NUR 6001 Exam 1 Actual Exam V1 | NUR 6001 Advanced Health
Assessment (NUR6001 Exam 1) | William Paterson University
1. When conducting a comprehensive health history, which component provides the most
critical subjective data regarding the patient’s current health status?
A. Review of Systems (ROS)
B. Physical Examination findings
C. History of Present Illness (HPI)
D. Family History
Answer: C
Rationale: The HPI is a chronological account of the patient’s chief complaint and is the
most critical source of subjective data. It utilizes the OLDCARTS mnemonic to detail the
symptoms and helps the provider narrow down the differential diagnosis. While the ROS is
important for identifying missed symptoms, the HPI provides the context and depth
needed for clinical reasoning.
2. A patient presents with a suspicious skin lesion. Which characteristic using the ABCDE
mnemonic most strongly suggests malignant melanoma?
A. Symmetry of the borders
B. Evolution or change in size over time
C. Diameter less than 4 mm
D. Uniform light brown color
Answer: B
Rationale: Evolution (E) is often the most sensitive factor in identifying melanoma as it
indicates a dynamic change in the lesion’s nature. Benign lesions typically remain stable
over long periods, whereas malignant cells proliferate and alter the lesion’s appearance.
Assessment of asymmetry, border irregularity, color variegation, and diameter are also
essential components of the evidence-based skin exam.
3. During a cardiac assessment, the nurse practitioner notes a low-pitched, mid-diastolic
murmur heard best at the apex with the patient in the left lateral decubitus position. This
finding is most consistent with:
A. Aortic regurgitation
B. Mitral regurgitation
C. Mitral stenosis
,D. Aortic stenosis
Answer: C
Rationale: Mitral stenosis typically produces a low-pitched rumbling murmur during
diastole, best heard at the apex with the bell of the stethoscope. Positioning the patient in
the left lateral decubitus position brings the heart closer to the chest wall, enhancing the
sound. This clinical finding is distinct from systolic murmurs like mitral regurgitation or
aortic stenosis.
4. Which physical exam finding is most indicative of pleural effusion during a pulmonary
assessment?
A. Hyperresonance on percussion
B. Increased tactile fremitus
C. Dullness to percussion over the affected area
D. Vesicular breath sounds throughout
Answer: C
Rationale: Dullness to percussion occurs when fluid replaces the air-filled lung tissue in
the pleural space. Tactile fremitus is decreased in pleural effusion because the fluid acts as
a barrier to sound vibration transmission. In contrast, hyperresonance is associated with
air-filled states like pneumothorax or COPD.
5. An elderly patient reports sudden, painless loss of vision in one eye described as a ‘curtain’
being pulled down. Which condition should the practitioner suspect?
A. Acute angle-closure glaucoma
B. Cataracts
C. Retinal detachment
D. Macular degeneration
Answer: C
Rationale: Retinal detachment often presents with the classic ‘curtain’ symptom and is a
medical emergency. Unlike glaucoma, which is usually painful and associated with redness,
retinal detachment is typically painless. Early identification and referral to ophthalmology
are critical to prevent permanent vision loss.
6. When assessing the abdomen, which sequence of techniques is evidence-based and avoids
altering the clinical findings?
A. Inspection, Auscultation, Percussion, Palpation
B. Inspection, Palpation, Percussion, Auscultation
, C. Auscultation, Inspection, Palpation, Percussion
D. Percussion, Palpation, Auscultation, Inspection
Answer: A
Rationale: Auscultation should always precede percussion and palpation because manual
manipulation of the bowel can increase peristalsis. Increased peristalsis may lead to a false
interpretation of bowel sounds. Following this specific order ensures the most accurate
assessment of the patient’s gastrointestinal status.
7. A patient exhibits a positive Murphy’s sign during the abdominal exam. This finding is
highly specific for which condition?
A. Acute cholecystitis
B. Acute appendicitis
C. Splenomegaly
D. Nephrolithiasis
Answer: A
Rationale: Murphy’s sign is elicited by asking the patient to take a deep breath while the
clinician applies pressure under the right costal margin; an abrupt halt in inspiration due to
pain indicates gallbladder inflammation. This sign has high specificity for acute
cholecystitis. Appendicitis would instead be associated with McBurney’s point tenderness
or the Psoas sign.
8. During a neurological exam, the clinician asks the patient to stand with feet together and
eyes closed. The patient begins to sway significantly and loses balance. This is a positive:
A. Babinski sign
B. Romberg test
C. Kernig sign
D. Brudzinski sign
Answer: B
Rationale: The Romberg test assesses proprioception and cerebellar function by removing
visual input. A positive result indicates a loss of sensory equilibrium or a vestibulocochlear
nerve issue. Babinski sign refers to plantar reflex, while Kernig and Brudzinski signs
indicate meningeal irritation.
9. Which cranial nerve is primarily responsible for the sensation of the face and the muscles
of mastication?
