NURS 5220 Exam 2 V1 | NURS 5220
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 2) |
The University of Texas at Arlington
1. A 22-year-old patient presents with a 2-cm, oval, salmon-colored patch on the chest,
followed by a systemic eruption of smaller maculopapular lesions in a Christmas tree pattern.
What is the primary diagnosis?
A. Tinea corporis
B. Psoriasis
C. Secondary syphilis
D. Pityriasis rosea
Answer: D
Rationale: Pityriasis rosea often begins with a single herald patch before the secondary
eruption occurs. The distribution of the smaller lesions typically follows the cleavage lines
of the skin on the back and trunk. This condition is self-limiting and usually resolves within
6 to 12 weeks without specific intervention.
,2. During a cardiac assessment, the nurse practitioner notes a moderately loud murmur that
is easily heard with the stethoscope but does not have a palpable thrill. How should this be
graded?
A. Grade II/VI
B. Grade IV/VI
C. Grade III/VI
D. Grade V/VI
Answer: C
Rationale: Grade III murmurs are moderately loud and easily heard by most clinicians.
They are distinguished from Grade IV murmurs by the absence of a palpable thrill. Grading
murmurs correctly is essential for determining the severity of valvular disease and
monitoring progression over time.
3. A patient with suspected pneumonia demonstrates increased vocal resonance. When the
patient says ‘99’, the sound is heard clearly and loudly through the stethoscope. This finding
is known as:
A. Egophony
B. Bronchophony
C. Whispered pectoriloquy
D. Tactile fremitus
, Answer: B
Rationale: Bronchophony occurs when spoken words are transmitted through
consolidated lung tissue, making them sound clearer than normal. In healthy lung tissue,
these sounds are typically muffled and indistinct. This assessment technique helps the
provider localize areas of consolidation such as pneumonia.
4. Which physical exam finding is most consistent with a tension pneumothorax?
A. Dullness on percussion and tracheal deviation to the ipsilateral side
B. Hyperresonance on the affected side and tracheal deviation to the contralateral side
C. Increased tactile fremitus and bronchial breath sounds
D. Normal percussion with increased vocal resonance
Answer: B
Rationale: A tension pneumothorax causes air to build up in the pleural space, leading to
lung collapse and mediastinal shift. The resulting pressure pushes the trachea toward the
unaffected (contralateral) side. This is a medical emergency that requires immediate
decompression to prevent cardiovascular collapse.
5. When assessing the lymph nodes of the neck, the nurse practitioner finds a hard, fixed, and
non-tender node in the left supraclavicular region. This is most suspicious for:
A. Acute pharyngitis
B. Chronic lymphocytic leukemia
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 2) |
The University of Texas at Arlington
1. A 22-year-old patient presents with a 2-cm, oval, salmon-colored patch on the chest,
followed by a systemic eruption of smaller maculopapular lesions in a Christmas tree pattern.
What is the primary diagnosis?
A. Tinea corporis
B. Psoriasis
C. Secondary syphilis
D. Pityriasis rosea
Answer: D
Rationale: Pityriasis rosea often begins with a single herald patch before the secondary
eruption occurs. The distribution of the smaller lesions typically follows the cleavage lines
of the skin on the back and trunk. This condition is self-limiting and usually resolves within
6 to 12 weeks without specific intervention.
,2. During a cardiac assessment, the nurse practitioner notes a moderately loud murmur that
is easily heard with the stethoscope but does not have a palpable thrill. How should this be
graded?
A. Grade II/VI
B. Grade IV/VI
C. Grade III/VI
D. Grade V/VI
Answer: C
Rationale: Grade III murmurs are moderately loud and easily heard by most clinicians.
They are distinguished from Grade IV murmurs by the absence of a palpable thrill. Grading
murmurs correctly is essential for determining the severity of valvular disease and
monitoring progression over time.
3. A patient with suspected pneumonia demonstrates increased vocal resonance. When the
patient says ‘99’, the sound is heard clearly and loudly through the stethoscope. This finding
is known as:
A. Egophony
B. Bronchophony
C. Whispered pectoriloquy
D. Tactile fremitus
, Answer: B
Rationale: Bronchophony occurs when spoken words are transmitted through
consolidated lung tissue, making them sound clearer than normal. In healthy lung tissue,
these sounds are typically muffled and indistinct. This assessment technique helps the
provider localize areas of consolidation such as pneumonia.
4. Which physical exam finding is most consistent with a tension pneumothorax?
A. Dullness on percussion and tracheal deviation to the ipsilateral side
B. Hyperresonance on the affected side and tracheal deviation to the contralateral side
C. Increased tactile fremitus and bronchial breath sounds
D. Normal percussion with increased vocal resonance
Answer: B
Rationale: A tension pneumothorax causes air to build up in the pleural space, leading to
lung collapse and mediastinal shift. The resulting pressure pushes the trachea toward the
unaffected (contralateral) side. This is a medical emergency that requires immediate
decompression to prevent cardiovascular collapse.
5. When assessing the lymph nodes of the neck, the nurse practitioner finds a hard, fixed, and
non-tender node in the left supraclavicular region. This is most suspicious for:
A. Acute pharyngitis
B. Chronic lymphocytic leukemia
