1|Page
NURS 5220 Exam 1 (2026/2027) Advanced Health
Assessment – Complete Q&A 1-300 with Verified
Answers & Detailed Rationales | Latest Update
NURS 5220 Exam 1 (2026/2027) – Advanced Health Assessment
| 300 Q&A with Rationales
Ace your NURS 5220 Advanced Health Assessment Exam 1 with
this comprehensive study guide featuring 300 multiple-
choice questions and verified answers with detailed clinical
rationales. Covers: Health History, Interviewing Techniques,
Physical Exam, Differential Diagnosis, SOAP Documentation,
and Common Pathologies (Cardiac, Pulmonary, Endocrine,
Neuro, MSK). Updated for 2026/2027 curriculum. Perfect for
NP, FNP, and MSN students. Includes questions on geriatrics,
pediatrics, and pregnant patients. Pass with confidence! Ideal
for Walden, Chamberlain, UTA, Purdue, Capella. Instant
download. High-yield board-style questions.
, 2|Page
1. A 72-year-old male with a 45-pack-year smoking history presents with a new onset
of hoarseness and a persistent cough for 6 weeks. On examination, you note a fixed,
firm, non-tender left supraclavicular lymph node (Virchow's node). Which of the
following is the most appropriate next step in the diagnostic workup for this patient?
A) Initiate a course of oral antibiotics and schedule a follow-up in 2 weeks.
B) Order a chest X-ray and pulmonary function tests.
C) Perform an excisional biopsy of the left supraclavicular lymph node.
D) Obtain a high-resolution CT scan of the neck and chest.
Answer: C) Perform an excisional biopsy of the left supraclavicular lymph node.
Rationale: A fixed, firm, non-tender supraclavicular (Virchow's) node in a patient with
significant smoking history and persistent respiratory symptoms is highly suspicious for
a metastatic malignancy, most commonly from a primary lung or gastrointestinal
source. The most definitive and high-yield next step is a tissue diagnosis via excisional
biopsy of the palpable node, as this will provide histological confirmation and guide
further oncologic workup. While a CT scan is important for staging, it should not delay
the confirmatory biopsy. Antibiotics are inappropriate for a suspected malignancy, and
a chest X-ray with PFTs would not be sufficient to diagnose or stage a probable cancer.
2. A 45-year-old female presents with fatigue, weight gain, cold intolerance, and dry
skin. On physical exam, you note bradycardia and a delayed relaxation phase of the
deep tendon reflexes. Which thyroid disorder is most consistent with these findings?
A) Graves' disease
B) Toxic multinodular goiter
C) Hashimoto's thyroiditis with hypothyroidism
D) Subacute thyroiditis
Answer: C) Hashimoto's thyroiditis with hypothyroidism.
Rationale: The constellation of fatigue, weight gain, cold intolerance, dry skin,
bradycardia, and delayed DTR relaxation is classic for hypothyroidism. Hashimoto's
thyroiditis is the most common cause of hypothyroidism in the United States. Graves'
disease and toxic multinodular goiter cause hyperthyroidism, while subacute thyroiditis
typically presents with a painful goiter and transient hyperthyroidism.
3. A 60-year-old male with a history of hypertension and diabetes presents with a
painful, red, swollen right great toe. He reports that the pain began suddenly last
night and is so severe that he cannot bear the weight of a bedsheet on it. Which of
the following is the most likely diagnosis?
A) Septic arthritis
, 3|Page
B) Gout
C) Osteoarthritis
D) Rheumatoid arthritis
Answer: B) Gout.
Rationale: Acute gout typically presents with sudden onset of severe pain, redness,
swelling, and warmth in a single joint, most classically the first metatarsophalangeal
joint (podagra). The pain is often described as excruciating and precipitated by factors
like alcohol, dehydration, or purine-rich meals. Septic arthritis is also acute but usually
associated with fever and systemic symptoms; osteoarthritis is chronic and
degenerative; rheumatoid arthritis is symmetric and polyarticular.
4. A 30-year-old pregnant woman at 28 weeks gestation complains of heartburn and
regurgitation after meals. She denies hematemesis, melena, or weight loss. Which of
the following is the most appropriate initial management?
A) Start a proton pump inhibitor (PPI) daily
B) Recommend lifestyle modifications and antacids
C) Refer for upper endoscopy
D) Prescribe metoclopramide
Answer: B) Recommend lifestyle modifications and antacids.
Rationale: Gastroesophageal reflux disease (GERD) is common in pregnancy due to
hormonal changes and increased intra-abdominal pressure. Initial management should
be lifestyle modifications (small frequent meals, avoid lying down after eating, elevate
head of bed) and antacids (calcium carbonate) which are safe in pregnancy. PPIs are
second-line if symptoms persist. Endoscopy is reserved for refractory or concerning
symptoms (e.g., dysphagia, bleeding, weight loss).