A. CN VII (Facial)
Assessment (NUR6001 Exam 1) | William Paterson University
1. When conducting a comprehensive health history, which component provides the most
critical subjective data regarding the patient’s current health status?
A. Review of Systems (ROS)
B. Physical Examination findings
C. History of Present Illness (HPI)
D. Family History
Answer: C
Rationale: The HPI is a chronological account of the patient’s chief complaint and is the
most critical source of subjective data. It utilizes the OLDCARTS mnemonic to detail the
symptoms and helps the provider narrow down the differential diagnosis. While the ROS is
important for identifying missed symptoms, the HPI provides the context and depth
needed for clinical reasoning.
2. A patient presents with a suspicious skin lesion. Which characteristic using the ABCDE
mnemonic most strongly suggests malignant melanoma?
A. Symmetry of the borders
B. Evolution or change in size over time
C. Diameter less than 4 mm
D. Uniform light brown color
Answer: B
Rationale: Evolution (E) is often the most sensitive factor in identifying melanoma as it
indicates a dynamic change in the lesion’s nature. Benign lesions typically remain stable
over long periods, whereas malignant cells proliferate and alter the lesion’s appearance.
Assessment of asymmetry, border irregularity, color variegation, and diameter are also
essential components of the evidence-based skin exam.
3. During a cardiac assessment, the nurse practitioner notes a low-pitched, mid-diastolic
murmur heard best at the apex with the patient in the left lateral decubitus position. This
finding is most consistent with:
A. Aortic regurgitation
B. Mitral regurgitation
C. Mitral stenosis
,D. Aortic stenosis
Answer: C
Rationale: Mitral stenosis typically produces a low-pitched rumbling murmur during
diastole, best heard at the apex with the bell of the stethoscope. Positioning the patient in
the left lateral decubitus position brings the heart closer to the chest wall, enhancing the
sound. This clinical finding is distinct from systolic murmurs like mitral regurgitation or
aortic stenosis.
4. Which physical exam finding is most indicative of pleural effusion during a pulmonary
assessment?
A. Hyperresonance on percussion
B. Increased tactile fremitus
C. Dullness to percussion over the affected area
D. Vesicular breath sounds throughout
Answer: C
Rationale: Dullness to percussion occurs when fluid replaces the air-filled lung tissue in
the pleural space. Tactile fremitus is decreased in pleural effusion because the fluid acts as
a barrier to sound vibration transmission. In contrast, hyperresonance is associated with
air-filled states like pneumothorax or COPD.
5. An elderly patient reports sudden, painless loss of vision in one eye described as a ‘curtain’
being pulled down. Which condition should the practitioner suspect?
A. Acute angle-closure glaucoma
B. Cataracts
C. Retinal detachment
D. Macular degeneration
Answer: C
Rationale: Retinal detachment often presents with the classic ‘curtain’ symptom and is a
medical emergency. Unlike glaucoma, which is usually painful and associated with redness,
retinal detachment is typically painless. Early identification and referral to ophthalmology
are critical to prevent permanent vision loss.
6. When assessing the abdomen, which sequence of techniques is evidence-based and avoids
altering the clinical findings?
A. Inspection, Auscultation, Percussion, Palpation
B. Inspection, Palpation, Percussion, Auscultation
, C. Auscultation, Inspection, Palpation, Percussion
D. Percussion, Palpation, Auscultation, Inspection
Answer: A
Rationale: Auscultation should always precede percussion and palpation because manual
manipulation of the bowel can increase peristalsis. Increased peristalsis may lead to a false
interpretation of bowel sounds. Following this specific order ensures the most accurate
assessment of the patient’s gastrointestinal status.
7. A patient exhibits a positive Murphy’s sign during the abdominal exam. This finding is
highly specific for which condition?
A. Acute cholecystitis
B. Acute appendicitis
C. Splenomegaly
D. Nephrolithiasis
Answer: A
Rationale: Murphy’s sign is elicited by asking the patient to take a deep breath while the
clinician applies pressure under the right costal margin; an abrupt halt in inspiration due to
pain indicates gallbladder inflammation. This sign has high specificity for acute
cholecystitis. Appendicitis would instead be associated with McBurney’s point tenderness
or the Psoas sign.
8. During a neurological exam, the clinician asks the patient to stand with feet together and
eyes closed. The patient begins to sway significantly and loses balance. This is a positive:
A. Babinski sign
B. Romberg test
C. Kernig sign
D. Brudzinski sign
Answer: B
Rationale: The Romberg test assesses proprioception and cerebellar function by removing
visual input. A positive result indicates a loss of sensory equilibrium or a vestibulocochlear
nerve issue. Babinski sign refers to plantar reflex, while Kernig and Brudzinski signs
indicate meningeal irritation.
9. Which cranial nerve is primarily responsible for the sensation of the face and the muscles
of mastication?
A. CN VII (Facial)
