NURS 5334 ADVANCED HEALTH
ASSESSMENT TEST 2 2026/2027
QUESTIONS AND ANSWERS
1. When assessing for tactile fremitus on the posterior thorax, the nurse practitioner notes
increased fremitus over the right lower lobe. This finding is most consistent with which
clinical condition?
A. Pneumothorax
B. Pleural effusion
C. Chronic obstructive pulmonary disease
D. Lobar pneumonia
Answer: D
Conceptual Explanation: Tactile fremitus increases with conditions that increase the
density of lung tissue, such as consolidation in pneumonia. Pneumothorax, effusion, and
COPD typically decrease or absent fremitus because they provide a barrier to sound
vibration.
,2. During a cardiac auscultation, a mid-systolic click followed by a late systolic murmur is
heard at the apex. This is most likely indicative of:
A. Aortic stenosis
B. Mitral regurgitation
C. Mitral valve prolapse
D. Tricuspid regurgitation
Answer: C
Conceptual Explanation: A mid-systolic click is the hallmark finding of mitral valve
prolapse (MVP), often followed by a late systolic murmur of mitral regurgitation.
3. A 65-year-old patient reports a sudden onset of ‘curtain dropping’ over their vision in the
right eye, accompanied by floaters and flashes of light. What is the most likely diagnosis?
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Macular degeneration
D. Cataract progression
Answer: B
Conceptual Explanation: Sudden vision loss described as a curtain being drawn, flashes
(photopsia), and floaters are classic signs of retinal detachment, a medical emergency.
, 4. Which of the following findings on a skin examination would most strongly suggest
malignant melanoma?
A. An asymmetric lesion with irregular borders and color variegation
B. A pearly papule with telangiectasia and a central ulcer
C. A uniform, dark brown macule 4mm in diameter
D. A well-demarcated erythematous plaque with silvery scales
Answer: A
Conceptual Explanation: The ABCDE criteria for melanoma include Asymmetry, Border
irregularity, Color variegation, Diameter >6mm, and Evolving features.
5. A patient presents with a ‘blowing’ holosystolic murmur heard best at the apex that
radiates to the left axilla. This is consistent with:
A. Mitral regurgitation
B. Aortic regurgitation
C. Mitral stenosis
D. Aortic stenosis
Answer: A
Conceptual Explanation: Mitral regurgitation produces a holosystolic murmur at the apex
that radiates to the axilla. Aortic stenosis is mid-systolic and radiates to the neck.
ASSESSMENT TEST 2 2026/2027
QUESTIONS AND ANSWERS
1. When assessing for tactile fremitus on the posterior thorax, the nurse practitioner notes
increased fremitus over the right lower lobe. This finding is most consistent with which
clinical condition?
A. Pneumothorax
B. Pleural effusion
C. Chronic obstructive pulmonary disease
D. Lobar pneumonia
Answer: D
Conceptual Explanation: Tactile fremitus increases with conditions that increase the
density of lung tissue, such as consolidation in pneumonia. Pneumothorax, effusion, and
COPD typically decrease or absent fremitus because they provide a barrier to sound
vibration.
,2. During a cardiac auscultation, a mid-systolic click followed by a late systolic murmur is
heard at the apex. This is most likely indicative of:
A. Aortic stenosis
B. Mitral regurgitation
C. Mitral valve prolapse
D. Tricuspid regurgitation
Answer: C
Conceptual Explanation: A mid-systolic click is the hallmark finding of mitral valve
prolapse (MVP), often followed by a late systolic murmur of mitral regurgitation.
3. A 65-year-old patient reports a sudden onset of ‘curtain dropping’ over their vision in the
right eye, accompanied by floaters and flashes of light. What is the most likely diagnosis?
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Macular degeneration
D. Cataract progression
Answer: B
Conceptual Explanation: Sudden vision loss described as a curtain being drawn, flashes
(photopsia), and floaters are classic signs of retinal detachment, a medical emergency.
, 4. Which of the following findings on a skin examination would most strongly suggest
malignant melanoma?
A. An asymmetric lesion with irregular borders and color variegation
B. A pearly papule with telangiectasia and a central ulcer
C. A uniform, dark brown macule 4mm in diameter
D. A well-demarcated erythematous plaque with silvery scales
Answer: A
Conceptual Explanation: The ABCDE criteria for melanoma include Asymmetry, Border
irregularity, Color variegation, Diameter >6mm, and Evolving features.
5. A patient presents with a ‘blowing’ holosystolic murmur heard best at the apex that
radiates to the left axilla. This is consistent with:
A. Mitral regurgitation
B. Aortic regurgitation
C. Mitral stenosis
D. Aortic stenosis
Answer: A
Conceptual Explanation: Mitral regurgitation produces a holosystolic murmur at the apex
that radiates to the axilla. Aortic stenosis is mid-systolic and radiates to the neck.
