NUR 504 Final Exam | (2026) Health Assessment
Questions | Advanced Nursing (PDF)
1. An advanced practice nurse is assessing a 72-year-old
patient with new-onset confusion. Which assessment
approach is most appropriate first?
A. Mini-Mental State Examination
B. Review of medication list for anticholinergics
C. Cranial nerve examination
D. Serum glucose measurement
Correct Answer: B
Rationale: In older adults, new confusion is often
iatrogenic. Medications (anticholinergics, benzodiazepines,
opioids) are a common cause. Assessing medication
effects should precede cognitive testing or lab work
unless hypoglycemia is suspected.
2. Which technique best assesses for hepatojugular reflux?
A. Auscultating over the liver while the patient inhales
1
,deeply
B. Applying sustained pressure to the right upper
quadrant for 30–60 seconds
C. Percussing the lower border of the liver in the
midclavicular line
D. Palpating the liver edge during Valsalva maneuver
Correct Answer: B
Rationale: Hepatojugular reflux is assessed by firm,
sustained pressure over the liver; a rise in jugular venous
pressure >3 cm suggests right heart failure or volume
overload.
3. A patient reports chest pain that worsens when lying
flat and improves when leaning forward. This is most
characteristic of:
A. Pericarditis
B. Myocardial ischemia
C. Aortic dissection
D. Pulmonary embolism
2
,Correct Answer: A
Rationale: Pericarditis pain is typically pleuritic, positional
(worse supine, better leaning forward), and may be
associated with a friction rub.
4. When auscultating the lungs, you hear a high-pitched,
musical sound during expiration. This is best described as:
A. Stridor
B. Rhonchi
C. Wheezes
D. Crackles
Correct Answer: C
Rationale: Wheezes are continuous, high-pitched
(sonorous) sounds from narrowed airways, typically
during expiration. Stridor is inspiratory and upper airway.
5. A patient has a positive Murphy’s sign. Which anatomic
structure is most likely involved?
A. Appendix
B. Gallbladder
3
, C. Spleen
D. Kidney
Correct Answer: B j6 j6
Rationale: Murphy’s sign – inspiratory arrest during palpation
j6 j6 j6 j6 j6 j6 j6
j6 of the right upper quadrant – indicates acute cholecystitis.
j6 j6 j6 j6 j6 j6 j6 j6
6. Which finding suggests a lower motor neuron (LMN)
j6 j6 j6 j6 j6 j6 j6
j6 lesion versus upper motor neuron (UMN)?
j6 j6 j6 j6 j6
A. Hyperreflexia
B. Babinski sign present j6 j6
C. Fasciculations
D. Spasticity
j6 Correct Answer: C j6 j6
Rationale: Fasciculations indicate LMN pathology (e.g.,
j6 j6 j6 j6 j6
j 6 ALS, peripheral neuropathy). UMN signs include
j6 j6 j6 j6 j6
j6 hyperreflexia, Babinski, and spasticity. j6 j6 j6
7. You palpate a thrill over the carotid artery. This
j6 j6 j6 j6 j6 j6 j6 j6
j6 suggests:
4
Questions | Advanced Nursing (PDF)
1. An advanced practice nurse is assessing a 72-year-old
patient with new-onset confusion. Which assessment
approach is most appropriate first?
A. Mini-Mental State Examination
B. Review of medication list for anticholinergics
C. Cranial nerve examination
D. Serum glucose measurement
Correct Answer: B
Rationale: In older adults, new confusion is often
iatrogenic. Medications (anticholinergics, benzodiazepines,
opioids) are a common cause. Assessing medication
effects should precede cognitive testing or lab work
unless hypoglycemia is suspected.
2. Which technique best assesses for hepatojugular reflux?
A. Auscultating over the liver while the patient inhales
1
,deeply
B. Applying sustained pressure to the right upper
quadrant for 30–60 seconds
C. Percussing the lower border of the liver in the
midclavicular line
D. Palpating the liver edge during Valsalva maneuver
Correct Answer: B
Rationale: Hepatojugular reflux is assessed by firm,
sustained pressure over the liver; a rise in jugular venous
pressure >3 cm suggests right heart failure or volume
overload.
3. A patient reports chest pain that worsens when lying
flat and improves when leaning forward. This is most
characteristic of:
A. Pericarditis
B. Myocardial ischemia
C. Aortic dissection
D. Pulmonary embolism
2
,Correct Answer: A
Rationale: Pericarditis pain is typically pleuritic, positional
(worse supine, better leaning forward), and may be
associated with a friction rub.
4. When auscultating the lungs, you hear a high-pitched,
musical sound during expiration. This is best described as:
A. Stridor
B. Rhonchi
C. Wheezes
D. Crackles
Correct Answer: C
Rationale: Wheezes are continuous, high-pitched
(sonorous) sounds from narrowed airways, typically
during expiration. Stridor is inspiratory and upper airway.
5. A patient has a positive Murphy’s sign. Which anatomic
structure is most likely involved?
A. Appendix
B. Gallbladder
3
, C. Spleen
D. Kidney
Correct Answer: B j6 j6
Rationale: Murphy’s sign – inspiratory arrest during palpation
j6 j6 j6 j6 j6 j6 j6
j6 of the right upper quadrant – indicates acute cholecystitis.
j6 j6 j6 j6 j6 j6 j6 j6
6. Which finding suggests a lower motor neuron (LMN)
j6 j6 j6 j6 j6 j6 j6
j6 lesion versus upper motor neuron (UMN)?
j6 j6 j6 j6 j6
A. Hyperreflexia
B. Babinski sign present j6 j6
C. Fasciculations
D. Spasticity
j6 Correct Answer: C j6 j6
Rationale: Fasciculations indicate LMN pathology (e.g.,
j6 j6 j6 j6 j6
j 6 ALS, peripheral neuropathy). UMN signs include
j6 j6 j6 j6 j6
j6 hyperreflexia, Babinski, and spasticity. j6 j6 j6
7. You palpate a thrill over the carotid artery. This
j6 j6 j6 j6 j6 j6 j6 j6
j6 suggests:
4
