NURS 5220 Exam 3 (pdf) | 2026/2027 | Comprehensive
Health Assessment Q&A | Nursing
1. Which of the following best describes the primary purpose of the "S" component in a SOAP
note?
A) Documentation of vital signs and physical exam findings
B) Patient's chief complaint, history of present illness, and review of systems
C) Assessment including differential diagnoses
D) Diagnostic test results and laboratory values
Correct Answer: Patient's chief complaint, history of present illness, and review of systems
Rationale: The "S" in SOAP represents subjective data, which encompasses information reported by
the patient rather than observed by the clinician. This includes the chief complaint, history of present
illness, past medical history, and review of systems. Options A and D represent objective data, while
option C represents the assessment component. Therefore, option B is the correct answer.
2. What is the most likely diagnosis when a practitioner auscultates a low-pitched, rumbling
diastolic murmur at the apex, best heard with the patient in the left lateral decubitus
position?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Aortic regurgitation
Correct Answer: Mitral stenosis
Rationale: Mitral stenosis produces a characteristic low-pitched, rumbling diastolic murmur heard
best at the apex with the bell of the stethoscope. Positioning the patient in the left lateral decubitus
position brings the apex closer to the chest wall, enhancing auscultation. Aortic stenosis and mitral
regurgitation produce systolic murmurs, while aortic regurgitation produces a high-pitched diastolic
murmur at the left sternal border. Therefore, option C is correct.
3. Which term refers to a systematic inquiry about symptoms in each body system during the
health history?
A) Chief complaint
B) History of present illness
C) Review of systems
,D) Past medical history
Correct Answer: Review of systems
Rationale: The review of systems is a head-to-toe, system-by-system inquiry about symptoms the
patient may be experiencing. It ensures that pertinent positives and negatives are elicited for each
body system. The chief complaint is the primary reason for the visit, while the history of present
illness elaborates on that specific concern. Therefore, option C is the correct answer.
4. A researcher is studying patterns of chest pain presentation. Which characteristic is most
consistent with stable angina?
A) Pain that occurs at rest and lasts 30 minutes
B) Pain relieved by rest or nitroglycerin within 5 minutes
C) Pain that is sharp and pleuritic in nature
D) Pain that worsens with deep inspiration
Correct Answer: Pain relieved by rest or nitroglycerin within 5 minutes
Rationale: Stable angina is characterized by predictable chest pain that occurs with exertion and is
relieved by rest or nitroglycerin. The pain typically resolves within 5 minutes of rest. Unstable angina
occurs at rest or with minimal exertion, while pleuritic pain that worsens with inspiration suggests
pericarditis or pleural inflammation. Therefore, option B is correct.
5. In the context of cultural humility, what is the most appropriate interpretation when a
patient avoids direct eye contact with the provider?
A) The patient is being deceptive
B) The patient may be demonstrating cultural respect
C) The patient is experiencing depression
D) The patient is not paying attention
Correct Answer: The patient may be demonstrating cultural respect
Rationale: In many cultures, avoiding direct eye contact with authority figures is a sign of respect and
deference. Cultural humility requires clinicians to recognize these variations without pathologizing
the behavior or making assumptions about dishonesty or depression. Understanding cultural context
prevents miscommunication and builds therapeutic rapport. Therefore, option B is correct.
6. What is the primary function of the "O" component in a SOAP note?
A) Documentation of patient-reported symptoms
B) Recording of physical examination findings, vital signs, and laboratory results
C) Development of a differential diagnosis list
,D) Formulation of the treatment plan
Correct Answer: Recording of physical examination findings, vital signs, and laboratory results
Rationale: The "O" in SOAP stands for objective data, which includes measurable and observable
information obtained by the clinician. This encompasses physical examination findings, vital signs,
and laboratory or diagnostic test results. Subjective data is patient-reported, while the assessment
and plan comprise the "A" and "P" components. Therefore, option B is the correct answer.
7. Which maneuver is most appropriate for assessing for a torn meniscus in the knee?
A) Anterior drawer test
B) Lachman test
C) McMurray test
D) Valgus stress test
Correct Answer: McMurray test
Rationale: The McMurray test is a specialized orthopedic maneuver used to assess for meniscal tears.
The clinician rotates the tibia while flexing and extending the knee, and a palpable or audible click
may indicate a torn meniscus. The anterior drawer and Lachman tests assess the anterior cruciate
ligament, while the valgus stress test evaluates the medial collateral ligament. Therefore, option C is
correct.
