1|Page
NURS 5220 Exam 2 (2026/2027) Advanced Health
Assessment – Cardiovascular, Pulmonary, GI,
Renal, Neuro, MSK & Endocrine Q&A 1-300 with
Verified Answers & Detailed Clinical Rationales |
Latest Update
NURS 5220 Exam 2 (2026/2027) – Advanced Health Assessment |
300 Q&A with Rationales
Ace your NURS 5220 Advanced Health Assessment Exam 2 with this
comprehensive study guide featuring 300 multiple-choice questions
and verified answers with detailed clinical rationales. Covers:
Cardiovascular (HF, CAD, PAD, Pericarditis), Pulmonary (COPD,
Pneumonia, TB, Asthma), Gastrointestinal (Pancreatitis,
Cholecystitis, Achalasia, Esophageal Cancer), Renal/Genitourinary
(Nephrolithiasis, BPH, Prostate Cancer), Neurologic (Dementia,
NPH, DLB, Stroke), Musculoskeletal (Dermatomyositis,
Claudication), and Endocrine (Thyroid disorders,
Hyperparathyroidism). Updated for 2026/2027 curriculum. Perfect for
NP, FNP, and MSN students. High-yield board-style questions with
differential diagnosis focus. Pass with confidence! Ideal for Walden,
Chamberlain, UTA, Purdue, Capella
, 2|Page
1. A 58-year-old male with a history of hypertension presents with a 2-week history of
progressive dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea. On
exam, he has jugular venous distension, crackles at both lung bases, and a third heart
sound (S3). What is the most likely diagnosis?
A) Chronic obstructive pulmonary disease (COPD)
B) Heart failure with reduced ejection fraction (HFrEF)
C) Pulmonary embolism
D) Pericardial effusion
Answer: B) Heart failure with reduced ejection fraction (HFrEF).
Rationale: The classic triad of dyspnea on exertion, orthopnea, and paroxysmal
nocturnal dyspnea, along with JVD, crackles, and an S3 gallop, is highly suggestive of
HFrEF. An S3 indicates elevated ventricular filling pressures. COPD would present with
chronic cough and wheezing. Pulmonary embolism presents acutely with pleuritic chest
pain and hypoxia. Pericardial effusion presents with muffled heart sounds and pulsus
paradoxus, not crackles or S3.
2. A 65-year-old male with a 45-pack-year smoking history presents with a chronic
cough productive of purulent sputum for most days over the past 3 months, for 2
consecutive years. On exam, he has barrel-shaped chest, prolonged expiration, and
wheezing. What is the most likely diagnosis?
A) Asthma
B) Chronic bronchitis
C) Emphysema
D) Bronchiectasis
Answer: B) Chronic bronchitis.
Rationale: Chronic bronchitis is defined by a productive cough for at least 3 months in
2 consecutive years. The patient has a smoking history and chronic productive cough.
Emphysema is characterized by destruction of alveoli without predominant cough.
Asthma is episodic and reversible. Bronchiectasis involves permanent dilation of
airways with recurrent infections and copious purulent sputum.
3. A 72-year-old female presents with a 3-day history of fever, productive cough with
rust-colored sputum, and pleuritic chest pain. On exam, she has crackles in the right
lower lung field. A chest X-ray shows right lower lobe consolidation. What is the
most likely causative organism?
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A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Legionella pneumophila
D) Chlamydophila pneumoniae
Answer: B) Streptococcus pneumoniae.
Rationale: Streptococcus pneumoniae is the most common cause of community-
acquired pneumonia presenting with acute onset of fever, productive cough with rust-
colored sputum, and lobar consolidation on CXR. Mycoplasma and Chlamydophila
cause atypical pneumonia with dry cough and extrapulmonary symptoms. Legionella
presents with severe pneumonia, diarrhea, and hyponatremia.
4. A 55-year-old male with a history of alcohol use disorder presents with acute
epigastric pain radiating to his back, nausea, and vomiting. Serum lipase is 1,200 U/L
(normal < 60). On exam, he has epigastric tenderness and guarding. What is the
most likely diagnosis?
A) Acute cholecystitis
B) Acute pancreatitis
C) Perforated peptic ulcer
D) Acute gastritis
Answer: B) Acute pancreatitis.
Rationale: Acute pancreatitis presents with severe epigastric pain radiating to the back,
nausea, vomiting, and marked elevation of serum lipase (typically > 3 times upper
normal). Alcohol and gallstones are the most common causes. Cholecystitis presents
with right upper quadrant pain and Murphy's sign. Perforated ulcer causes sudden,
severe, diffuse abdominal pain with rigidity. Gastritis is milder.
5. A 62-year-old female presents with a 6-month history of progressive dysphagia to
solids, weight loss of 15 pounds, and hoarseness. She has a 30-year smoking history.
