NUR 600 ADVANCED HEALTH
ASSESSMENT 200 QUESTION
MIDTERM MASTERY BANK
PEDIATRIC GERIATRIC AND ADULT
NUR 600 Midterm Practice Questions
What are the four primary components of a SOAP note?
The correct components are Subjective, Objective, Assessment,
and Plan.
Rationale: The SOAP note is a standard format used by advanced
practice nurses to organize clinical data; "Subjective" covers what the
patient reports, "Objective" includes physical exam findings,
"Assessment" is the diagnosis, and "Plan" details the treatment.
1. Which section of the health history contains the patient's
primary reason for seeking care in their own words?
This is documented in the Chief Complaint (CC).
Rationale: The Chief Complaint should be a concise statement,
often in the patient's own words, describing the symptom or
concern that prompted the visit.
2. What is included in the 'History of Present Illness' (HPI)
section?
The HPI is a chronological description of the development
of the patient's current illness from the first sign or
symptom to the present.
Rationale: It amplifies the chief complaint, incorporates pertinent
positives and negatives from the Review of Systems (ROS), and
includes the patient's feelings about the illness.
3. Which physical examination technique should always be
performed first when assessing the abdomen?
The first technique is Inspection.
Rationale: Inspection always precedes physical contact; for the
abdomen specifically, inspection is followed by auscultation to
avoid altering bowel sounds.
4. What are the key attributes used to characterize a
patient's symptom during an HPI?
, The attributes include Location, Quality, Quantity/Severity,
Timing (Onset, Duration, Frequency), Setting, Modifying
Factors, and Associated Manifestations.
Rationale: These attributes allow the clinician to fully "oldcart" or
"pqrst" a symptom to aid in diagnostic reasoning.
5. A patient presents with sharp, knifelike chest pain that
worsens when breathing or lying down but is relieved by
sitting forward. This is most indicative of:
The most likely diagnosis is Pericarditis.
Rationale: Positional chest pain that improves with leaning
forward is a hallmark sign of pericardial inflammation.
6. How is "Orthopnea" defined in a cardiovascular
assessment?
It is defined as dyspnea (shortness of breath) that occurs
when the patient is lying flat and is relieved by sitting up.
Rationale: Orthopnea is a common symptom of heart failure and
is often quantified by the number of pillows the patient requires to
sleep comfortably.
7. Which eye condition is characterized by a non-tender,
painless nodule caused by a blocked meibomian gland?
The condition is a Chalazion.
Rationale: This differentiates it from a hordeolum (stye), which is
an acute, tender, and painful infection of a lash follicle or gland.
8. What is the significance of "Auscultatory Gap" during
blood pressure measurement?
It is a silent interval that may be present between the
systolic and diastolic pressures, often found in older
hypertensive patients.
Rationale: Failure to recognize an auscultatory gap can lead to
an underestimation of systolic pressure or an overestimation of
diastolic pressure.
9. What are the classic symptoms of Meniere's Disease?
The triad includes severe vertigo, tinnitus, and
sensorineural hearing loss, often accompanied by a sensation
of ear fullness.
Rationale: These symptoms result from excessive fluid
(endolymph) buildup in the inner ear.
,10. Which cranial nerve is being tested when the NP
asks the patient to shrug their shoulders against
resistance?
The Spinal Accessory Nerve (Cranial Nerve XI).
Rationale: This nerve provides motor function to the trapezius
and sternocleidomastoid muscles.
11. In a general survey, what does "Apparent State of Health"
refer to?
It refers to whether the patient appears acutely or chronically
ill, frail, fit, or robust.
Rationale: This initial observation provides context for the
severity of the patient's condition.
12.What characterizes a 'Positive Murphy’s Sign'?
It is characterized by sharp tenderness and a sudden stop in
inspiratory effort (inspiratory arrest) when the clinician
palpates the right upper quadrant.
Rationale: This is a highly specific indicator of acute cholecystitis.
13.What is the 'Review of Systems' (ROS) intended to
uncover?
The ROS aims to uncover symptoms or problems the
patient may have overlooked or omitted during the HPI.
Rationale: It is a head-to-toe inquiry of symptoms across all body
systems, separate from the physical exam.
14.Which heart sound is considered pathological in adults
over 40 and often indicates heart failure or fluid
overload?
The S3 (Ventricular Gallop).
