,NUR 626 Final Exam Primary Care Across the Lifespan Practicum I
2026/2027 Questions And Answers SNHU
Q1. During an initial visit, an adult reports fatigue, poor sleep,
intermittent headaches, and difficulty concentrating. Which
interviewing strategy best supports accurate prioritization of the
concerns?
A) Allow the patient to identify all concerns first, then clarify chronology,
severity, and priorities
B) Select the symptom most likely to represent serious disease before
hearing the remainder
C) Complete the review of systems before discussing the presenting
concerns
D) Address each symptom separately without establishing whether they are
related
Correct Answer: A) Allow the patient to identify all concerns first, then
clarify chronology, severity, and priorities
Rationale: Beginning broadly reduces premature narrowing and allows
related concerns to emerge. Focused questioning can then establish timing,
severity, associated features, functional impact, and the patient's priorities
before the clinician organizes the diagnostic evaluation.
Q2. A person reports intermittent palpitations. Which additional
information provides the greatest immediate diagnostic value?
A) Whether relatives have ever experienced fatigue
B) Relationship of the palpitations to exertion, duration, associated syncope,
chest symptoms, and stimulant use
C) The patient's preferred pharmacy
D) Whether the patient has changed insurance plans
Correct Answer: B) Relationship of the palpitations to exertion, duration,
associated syncope, chest symptoms, and stimulant use
Rationale: Palpitations require characterization of timing, triggers, duration,
associated cardiopulmonary or neurologic symptoms, and relevant
exposures. These details help distinguish benign awareness of heartbeat
from arrhythmias or other clinically significant causes.
,Q3. Which finding most strongly changes the urgency of evaluating
a new headache?
A) Mild photophobia during a familiar headache pattern
B) Improvement after rest
C) Similar headaches occurring occasionally for several years
D) Abrupt onset with focal neurologic deficit
Correct Answer: D) Abrupt onset with focal neurologic deficit
Rationale: Sudden onset and new neurologic abnormalities are red flags for
potentially serious secondary headache causes. Their presence should alter
both the differential diagnosis and the urgency of further evaluation.
Q4. An office blood pressure is unexpectedly 182/106 mm Hg in an
asymptomatic patient whose previous readings were substantially
lower. What is the best immediate approach?
A) Diagnose persistent severe hypertension from this measurement alone
B) Ignore the value because symptoms are absent
C) Prescribe several medications before repeating the reading
D) Verify technique, repeat the measurement appropriately, and assess for
symptoms or signs of acute target-organ injury
Correct Answer: D) Verify technique, repeat the measurement
appropriately, and assess for symptoms or signs of acute target-organ injury
Rationale: A markedly elevated reading should be confirmed and
interpreted in clinical context. Proper cuff size, positioning, recent activity,
and symptoms suggesting acute organ injury influence whether the situation
represents measurement error, severe asymptomatic hypertension, or an
emergency.
Q5. Which physical-examination approach best follows from a
history of unilateral calf swelling after prolonged immobility?
A) Compare both lower extremities for swelling, warmth, tenderness,
circumference, skin changes, and vascular findings
B) Restrict the examination to the painful area
C) Evaluate only distal sensation
, D) Defer examination because history alone establishes the diagnosis
Correct Answer: A) Compare both lower extremities for swelling, warmth,
tenderness, circumference, skin changes, and vascular findings
Rationale: Comparative examination can identify asymmetry and clinically
important vascular findings. Examination does not confirm venous
thrombosis by itself but contributes to risk assessment and decisions about
diagnostic testing.
Q6. A patient reports dizziness only after rising from bed. Which
finding would most directly help determine whether the symptom
has a hemodynamic component?
A) Visual acuity
B) Blood pressure and pulse measured with appropriate positional changes
C) Abdominal auscultation
D) Grip strength alone
Correct Answer: B) Blood pressure and pulse measured with appropriate
positional changes
Rationale: Position-dependent dizziness can reflect impaired cardiovascular
compensation with standing. Orthostatic vital-sign assessment can add
useful objective information when interpreted alongside hydration status,
medications, symptoms, and other possible causes.
