NU 650 EXAMS SCRIPT 2026/2027 QUESTIONS AND
SOLUTIONS RATED A+
✔✔You are examining a 4 y.o boy who presents to the office with his mother who
complains that he gets bloody noses frequently. You know that the most common cause
of epitaxis in the age group is:
A. Chronic rhinitis
B. Foreign body
C. picking their nose
D. Allergic rhinitis - ✔✔C
✔✔You are examining a 9-month-old in your office and do not see a red reflex on the
fundoscopic exam. This finding would cause concern as it can indicate which of the
following?
A. Glaucoma
B. Dacryostenosis
C. Cararacts
D. Retinoblastoma - ✔✔D
✔✔A newborn is in the office with cold symptoms. you go into the room to see a
distressed mom who is very concerned about her baby. She expresses to you that
something is wrong. Your initial thought that comes to mind is that this could be RSV.
You must look for signs of respiratory distress. Those signs include________________
A. Vomiting and diarrhea
B. coughing, pulling legs up
C. retractions, nasal flaring, tachypnea, grunting
D. fever of 100.4 or higher, tachypnea, vomiting - ✔✔C
✔✔An 85 y.o. woman is brought to the urgent care center for possible aspiration
pneumonia. The NP understands that, based on normal anatomy adventitious lung
sounds will most likely be heard in which of the following areas?
A. left upper lobe
B. left middle & lower lobes
C. right upper lobe
D. Right middle and lower lobes - ✔✔D
✔✔Barrel chest is an abnormal chest configuration that may occur in which of the
following disorders?
A. COPD
B. Pneumonia
C. Pneumothorax
D. TBA - ✔✔A
✔✔Bronchovesticular sounds are heard normally at which location?
A. second intercostal space anteriorly bilaterally
,B. base of lungs bilaterally, posteriorly
C. laterally at the midaxillary line, bilaterally
D. Bilaterally at the mid-clabicular line, 5th intercostal space - ✔✔A
✔✔Normally when the lung fields are percussed the resulting sound is described as
_______:
A. hyperresonant
B. resonant
C. tympanic
D. Dull - ✔✔B
✔✔The clinic has extended hours to provide flu vaccines and preventative teaching for
the community. Based on current CDC influenza vaccine recommendations, the NP
understands which of the following patients has a contraindication and cannot receive
the vaccine?
A. healthy 2 month baby girl
B. primagravida at 32 weeks
C. 60 y.o male with hx CHF
D. 45 y.o female with BMI of 42 - ✔✔A
✔✔The NP will nose a history of chronic cough based on the patients report of
symptoms lasting for:
A. 1 week
B. 4 weeks
C. 6 weeks
D. 10 weeks - ✔✔D
✔✔When compared to wheezes and rhonchi, the NP notes that on auscultation,
crackles are:
A. musical in quality
B. prolonged sounds, typically persisting throughout the respiratory cycle
C. intermittent and discontinuous sounds
D. Relatively low-pitched with a snoring quality - ✔✔C
✔✔Which breath sound is normally heard over the sternal notch?
A. Bronchial
B. Bronchovesicular
C. Vesicular
D. Tracheal - ✔✔A
✔✔Which of the following findings will alert the NP to include pneumonia as a
differential diagnosis?
A. decreased tactile fremitus
B. symmetrical chest expansion/lung excursion
C. hyperresonance with percussion
,D. positive bronchophony - ✔✔D
✔✔Which of the following is an expected change of aging?
A. supraclavicular retractions with inspiration
B. Kyphosis
C. There is a decrease of the elastic properties within lungs
D. Pectus excavatum - ✔✔C
✔✔Cultural Humility: - ✔✔A process that requires humility as individuals continually
engage in self-reflection and self-critique as lifelong learners and reflective practitioners.
✔✔3 Dimensions of cultural humility - ✔✔1) Self-awareness: learn about your own
biases; we all have them.
2) Respectful communication: work to eliminate assumptions about what is "normal".
Learn directly from your patients; they are the experts on their culture and illness.
3) Collaborative partnerships: build your patient relationships on respect and mutually
acceptable plans.
✔✔True or False:
The beginning NP should focus on interpreting the findings of the physical examination.
