NUR 643E Advanced Health Assessment Final Exam
(2025/2026) – 2 Verified Versions (A & B) | Actual
Exam Questions with 100% Correct Answers and
Detailed Rationales | Graded A+
Q1. A 52-year-old male presents with dull, aching left lower quadrant pain for 3 days.
Rebound tenderness and guarding present. Most likely diagnosis? Diverticulitis.
Rationale: LLQ pain + rebound + guarding = left-sided diverticular inflammation.
Q2. On thyroid inspection, you note asymmetric enlargement with visible nodule. Next
step? Palpate nodule, check lymphadenopathy, order thyroid ultrasound.
Rationale: ATA 2024: any visible nodule requires US ± FNA.
Q3. Positive Rovsing sign indicates? Appendicitis. Rationale: RLQ pain when palpating
LLQ.
Q4. Normal location of point of maximal impulse (PMI)? 5th intercostal space,
midclavicular line. Rationale: Displacement suggests cardiomegaly or dextrocardia.
Q5. 34-year-old female with 2 cm firm, mobile breast mass in upper outer quadrant. No
skin changes. Next step? Diagnostic mammogram + ultrasound. Rationale: Age >30
→ mammogram first (BIRADS).
Q6. Erythematous plaques with silvery scales on extensor surfaces? Psoriasis.
Rationale: Auspitz sign, Koebner phenomenon.
Q7. High-pitched blowing systolic murmur at 2nd right ICS radiating to carotids? Aortic
stenosis. Rationale: Crescendo-decrescendo, radiates to neck.
, Q8. Positive Phalen test within 60 seconds? Carpal tunnel syndrome. Rationale:
Median nerve compression.
Q9. 68-year-old male with sudden tearing chest pain to back, unequal arm BP? Aortic
dissection. Rationale: Type A emergency; CXR may show widened mediastinum.
Q10. Weber test lateralizes to affected ear? Conductive hearing loss. Rationale: Bone
> air conduction in affected ear.
Q11. High-pitched inspiratory stridor at rest in a child? Croup. Rationale: Steeple sign,
barking cough.
Q12. Romberg test assesses? Proprioception/cerebellar function. Rationale: Positive
= sway with eyes closed.
Q13. Positive McMurray test? Meniscal tear. Rationale: Pain/click with tibial rotation.
Q14. Earliest sign of increased ICP? Change in LOC. Rationale: Cushing triad is late
finding.
Q15. 28-year-old female with irregular menses, hirsutism, acne? PCOS. Rationale:
Rotterdam criteria (2 of 3).
Q16. Positive Murphy sign? Acute cholecystitis. Rationale: Pain on inspiration during
RUQ palpation.
(2025/2026) – 2 Verified Versions (A & B) | Actual
Exam Questions with 100% Correct Answers and
Detailed Rationales | Graded A+
Q1. A 52-year-old male presents with dull, aching left lower quadrant pain for 3 days.
Rebound tenderness and guarding present. Most likely diagnosis? Diverticulitis.
Rationale: LLQ pain + rebound + guarding = left-sided diverticular inflammation.
Q2. On thyroid inspection, you note asymmetric enlargement with visible nodule. Next
step? Palpate nodule, check lymphadenopathy, order thyroid ultrasound.
Rationale: ATA 2024: any visible nodule requires US ± FNA.
Q3. Positive Rovsing sign indicates? Appendicitis. Rationale: RLQ pain when palpating
LLQ.
Q4. Normal location of point of maximal impulse (PMI)? 5th intercostal space,
midclavicular line. Rationale: Displacement suggests cardiomegaly or dextrocardia.
Q5. 34-year-old female with 2 cm firm, mobile breast mass in upper outer quadrant. No
skin changes. Next step? Diagnostic mammogram + ultrasound. Rationale: Age >30
→ mammogram first (BIRADS).
Q6. Erythematous plaques with silvery scales on extensor surfaces? Psoriasis.
Rationale: Auspitz sign, Koebner phenomenon.
Q7. High-pitched blowing systolic murmur at 2nd right ICS radiating to carotids? Aortic
stenosis. Rationale: Crescendo-decrescendo, radiates to neck.
, Q8. Positive Phalen test within 60 seconds? Carpal tunnel syndrome. Rationale:
Median nerve compression.
Q9. 68-year-old male with sudden tearing chest pain to back, unequal arm BP? Aortic
dissection. Rationale: Type A emergency; CXR may show widened mediastinum.
Q10. Weber test lateralizes to affected ear? Conductive hearing loss. Rationale: Bone
> air conduction in affected ear.
Q11. High-pitched inspiratory stridor at rest in a child? Croup. Rationale: Steeple sign,
barking cough.
Q12. Romberg test assesses? Proprioception/cerebellar function. Rationale: Positive
= sway with eyes closed.
Q13. Positive McMurray test? Meniscal tear. Rationale: Pain/click with tibial rotation.
Q14. Earliest sign of increased ICP? Change in LOC. Rationale: Cushing triad is late
finding.
Q15. 28-year-old female with irregular menses, hirsutism, acne? PCOS. Rationale:
Rotterdam criteria (2 of 3).
Q16. Positive Murphy sign? Acute cholecystitis. Rationale: Pain on inspiration during
RUQ palpation.
