NUR 529 EXAM BLUEPRINT
OBJECTIVE ASSESSMENT - EXAM
UNIVERSITY OF
ALABAMA NUR 529
EXAM 1, 2, 3 & 4 FULL
EXAM BLUEPRINT WITH
VERIFIED ANSWERS
2026/2027 OFFICIAL EDITION
200 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Advanced Health Assessment Nursing Theory & Research
Pathophysiology & Clinical Reasoning Leadership & Healthcare Systems
Pharmacology & Medication Management Evidence-Based Care & Quality Improvement
COVER PAGE - 1
, SECTION 1 | Exam 1 - Advanced Health Assessment | Q1-Q52 | NUR 529 Exam Blueprint 2026/2027
Q1 Question 1 of 200
A 68-year-old retired teacher presents to the outpatient clinic reporting new-onset
fatigue and a 4-kilogram weight loss over six weeks. The advanced registered nurse is
completing the comprehensive history. Which component of the history should be
collected first to best guide the rest of the encounter?
A. Review of systems organized from head to toe
B. History of present illness using the OLDCARTS framework
C. Family history with a three-generation pedigree
D. Past medical and surgical history with medication reconciliation
Correct Answer: B
Rationale:
The history of present illness contextualizes the chief complaint and directs the rest of the
assessment; gathering OLDCARTS data first ensures focused follow-up questions. The
review of systems, family history, and past medical history are essential but are refined once
the present illness is clarified, not before.
Q2 Question 2 of 200
A 52-year-old machinist is being evaluated for a suspected rotator cuff injury. During
the musculoskeletal exam the provider plans to assess active range of motion before
passive range of motion. What is the primary rationale for this sequencing?
A. Passive motion performed first may exacerbate inflammation and skew active results
B. Active motion identifies pain-limited movement that passive motion should not reproduce
C. Passive motion requires the patient to relax muscles that active motion evaluates
D. Active motion detects neurological deficits that passive motion would mask
Correct Answer: D
Rationale:
Active range of motion reflects the patient's voluntary effort and reveals pain or weakness
limitations; once established, passive range of motion can show whether restriction is
structural or muscular. Performing passive motion first could mislead the examiner about true
functional capacity. The other options mischaracterize the relationship between active and
passive testing.
NUR 529 Exam Blueprint - 2026/2027 Passing Score: 80% Page 2 of 104
, Q3 Question 3 of 200
A 47-year-old woman with type 2 diabetes is seen for a routine foot assessment. The
nurse uses a 5.07 Semmes-Weinstein monofilament on ten specified plantar sites.
What finding most strongly indicates loss of protective sensation and increased ulcer
risk?
A. The patient reports the filament as dull rather than sharp at any site
B. The patient consistently identifies touch only after a three-second delay
C. Two or more sites on the same foot fail to register the filament
D. One site on each foot fails to register the filament
Correct Answer: C
Rationale:
Loss of protective sensation is defined as failure to perceive the 10-gram monofilament at two
or more of the ten tested sites on a single foot, which predicts ulceration risk. A single missed
site is less predictive, and qualitative descriptors or delayed perception are not validated
thresholds. The other choices do not meet the validated diagnostic criterion.
Q4 Question 4 of 200
A 30-year-old male presents with acute onset right testicular pain that began four hours
ago. To differentiate epididymitis from testicular torsion, the examiner performs the
Prehn maneuver and evaluates the cremasteric reflex. Which finding most strongly
suggests torsion requiring immediate surgical intervention?
A. Pain relief with elevation of the scrotum and an absent cremasteric reflex
B. No pain relief with elevation of the scrotum and an absent cremasteric reflex
C. No pain relief with elevation of the scrotum and an intact cremasteric reflex
D. Pain relief with elevation of the scrotum and an intact cremasteric reflex
Correct Answer: D
Rationale:
Testicular torsion typically produces no pain relief with scrotal elevation (negative Prehn sign)
and an absent cremasteric reflex on the affected side, signaling ischemia requiring surgery.