5. A 55-year-old male with a history of coronary artery disease presents with a 2-day
history of sharp, pleuritic chest pain that worsens with deep inspiration and improves
when leaning forward. On auscultation, you hear a friction rub. What is the most
likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Pericarditis
D) Aortic dissection
Answer: C) Pericarditis.
Rationale: Acute pericarditis classically presents with sharp, pleuritic chest pain that is
positional (worse supine, better leaning forward) and associated with a pericardial
, 4|Page
friction rub on auscultation. The ECG may show diffuse ST-segment elevation and PR
depression. Myocardial infarction pain is not typically pleuritic or positional; pulmonary
embolism usually presents with dyspnea and hypoxia; aortic dissection presents with
tearing or ripping pain radiating to the back.
6. A 25-year-old female presents with palpitations, heat intolerance, tremors, and
unexplained weight loss over the past 3 months. On exam, you note a fine tremor,
tachycardia, and a diffusely enlarged, non-tender thyroid gland with a bruit. Which
test would confirm the diagnosis?
A) Elevated TSH and low free T4
B) Low TSH and elevated free T4
C) Normal TSH and elevated T3
D) Elevated TSH and elevated free T4
Answer: B) Low TSH and elevated free T4.
Rationale: This patient has classic signs and symptoms of hyperthyroidism, with Graves'
disease being the most likely etiology given the diffuse goiter and bruit. In primary
hyperthyroidism, the TSH is suppressed (low) and free T4 is elevated. Elevated TSH with
low free T4 would indicate hypothyroidism. Normal TSH with elevated T3 could occur
in T3 toxicosis but is less common.
7. A 68-year-old female presents with a 2-month history of progressive weakness in her
proximal muscles, difficulty rising from a chair, and a reddish-purple rash on her
eyelids and over her knuckles. Which diagnosis is most likely?
A) Systemic lupus erythematosus (SLE)
B) Dermatomyositis
C) Polymyalgia rheumatica
D) Rheumatoid arthritis
Answer: B) Dermatomyositis.
Rationale: Dermatomyositis is an inflammatory myopathy characterized by proximal
muscle weakness and characteristic skin findings, including a heliotrope rash (purplish
discoloration on the eyelids) and Gottron's papules (erythematous scaly plaques over
the knuckles). SLE can have a malar rash and arthritis but not typically proximal
muscle weakness with these specific skin changes. Polymyalgia rheumatica causes
shoulder and hip girdle pain without rash. Rheumatoid arthritis is a symmetric
polyarthritis.
NURS 5220 Exam 1 (2026/2027) Advanced Health
Assessment – Complete Q&A 1-300 with Verified
Answers & Detailed Rationales | Latest Update
NURS 5220 Exam 1 (2026/2027) – Advanced Health Assessment
| 300 Q&A with Rationales
Ace your NURS 5220 Advanced Health Assessment Exam 1 with
this comprehensive study guide featuring 300 multiple-
choice questions and verified answers with detailed clinical
rationales. Covers: Health History, Interviewing Techniques,
Physical Exam, Differential Diagnosis, SOAP Documentation,
and Common Pathologies (Cardiac, Pulmonary, Endocrine,
Neuro, MSK). Updated for 2026/2027 curriculum. Perfect for
NP, FNP, and MSN students. Includes questions on geriatrics,
pediatrics, and pregnant patients. Pass with confidence! Ideal
for Walden, Chamberlain, UTA, Purdue, Capella. Instant
download. High-yield board-style questions.
, 2|Page
1. A 72-year-old male with a 45-pack-year smoking history presents with a new onset
of hoarseness and a persistent cough for 6 weeks. On examination, you note a fixed,
firm, non-tender left supraclavicular lymph node (Virchow's node). Which of the
following is the most appropriate next step in the diagnostic workup for this patient?
A) Initiate a course of oral antibiotics and schedule a follow-up in 2 weeks.
B) Order a chest X-ray and pulmonary function tests.
C) Perform an excisional biopsy of the left supraclavicular lymph node.
D) Obtain a high-resolution CT scan of the neck and chest.
Answer: C) Perform an excisional biopsy of the left supraclavicular lymph node.
Rationale: A fixed, firm, non-tender supraclavicular (Virchow's) node in a patient with
significant smoking history and persistent respiratory symptoms is highly suspicious for
a metastatic malignancy, most commonly from a primary lung or gastrointestinal
source. The most definitive and high-yield next step is a tissue diagnosis via excisional
biopsy of the palpable node, as this will provide histological confirmation and guide
further oncologic workup. While a CT scan is important for staging, it should not delay
the confirmatory biopsy. Antibiotics are inappropriate for a suspected malignancy, and
a chest X-ray with PFTs would not be sufficient to diagnose or stage a probable cancer.
2. A 45-year-old female presents with fatigue, weight gain, cold intolerance, and dry
skin. On physical exam, you note bradycardia and a delayed relaxation phase of the
deep tendon reflexes. Which thyroid disorder is most consistent with these findings?