- ✔✔False
✔✔Which of the following statements represents a general goal for the comprehensive
or focused physical examination?
a. Avoid unnecessary changes in position
b. Maximize patient comfort
c. Enhance clinical efficiency
d. all of the above - ✔✔D
✔✔Chronic pain definition - ✔✔Pain that persists one month beyond the course of an
acute injury
✔✔Crackles auscultated sound description: - ✔✔Discontinuous
Non-musical
Like dots in time
✔✔Wheezes auscultated sound description: - ✔✔High pitched with hissing or shrill
quality
Continuous
✔✔Rhonchi auscultated sound description: - ✔✔Continuous
Low pitched with snoring quality
✔✔Vesicular breath sound characteristics: - ✔✔Inspiration longer than expiration
, Heard over most lung tissue
✔✔Tracheal breath sound characteristics: - ✔✔Inspiration & expiration almost equal
Relatively high pitched
Intensity of expiration very loud
✔✔Bronchovesicular breath sound characteristics: - ✔✔Inspiration and expiration
almost equal, and heard in the first and second interspaces anteriorly and between the
scapulae
✔✔Bronchial breath sound characteristics: - ✔✔Expiration longer than inspiration
Heard over large proximal airways
✔✔You are performing a thorough cardiac examination. Which of the following
chambers of the heart can you assess by palpation?
A) Left atrium
B) Right atrium
C) Right ventricle
D) Sinus node - ✔✔C
✔✔What is responsible for the inspiratory splitting of S2?
A) Closure of aortic, then pulmonic valves
B) Closure of mitral, then tricuspid valves
C) Closure of aortic, then tricuspid valves
D) Closure of mitral, then pulmonic valves - ✔✔A
✔✔A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As
part of your physical examination, you listen to her heart and hear a murmur only at the
cardiac apex. Which valve is most likely to be involved, based on the location of the
murmur?
A) Mitral
B) Tricuspid
C) Aortic
D) Pulmonic - ✔✔A
✔✔A 58-year-old teacher presents to your clinic complaining of breathlessness with
activity. The patient has no chronic conditions and takes no medications, herbs, or
supplements. Which of the following symptoms is appropriate to ask about in the
cardiovascular review of systems?
A) Abdominal pain
B) Orthopnea
C) Hematochezia
D) Tenesmus - ✔✔B
SOLUTIONS RATED A+
✔✔You are examining a 4 y.o boy who presents to the office with his mother who
complains that he gets bloody noses frequently. You know that the most common cause
of epitaxis in the age group is:
A. Chronic rhinitis
B. Foreign body
C. picking their nose
D. Allergic rhinitis - ✔✔C
✔✔You are examining a 9-month-old in your office and do not see a red reflex on the
fundoscopic exam. This finding would cause concern as it can indicate which of the
following?
A. Glaucoma
B. Dacryostenosis
C. Cararacts
D. Retinoblastoma - ✔✔D
✔✔A newborn is in the office with cold symptoms. you go into the room to see a
distressed mom who is very concerned about her baby. She expresses to you that
something is wrong. Your initial thought that comes to mind is that this could be RSV.
You must look for signs of respiratory distress. Those signs include________________
A. Vomiting and diarrhea
B. coughing, pulling legs up
C. retractions, nasal flaring, tachypnea, grunting
D. fever of 100.4 or higher, tachypnea, vomiting - ✔✔C
✔✔An 85 y.o. woman is brought to the urgent care center for possible aspiration
pneumonia. The NP understands that, based on normal anatomy adventitious lung
sounds will most likely be heard in which of the following areas?
A. left upper lobe
B. left middle & lower lobes
C. right upper lobe
D. Right middle and lower lobes - ✔✔D
✔✔Barrel chest is an abnormal chest configuration that may occur in which of the
following disorders?
A. COPD
B. Pneumonia
C. Pneumothorax
D. TBA - ✔✔A
✔✔Bronchovesticular sounds are heard normally at which location?
A. second intercostal space anteriorly bilaterally
,B. base of lungs bilaterally, posteriorly
C. laterally at the midaxillary line, bilaterally
D. Bilaterally at the mid-clabicular line, 5th intercostal space - ✔✔A
✔✔Normally when the lung fields are percussed the resulting sound is described as
_______:
A. hyperresonant
B. resonant
C. tympanic
D. Dull - ✔✔B
✔✔The clinic has extended hours to provide flu vaccines and preventative teaching for
the community. Based on current CDC influenza vaccine recommendations, the NP
understands which of the following patients has a contraindication and cannot receive
the vaccine?
