NURS 6512 ADVANCED HEALTH
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND VERIFIED ANSWERS |
100% CORRECT | GRADE A+
1. When assessing a patient for a suspected malignant melanoma, which ‘ABCDE’
characteristic is most suggestive of malignancy if the lesion has multiple shades of brown and
black?
A. Color Variation
B. Asymmetry
C. Diameter > 6mm
D. Evolution
Answer: A
Conceptual Explanation: Color variation, especially the presence of multiple colors or
shades within a single lesion, is a significant warning sign for melanoma according to the
ABCDE criteria.
2. During a cardiac auscultation, you hear a low-pitched extra heart sound in early diastole at
the apex. This finding in a 70-year-old patient is most likely:
A. A physiological S3
,B. A physiological S4
C. A pathological S4 (Atrial Gallop)
D. A pathological S3 (Ventricular Gallop)
Answer: D
Conceptual Explanation: In older adults, an S3 is often pathological and indicates
ventricular non-compliance or volume overload, such as in heart failure. S4 occurs in late
diastole.
3. A patient presents with sudden onset of facial drooping. To differentiate between a Bell’s
palsy and a stroke, the nurse practitioner checks if the patient can wrinkle their forehead. If
the patient CAN wrinkle the forehead, the likely diagnosis is:
A. Trigeminal Neuralgia
B. Peripheral Cranial Nerve VII lesion (Bell’s Palsy)
C. Central Cranial Nerve VII lesion (Stroke)
D. Cranial Nerve V impairment
Answer: C
Conceptual Explanation: In a central lesion like a stroke, the upper face (forehead) is
often spared due to bilateral innervation, whereas Bell’s palsy affects both upper and lower
facial muscles.
, 4. Which physical exam maneuver is performed by palpating the right upper quadrant while
the patient takes a deep breath, looking for a sudden halt in inspiration due to pain?
A. Rovsing’s Sign
B. Murphy’s Sign
C. McBurney’s Point tenderness
D. Psoas Sign
Answer: B
Conceptual Explanation: Murphy’s sign is specific for acute cholecystitis. A positive sign is
indicated when the patient stops breathing in (inspiratory arrest) because of pain when the
gallbladder descends onto the examiner’s fingers.
5. Upon percussion of the lungs in a patient with a large pleural effusion, the examiner should
expect to hear:
A. Resonance
B. Hyper-resonance
C. Dullness
D. Tympany
Answer: C
Conceptual Explanation: Dullness replaces resonance when fluid (effusion) or solid tissue
(pneumonia/tumor) replaces air-containing lung tissue.
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND VERIFIED ANSWERS |
100% CORRECT | GRADE A+
1. When assessing a patient for a suspected malignant melanoma, which ‘ABCDE’
characteristic is most suggestive of malignancy if the lesion has multiple shades of brown and
black?
A. Color Variation
B. Asymmetry
C. Diameter > 6mm
D. Evolution
Answer: A
Conceptual Explanation: Color variation, especially the presence of multiple colors or
shades within a single lesion, is a significant warning sign for melanoma according to the
ABCDE criteria.
2. During a cardiac auscultation, you hear a low-pitched extra heart sound in early diastole at
the apex. This finding in a 70-year-old patient is most likely:
A. A physiological S3
,B. A physiological S4
C. A pathological S4 (Atrial Gallop)
D. A pathological S3 (Ventricular Gallop)
Answer: D
Conceptual Explanation: In older adults, an S3 is often pathological and indicates
ventricular non-compliance or volume overload, such as in heart failure. S4 occurs in late
diastole.
3. A patient presents with sudden onset of facial drooping. To differentiate between a Bell’s
palsy and a stroke, the nurse practitioner checks if the patient can wrinkle their forehead. If
the patient CAN wrinkle the forehead, the likely diagnosis is:
A. Trigeminal Neuralgia
B. Peripheral Cranial Nerve VII lesion (Bell’s Palsy)
C. Central Cranial Nerve VII lesion (Stroke)
D. Cranial Nerve V impairment
Answer: C
Conceptual Explanation: In a central lesion like a stroke, the upper face (forehead) is
often spared due to bilateral innervation, whereas Bell’s palsy affects both upper and lower
facial muscles.
, 4. Which physical exam maneuver is performed by palpating the right upper quadrant while
the patient takes a deep breath, looking for a sudden halt in inspiration due to pain?
A. Rovsing’s Sign
B. Murphy’s Sign
C. McBurney’s Point tenderness
D. Psoas Sign
Answer: B
Conceptual Explanation: Murphy’s sign is specific for acute cholecystitis. A positive sign is
indicated when the patient stops breathing in (inspiratory arrest) because of pain when the
gallbladder descends onto the examiner’s fingers.
5. Upon percussion of the lungs in a patient with a large pleural effusion, the examiner should
expect to hear:
A. Resonance
B. Hyper-resonance
C. Dullness
D. Tympany
Answer: C
Conceptual Explanation: Dullness replaces resonance when fluid (effusion) or solid tissue
(pneumonia/tumor) replaces air-containing lung tissue.
