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NR607 PRE-DIAGNOSTIC EXAM CHAMBERLAIN
OFFICIAL PRACTICE EXAM 2026/2027 Actual
Exam 2026/2027 with Detailed Rationales Complete
Exam-Style Questions Pass Guaranteed – A+ Graded
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TABLE OF CONTENTS
Section 1 | Advanced Health Assessment | Q1 – Q10
Section 2 | Pathophysiology Across the Lifespan | Q11 – Q20
Section 3 | Pharmacology & Clinical Management | Q21 – Q30
Section 4 | Diagnostic Reasoning & Differential Diagnosis | Q31 – Q40
Section 5 | Evidence-Based Practice & Professional Role | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
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SECTION 1: ADVANCED HEALTH ASSESSMENT Q1 – Q10
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Question 1 of 50
A 55-year-old male presents for a routine physical examination. During auscultation of the heart,
the nurse practitioner hears a harsh, crescendo-decrescendo systolic murmur best heard at the
right second intercostal space, radiating to the carotids. Which of the following valvular defects
is most consistent with this finding?
A. Mitral regurgitation
B. Aortic stenosis
,2
C. Tricuspid regurgitation
D. Mitral stenosis
Correct Answer: B
Rationale: Aortic stenosis typically produces a harsh, crescendo-decrescendo systolic murmur
heard best at the right second intercostal space (aortic area) with radiation to the carotids. Mitral
regurgitation usually presents as a holosystolic murmur at the apex radiating to the axilla.
Tricuspid regurgitation is also holosystolic but is heard best at the lower left sternal border.
Mitral stenosis is a diastolic murmur heard best at the apex.
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Question 2 of 50
A 30-year-old female presents with complaints of diffuse, "aching" abdominal pain and bloating
that worsens as the day progresses. She reports the pain is relieved with defecation. On physical
examination, the abdomen is soft and non-tender, but the patient notes discomfort during
palpation of the left lower quadrant. Based on the history, which assessment technique is most
appropriate to evaluate for tenderness specific to her condition?
A. Deep palpation of the epigastrium
B. Rebound tenderness testing at McBurney’s point
C. Shaking tenderness over the right flank
D. Light palpation of the left lower quadrant
Correct Answer: D
Rationale: The patient's symptoms suggest Irritable Bowel Syndrome (IBS), often associated
with left lower quadrant discomfort. Light palpation is the initial step to assess for superficial
tenderness and muscle guarding; deep palpation may be unnecessary or painful if the area is
already tender. Rebound tenderness suggests peritoneal irritation (not indicated here). Shaking
tenderness assesses for pyelonephritis.
,3
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Question 3 of 50
During a well-child visit for a 4-year-old, the nurse practitioner observes that the child can hop
on one foot, copy a circle, and speaks in 4-5 word sentences. The parent asks if these milestones
are appropriate. How should the NP interpret these findings?
A. The child is showing significant developmental delay requiring immediate referral.
B. The child is meeting expected milestones for age.
C. The child is advanced for gross motor skills but delayed in language.
D. The child is displaying typical behavior for a 2-year-old.
Correct Answer: B
Rationale: A 4-year-old child is expected to balance on one foot for at least 5 seconds (hop), copy
geometric shapes like a circle or cross, and use 4-5 word sentences or tell stories. These findings
fall within the normal range of developmental milestones for this age group. There is no
evidence of delay or advancement significant enough to warrant alarm.
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Question 4 of 50
A 65-year-old patient with a history of chronic obstructive pulmonary disease (COPD) presents
for a follow-up. Upon inspection of the chest, the nurse practitioner notes an increased anterior-
posterior diameter and a barrel chest configuration. Which percussion sound would most likely
be elicited over this patient's lung fields?
A. Dullness
, 4
B. Flatness
C. Hyperresonance
D. Tympany
Correct Answer: C
Rationale: Hyperresonance is the typical percussion sound found in patients with COPD or
emphysema due to air trapping and hyperinflation of the lungs, which creates the barrel chest
appearance. Dullness is associated with consolidation or pleural effusion. Flatness is heard over
the thigh or massive pleural effusion. Tympany is heard over the stomach.
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Question 5 of 50
A 24-year-old female presents with a painful, swollen knee. She reports a history of a tick bite
two weeks ago. During the musculoskeletal examination, the nurse practitioner assesses the
range of motion. Which maneuver is specifically used to evaluate for the presence of joint
effusion in this patient?
A. McMurray test
B. Balloon sign
C. Lachman test
D. Phalen’s maneuver
Correct Answer: B
Rationale: The balloon sign (or patellar tap/ballottement) is used to detect fluid in the knee joint.
It involves milking fluid upward from the medial side of the knee and tapping the patella to see if
it bounces against the femur. The McMurray test checks for meniscal tears. The Lachman test
assesses anterior cruciate ligament (ACL) integrity. Phalen’s maneuver is used to diagnose carpal
tunnel syndrome.
