NUR 6001 Exam 1 Actual Exam V3 | NUR 6001 Advanced Health
Assessment (NUR6001 Exam 1) | William Paterson University
1. A 55-year-old patient presents for a comprehensive health assessment. Which of the
following best describes the ‘Review of Systems’ portion of the health history?
A. A physical examination of each body system to identify abnormalities.
B. A series of questions about the patient’s past medical history and surgical procedures.
C. Subjective information regarding the presence or absence of health-related symptoms in
body systems.
D. The clinician’s objective findings during the head-to-toe assessment.
Answer: C
Rationale: The Review of Systems (ROS) is strictly subjective data collected through a
systematic series of questions regarding each body system. It is distinct from the physical
examination, which provides objective data. This phase helps the advanced practice nurse
uncover symptoms that the patient may have omitted in the History of Present Illness.
2. During a physical exam, the nurse practitioner uses the diaphragm of the stethoscope. For
which of the following sounds is the diaphragm most effective?
A. High-pitched sounds such as breath sounds and normal heart sounds.
B. Low-pitched heart murmurs such as mitral stenosis.
C. Low-frequency bruits over the carotid arteries.
D. Extra heart sounds like S3 and S4.
Answer: A
Rationale: The diaphragm of the stethoscope is designed to pick up high-pitched sounds
by pressing it firmly against the skin. This includes normal heart sounds (S1, S2), breath
sounds, and bowel sounds. In contrast, the bell is used for low-pitched sounds like S3, S4,
and certain murmurs.
3. An 82-year-old male is being evaluated for orthostatic hypotension. Which findings would
support this diagnosis?
A. A drop in systolic BP of 10 mmHg when moving from supine to standing.
B. A drop in systolic BP of at least 20 mmHg or diastolic BP of at least 10 mmHg within 3
minutes of standing.
C. A rise in heart rate of 5 beats per minute when standing.
D. An increase in diastolic BP of 5 mmHg upon standing.
,Answer: B
Rationale: Orthostatic hypotension is defined as a significant drop in blood pressure
triggered by postural changes. Specifically, a drop in systolic blood pressure of 20 mmHg or
more, or a diastolic drop of 10 mmHg or more, is diagnostic. These measurements must be
taken within three minutes of the patient standing up from a supine or sitting position.
4. A patient presents with a skin lesion that is asymmetrical, has irregular borders, and shows
color variation. Which tool is most appropriate for assessing this potential malignancy?
A. The Braden Scale.
B. The ABCDE mnemonic.
C. The PQRST mnemonic.
D. The Glasgow Coma Scale.
Answer: B
Rationale: The ABCDE mnemonic is the standard evidence-based tool for screening skin
lesions for melanoma. It stands for Asymmetry, Border irregularity, Color variation,
Diameter greater than 6mm, and Evolving or Elevation. Identifying these characteristics
early is critical for the diagnosis and management of skin cancers.
5. During a cardiac assessment, the nurse practitioner hears a murmur at the 2nd right
intercostal space that radiates to the neck. Which murmur is most likely?
A. Aortic Stenosis.
B. Mitral Regurgitation.
C. Pulmonic Stenosis.
D. Tricuspid Regurgitation.
Answer: A
Rationale: The 2nd right intercostal space at the sternal border is the aortic area. A
systolic crescendo-decrescendo murmur heard here that radiates to the carotid arteries is
characteristic of aortic stenosis. This clinical finding necessitates further evaluation with an
echocardiogram to determine the severity of the valve narrowing.
6. A patient describes a headache as ‘the worst headache of my life,’ accompanied by neck
stiffness and photophobia. What is the most critical differential diagnosis?
A. Tension headache.
B. Classic migraine.
C. Cluster headache.
D. Subarachnoid hemorrhage.
, Answer: D
Rationale: A ‘thunderclap’ headache described as the worst headache of one’s life is a red-
flag symptom for subarachnoid hemorrhage. The presence of meningeal signs like neck
stiffness and photophobia further increases the clinical suspicion for intracranial bleeding.
This is a medical emergency requiring immediate imaging and neurological intervention.
7. Which percussion note is expected when examining a patient with a large pneumothorax?
A. Hyperresonance.
B. Dullness.
C. Resonance.
D. Flatness.
Answer: A
Rationale: Hyperresonance is an exaggerated resonance heard when there is an increased
amount of air in the pleural space or lungs. In a pneumothorax, the lung collapses and the
pleural space fills with air, leading to this ‘booming’ sound upon percussion. Normal lung
tissue should produce a resonant sound, while solid organs or fluid produce dullness.
8. When assessing the thyroid gland using the posterior approach, what is the correct
instruction for the patient?
A. Tilt the head back and cough.
B. Hyperextend the neck to the right.
C. Turn the head to the left and hold their breath.
D. Flex the neck slightly forward and swallow a sip of water.
Answer: D
Rationale: Slightly flexing the neck relaxes the sternocleidomastoid muscles, making the
thyroid easier to palpate. Swallowing causes the thyroid gland and cartilage to move
upward, allowing the examiner to feel the isthmus and lobes beneath the fingers. This
technique helps identify nodules, enlargement, or asymmetry in the gland.
9. A patient presents with sharp, localized chest pain that increases with inspiration and is
relieved by sitting forward. What is the most likely diagnosis?