What is the most appropriate diagnostic test?
A) Barium swallow
B) Upper endoscopy with biopsy (EGD)
C) Chest CT scan
D) Esophageal manometry
Answer: B) Upper endoscopy with biopsy (EGD).
Rationale: Progressive dysphagia to solids with weight loss and hoarseness in a smoker
is concerning for esophageal cancer. EGD with biopsy is the gold standard for
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diagnosis, allowing direct visualization and tissue sampling. Barium swallow may show
a filling defect but cannot biopsy. CT is for staging. Manometry is for motility disorders.
6. A 48-year-old male presents with acute onset of severe, tearing chest pain radiating
to his back. His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg
in the left arm. What is the most appropriate immediate imaging study?
A) Chest X-ray
B) CT angiography of the chest
C) Transesophageal echocardiogram (TEE)
D) MRI of the chest
Answer: B) CT angiography of the chest.
Rationale: Acute aortic dissection presents with tearing chest pain radiating to the back
and pulse/blood pressure differential between arms. CT angiography is the imaging
modality of choice in the emergency setting due to its high sensitivity, specificity, and
rapid availability. TEE is also accurate but more invasive and operator-dependent. CXR
may show widened mediastinum but is not diagnostic. MRI takes too long.
7. A 70-year-old male with a history of hypertension and diabetes presents with a 1-
week history of progressive confusion, urinary incontinence, and a shuffling, wide-
based gait. What is the most likely diagnosis?
A) Alzheimer's disease
B) Parkinson's disease
C) Normal pressure hydrocephalus (NPH)
D) Vascular dementia
Answer: C) Normal pressure hydrocephalus (NPH).
Rationale: NPH presents with the classic triad of dementia (confusion), gait disturbance
(shuffling, wide-based), and urinary incontinence. Alzheimer's lacks prominent gait
disturbance early. Parkinson's has bradykinesia and rigidity but not the classic triad.
Vascular dementia has a stepwise decline with focal neurologic deficits.
8. A 35-year-old female presents with a 3-week history of fatigue, weight gain, cold
intolerance, and constipation. On exam, she has bradycardia, dry skin, and a delayed
relaxation phase of deep tendon reflexes. TSH is 18 mIU/L and free T4 is low. What is
the most likely cause?
A) Graves' disease
NURS 5220 Exam 2 (2026/2027) Advanced Health
Assessment – Cardiovascular, Pulmonary, GI,
Renal, Neuro, MSK & Endocrine Q&A 1-300 with
Verified Answers & Detailed Clinical Rationales |
Latest Update
NURS 5220 Exam 2 (2026/2027) – Advanced Health Assessment |
300 Q&A with Rationales
Ace your NURS 5220 Advanced Health Assessment Exam 2 with this
comprehensive study guide featuring 300 multiple-choice questions
and verified answers with detailed clinical rationales. Covers:
Cardiovascular (HF, CAD, PAD, Pericarditis), Pulmonary (COPD,
Pneumonia, TB, Asthma), Gastrointestinal (Pancreatitis,
Cholecystitis, Achalasia, Esophageal Cancer), Renal/Genitourinary
(Nephrolithiasis, BPH, Prostate Cancer), Neurologic (Dementia,
NPH, DLB, Stroke), Musculoskeletal (Dermatomyositis,
Claudication), and Endocrine (Thyroid disorders,
Hyperparathyroidism). Updated for 2026/2027 curriculum. Perfect for
NP, FNP, and MSN students. High-yield board-style questions with
differential diagnosis focus. Pass with confidence! Ideal for Walden,
Chamberlain, UTA, Purdue, Capella
, 2|Page
1. A 58-year-old male with a history of hypertension presents with a 2-week history of
progressive dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea. On
exam, he has jugular venous distension, crackles at both lung bases, and a third heart
sound (S3). What is the most likely diagnosis?
A) Chronic obstructive pulmonary disease (COPD)
B) Heart failure with reduced ejection fraction (HFrEF)
C) Pulmonary embolism
D) Pericardial effusion
Answer: B) Heart failure with reduced ejection fraction (HFrEF).
Rationale: The classic triad of dyspnea on exertion, orthopnea, and paroxysmal
nocturnal dyspnea, along with JVD, crackles, and an S3 gallop, is highly suggestive of
HFrEF. An S3 indicates elevated ventricular filling pressures. COPD would present with
chronic cough and wheezing. Pulmonary embolism presents acutely with pleuritic chest
pain and hypoxia. Pericardial effusion presents with muffled heart sounds and pulsus
paradoxus, not crackles or S3.