Rationale: While normal in children and young adults, an S3 in
older populations suggests a non-compliant or failing ventricle.
15. What is the hallmark physical exam finding for a
Pneumothorax?
Findings include decreased or absent breath sounds on the
affected side and hyper-resonance on percussion.
Rationale: Air in the pleural space prevents lung expansion and
prevents sound transmission.
16.Which type of skin lesion is described as a rough, scaly
patch that is a precursor to squamous cell carcinoma?
, This is an Actinic Keratosis.
Rationale: These are precancerous lesions caused by chronic sun
exposure.
17. What does a positive "Tinel’s Sign" at the wrist indicate?
It suggests Carpal Tunnel Syndrome.
Rationale: Light percussion over the median nerve at the wrist
that produces tingling or "pins and needles" is a positive finding.
18. What is the primary difference between BPPV and
Meniere's Disease?
Benign Paroxysmal Positional Vertigo (BPPV) is triggered
by head movement and lasts seconds,
whereas Meniere's includes hearing loss and lasts for hours.
Rationale: BPPV is caused by displaced otoliths (crystals) in the
semicircular canals.
19.Which physical exam maneuver is used to assess for an
ACL tear?
The Lachman Test (or Anterior Drawer Test).
Rationale: The Lachman test is considered the most sensitive
maneuver for assessing the integrity of the anterior cruciate
ligament.
20. What is the significance of 'AV Nicking' on a
fundoscopic exam?
It is a sign of Hypertensive Retinal Damage where an artery
crosses over a vein, causing the vein to appear compressed.
Rationale: Chronic high blood pressure leads to vascular wall
thickening and visible changes in the retina.
21.What are the ABCDEs of melanoma screening?
They stand for Asymmetry, Border irregularity, Color
variation, Diameter (>6mm), and Evolving.
Rationale: These criteria help distinguish benign moles from
potentially malignant melanoma.
22. Which heart valve closure marks the start of systole?
The closure of the Mitral and Tricuspid valves (S1 sound).
Rationale: S1 corresponds to the "lub" sound and indicates the
ventricles have begun to contract.
23. A patient presents with sudden, severe RLQ pain,
amenorrhea, and a pelvic mass. What is the priority
ASSESSMENT 200 QUESTION
MIDTERM MASTERY BANK
PEDIATRIC GERIATRIC AND ADULT
NUR 600 Midterm Practice Questions
What are the four primary components of a SOAP note?
The correct components are Subjective, Objective, Assessment,
and Plan.
Rationale: The SOAP note is a standard format used by advanced
practice nurses to organize clinical data; "Subjective" covers what the
patient reports, "Objective" includes physical exam findings,
"Assessment" is the diagnosis, and "Plan" details the treatment.
1. Which section of the health history contains the patient's
primary reason for seeking care in their own words?
This is documented in the Chief Complaint (CC).
Rationale: The Chief Complaint should be a concise statement,
often in the patient's own words, describing the symptom or
concern that prompted the visit.
2. What is included in the 'History of Present Illness' (HPI)
section?
The HPI is a chronological description of the development
of the patient's current illness from the first sign or
symptom to the present.
Rationale: It amplifies the chief complaint, incorporates pertinent
positives and negatives from the Review of Systems (ROS), and
includes the patient's feelings about the illness.
3. Which physical examination technique should always be
performed first when assessing the abdomen?
The first technique is Inspection.
Rationale: Inspection always precedes physical contact; for the
abdomen specifically, inspection is followed by auscultation to
avoid altering bowel sounds.
4. What are the key attributes used to characterize a
patient's symptom during an HPI?
, The attributes include Location, Quality, Quantity/Severity,
Timing (Onset, Duration, Frequency), Setting, Modifying
Factors, and Associated Manifestations.
Rationale: These attributes allow the clinician to fully "oldcart" or
"pqrst" a symptom to aid in diagnostic reasoning.
5. A patient presents with sharp, knifelike chest pain that
worsens when breathing or lying down but is relieved by
sitting forward. This is most indicative of:
The most likely diagnosis is Pericarditis.
Rationale: Positional chest pain that improves with leaning
forward is a hallmark sign of pericardial inflammation.
6. How is "Orthopnea" defined in a cardiovascular
assessment?
It is defined as dyspnea (shortness of breath) that occurs
when the patient is lying flat and is relieved by sitting up.
