NR509 WEEK 4 MIDTERM EXAM COMPREHENSIVE
GUIDE Questions And Correct Answers 2026 Edition
1. When assessing a patient's principal symptom using the
seven attributes, which attribute specifically addresses what
makes the symptom better or worse?
A. Quality
B. Severity
C. Aggravating and relieving factors
D. Timing
Correct Answer: C
Explanation: Aggravating and relieving factors identify
what makes the symptom better or worse. Quality describes
the nature of the symptom, severity measures intensity
(often using a 0-10 scale), and timing refers to onset,
duration, and frequency.
2. A nurse is conducting a cardiovascular assessment and hears
a mid-systolic click followed by a murmur. Which valvular
condition does this finding most likely indicate?
A. Aortic stenosis
B. Mitral stenosis
C. Mitral valve prolapse
D. Tricuspid regurgitation
Correct Answer: C
Explanation: Mitral valve prolapse (MVP) presents with a
"click then murmur" pattern - specifically a mid-systolic
click followed by a murmur. Aortic stenosis presents with
crescendo-decrescendo murmur radiating to carotids,
mitral stenosis shows opening snap with diastolic rumble.
,3. During peripheral vascular examination, you palpate the
radial and femoral pulses simultaneously and detect a delay.
What condition does radio-femoral delay suggest?
A. Deep vein thrombosis
B. Coarctation of the aorta
C. Chronic venous insufficiency
D. Peripheral arterial disease
Correct Answer: B
Explanation: Radio-femoral delay occurs when the femoral
pulse is delayed compared to the radial pulse, indicating
coarctation of the aorta. In healthy individuals, both pulses
should occur simultaneously.
4. Which of the following is the hallmark symptom of
intermittent claudication in peripheral arterial disease?
A. Sharp chest pain during exertion
B. Pain and cramping in calves with exercise relieved by rest
C. Numbness and tingling in toes at night
D. Swelling of both lower extremities
Correct Answer: B
Explanation: Intermittent claudication is characterized by
pain and cramping in the calves brought on by
exercise/ambulation and relieved with rest. This is caused
by atherosclerosis and fatty plaque buildup in arteries.
5. When measuring blood pressure, what error occurs if the
cuff is too small for the patient's arm?
, A. Falsely low reading
B. Falsely high reading
C. Accurate reading
D. Variable reading depending on position
Correct Answer: B
Explanation: A cuff that is too small will produce a falsely
high blood pressure reading. Conversely, a cuff that is too
large will read low on a small arm and high on a large arm.
6. Which component is NOT part of the OLDCART mnemonic
for History of Present Illness (HPI)?
A. Onset
B. Location
C. Diagnosis
D. Radiation
Correct Answer: C
Explanation: OLDCART stands for Onset, Location,
Duration, Character, Aggravating/Relieving factors,
Radiation, and Timing. Diagnosis is not part of this
mnemonic; it's determined after assessment.
7. A patient presents with sudden, painless, unilateral vision
loss. Which condition should the nurse suspect?
A. Glaucoma
B. Retinal detachment
C. Cataracts
D. Macular degeneration
Correct Answer: B
Explanation: Retinal detachment presents with sudden,
, painless, unilateral vision loss. This is a medical emergency
requiring immediate ophthalmologic evaluation.
8. In the SOAP note format, which section includes the
differential diagnoses?
A. S (Subjective)
B. O (Objective)
C. A (Assessment)
D. P (Plan)
Correct Answer: C
Explanation: The Assessment (A) section of a SOAP note
includes differential diagnoses. Subjective contains CC, HPI,
ROS; Objective contains vitals and physical exam; Plan
contains labs, meds, follow-up.
9. Which pulse should be assessed at the mid-inguinal point,
halfway between the anterior superior iliac spine and pubic
symphysis?
A. Popliteal pulse
B. Dorsalis pedis pulse
C. Femoral pulse
D. Posterior tibial pulse
Correct Answer: C
Explanation: The femoral pulse is palpated at the mid-
inguinal point, located halfway between the anterior
superior iliac spine and the pubic symphysis.