2. A 65-year-old male with a 45-pack-year smoking history presents with a chronic
cough productive of purulent sputum for most days over the past 3 months, for 2
consecutive years. On exam, he has barrel-shaped chest, prolonged expiration, and
wheezing. What is the most likely diagnosis?
A) Asthma
B) Chronic bronchitis
C) Emphysema
D) Bronchiectasis
Answer: B) Chronic bronchitis.
Rationale: Chronic bronchitis is defined by a productive cough for at least 3 months in
2 consecutive years. The patient has a smoking history and chronic productive cough.
Emphysema is characterized by destruction of alveoli without predominant cough.
Asthma is episodic and reversible. Bronchiectasis involves permanent dilation of
airways with recurrent infections and copious purulent sputum.
3. A 72-year-old female presents with a 3-day history of fever, productive cough with
rust-colored sputum, and pleuritic chest pain. On exam, she has crackles in the right
lower lung field. A chest X-ray shows right lower lobe consolidation. What is the
most likely causative organism?
, 3|Page
A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Legionella pneumophila
D) Chlamydophila pneumoniae
Answer: B) Streptococcus pneumoniae.
Rationale: Streptococcus pneumoniae is the most common cause of community-
acquired pneumonia presenting with acute onset of fever, productive cough with rust-
colored sputum, and lobar consolidation on CXR. Mycoplasma and Chlamydophila
cause atypical pneumonia with dry cough and extrapulmonary symptoms. Legionella
presents with severe pneumonia, diarrhea, and hyponatremia.
4. A 55-year-old male with a history of alcohol use disorder presents with acute
epigastric pain radiating to his back, nausea, and vomiting. Serum lipase is 1,200 U/L
(normal < 60). On exam, he has epigastric tenderness and guarding. What is the
most likely diagnosis?
A) Acute cholecystitis
B) Acute pancreatitis
C) Perforated peptic ulcer
D) Acute gastritis
Answer: B) Acute pancreatitis.
Rationale: Acute pancreatitis presents with severe epigastric pain radiating to the back,
nausea, vomiting, and marked elevation of serum lipase (typically > 3 times upper
normal). Alcohol and gallstones are the most common causes. Cholecystitis presents
with right upper quadrant pain and Murphy's sign. Perforated ulcer causes sudden,
severe, diffuse abdominal pain with rigidity. Gastritis is milder.
5. A 62-year-old female presents with a 6-month history of progressive dysphagia to
solids, weight loss of 15 pounds, and hoarseness. She has a 30-year smoking history.
What is the most appropriate diagnostic test?
A) Barium swallow
B) Upper endoscopy with biopsy (EGD)
C) Chest CT scan
D) Esophageal manometry
Answer: B) Upper endoscopy with biopsy (EGD).
Rationale: Progressive dysphagia to solids with weight loss and hoarseness in a smoker
is concerning for esophageal cancer. EGD with biopsy is the gold standard for
, 4|Page
diagnosis, allowing direct visualization and tissue sampling. Barium swallow may show
a filling defect but cannot biopsy. CT is for staging. Manometry is for motility disorders.
6. A 48-year-old male presents with acute onset of severe, tearing chest pain radiating
to his back. His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg
in the left arm. What is the most appropriate immediate imaging study?
A) Chest X-ray
B) CT angiography of the chest
C) Transesophageal echocardiogram (TEE)
D) MRI of the chest
Answer: B) CT angiography of the chest.
Rationale: Acute aortic dissection presents with tearing chest pain radiating to the back
and pulse/blood pressure differential between arms. CT angiography is the imaging
modality of choice in the emergency setting due to its high sensitivity, specificity, and
rapid availability. TEE is also accurate but more invasive and operator-dependent. CXR
may show widened mediastinum but is not diagnostic. MRI takes too long.
7. A 70-year-old male with a history of hypertension and diabetes presents with a 1-
week history of progressive confusion, urinary incontinence, and a shuffling, wide-
based gait. What is the most likely diagnosis?
A) Alzheimer's disease
B) Parkinson's disease
C) Normal pressure hydrocephalus (NPH)
D) Vascular dementia
Answer: C) Normal pressure hydrocephalus (NPH).
Rationale: NPH presents with the classic triad of dementia (confusion), gait disturbance
(shuffling, wide-based), and urinary incontinence. Alzheimer's lacks prominent gait
disturbance early. Parkinson's has bradykinesia and rigidity but not the classic triad.
Vascular dementia has a stepwise decline with focal neurologic deficits.
8. A 35-year-old female presents with a 3-week history of fatigue, weight gain, cold
intolerance, and constipation. On exam, she has bradycardia, dry skin, and a delayed
relaxation phase of deep tendon reflexes. TSH is 18 mIU/L and free T4 is low. What is
the most likely cause?
A) Graves' disease