Rationale: Orthopnea is a common symptom of heart failure and
is often quantified by the number of pillows the patient requires to
sleep comfortably.
7. Which eye condition is characterized by a non-tender,
painless nodule caused by a blocked meibomian gland?
The condition is a Chalazion.
Rationale: This differentiates it from a hordeolum (stye), which is
an acute, tender, and painful infection of a lash follicle or gland.
8. What is the significance of "Auscultatory Gap" during
blood pressure measurement?
It is a silent interval that may be present between the
systolic and diastolic pressures, often found in older
hypertensive patients.
Rationale: Failure to recognize an auscultatory gap can lead to
an underestimation of systolic pressure or an overestimation of
diastolic pressure.
9. What are the classic symptoms of Meniere's Disease?
The triad includes severe vertigo, tinnitus, and
sensorineural hearing loss, often accompanied by a sensation
of ear fullness.
Rationale: These symptoms result from excessive fluid
(endolymph) buildup in the inner ear.
,10. Which cranial nerve is being tested when the NP
asks the patient to shrug their shoulders against
resistance?
The Spinal Accessory Nerve (Cranial Nerve XI).
Rationale: This nerve provides motor function to the trapezius
and sternocleidomastoid muscles.
11. In a general survey, what does "Apparent State of Health"
refer to?
It refers to whether the patient appears acutely or chronically
ill, frail, fit, or robust.
Rationale: This initial observation provides context for the
severity of the patient's condition.
12.What characterizes a 'Positive Murphy’s Sign'?
It is characterized by sharp tenderness and a sudden stop in
inspiratory effort (inspiratory arrest) when the clinician
palpates the right upper quadrant.
Rationale: This is a highly specific indicator of acute cholecystitis.
13.What is the 'Review of Systems' (ROS) intended to
uncover?
The ROS aims to uncover symptoms or problems the
patient may have overlooked or omitted during the HPI.
Rationale: It is a head-to-toe inquiry of symptoms across all body
systems, separate from the physical exam.
14.Which heart sound is considered pathological in adults
over 40 and often indicates heart failure or fluid
overload?
The S3 (Ventricular Gallop).
Rationale: While normal in children and young adults, an S3 in
older populations suggests a non-compliant or failing ventricle.
15. What is the hallmark physical exam finding for a
Pneumothorax?
Findings include decreased or absent breath sounds on the
affected side and hyper-resonance on percussion.
Rationale: Air in the pleural space prevents lung expansion and
prevents sound transmission.
16.Which type of skin lesion is described as a rough, scaly
patch that is a precursor to squamous cell carcinoma?
, This is an Actinic Keratosis.
Rationale: These are precancerous lesions caused by chronic sun
exposure.
17. What does a positive "Tinel’s Sign" at the wrist indicate?
It suggests Carpal Tunnel Syndrome.
Rationale: Light percussion over the median nerve at the wrist
that produces tingling or "pins and needles" is a positive finding.
18. What is the primary difference between BPPV and
Meniere's Disease?
Benign Paroxysmal Positional Vertigo (BPPV) is triggered
by head movement and lasts seconds,
whereas Meniere's includes hearing loss and lasts for hours.
Rationale: BPPV is caused by displaced otoliths (crystals) in the
semicircular canals.
19.Which physical exam maneuver is used to assess for an
ACL tear?
The Lachman Test (or Anterior Drawer Test).
Rationale: The Lachman test is considered the most sensitive
maneuver for assessing the integrity of the anterior cruciate
ligament.
20. What is the significance of 'AV Nicking' on a
fundoscopic exam?
It is a sign of Hypertensive Retinal Damage where an artery
crosses over a vein, causing the vein to appear compressed.
Rationale: Chronic high blood pressure leads to vascular wall
thickening and visible changes in the retina.
21.What are the ABCDEs of melanoma screening?
They stand for Asymmetry, Border irregularity, Color
variation, Diameter (>6mm), and Evolving.
Rationale: These criteria help distinguish benign moles from
potentially malignant melanoma.
22. Which heart valve closure marks the start of systole?
The closure of the Mitral and Tricuspid valves (S1 sound).
Rationale: S1 corresponds to the "lub" sound and indicates the
ventricles have begun to contract.
23. A patient presents with sudden, severe RLQ pain,
amenorrhea, and a pelvic mass. What is the priority
