NSG 6020 Final Exam Practice Questions and
Answers (NCLEX)
Advanced health assessment
Diagnostic reasoning
Pathophysiology
Pharmacology
Clinical case studies
Cardiac assessment
A patient presents with an S4 heart sound. Which condition is most likely?
A. Mitral regurgitation
B. Left ventricular hypertrophy
C. Aortic stenosis
D. Pulmonary embolism
Rationale: S4 is caused by atrial contraction against a stiff ventricle, common in LV
hypertrophy.
Blood pressure
Hypertension is diagnosed when BP readings are consistently:
A. ≥120/70 mmHg
B. ≥130/80 mmHg
C. ≥140/90 mmHg
D. ≥150/95 mmHg
Rationale: Current guidelines define hypertension at ≥130/80 mmHg.
Jugular venous distension
Elevated JVP is most consistent with:
A. Left-sided heart failure
B. Right-sided heart failure
C. Pulmonary embolism
D. Mitral stenosis
Rationale: JVP reflects right atrial pressure.
Murmur location
A systolic murmur at the right sternal border suggests:
A. Mitral regurgitation
B. Aortic stenosis
C. Tricuspid regurgitation
D. Pulmonic stenosis
Pulse deficit
A difference between apical and radial pulse indicates:
,A. Bradycardia
B. Atrial fibrillation
C. Heart block
D. Ventricular tachycardia
Crackles
Fine inspiratory crackles are typical of:
A. Asthma
B. Pulmonary fibrosis
C. COPD
D. Pneumothorax
Wheezing
Expiratory wheezing is most consistent with:
A. Pneumonia
B. Asthma
C. Pleural effusion
D. CHF
Percussion note
Dullness to percussion over lung fields suggests:
A. Pneumothorax
B. Consolidation
C. Emphysema
D. Asthma
Respiratory distress
Use of accessory muscles indicates:
A. Mild asthma
B. Severe respiratory compromise
C. Normal breathing
D. Pleural effusion
Cyanosis
Central cyanosis indicates:
A. Peripheral vasoconstriction
B. Low arterial oxygen saturation
C. Cold exposure
D. Anemia
Cranial nerve II
Cranial nerve II is tested by:
A. Facial symmetry
B. Visual acuity and fields
C. Hearing
, D. Tongue movement
Romberg test
A positive Romberg test suggests:
A. Cerebellar dysfunction
B. Posterior column dysfunction
C. Vestibular dysfunction
D. Cranial nerve VII lesion
Babinski sign
A positive Babinski reflex indicates:
A. Lower motor neuron lesion
B. Upper motor neuron lesion
C. Peripheral neuropathy
D. Cerebellar dysfunction
Cranial nerve VII
Cranial nerve VII controls:
A. Facial movement and taste on anterior tongue
B. Hearing
C. Swallowing
D. Vision
Murphy’s sign
A positive Murphy’s sign indicates:
A. Appendicitis
B. Acute cholecystitis
C. Pancreatitis
D. Gastritis
Rebound tenderness
RLQ pain on release suggests:
A. Gastritis
B. Appendicitis
C. Cholecystitis
D. Diverticulitis
Melena
Black tarry stool indicates:
A. Lower GI bleed
B. Upper GI bleed
C. Hemorrhoids
D. IBS
Hepatomegaly
Enlarged liver is commonly seen in:
Answers (NCLEX)
Advanced health assessment
Diagnostic reasoning
Pathophysiology
Pharmacology
Clinical case studies
Cardiac assessment
A patient presents with an S4 heart sound. Which condition is most likely?
A. Mitral regurgitation
B. Left ventricular hypertrophy
C. Aortic stenosis
D. Pulmonary embolism
Rationale: S4 is caused by atrial contraction against a stiff ventricle, common in LV
hypertrophy.
Blood pressure
Hypertension is diagnosed when BP readings are consistently:
A. ≥120/70 mmHg
B. ≥130/80 mmHg
C. ≥140/90 mmHg
D. ≥150/95 mmHg
Rationale: Current guidelines define hypertension at ≥130/80 mmHg.
Jugular venous distension
Elevated JVP is most consistent with:
A. Left-sided heart failure
B. Right-sided heart failure
C. Pulmonary embolism
D. Mitral stenosis
Rationale: JVP reflects right atrial pressure.
Murmur location
A systolic murmur at the right sternal border suggests:
A. Mitral regurgitation
B. Aortic stenosis
C. Tricuspid regurgitation
D. Pulmonic stenosis
Pulse deficit
A difference between apical and radial pulse indicates:
,A. Bradycardia
B. Atrial fibrillation
C. Heart block
D. Ventricular tachycardia
Crackles
Fine inspiratory crackles are typical of:
A. Asthma
B. Pulmonary fibrosis
C. COPD
D. Pneumothorax
Wheezing
Expiratory wheezing is most consistent with:
A. Pneumonia
B. Asthma
C. Pleural effusion
D. CHF
Percussion note
Dullness to percussion over lung fields suggests:
A. Pneumothorax
B. Consolidation
C. Emphysema
D. Asthma
Respiratory distress
Use of accessory muscles indicates:
A. Mild asthma
B. Severe respiratory compromise
C. Normal breathing
D. Pleural effusion
Cyanosis
Central cyanosis indicates:
A. Peripheral vasoconstriction
B. Low arterial oxygen saturation
C. Cold exposure
D. Anemia
Cranial nerve II
Cranial nerve II is tested by:
A. Facial symmetry
B. Visual acuity and fields
C. Hearing
, D. Tongue movement
Romberg test
A positive Romberg test suggests:
A. Cerebellar dysfunction
B. Posterior column dysfunction
C. Vestibular dysfunction
D. Cranial nerve VII lesion
Babinski sign
A positive Babinski reflex indicates:
A. Lower motor neuron lesion
B. Upper motor neuron lesion
C. Peripheral neuropathy
D. Cerebellar dysfunction
Cranial nerve VII
Cranial nerve VII controls:
A. Facial movement and taste on anterior tongue
B. Hearing
C. Swallowing
D. Vision
Murphy’s sign
A positive Murphy’s sign indicates:
A. Appendicitis
B. Acute cholecystitis
C. Pancreatitis
D. Gastritis
Rebound tenderness
RLQ pain on release suggests:
A. Gastritis
B. Appendicitis
C. Cholecystitis
D. Diverticulitis
Melena
Black tarry stool indicates:
A. Lower GI bleed
B. Upper GI bleed
C. Hemorrhoids
D. IBS
Hepatomegaly
Enlarged liver is commonly seen in:
