NU 650 Advanced Health Assessment | Regis University |
Academic Year 2026/2027 | Examination 3 Comprehensive
Examination | 100 Verified Questions and Correct Answer
Rationales
SECTION I: ABDOMINAL ASSESSMENT (Questions 1–30)
1. The nurse practitioner is preparing to perform an abdominal assessment on an
adult patient. Which sequence of examination techniques is correct?
• A. Inspection, palpation, percussion, auscultation
• B. Inspection, auscultation, percussion, palpation
• C. Auscultation, inspection, palpation, percussion
• D. Palpation, percussion, auscultation, inspection
Correct Answer: B. Inspection, auscultation, percussion, palpation
Rationale: The correct sequence for abdominal assessment is inspection,
auscultation, percussion, and palpation. Auscultation is performed before
percussion and palpation because these techniques can alter bowel sounds. This
sequence differs from other body systems where palpation typically follows
inspection.
2. When percussing the abdomen of a patient with constipation, which sound
would the nurse practitioner expect to find in the left lower quadrant (LLQ)?
• A. Tympanic
• B. Dull
• C. Resonant
• D. Hyperresonant
Correct Answer: B. Dull
, Rationale: In a patient with constipation, the LLQ may contain impacted stool,
which produces a dull sound on percussion. Tympanic sounds are normally heard
over air-filled structures like the stomach and intestines.
3. The nurse practitioner is performing light palpation of the abdomen. What is
the primary purpose of light palpation?
• A. To assess deep organs and masses
• B. To determine muscular resistance, superficial organs, and masses
• C. To assess for rebound tenderness
• D. To evaluate bowel sounds
Correct Answer: B. To determine muscular resistance, superficial organs, and
masses
Rationale: Light palpation is used to assess muscular resistance, superficial
organs, and masses. Deep palpation is used to assess deeper structures and
organs.
4. Which technique should the nurse practitioner use to help a patient relax
during an abdominal examination?
• A. Ask the patient to hold their breath
• B. Palpate the abdomen after inspiration
• C. Palpate the abdomen after expiration
• D. Palpate the abdomen using quick, short movements
Correct Answer: C. Palpate the abdomen after expiration
, Rationale: Asking the patient to bend their knees and breathe slowly through
the mouth helps relax the abdominal muscles. Palpating after expiration is also
helpful because the abdominal muscles are most relaxed at the end of expiration.
5. Which of the following represents the proper position for the NP to assess the
patient's abdomen?
• A. Stand at the patient's left side and proceed in a systematic fashion
• B. Stand at the patient's left side and assess any problem areas first
• C. Stand at the patient's right side and proceed in a systematic fashion
• D. Stand at the patient's right side and assess any problem areas first
Correct Answer: C. Stand at the patient's right side and proceed in a
systematic fashion
Rationale: The examiner should stand on the patient's right side to perform
the abdominal examination. This allows the right hand to palpate effectively and is
the traditional and most ergonomic position. The examination should proceed
systematically from the right lower quadrant around the abdomen.
6. A 36-year-old female patient is seen in the clinic for a reported fever and back
pain. She complains of pain when the NP percusses over the left CVA angle. This
finding supports which of the following differential diagnoses?
• A. Pyelonephritis
• B. Left lower lobe pneumonia
• C. Splenomegaly
• D. Cholecystitis
Correct Answer: A. Pyelonephritis
, Rationale: Tenderness on percussion over the costovertebral angle (CVA) is a
classic sign of pyelonephritis (kidney infection/inflammation). Fever and back pain
further support this diagnosis.
7. The liver border can be palpated normally below the costal margin at the:
• A. Left mid-clavicular line
• B. Right mid-axillary line
• C. Right mid-clavicular line
• D. Left mid-axillary line
Correct Answer: C. Right mid-clavicular line
Rationale: The liver is located in the right upper quadrant, and its lower
border can normally be palpated at or slightly below the right costal margin in the
right mid-clavicular line.
8. The NP will recognize which of the following subjective or objective findings as
worrisome for an abdominal aortic aneurysm?
• A. Aortic width of 2.8 cm
• B. 25 pack-year smoking history
• C. Age of 60
• D. Female gender
Correct Answer: B. 25 pack-year smoking history
Rationale: Smoking history is a significant risk factor for abdominal aortic
aneurysm (AAA), with a 25 pack-year history being particularly concerning. An
aortic width of 2.8 cm is within normal limits (AAA is typically defined as >3.0 cm).
Academic Year 2026/2027 | Examination 3 Comprehensive
Examination | 100 Verified Questions and Correct Answer
Rationales
SECTION I: ABDOMINAL ASSESSMENT (Questions 1–30)
1. The nurse practitioner is preparing to perform an abdominal assessment on an
adult patient. Which sequence of examination techniques is correct?
• A. Inspection, palpation, percussion, auscultation
• B. Inspection, auscultation, percussion, palpation
• C. Auscultation, inspection, palpation, percussion
• D. Palpation, percussion, auscultation, inspection
Correct Answer: B. Inspection, auscultation, percussion, palpation
Rationale: The correct sequence for abdominal assessment is inspection,
auscultation, percussion, and palpation. Auscultation is performed before
percussion and palpation because these techniques can alter bowel sounds. This
sequence differs from other body systems where palpation typically follows
inspection.
2. When percussing the abdomen of a patient with constipation, which sound
would the nurse practitioner expect to find in the left lower quadrant (LLQ)?
• A. Tympanic
• B. Dull
• C. Resonant
• D. Hyperresonant
Correct Answer: B. Dull
, Rationale: In a patient with constipation, the LLQ may contain impacted stool,
which produces a dull sound on percussion. Tympanic sounds are normally heard
over air-filled structures like the stomach and intestines.
3. The nurse practitioner is performing light palpation of the abdomen. What is
the primary purpose of light palpation?
• A. To assess deep organs and masses
• B. To determine muscular resistance, superficial organs, and masses
• C. To assess for rebound tenderness
• D. To evaluate bowel sounds
Correct Answer: B. To determine muscular resistance, superficial organs, and
masses
Rationale: Light palpation is used to assess muscular resistance, superficial
organs, and masses. Deep palpation is used to assess deeper structures and
organs.
4. Which technique should the nurse practitioner use to help a patient relax
during an abdominal examination?
• A. Ask the patient to hold their breath
• B. Palpate the abdomen after inspiration
• C. Palpate the abdomen after expiration
• D. Palpate the abdomen using quick, short movements
Correct Answer: C. Palpate the abdomen after expiration
, Rationale: Asking the patient to bend their knees and breathe slowly through
the mouth helps relax the abdominal muscles. Palpating after expiration is also
helpful because the abdominal muscles are most relaxed at the end of expiration.
5. Which of the following represents the proper position for the NP to assess the
patient's abdomen?
• A. Stand at the patient's left side and proceed in a systematic fashion
• B. Stand at the patient's left side and assess any problem areas first
• C. Stand at the patient's right side and proceed in a systematic fashion
• D. Stand at the patient's right side and assess any problem areas first
Correct Answer: C. Stand at the patient's right side and proceed in a
systematic fashion
Rationale: The examiner should stand on the patient's right side to perform
the abdominal examination. This allows the right hand to palpate effectively and is
the traditional and most ergonomic position. The examination should proceed
systematically from the right lower quadrant around the abdomen.
6. A 36-year-old female patient is seen in the clinic for a reported fever and back
pain. She complains of pain when the NP percusses over the left CVA angle. This
finding supports which of the following differential diagnoses?
• A. Pyelonephritis
• B. Left lower lobe pneumonia
• C. Splenomegaly
• D. Cholecystitis
Correct Answer: A. Pyelonephritis
, Rationale: Tenderness on percussion over the costovertebral angle (CVA) is a
classic sign of pyelonephritis (kidney infection/inflammation). Fever and back pain
further support this diagnosis.
7. The liver border can be palpated normally below the costal margin at the:
• A. Left mid-clavicular line
• B. Right mid-axillary line
• C. Right mid-clavicular line
• D. Left mid-axillary line
Correct Answer: C. Right mid-clavicular line
Rationale: The liver is located in the right upper quadrant, and its lower
border can normally be palpated at or slightly below the right costal margin in the
right mid-clavicular line.
8. The NP will recognize which of the following subjective or objective findings as
worrisome for an abdominal aortic aneurysm?
• A. Aortic width of 2.8 cm
• B. 25 pack-year smoking history
• C. Age of 60
• D. Female gender
Correct Answer: B. 25 pack-year smoking history
Rationale: Smoking history is a significant risk factor for abdominal aortic
aneurysm (AAA), with a 25 pack-year history being particularly concerning. An
aortic width of 2.8 cm is within normal limits (AAA is typically defined as >3.0 cm).
