NU 673 Midterm Exam 2026/2027 Complete Exam-Style
Questions with Detailed Rationales EXAM COVERAGE AREAS
(MOST FREQUENTLY TESTED)
Ace your psychiatric-mental health nurse practitioner milestone assessment with this
definitive NU 673 Midterm Exam preparation bank for the 2026/2027 academic cycle.
This comprehensive study guide features high-yield, exam-style practice questions
paired with verified answers and explicit clinical rationales tracking the most frequently
tested coverage areas, including DSM-5-TR diagnostic criteria, advanced
psychopathology, neurobiology, and child/adolescent mental health interventions. It is
an indispensable resource for graduate nursing students looking to compress study
routines, master complex clinical case studies, and confidently secure an A+ grade.
1. A patient presents with a pruritic rash over the knees and elbows
that has come and gone for several years. It worsens in winter and
improves with sun exposure. On exam, the APRN notes erythematous
well-circumscribed plaques with silvery scale. What skin condition
does the APRN suspect?
A. Atopic dermatitis
B. Seborrheic dermatitis
C. Psoriasis
D. Lichen planus
Rationale: Psoriasis presents with well-circumscribed erythematous plaques
with silvery scale, commonly affecting extensor surfaces (knees, elbows). It is
chronic, worsens with winter/cold, and improves with sun exposure .
,2. A 68-year-old male presents for evaluation of leg swelling. He is a
smoker and on antihypertensive medication. The APRN is concerned
about peripheral vascular disease risk. Which test is appropriate for
INITIAL evaluation of this condition?
A. Doppler ultrasound
B. Venous duplex study
C. Ankle-brachial index (ABI)
D. Arteriography
Rationale: The ankle-brachial index (ABI) is the initial non-invasive screening
test for peripheral arterial disease. An ABI <0.90 indicates PAD .
3. A 45-year-old female presents with respiratory distress, and the
APRN intends to draw an arterial blood gas (ABG). Prior to drawing
the ABG, the APRN will perform which test to ensure patency of the
ulnar artery before puncturing the radial artery?
A. Allen test
B. Trendelenburg test
C. Homan's sign
D. Phalen's maneuver
Rationale: The Allen test is performed before radial artery puncture to assess
ulnar artery collateral circulation. If ulnar circulation is inadequate, the radial
artery should not be punctured to prevent ischemic complications .
4. An APRN notes a 12 mm Hg difference in systolic BP during
inspiration. How should the APRN document this finding?
A. Acute stenosis
B. Carotid arterial disease
,C. Paradoxical pulse
D. Pulsus alternans
Rationale: A pulsus paradoxus is defined as a decrease in systolic BP >10
mmHg during inspiration. It is associated with cardiac tamponade, severe
asthma, and COPD .
5. Which of the following percussion notes is obtained over a gastric
bubble?
A. Flatness
B. Hyperresonance
C. Tympany
D. Resonance
Rationale: Tympany is a high-pitched, drum-like percussion sound heard over
hollow organs containing air, such as the stomach. Resonance is heard over
normal lung tissue .
6. The APRN is performing a cardiac exam on a patient with SOB and
palpitations. The APRN listens to the heart with the patient sitting
upright, then supine, then left lateral decubitus. Which valvular defect
is BEST heard in the left lateral decubitus position?
A. Mitral stenosis
B. Aortic stenosis
C. Tricuspid regurgitation
D. Pulmonic stenosis
Rationale: Left lateral decubitus position brings the mitral valve closer to the
chest wall, making mitral stenosis murmurs (diastolic rumble) more audible .
, 7. A 20-year-old male has a history of leukemia and an enlarged
spleen. He presents with significant left upper quadrant pain. On
exam, a rough grating noise is heard. What is this sound known as?
A. Variant of bowel noise
B. Splenic rub
C. Vascular bruit
D. Peritoneal friction rub
Rationale: A splenic rub is a rough, grating sound heard over the spleen,
indicating inflammation or infarction of the splenic capsule. This can occur in
conditions that enlarge the spleen .
8. An APRN notes a 0.5 cm nodule on the helix of an older adult's ear
with central scabbed ulceration and firm edges. What is the most likely
diagnosis?
A. Basal cell carcinoma
B. Melanoma
C. Actinic keratosis
D. Squamous cell carcinoma
Rationale: Squamous cell carcinoma on the ear presents as a scaly, crusted
nodule or ulcer with firm edges. The helix of the ear is a common location for
sun-induced SCC. Basal cell carcinoma is less likely with central scabbing .
9. A retired farmer presents with a flattened papule on the right
temporal area of the forehead. It is skin-colored with a dry scale.
Several more similar lesions are scattered on the forehead, arms, and
legs. What is the most likely diagnosis?