NR607 PRE-DIAGNOSTIC EXAM CHAMBERLAIN
OFFICIAL PRACTICE EXAM 2026/2027 Actual
Exam 2026/2027 with Detailed Rationales Complete
Exam-Style Questions Pass Guaranteed – A+ Graded
──────────────────────────────────────────────────────
TABLE OF CONTENTS
Section 1 | Advanced Health Assessment | Q1 – Q10
Section 2 | Pathophysiology Across the Lifespan | Q11 – Q20
Section 3 | Pharmacology & Clinical Management | Q21 – Q30
Section 4 | Diagnostic Reasoning & Differential Diagnosis | Q31 – Q40
Section 5 | Evidence-Based Practice & Professional Role | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════════════════
SECTION 1: ADVANCED HEALTH ASSESSMENT Q1 – Q10
══════════════════════════════════════════════════
Question 1 of 50
A 55-year-old male presents for a routine physical examination. During auscultation of the heart,
the nurse practitioner hears a harsh, crescendo-decrescendo systolic murmur best heard at the
right second intercostal space, radiating to the carotids. Which of the following valvular defects
is most consistent with this finding?
A. Mitral regurgitation
B. Aortic stenosis
,2
C. Tricuspid regurgitation
D. Mitral stenosis
Correct Answer: B
Rationale: Aortic stenosis typically produces a harsh, crescendo-decrescendo systolic murmur
heard best at the right second intercostal space (aortic area) with radiation to the carotids. Mitral
regurgitation usually presents as a holosystolic murmur at the apex radiating to the axilla.
Tricuspid regurgitation is also holosystolic but is heard best at the lower left sternal border.
Mitral stenosis is a diastolic murmur heard best at the apex.
──────────────────────────────────────────────────
Question 2 of 50
A 30-year-old female presents with complaints of diffuse, "aching" abdominal pain and bloating
that worsens as the day progresses. She reports the pain is relieved with defecation. On physical
examination, the abdomen is soft and non-tender, but the patient notes discomfort during
palpation of the left lower quadrant. Based on the history, which assessment technique is most
appropriate to evaluate for tenderness specific to her condition?
A. Deep palpation of the epigastrium
B. Rebound tenderness testing at McBurney’s point
C. Shaking tenderness over the right flank
D. Light palpation of the left lower quadrant
Correct Answer: D
Rationale: The patient's symptoms suggest Irritable Bowel Syndrome (IBS), often associated
with left lower quadrant discomfort. Light palpation is the initial step to assess for superficial
tenderness and muscle guarding; deep palpation may be unnecessary or painful if the area is
already tender. Rebound tenderness suggests peritoneal irritation (not indicated here). Shaking
tenderness assesses for pyelonephritis.
,3
──────────────────────────────────────────────────
Question 3 of 50
During a well-child visit for a 4-year-old, the nurse practitioner observes that the child can hop
on one foot, copy a circle, and speaks in 4-5 word sentences. The parent asks if these milestones
are appropriate. How should the NP interpret these findings?
A. The child is showing significant developmental delay requiring immediate referral.
B. The child is meeting expected milestones for age.
C. The child is advanced for gross motor skills but delayed in language.
D. The child is displaying typical behavior for a 2-year-old.
Correct Answer: B
Rationale: A 4-year-old child is expected to balance on one foot for at least 5 seconds (hop), copy
geometric shapes like a circle or cross, and use 4-5 word sentences or tell stories. These findings
fall within the normal range of developmental milestones for this age group. There is no
evidence of delay or advancement significant enough to warrant alarm.
──────────────────────────────────────────────────
Question 4 of 50
A 65-year-old patient with a history of chronic obstructive pulmonary disease (COPD) presents
for a follow-up. Upon inspection of the chest, the nurse practitioner notes an increased anterior-
posterior diameter and a barrel chest configuration. Which percussion sound would most likely
be elicited over this patient's lung fields?
A. Dullness
, 4
B. Flatness
C. Hyperresonance
D. Tympany
Correct Answer: C
Rationale: Hyperresonance is the typical percussion sound found in patients with COPD or
emphysema due to air trapping and hyperinflation of the lungs, which creates the barrel chest
appearance. Dullness is associated with consolidation or pleural effusion. Flatness is heard over
the thigh or massive pleural effusion. Tympany is heard over the stomach.
──────────────────────────────────────────────────
Question 5 of 50
A 24-year-old female presents with a painful, swollen knee. She reports a history of a tick bite
two weeks ago. During the musculoskeletal examination, the nurse practitioner assesses the
range of motion. Which maneuver is specifically used to evaluate for the presence of joint
effusion in this patient?
A. McMurray test
B. Balloon sign
C. Lachman test
D. Phalen’s maneuver
Correct Answer: B
Rationale: The balloon sign (or patellar tap/ballottement) is used to detect fluid in the knee joint.
It involves milking fluid upward from the medial side of the knee and tapping the patella to see if
it bounces against the femur. The McMurray test checks for meniscal tears. The Lachman test
assesses anterior cruciate ligament (ACL) integrity. Phalen’s maneuver is used to diagnose carpal
tunnel syndrome.