8. Which finding would most likely indicate increased tactile fremitus during chest palpation?
A) Pneumothorax
B) Pleural effusion
C) Lobar pneumonia
D) Emphysema
Correct Answer: Lobar pneumonia
Rationale: Tactile fremitus is increased when lung tissue is consolidated, as sound vibrations travel
more efficiently through solid or liquid media than through air. Lobar pneumonia causes
consolidation, thereby increasing tactile fremitus. Pneumothorax, pleural effusion, and emphysema
all decrease tactile fremitus because air or fluid separates the lung from the chest wall. Therefore,
option C is correct.
9. According to the Clinical Judgment Measurement Model, what is the first cognitive step in
the diagnostic reasoning process?
A) Generating hypotheses
B) Recognizing cues
, C) Prioritizing hypotheses
D) Evaluating outcomes
Correct Answer: Recognizing cues
Rationale: The Clinical Judgment Measurement Model begins with recognizing cues, which involves
identifying relevant clinical data from the patient's presentation. This step precedes hypothesis
generation, prioritization of hypotheses, and solution generation. Recognizing cues is foundational
because accurate identification of pertinent data informs all subsequent reasoning. Therefore, option
B is correct.
10. A 45-year-old male presents with sharp, stabbing chest pain that worsens with deep
breathing and is accompanied by a high-pitched, scratchy sound heard during both systole
and diastole. What is the most likely diagnosis?
A) Myocardial infarction
B) Pericardial friction rub
C) Congestive heart failure
D) Pleural effusion
Correct Answer: Pericardial friction rub
Rationale: A pericardial friction rub is a high-pitched, scratchy sound produced by inflammation of
the pericardial sac. It is characteristically heard during both systole and diastole and is often
associated with sharp, pleuritic chest pain that worsens with deep inspiration. Myocardial infarction
typically presents with pressure-like pain, while pleural effusion would produce dullness to percussion
and decreased breath sounds. Therefore, option B is correct.
11. Which term refers to a list of possible conditions that could explain a patient's clinical
presentation?
A) Chief complaint
B) Differential diagnosis
C) Review of systems
D) Assessment
Correct Answer: Differential diagnosis
Rationale: A differential diagnosis is a systematic list of potential conditions that could account for
the patient's signs and symptoms. It guides the diagnostic workup and helps the clinician prioritize
testing and treatment. The chief complaint is the presenting concern, while the review of systems is a
systematic symptom inquiry. Therefore, option B is correct.
12. What would most appropriately be documented in the "A" section of a SOAP note?
Health Assessment Q&A | Nursing
1. Which of the following best describes the primary purpose of the "S" component in a SOAP
note?
A) Documentation of vital signs and physical exam findings
B) Patient's chief complaint, history of present illness, and review of systems
C) Assessment including differential diagnoses
D) Diagnostic test results and laboratory values
Correct Answer: Patient's chief complaint, history of present illness, and review of systems
Rationale: The "S" in SOAP represents subjective data, which encompasses information reported by
the patient rather than observed by the clinician. This includes the chief complaint, history of present
illness, past medical history, and review of systems. Options A and D represent objective data, while
option C represents the assessment component. Therefore, option B is the correct answer.
2. What is the most likely diagnosis when a practitioner auscultates a low-pitched, rumbling
diastolic murmur at the apex, best heard with the patient in the left lateral decubitus
position?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Aortic regurgitation
Correct Answer: Mitral stenosis
Rationale: Mitral stenosis produces a characteristic low-pitched, rumbling diastolic murmur heard
best at the apex with the bell of the stethoscope. Positioning the patient in the left lateral decubitus
position brings the apex closer to the chest wall, enhancing auscultation. Aortic stenosis and mitral
regurgitation produce systolic murmurs, while aortic regurgitation produces a high-pitched diastolic
murmur at the left sternal border. Therefore, option C is correct.
3. Which term refers to a systematic inquiry about symptoms in each body system during the
health history?
A) Chief complaint
B) History of present illness
C) Review of systems
,D) Past medical history
Correct Answer: Review of systems
Rationale: The review of systems is a head-to-toe, system-by-system inquiry about symptoms the
patient may be experiencing. It ensures that pertinent positives and negatives are elicited for each
body system. The chief complaint is the primary reason for the visit, while the history of present
illness elaborates on that specific concern. Therefore, option C is the correct answer.
4. A researcher is studying patterns of chest pain presentation. Which characteristic is most
consistent with stable angina?
A) Pain that occurs at rest and lasts 30 minutes
B) Pain relieved by rest or nitroglycerin within 5 minutes
C) Pain that is sharp and pleuritic in nature
D) Pain that worsens with deep inspiration
Correct Answer: Pain relieved by rest or nitroglycerin within 5 minutes
Rationale: Stable angina is characterized by predictable chest pain that occurs with exertion and is
relieved by rest or nitroglycerin. The pain typically resolves within 5 minutes of rest. Unstable angina
occurs at rest or with minimal exertion, while pleuritic pain that worsens with inspiration suggests
pericarditis or pleural inflammation. Therefore, option B is correct.