GUIDE Questions And Correct Answers 2026 Edition
1. When assessing a patient's principal symptom using the
seven attributes, which attribute specifically addresses what
makes the symptom better or worse?
A. Quality
B. Severity
C. Aggravating and relieving factors
D. Timing
Correct Answer: C
Explanation: Aggravating and relieving factors identify
what makes the symptom better or worse. Quality describes
the nature of the symptom, severity measures intensity
(often using a 0-10 scale), and timing refers to onset,
duration, and frequency.
2. A nurse is conducting a cardiovascular assessment and hears
a mid-systolic click followed by a murmur. Which valvular
condition does this finding most likely indicate?
A. Aortic stenosis
B. Mitral stenosis
C. Mitral valve prolapse
D. Tricuspid regurgitation
Correct Answer: C
Explanation: Mitral valve prolapse (MVP) presents with a
"click then murmur" pattern - specifically a mid-systolic
click followed by a murmur. Aortic stenosis presents with
crescendo-decrescendo murmur radiating to carotids,
mitral stenosis shows opening snap with diastolic rumble.
,3. During peripheral vascular examination, you palpate the
radial and femoral pulses simultaneously and detect a delay.
What condition does radio-femoral delay suggest?
A. Deep vein thrombosis
B. Coarctation of the aorta
C. Chronic venous insufficiency
D. Peripheral arterial disease
Correct Answer: B
Explanation: Radio-femoral delay occurs when the femoral
pulse is delayed compared to the radial pulse, indicating
coarctation of the aorta. In healthy individuals, both pulses
should occur simultaneously.
4. Which of the following is the hallmark symptom of
intermittent claudication in peripheral arterial disease?
A. Sharp chest pain during exertion
B. Pain and cramping in calves with exercise relieved by rest
C. Numbness and tingling in toes at night
D. Swelling of both lower extremities
Correct Answer: B
Explanation: Intermittent claudication is characterized by
pain and cramping in the calves brought on by
exercise/ambulation and relieved with rest. This is caused
by atherosclerosis and fatty plaque buildup in arteries.
5. When measuring blood pressure, what error occurs if the
cuff is too small for the patient's arm?
, A. Falsely low reading
B. Falsely high reading
C. Accurate reading
D. Variable reading depending on position
Correct Answer: B
Explanation: A cuff that is too small will produce a falsely
high blood pressure reading. Conversely, a cuff that is too
large will read low on a small arm and high on a large arm.
6. Which component is NOT part of the OLDCART mnemonic
for History of Present Illness (HPI)?
A. Onset
B. Location
C. Diagnosis
D. Radiation
Correct Answer: C
Explanation: OLDCART stands for Onset, Location,
Duration, Character, Aggravating/Relieving factors,
Radiation, and Timing. Diagnosis is not part of this
mnemonic; it's determined after assessment.
7. A patient presents with sudden, painless, unilateral vision
loss. Which condition should the nurse suspect?
A. Glaucoma
B. Retinal detachment
C. Cataracts
D. Macular degeneration
Correct Answer: B
Explanation: Retinal detachment presents with sudden,
, painless, unilateral vision loss. This is a medical emergency
requiring immediate ophthalmologic evaluation.
8. In the SOAP note format, which section includes the
differential diagnoses?
A. S (Subjective)
B. O (Objective)
C. A (Assessment)
D. P (Plan)
Correct Answer: C
Explanation: The Assessment (A) section of a SOAP note
includes differential diagnoses. Subjective contains CC, HPI,
ROS; Objective contains vitals and physical exam; Plan
contains labs, meds, follow-up.
9. Which pulse should be assessed at the mid-inguinal point,
halfway between the anterior superior iliac spine and pubic
symphysis?
A. Popliteal pulse
B. Dorsalis pedis pulse
C. Femoral pulse
D. Posterior tibial pulse
Correct Answer: C
Explanation: The femoral pulse is palpated at the mid-
inguinal point, located halfway between the anterior
superior iliac spine and the pubic symphysis.
