OA ACTUAL EXAM
STUDY GUIDE 2025/2026 COMPLETE
QUESTION BANK AND CORRECT DETAILED
ANSWERS WITH RATIONALES || 100%
GUARANTEED PASS <LATEST VERSION>
NURS 612 Advanced Health Assessment: Exam 2 Question Bank
1. A 65-year-old patient with a history of hypertension presents for a routine
physical. During auscultation of the carotid arteries, you note a medium-
pitched, harsh sound heard throughout systole. This is most consistent with:
A. A carotid bruit
B. A venous hum
C. A transmitted cardiac murmur
D. A normal finding in an older adult
Answer: A. A carotid bruit
Rationale: A bruit is a blowing, swooshing sound caused by turbulent blood flow
through a narrowed or irregular artery. A carotid bruit is specifically heard over the
carotid artery and indicates atherosclerotic plaque, which is a risk factor for stroke.
A venous hum (B) is a continuous sound heard in the neck, often in children or
anemic patients. A transmitted cardiac murmur (C) would be loudest over the
precordium, not the neck. While atherosclerosis is more common with age, a
carotid bruit is never a normal finding (D).
2. When assessing the precordium of a patient, you palpate a pulsation at the
5th intercostal space, left midclavicular line. You document this as the:
A. Aortic area
B. Pulmonic area
C. Point of Maximal Impulse (PMI)
D. Tricuspid area
,Answer: C. Point of Maximal Impulse (PMI)
Rationale: The PMI is the location where the apical pulse is palpated most
strongly, typically at the 5th intercostal space at or just medial to the left
midclavicular line. It corresponds to the apex of the heart. The aortic area (A) is at
the 2nd right intercostal space, the pulmonic (B) at the 2nd left, and the tricuspid
(D) at the 4th or 5th left lower sternal border.
3. During a cardiovascular exam, you auscultate a high-pitched, blowing,
decrescendo diastolic murmur at the 2nd right intercostal space. This finding
is most suggestive of:
A. Aortic Stenosis
B. Mitral Regurgitation
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: C. Aortic Regurgitation
Rationale: Aortic regurgitation produces a diastolic murmur as blood flows back
from the aorta into the left ventricle during diastole. It is best heard at the 2nd right
intercostal space (aortic area) with the patient leaning forward. Aortic stenosis (A)
is a systolic murmur. Mitral regurgitation (B) is a holosystolic murmur. Mitral
stenosis (D) is a diastolic murmur but is low-pitched and rumbling, heard best at
the apex.
4. The Allen test is performed to assess:
A. Patency of the radial and ulnar arteries
B. Deep vein thrombosis in the lower extremities
C. Capillary refill in the fingertips
D. Carotid artery blood flow
Answer: A. Patency of the radial and ulnar arteries
Rationale: The Allen test is used to evaluate the adequacy of collateral circulation
(via the ulnar artery) before performing a radial artery puncture. The patient makes
a fist, the examiner occludes both radial and ulnar arteries, the patient opens their
hand, pressure on the ulnar artery is released, and color should return to the palm
within 5-6 seconds, indicating patent ulnar artery.
,5. A 55-year-old patient presents with unilateral leg swelling, warmth, and
tenderness along the calf. The Homan's sign is positive. The most appropriate
initial action is to:
A. Order a Doppler ultrasound to rule out Deep Vein Thrombosis (DVT)
B. Massage the calf to relieve the spasm
C. Apply warm compresses and advise rest
D. Instruct the patient to ambulate frequently to promote circulation
Answer: A. Order a Doppler ultrasound to rule out Deep Vein Thrombosis
(DVT)
Rationale: Unilateral leg swelling, warmth, tenderness, and a positive Homan's
sign (pain in the calf on dorsiflexion of the foot) are classic signs of a DVT. The
Homan's sign is unreliable, but the clinical presentation is highly suspicious. The
initial action is diagnostic confirmation with a Doppler ultrasound to prevent a
potentially fatal pulmonary embolism. Massaging (B) or ambulating (D) could
dislodge the clot.
6. When percussing the abdomen, a tympanitic sound is heard over most of
the abdomen. This is expected because tympany is the sound produced by:
A. A solid organ like the liver
B. A fluid-filled structure
C. Air-filled viscera like the stomach and intestines
D. Dense fecal matter
Answer: C. Air-filled viscera like the stomach and intestines
Rationale: Tympany is a high-pitched, drum-like sound produced when percussing
over an air-filled cavity. Since the stomach and intestines contain air, tympany is
the predominant sound during abdominal percussion. Dullness (A & B) is heard
over solid or fluid-filled structures.
7. A patient complains of sharp, right upper quadrant pain that radiates to the
right scapula. This pattern of pain is most commonly associated with:
A. Acute pancreatitis
B. Acute cholecystitis
C. Appendicitis
D. Peptic ulcer disease
, Answer: B. Acute cholecystitis
Rationale: Pain from cholecystitis (inflammation of the gallbladder) often
localizes to the right upper quadrant and can refer to the right scapular region due
to shared nerve pathways (phrenic nerve irritation). Pancreatitis (A) pain is
typically epigastric and may radiate to the back. Appendicitis (C) pain starts
periumbilical and migrates to the right lower quadrant. Peptic ulcer disease (D)
pain is often epigastric and burning.
8. During a musculoskeletal exam, you ask the patient to "rotate the forearm
so that the palm is facing down." You document this movement as:
A. Supination
B. Pronation
C. Eversion
D. Inversion
Answer: B. Pronation
Rationale: Pronation is the rotation of the forearm that turns the palm posteriorly
or downward. Supination (A) is the opposite movement (palm up). Eversion (C)
and inversion (D) are movements of the ankle.
9. The Glasgow Coma Scale (GCS) is used to assess a patient's level of
consciousness. The three components scored are:
A. Memory, Orientation, Calculation
B. Eye Opening, Verbal Response, Motor Response
C. Cranial Nerves, Reflexes, Sensation
D. Affect, Behavior, Speech
Answer: B. Eye Opening, Verbal Response, Motor Response
Rationale: The GCS is a standardized tool for assessing impaired consciousness. It
scores three categories: Eye Opening (1-4), Verbal Response (1-5), and Motor
Response (1-6), with a total score ranging from 3 (deeply comatose) to 15 (fully
alert).
10. To test the function of Cranial Nerve VIII (Acoustic), the nurse
practitioner should:
A. Test for air and bone conduction (Rinne test) and check for lateralization
(Weber test)
