NURS 5432 FNP 1 COMPREHENSIVE
MIDTERM AND FINAL EXAM
(MODULES 1-6) QUESTIONS AND
ANSWERS
1. A 68-year-old patient presents with a complaint of sudden, painless loss of vision in the
right eye described as a ‘curtain coming down.’ What is the most likely diagnosis?
A. Acute angle-closure glaucoma
B. Macular degeneration
C. Retinal detachment
D. Cataracts
Answer: C
Conceptual Explanation: Retinal detachment typically presents as a sudden, painless loss
of vision, often described as a shadow or curtain falling across the field of vision.
,2. During a physical exam, you perform the Weber test. The patient reports that the sound
lateralizes to the right ear. The Rinne test shows BC > AC in the right ear. What is the
interpretation?
A. Conductive hearing loss in the right ear
B. Sensorineural hearing loss in the right ear
C. Normal hearing
D. Conductive hearing loss in the left ear
Answer: A
Conceptual Explanation: In conductive hearing loss, the Weber test lateralizes to the
affected ear and the Rinne test shows bone conduction (BC) is greater than air conduction
(AC).
3. Which of the following physical exam findings is most characteristic of a patient with lobar
pneumonia?
A. Hyperresonance on percussion
B. Decreased tactile fremitus
C. Increased tactile fremitus and dullness to percussion
D. Tracheal deviation to the opposite side
Answer: C
, Conceptual Explanation: Pneumonia causes consolidation in the lung tissue, which
increases the transmission of vibrations (tactile fremitus) and produces a dull sound on
percussion.
4. A 45-year-old female complains of right upper quadrant pain that radiates to her right
shoulder after eating a fatty meal. Murphy’s sign is positive. What is the most likely
diagnosis?
A. Acute Cholecystitis
B. Acute Appendicitis
C. Acute Pancreatitis
D. Peptic Ulcer Disease
Answer: A
Conceptual Explanation: A positive Murphy’s sign (pain and cessation of inspiration upon
palpation of the gallbladder) is highly suggestive of acute cholecystitis.
5. When assessing for a heart murmur, you hear a harsh, mid-systolic crescendo-decrescendo
murmur at the 2nd intercostal space, right sternal border, radiating to the carotid arteries.
This is most likely:
A. Mitral Regurgitation
B. Aortic Regurgitation
C. Aortic Stenosis
MIDTERM AND FINAL EXAM
(MODULES 1-6) QUESTIONS AND
ANSWERS
1. A 68-year-old patient presents with a complaint of sudden, painless loss of vision in the
right eye described as a ‘curtain coming down.’ What is the most likely diagnosis?
A. Acute angle-closure glaucoma
B. Macular degeneration
C. Retinal detachment
D. Cataracts
Answer: C
Conceptual Explanation: Retinal detachment typically presents as a sudden, painless loss
of vision, often described as a shadow or curtain falling across the field of vision.
,2. During a physical exam, you perform the Weber test. The patient reports that the sound
lateralizes to the right ear. The Rinne test shows BC > AC in the right ear. What is the
interpretation?
A. Conductive hearing loss in the right ear
B. Sensorineural hearing loss in the right ear
C. Normal hearing
D. Conductive hearing loss in the left ear
Answer: A
Conceptual Explanation: In conductive hearing loss, the Weber test lateralizes to the
affected ear and the Rinne test shows bone conduction (BC) is greater than air conduction
(AC).
3. Which of the following physical exam findings is most characteristic of a patient with lobar
pneumonia?
A. Hyperresonance on percussion
B. Decreased tactile fremitus
C. Increased tactile fremitus and dullness to percussion
D. Tracheal deviation to the opposite side
Answer: C
, Conceptual Explanation: Pneumonia causes consolidation in the lung tissue, which
increases the transmission of vibrations (tactile fremitus) and produces a dull sound on
percussion.
4. A 45-year-old female complains of right upper quadrant pain that radiates to her right
shoulder after eating a fatty meal. Murphy’s sign is positive. What is the most likely
diagnosis?
A. Acute Cholecystitis
B. Acute Appendicitis
C. Acute Pancreatitis
D. Peptic Ulcer Disease
Answer: A
Conceptual Explanation: A positive Murphy’s sign (pain and cessation of inspiration upon
palpation of the gallbladder) is highly suggestive of acute cholecystitis.
5. When assessing for a heart murmur, you hear a harsh, mid-systolic crescendo-decrescendo
murmur at the 2nd intercostal space, right sternal border, radiating to the carotid arteries.
This is most likely:
A. Mitral Regurgitation
B. Aortic Regurgitation
C. Aortic Stenosis