5. In the context of cultural humility, what is the most appropriate interpretation when a
patient avoids direct eye contact with the provider?
A) The patient is being deceptive
B) The patient may be demonstrating cultural respect
C) The patient is experiencing depression
D) The patient is not paying attention
Correct Answer: The patient may be demonstrating cultural respect
Rationale: In many cultures, avoiding direct eye contact with authority figures is a sign of respect and
deference. Cultural humility requires clinicians to recognize these variations without pathologizing
the behavior or making assumptions about dishonesty or depression. Understanding cultural context
prevents miscommunication and builds therapeutic rapport. Therefore, option B is correct.
6. What is the primary function of the "O" component in a SOAP note?
A) Documentation of patient-reported symptoms
B) Recording of physical examination findings, vital signs, and laboratory results
C) Development of a differential diagnosis list
,D) Formulation of the treatment plan
Correct Answer: Recording of physical examination findings, vital signs, and laboratory results
Rationale: The "O" in SOAP stands for objective data, which includes measurable and observable
information obtained by the clinician. This encompasses physical examination findings, vital signs,
and laboratory or diagnostic test results. Subjective data is patient-reported, while the assessment
and plan comprise the "A" and "P" components. Therefore, option B is the correct answer.
7. Which maneuver is most appropriate for assessing for a torn meniscus in the knee?
A) Anterior drawer test
B) Lachman test
C) McMurray test
D) Valgus stress test
Correct Answer: McMurray test
Rationale: The McMurray test is a specialized orthopedic maneuver used to assess for meniscal tears.
The clinician rotates the tibia while flexing and extending the knee, and a palpable or audible click
may indicate a torn meniscus. The anterior drawer and Lachman tests assess the anterior cruciate
ligament, while the valgus stress test evaluates the medial collateral ligament. Therefore, option C is
correct.
8. Which finding would most likely indicate increased tactile fremitus during chest palpation?
A) Pneumothorax
B) Pleural effusion
C) Lobar pneumonia
D) Emphysema
Correct Answer: Lobar pneumonia
Rationale: Tactile fremitus is increased when lung tissue is consolidated, as sound vibrations travel
more efficiently through solid or liquid media than through air. Lobar pneumonia causes
consolidation, thereby increasing tactile fremitus. Pneumothorax, pleural effusion, and emphysema
all decrease tactile fremitus because air or fluid separates the lung from the chest wall. Therefore,
option C is correct.
9. According to the Clinical Judgment Measurement Model, what is the first cognitive step in
the diagnostic reasoning process?
A) Generating hypotheses
B) Recognizing cues
, C) Prioritizing hypotheses
D) Evaluating outcomes
Correct Answer: Recognizing cues
Rationale: The Clinical Judgment Measurement Model begins with recognizing cues, which involves
identifying relevant clinical data from the patient's presentation. This step precedes hypothesis
generation, prioritization of hypotheses, and solution generation. Recognizing cues is foundational
because accurate identification of pertinent data informs all subsequent reasoning. Therefore, option
B is correct.
10. A 45-year-old male presents with sharp, stabbing chest pain that worsens with deep
breathing and is accompanied by a high-pitched, scratchy sound heard during both systole
and diastole. What is the most likely diagnosis?
A) Myocardial infarction
B) Pericardial friction rub
C) Congestive heart failure
D) Pleural effusion
Correct Answer: Pericardial friction rub
Rationale: A pericardial friction rub is a high-pitched, scratchy sound produced by inflammation of
the pericardial sac. It is characteristically heard during both systole and diastole and is often
associated with sharp, pleuritic chest pain that worsens with deep inspiration. Myocardial infarction
typically presents with pressure-like pain, while pleural effusion would produce dullness to percussion
and decreased breath sounds. Therefore, option B is correct.
11. Which term refers to a list of possible conditions that could explain a patient's clinical
presentation?
A) Chief complaint
B) Differential diagnosis
C) Review of systems
D) Assessment
Correct Answer: Differential diagnosis
Rationale: A differential diagnosis is a systematic list of potential conditions that could account for
the patient's signs and symptoms. It guides the diagnostic workup and helps the clinician prioritize
testing and treatment. The chief complaint is the presenting concern, while the review of systems is a
systematic symptom inquiry. Therefore, option B is correct.
12. What would most appropriately be documented in the "A" section of a SOAP note?