A. healthy 2 month baby girl
B. primagravida at 32 weeks
C. 60 y.o male with hx CHF
D. 45 y.o female with BMI of 42 - ✔✔A
✔✔The NP will nose a history of chronic cough based on the patients report of
symptoms lasting for:
A. 1 week
B. 4 weeks
C. 6 weeks
D. 10 weeks - ✔✔D
✔✔When compared to wheezes and rhonchi, the NP notes that on auscultation,
crackles are:
A. musical in quality
B. prolonged sounds, typically persisting throughout the respiratory cycle
C. intermittent and discontinuous sounds
D. Relatively low-pitched with a snoring quality - ✔✔C
✔✔Which breath sound is normally heard over the sternal notch?
A. Bronchial
B. Bronchovesicular
C. Vesicular
D. Tracheal - ✔✔A
✔✔Which of the following findings will alert the NP to include pneumonia as a
differential diagnosis?
A. decreased tactile fremitus
B. symmetrical chest expansion/lung excursion
C. hyperresonance with percussion
,D. positive bronchophony - ✔✔D
✔✔Which of the following is an expected change of aging?
A. supraclavicular retractions with inspiration
B. Kyphosis
C. There is a decrease of the elastic properties within lungs
D. Pectus excavatum - ✔✔C
✔✔Cultural Humility: - ✔✔A process that requires humility as individuals continually
engage in self-reflection and self-critique as lifelong learners and reflective practitioners.
✔✔3 Dimensions of cultural humility - ✔✔1) Self-awareness: learn about your own
biases; we all have them.
2) Respectful communication: work to eliminate assumptions about what is "normal".
Learn directly from your patients; they are the experts on their culture and illness.
3) Collaborative partnerships: build your patient relationships on respect and mutually
acceptable plans.
✔✔True or False:
The beginning NP should focus on interpreting the findings of the physical examination.
- ✔✔False
✔✔Which of the following statements represents a general goal for the comprehensive
or focused physical examination?
a. Avoid unnecessary changes in position
b. Maximize patient comfort
c. Enhance clinical efficiency
d. all of the above - ✔✔D
✔✔Chronic pain definition - ✔✔Pain that persists one month beyond the course of an
acute injury
✔✔Crackles auscultated sound description: - ✔✔Discontinuous
Non-musical
Like dots in time
✔✔Wheezes auscultated sound description: - ✔✔High pitched with hissing or shrill
quality
Continuous
✔✔Rhonchi auscultated sound description: - ✔✔Continuous
Low pitched with snoring quality
✔✔Vesicular breath sound characteristics: - ✔✔Inspiration longer than expiration
, Heard over most lung tissue
✔✔Tracheal breath sound characteristics: - ✔✔Inspiration & expiration almost equal
Relatively high pitched
Intensity of expiration very loud
✔✔Bronchovesicular breath sound characteristics: - ✔✔Inspiration and expiration
almost equal, and heard in the first and second interspaces anteriorly and between the
scapulae
✔✔Bronchial breath sound characteristics: - ✔✔Expiration longer than inspiration
Heard over large proximal airways
✔✔You are performing a thorough cardiac examination. Which of the following
chambers of the heart can you assess by palpation?
A) Left atrium
B) Right atrium
C) Right ventricle
D) Sinus node - ✔✔C
✔✔What is responsible for the inspiratory splitting of S2?
A) Closure of aortic, then pulmonic valves
B) Closure of mitral, then tricuspid valves
C) Closure of aortic, then tricuspid valves
D) Closure of mitral, then pulmonic valves - ✔✔A
✔✔A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As
part of your physical examination, you listen to her heart and hear a murmur only at the
cardiac apex. Which valve is most likely to be involved, based on the location of the
murmur?
A) Mitral
B) Tricuspid
C) Aortic
D) Pulmonic - ✔✔A
✔✔A 58-year-old teacher presents to your clinic complaining of breathlessness with
activity. The patient has no chronic conditions and takes no medications, herbs, or
supplements. Which of the following symptoms is appropriate to ask about in the
cardiovascular review of systems?
A) Abdominal pain
B) Orthopnea
C) Hematochezia
D) Tenesmus - ✔✔B