Epididymitis often improves with elevation and retains the cremasteric reflex. The other
combinations either suggest epididymitis or are atypical for torsion.
NUR 529 Exam Blueprint - 2026/2027 Passing Score: 80% Page 3 of 104
, Q5 Question 5 of 200
A 6-year-old child is brought to the clinic for a school physical. During the eye
examination the nurse uses the Snellen chart and notes the child can read the 20/40
line with the right eye but skips letters. What is the most appropriate next step in the
assessment?
A. Re-test using the HOTV or Allen picture chart and document any asymmetry between
eyes
B. Conclude amblyopia and patch the unaffected eye immediately
C. Repeat the test with a pinhole occluder to confirm refractive error
D. Document 20/40 vision and refer to optometry in one year
Correct Answer: C
Rationale:
Young children may not reliably identify Snellen letters; re-testing with a developmentally
appropriate chart such as HOTV or Allen pictures more accurately assesses acuity and any
inter-eye asymmetry. Pinhole testing, patching, or delaying referral without re-testing would
skip the validated pediatric approach. The other options either over-diagnose or
under-evaluate the finding.
Q6 Question 6 of 200
A 71-year-old man with hypertension and osteoarthritis is evaluated for dizziness when
rolling over in bed. The provider performs the Dix-Hallpike maneuver. Which response
is most consistent with benign paroxysmal positional vertigo?
A. Vertical down-beating nystagmus without latency and without fatigability
B. Loss of consciousness with reproducible symptoms on left lateral decubitus
C. Immediate vertigo with torsional nystagmus lasting less than one minute and
fatiguing on repeat
D. Vertigo lasting longer than five minutes without nystagmus
Correct Answer: C
Rationale:
BPPV classically produces brief, delayed vertigo with torsional upbeat nystagmus that
fatigues with repetition due to canalithiasis of the posterior canal. Prolonged vertigo, vertical
nystagmus without latency, or syncope suggest central causes. The other patterns do not
match the hallmark canalith response.
NUR 529 Exam Blueprint - 2026/2027 Passing Score: 80% Page 4 of 104
OBJECTIVE ASSESSMENT - EXAM
UNIVERSITY OF
ALABAMA NUR 529
EXAM 1, 2, 3 & 4 FULL
EXAM BLUEPRINT WITH
VERIFIED ANSWERS
2026/2027 OFFICIAL EDITION
200 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Advanced Health Assessment Nursing Theory & Research
Pathophysiology & Clinical Reasoning Leadership & Healthcare Systems
Pharmacology & Medication Management Evidence-Based Care & Quality Improvement
COVER PAGE - 1
, SECTION 1 | Exam 1 - Advanced Health Assessment | Q1-Q52 | NUR 529 Exam Blueprint 2026/2027
Q1 Question 1 of 200
A 68-year-old retired teacher presents to the outpatient clinic reporting new-onset
fatigue and a 4-kilogram weight loss over six weeks. The advanced registered nurse is
completing the comprehensive history. Which component of the history should be
collected first to best guide the rest of the encounter?
A. Review of systems organized from head to toe
B. History of present illness using the OLDCARTS framework
C. Family history with a three-generation pedigree
D. Past medical and surgical history with medication reconciliation
Correct Answer: B
Rationale:
The history of present illness contextualizes the chief complaint and directs the rest of the
assessment; gathering OLDCARTS data first ensures focused follow-up questions. The
review of systems, family history, and past medical history are essential but are refined once
the present illness is clarified, not before.
Q2 Question 2 of 200
A 52-year-old machinist is being evaluated for a suspected rotator cuff injury. During
the musculoskeletal exam the provider plans to assess active range of motion before
passive range of motion. What is the primary rationale for this sequencing?
A. Passive motion performed first may exacerbate inflammation and skew active results
B. Active motion identifies pain-limited movement that passive motion should not reproduce
C. Passive motion requires the patient to relax muscles that active motion evaluates
D. Active motion detects neurological deficits that passive motion would mask
Correct Answer: D
Rationale:
Active range of motion reflects the patient's voluntary effort and reveals pain or weakness
limitations; once established, passive range of motion can show whether restriction is
structural or muscular. Performing passive motion first could mislead the examiner about true
functional capacity. The other options mischaracterize the relationship between active and
passive testing.
