NURS 5220 ADVANCED HEALTH
ASSESSMENT AND DIAGNOSTIC
REASONING — EXAM 1 QUESTIONS
AND CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. A patient presents with a ‘silent’ gap between the first and second heart sounds. Which of
the following best describes this phase of the cardiac cycle?
A. Ventricular diastole
B. Atrial kick
C. Ventricular systole
D. Isovolumetric relaxation
Answer: C
Conceptual Explanation: Systole occurs between S1 (closure of AV valves) and S2 (closure
of semilunar valves). Diastole occurs between S2 and the next S1.
2. When evaluating a diagnostic test, the clinician notes that the test has a high sensitivity.
This indicates that the test is most useful for:
A. Confirming a specific diagnosis
B. Ruling in a disease
,C. Ruling out a disease when the result is negative
D. Determining the true prevalence in a population
Answer: C
Conceptual Explanation: High sensitivity (SnNout) means that a negative test result is
very likely to rule out the disease.
3. During the examination of the neck, you palpate the thyroid gland. Which finding is
considered abnormal in a healthy adult?
A. Presence of a distinct localized bruit
B. A thin, smooth thyroid isthmus
C. A soft, non-tender right lobe slightly larger than the left
D. Non-palpable thyroid lobes
Answer: A
Conceptual Explanation: A thyroid bruit indicates hypervascularity, common in Graves’
disease, and is an abnormal finding. Lobes are often not palpable or are smooth and soft.
4. Which cranial nerve is primarily responsible for the downward and internal rotation of the
eye?
A. CN IV (Trochlear)
B. CN III (Oculomotor)
C. CN VI (Abducens)
, D. CN II (Optic)
Answer: A
Conceptual Explanation: The trochlear nerve (CN IV) innervates the superior oblique
muscle, which moves the eye downward and inward.
5. A 65-year-old patient reports sudden, painless loss of vision in one eye described as a
‘curtain coming down.’ This is highly suggestive of:
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Macular degeneration
D. Cataracts
Answer: B
Conceptual Explanation: Retinal detachment typically presents as a painless loss of
vision, often described as a shadow or curtain falling across the field of vision.
6. In the SOAP note format, where should the provider document the patient’s reported
‘sharp, stabbing chest pain’?
A. Subjective
B. Objective
C. Assessment
D. Plan
ASSESSMENT AND DIAGNOSTIC
REASONING — EXAM 1 QUESTIONS
AND CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. A patient presents with a ‘silent’ gap between the first and second heart sounds. Which of
the following best describes this phase of the cardiac cycle?
A. Ventricular diastole
B. Atrial kick
C. Ventricular systole
D. Isovolumetric relaxation
Answer: C
Conceptual Explanation: Systole occurs between S1 (closure of AV valves) and S2 (closure
of semilunar valves). Diastole occurs between S2 and the next S1.
2. When evaluating a diagnostic test, the clinician notes that the test has a high sensitivity.
This indicates that the test is most useful for:
A. Confirming a specific diagnosis
B. Ruling in a disease
,C. Ruling out a disease when the result is negative
D. Determining the true prevalence in a population
Answer: C
Conceptual Explanation: High sensitivity (SnNout) means that a negative test result is
very likely to rule out the disease.
3. During the examination of the neck, you palpate the thyroid gland. Which finding is
considered abnormal in a healthy adult?
A. Presence of a distinct localized bruit
B. A thin, smooth thyroid isthmus
C. A soft, non-tender right lobe slightly larger than the left
D. Non-palpable thyroid lobes
Answer: A
Conceptual Explanation: A thyroid bruit indicates hypervascularity, common in Graves’
disease, and is an abnormal finding. Lobes are often not palpable or are smooth and soft.
4. Which cranial nerve is primarily responsible for the downward and internal rotation of the
eye?
A. CN IV (Trochlear)
B. CN III (Oculomotor)
C. CN VI (Abducens)
, D. CN II (Optic)
Answer: A
Conceptual Explanation: The trochlear nerve (CN IV) innervates the superior oblique
muscle, which moves the eye downward and inward.
5. A 65-year-old patient reports sudden, painless loss of vision in one eye described as a
‘curtain coming down.’ This is highly suggestive of:
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Macular degeneration
D. Cataracts
Answer: B
Conceptual Explanation: Retinal detachment typically presents as a painless loss of
vision, often described as a shadow or curtain falling across the field of vision.
6. In the SOAP note format, where should the provider document the patient’s reported
‘sharp, stabbing chest pain’?
A. Subjective
B. Objective
C. Assessment
D. Plan