A) Graves' disease
B) Toxic multinodular goiter
C) Hashimoto's thyroiditis with hypothyroidism
D) Subacute thyroiditis
Answer: C) Hashimoto's thyroiditis with hypothyroidism.
Rationale: The constellation of fatigue, weight gain, cold intolerance, dry skin,
bradycardia, and delayed DTR relaxation is classic for hypothyroidism. Hashimoto's
thyroiditis is the most common cause of hypothyroidism in the United States. Graves'
disease and toxic multinodular goiter cause hyperthyroidism, while subacute thyroiditis
typically presents with a painful goiter and transient hyperthyroidism.
3. A 60-year-old male with a history of hypertension and diabetes presents with a
painful, red, swollen right great toe. He reports that the pain began suddenly last
night and is so severe that he cannot bear the weight of a bedsheet on it. Which of
the following is the most likely diagnosis?
A) Septic arthritis
, 3|Page
B) Gout
C) Osteoarthritis
D) Rheumatoid arthritis
Answer: B) Gout.
Rationale: Acute gout typically presents with sudden onset of severe pain, redness,
swelling, and warmth in a single joint, most classically the first metatarsophalangeal
joint (podagra). The pain is often described as excruciating and precipitated by factors
like alcohol, dehydration, or purine-rich meals. Septic arthritis is also acute but usually
associated with fever and systemic symptoms; osteoarthritis is chronic and
degenerative; rheumatoid arthritis is symmetric and polyarticular.
4. A 30-year-old pregnant woman at 28 weeks gestation complains of heartburn and
regurgitation after meals. She denies hematemesis, melena, or weight loss. Which of
the following is the most appropriate initial management?
A) Start a proton pump inhibitor (PPI) daily
B) Recommend lifestyle modifications and antacids
C) Refer for upper endoscopy
D) Prescribe metoclopramide
Answer: B) Recommend lifestyle modifications and antacids.
Rationale: Gastroesophageal reflux disease (GERD) is common in pregnancy due to
hormonal changes and increased intra-abdominal pressure. Initial management should
be lifestyle modifications (small frequent meals, avoid lying down after eating, elevate
head of bed) and antacids (calcium carbonate) which are safe in pregnancy. PPIs are
second-line if symptoms persist. Endoscopy is reserved for refractory or concerning
symptoms (e.g., dysphagia, bleeding, weight loss).
5. A 55-year-old male with a history of coronary artery disease presents with a 2-day
history of sharp, pleuritic chest pain that worsens with deep inspiration and improves
when leaning forward. On auscultation, you hear a friction rub. What is the most
likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Pericarditis
D) Aortic dissection
Answer: C) Pericarditis.
Rationale: Acute pericarditis classically presents with sharp, pleuritic chest pain that is
positional (worse supine, better leaning forward) and associated with a pericardial
, 4|Page
friction rub on auscultation. The ECG may show diffuse ST-segment elevation and PR
depression. Myocardial infarction pain is not typically pleuritic or positional; pulmonary
embolism usually presents with dyspnea and hypoxia; aortic dissection presents with
tearing or ripping pain radiating to the back.
6. A 25-year-old female presents with palpitations, heat intolerance, tremors, and
unexplained weight loss over the past 3 months. On exam, you note a fine tremor,
tachycardia, and a diffusely enlarged, non-tender thyroid gland with a bruit. Which
test would confirm the diagnosis?
A) Elevated TSH and low free T4
B) Low TSH and elevated free T4
C) Normal TSH and elevated T3
D) Elevated TSH and elevated free T4
Answer: B) Low TSH and elevated free T4.
Rationale: This patient has classic signs and symptoms of hyperthyroidism, with Graves'
disease being the most likely etiology given the diffuse goiter and bruit. In primary
hyperthyroidism, the TSH is suppressed (low) and free T4 is elevated. Elevated TSH with
low free T4 would indicate hypothyroidism. Normal TSH with elevated T3 could occur
in T3 toxicosis but is less common.
7. A 68-year-old female presents with a 2-month history of progressive weakness in her
proximal muscles, difficulty rising from a chair, and a reddish-purple rash on her
eyelids and over her knuckles. Which diagnosis is most likely?
A) Systemic lupus erythematosus (SLE)
B) Dermatomyositis
C) Polymyalgia rheumatica
D) Rheumatoid arthritis
Answer: B) Dermatomyositis.
Rationale: Dermatomyositis is an inflammatory myopathy characterized by proximal
muscle weakness and characteristic skin findings, including a heliotrope rash (purplish
discoloration on the eyelids) and Gottron's papules (erythematous scaly plaques over
the knuckles). SLE can have a malar rash and arthritis but not typically proximal
muscle weakness with these specific skin changes. Polymyalgia rheumatica causes
shoulder and hip girdle pain without rash. Rheumatoid arthritis is a symmetric
polyarthritis.