A. Myocardial Infarction.
B. Pericarditis.
C. Pleuritic Chest Pain.
D. Stable Angina.
Answer: B
Assessment (NUR6001 Exam 1) | William Paterson University
1. A 55-year-old patient presents for a comprehensive health assessment. Which of the
following best describes the ‘Review of Systems’ portion of the health history?
A. A physical examination of each body system to identify abnormalities.
B. A series of questions about the patient’s past medical history and surgical procedures.
C. Subjective information regarding the presence or absence of health-related symptoms in
body systems.
D. The clinician’s objective findings during the head-to-toe assessment.
Answer: C
Rationale: The Review of Systems (ROS) is strictly subjective data collected through a
systematic series of questions regarding each body system. It is distinct from the physical
examination, which provides objective data. This phase helps the advanced practice nurse
uncover symptoms that the patient may have omitted in the History of Present Illness.
2. During a physical exam, the nurse practitioner uses the diaphragm of the stethoscope. For
which of the following sounds is the diaphragm most effective?
A. High-pitched sounds such as breath sounds and normal heart sounds.
B. Low-pitched heart murmurs such as mitral stenosis.
C. Low-frequency bruits over the carotid arteries.
D. Extra heart sounds like S3 and S4.
Answer: A
Rationale: The diaphragm of the stethoscope is designed to pick up high-pitched sounds
by pressing it firmly against the skin. This includes normal heart sounds (S1, S2), breath
sounds, and bowel sounds. In contrast, the bell is used for low-pitched sounds like S3, S4,
and certain murmurs.
3. An 82-year-old male is being evaluated for orthostatic hypotension. Which findings would
support this diagnosis?
A. A drop in systolic BP of 10 mmHg when moving from supine to standing.
B. A drop in systolic BP of at least 20 mmHg or diastolic BP of at least 10 mmHg within 3
minutes of standing.
C. A rise in heart rate of 5 beats per minute when standing.
D. An increase in diastolic BP of 5 mmHg upon standing.
,Answer: B
Rationale: Orthostatic hypotension is defined as a significant drop in blood pressure
triggered by postural changes. Specifically, a drop in systolic blood pressure of 20 mmHg or
more, or a diastolic drop of 10 mmHg or more, is diagnostic. These measurements must be
taken within three minutes of the patient standing up from a supine or sitting position.
4. A patient presents with a skin lesion that is asymmetrical, has irregular borders, and shows
color variation. Which tool is most appropriate for assessing this potential malignancy?
A. The Braden Scale.
B. The ABCDE mnemonic.
C. The PQRST mnemonic.
D. The Glasgow Coma Scale.
Answer: B
Rationale: The ABCDE mnemonic is the standard evidence-based tool for screening skin
lesions for melanoma. It stands for Asymmetry, Border irregularity, Color variation,
Diameter greater than 6mm, and Evolving or Elevation. Identifying these characteristics
early is critical for the diagnosis and management of skin cancers.
5. During a cardiac assessment, the nurse practitioner hears a murmur at the 2nd right
intercostal space that radiates to the neck. Which murmur is most likely?
A. Aortic Stenosis.
B. Mitral Regurgitation.
C. Pulmonic Stenosis.
D. Tricuspid Regurgitation.
Answer: A
Rationale: The 2nd right intercostal space at the sternal border is the aortic area. A
systolic crescendo-decrescendo murmur heard here that radiates to the carotid arteries is
characteristic of aortic stenosis. This clinical finding necessitates further evaluation with an
echocardiogram to determine the severity of the valve narrowing.
6. A patient describes a headache as ‘the worst headache of my life,’ accompanied by neck
stiffness and photophobia. What is the most critical differential diagnosis?
A. Tension headache.
B. Classic migraine.
C. Cluster headache.
D. Subarachnoid hemorrhage.
, Answer: D
Rationale: A ‘thunderclap’ headache described as the worst headache of one’s life is a red-
flag symptom for subarachnoid hemorrhage. The presence of meningeal signs like neck
stiffness and photophobia further increases the clinical suspicion for intracranial bleeding.
This is a medical emergency requiring immediate imaging and neurological intervention.
7. Which percussion note is expected when examining a patient with a large pneumothorax?
A. Hyperresonance.
B. Dullness.
C. Resonance.
D. Flatness.
Answer: A
Rationale: Hyperresonance is an exaggerated resonance heard when there is an increased
amount of air in the pleural space or lungs. In a pneumothorax, the lung collapses and the
pleural space fills with air, leading to this ‘booming’ sound upon percussion. Normal lung
tissue should produce a resonant sound, while solid organs or fluid produce dullness.
8. When assessing the thyroid gland using the posterior approach, what is the correct
instruction for the patient?
A. Tilt the head back and cough.
B. Hyperextend the neck to the right.
C. Turn the head to the left and hold their breath.
D. Flex the neck slightly forward and swallow a sip of water.
Answer: D
Rationale: Slightly flexing the neck relaxes the sternocleidomastoid muscles, making the
thyroid easier to palpate. Swallowing causes the thyroid gland and cartilage to move
upward, allowing the examiner to feel the isthmus and lobes beneath the fingers. This
technique helps identify nodules, enlargement, or asymmetry in the gland.
9. A patient presents with sharp, localized chest pain that increases with inspiration and is
relieved by sitting forward. What is the most likely diagnosis?
A. Myocardial Infarction.
B. Pericarditis.
C. Pleuritic Chest Pain.
D. Stable Angina.
Answer: B