Questions with Detailed Rationales EXAM COVERAGE AREAS
(MOST FREQUENTLY TESTED)
Ace your psychiatric-mental health nurse practitioner milestone assessment with this
definitive NU 673 Midterm Exam preparation bank for the 2026/2027 academic cycle.
This comprehensive study guide features high-yield, exam-style practice questions
paired with verified answers and explicit clinical rationales tracking the most frequently
tested coverage areas, including DSM-5-TR diagnostic criteria, advanced
psychopathology, neurobiology, and child/adolescent mental health interventions. It is
an indispensable resource for graduate nursing students looking to compress study
routines, master complex clinical case studies, and confidently secure an A+ grade.
1. A patient presents with a pruritic rash over the knees and elbows
that has come and gone for several years. It worsens in winter and
improves with sun exposure. On exam, the APRN notes erythematous
well-circumscribed plaques with silvery scale. What skin condition
does the APRN suspect?
A. Atopic dermatitis
B. Seborrheic dermatitis
C. Psoriasis
D. Lichen planus
Rationale: Psoriasis presents with well-circumscribed erythematous plaques
with silvery scale, commonly affecting extensor surfaces (knees, elbows). It is
chronic, worsens with winter/cold, and improves with sun exposure .
,2. A 68-year-old male presents for evaluation of leg swelling. He is a
smoker and on antihypertensive medication. The APRN is concerned
about peripheral vascular disease risk. Which test is appropriate for
INITIAL evaluation of this condition?
A. Doppler ultrasound
B. Venous duplex study
C. Ankle-brachial index (ABI)
D. Arteriography
Rationale: The ankle-brachial index (ABI) is the initial non-invasive screening
test for peripheral arterial disease. An ABI <0.90 indicates PAD .
3. A 45-year-old female presents with respiratory distress, and the
APRN intends to draw an arterial blood gas (ABG). Prior to drawing
the ABG, the APRN will perform which test to ensure patency of the
ulnar artery before puncturing the radial artery?
A. Allen test
B. Trendelenburg test
C. Homan's sign
D. Phalen's maneuver
Rationale: The Allen test is performed before radial artery puncture to assess
ulnar artery collateral circulation. If ulnar circulation is inadequate, the radial
artery should not be punctured to prevent ischemic complications .
4. An APRN notes a 12 mm Hg difference in systolic BP during
inspiration. How should the APRN document this finding?
A. Acute stenosis
B. Carotid arterial disease
,C. Paradoxical pulse
D. Pulsus alternans
Rationale: A pulsus paradoxus is defined as a decrease in systolic BP >10
mmHg during inspiration. It is associated with cardiac tamponade, severe
asthma, and COPD .
5. Which of the following percussion notes is obtained over a gastric
bubble?
A. Flatness
B. Hyperresonance
C. Tympany
D. Resonance
Rationale: Tympany is a high-pitched, drum-like percussion sound heard over
hollow organs containing air, such as the stomach. Resonance is heard over
normal lung tissue .
6. The APRN is performing a cardiac exam on a patient with SOB and
palpitations. The APRN listens to the heart with the patient sitting
upright, then supine, then left lateral decubitus. Which valvular defect
is BEST heard in the left lateral decubitus position?
A. Mitral stenosis
B. Aortic stenosis
C. Tricuspid regurgitation
D. Pulmonic stenosis
Rationale: Left lateral decubitus position brings the mitral valve closer to the
chest wall, making mitral stenosis murmurs (diastolic rumble) more audible .
, 7. A 20-year-old male has a history of leukemia and an enlarged
spleen. He presents with significant left upper quadrant pain. On
exam, a rough grating noise is heard. What is this sound known as?
A. Variant of bowel noise
B. Splenic rub
C. Vascular bruit
D. Peritoneal friction rub
Rationale: A splenic rub is a rough, grating sound heard over the spleen,
indicating inflammation or infarction of the splenic capsule. This can occur in
conditions that enlarge the spleen .
8. An APRN notes a 0.5 cm nodule on the helix of an older adult's ear
with central scabbed ulceration and firm edges. What is the most likely
diagnosis?
A. Basal cell carcinoma
B. Melanoma
C. Actinic keratosis
D. Squamous cell carcinoma
Rationale: Squamous cell carcinoma on the ear presents as a scaly, crusted
nodule or ulcer with firm edges. The helix of the ear is a common location for
sun-induced SCC. Basal cell carcinoma is less likely with central scabbing .
9. A retired farmer presents with a flattened papule on the right
temporal area of the forehead. It is skin-colored with a dry scale.
Several more similar lesions are scattered on the forehead, arms, and
legs. What is the most likely diagnosis?