NUR 529 Exam Blueprint - 2026/2027 Passing Score: 80% Page 2 of 104
, Q3 Question 3 of 200
A 47-year-old woman with type 2 diabetes is seen for a routine foot assessment. The
nurse uses a 5.07 Semmes-Weinstein monofilament on ten specified plantar sites.
What finding most strongly indicates loss of protective sensation and increased ulcer
risk?
A. The patient reports the filament as dull rather than sharp at any site
B. The patient consistently identifies touch only after a three-second delay
C. Two or more sites on the same foot fail to register the filament
D. One site on each foot fails to register the filament
Correct Answer: C
Rationale:
Loss of protective sensation is defined as failure to perceive the 10-gram monofilament at two
or more of the ten tested sites on a single foot, which predicts ulceration risk. A single missed
site is less predictive, and qualitative descriptors or delayed perception are not validated
thresholds. The other choices do not meet the validated diagnostic criterion.
Q4 Question 4 of 200
A 30-year-old male presents with acute onset right testicular pain that began four hours
ago. To differentiate epididymitis from testicular torsion, the examiner performs the
Prehn maneuver and evaluates the cremasteric reflex. Which finding most strongly
suggests torsion requiring immediate surgical intervention?
A. Pain relief with elevation of the scrotum and an absent cremasteric reflex
B. No pain relief with elevation of the scrotum and an absent cremasteric reflex
C. No pain relief with elevation of the scrotum and an intact cremasteric reflex
D. Pain relief with elevation of the scrotum and an intact cremasteric reflex
Correct Answer: D
Rationale:
Testicular torsion typically produces no pain relief with scrotal elevation (negative Prehn sign)
and an absent cremasteric reflex on the affected side, signaling ischemia requiring surgery.
Epididymitis often improves with elevation and retains the cremasteric reflex. The other
combinations either suggest epididymitis or are atypical for torsion.
NUR 529 Exam Blueprint - 2026/2027 Passing Score: 80% Page 3 of 104
, Q5 Question 5 of 200
A 6-year-old child is brought to the clinic for a school physical. During the eye
examination the nurse uses the Snellen chart and notes the child can read the 20/40
line with the right eye but skips letters. What is the most appropriate next step in the
assessment?
A. Re-test using the HOTV or Allen picture chart and document any asymmetry between
eyes
B. Conclude amblyopia and patch the unaffected eye immediately
C. Repeat the test with a pinhole occluder to confirm refractive error
D. Document 20/40 vision and refer to optometry in one year
Correct Answer: C
Rationale:
Young children may not reliably identify Snellen letters; re-testing with a developmentally
appropriate chart such as HOTV or Allen pictures more accurately assesses acuity and any
inter-eye asymmetry. Pinhole testing, patching, or delaying referral without re-testing would
skip the validated pediatric approach. The other options either over-diagnose or
under-evaluate the finding.
Q6 Question 6 of 200
A 71-year-old man with hypertension and osteoarthritis is evaluated for dizziness when
rolling over in bed. The provider performs the Dix-Hallpike maneuver. Which response
is most consistent with benign paroxysmal positional vertigo?
A. Vertical down-beating nystagmus without latency and without fatigability
B. Loss of consciousness with reproducible symptoms on left lateral decubitus
C. Immediate vertigo with torsional nystagmus lasting less than one minute and
fatiguing on repeat
D. Vertigo lasting longer than five minutes without nystagmus
Correct Answer: C
Rationale:
BPPV classically produces brief, delayed vertigo with torsional upbeat nystagmus that
fatigues with repetition due to canalithiasis of the posterior canal. Prolonged vertigo, vertical
nystagmus without latency, or syncope suggest central causes. The other patterns do not
match the hallmark canalith response.
NUR 529 Exam Blueprint - 2026/2027 Passing Score: 80% Page 4 of 104