Q7. Why are pertinent negative findings important when evaluating
a focused complaint?
A) Their absence can alter the likelihood of competing diagnoses when the
missing finding would otherwise be expected
B) They prove that a diagnosis is impossible
C) They eliminate the need for diagnostic testing
D) They should be documented for every body system regardless of
relevance
Correct Answer: A) Their absence can alter the likelihood of competing
diagnoses when the missing finding would otherwise be expected
Rationale: Pertinent negatives are diagnostically useful because they
address clinically relevant alternative explanations. They modify probability
2026/2027 Questions And Answers SNHU
Q1. During an initial visit, an adult reports fatigue, poor sleep,
intermittent headaches, and difficulty concentrating. Which
interviewing strategy best supports accurate prioritization of the
concerns?
A) Allow the patient to identify all concerns first, then clarify chronology,
severity, and priorities
B) Select the symptom most likely to represent serious disease before
hearing the remainder
C) Complete the review of systems before discussing the presenting
concerns
D) Address each symptom separately without establishing whether they are
related
Correct Answer: A) Allow the patient to identify all concerns first, then
clarify chronology, severity, and priorities
Rationale: Beginning broadly reduces premature narrowing and allows
related concerns to emerge. Focused questioning can then establish timing,
severity, associated features, functional impact, and the patient's priorities
before the clinician organizes the diagnostic evaluation.
Q2. A person reports intermittent palpitations. Which additional
information provides the greatest immediate diagnostic value?
A) Whether relatives have ever experienced fatigue
B) Relationship of the palpitations to exertion, duration, associated syncope,
chest symptoms, and stimulant use
C) The patient's preferred pharmacy
D) Whether the patient has changed insurance plans
Correct Answer: B) Relationship of the palpitations to exertion, duration,
associated syncope, chest symptoms, and stimulant use
Rationale: Palpitations require characterization of timing, triggers, duration,
associated cardiopulmonary or neurologic symptoms, and relevant
exposures. These details help distinguish benign awareness of heartbeat
from arrhythmias or other clinically significant causes.
,Q3. Which finding most strongly changes the urgency of evaluating
a new headache?
A) Mild photophobia during a familiar headache pattern
B) Improvement after rest
C) Similar headaches occurring occasionally for several years
D) Abrupt onset with focal neurologic deficit
Correct Answer: D) Abrupt onset with focal neurologic deficit
Rationale: Sudden onset and new neurologic abnormalities are red flags for
potentially serious secondary headache causes. Their presence should alter
both the differential diagnosis and the urgency of further evaluation.
Q4. An office blood pressure is unexpectedly 182/106 mm Hg in an
asymptomatic patient whose previous readings were substantially
lower. What is the best immediate approach?
A) Diagnose persistent severe hypertension from this measurement alone
B) Ignore the value because symptoms are absent
C) Prescribe several medications before repeating the reading
D) Verify technique, repeat the measurement appropriately, and assess for
symptoms or signs of acute target-organ injury
Correct Answer: D) Verify technique, repeat the measurement
appropriately, and assess for symptoms or signs of acute target-organ injury
Rationale: A markedly elevated reading should be confirmed and
interpreted in clinical context. Proper cuff size, positioning, recent activity,
and symptoms suggesting acute organ injury influence whether the situation
represents measurement error, severe asymptomatic hypertension, or an
emergency.
Q5. Which physical-examination approach best follows from a
history of unilateral calf swelling after prolonged immobility?
A) Compare both lower extremities for swelling, warmth, tenderness,
circumference, skin changes, and vascular findings
B) Restrict the examination to the painful area
C) Evaluate only distal sensation
, D) Defer examination because history alone establishes the diagnosis
Correct Answer: A) Compare both lower extremities for swelling, warmth,
tenderness, circumference, skin changes, and vascular findings
Rationale: Comparative examination can identify asymmetry and clinically
important vascular findings. Examination does not confirm venous
thrombosis by itself but contributes to risk assessment and decisions about
diagnostic testing.
Q6. A patient reports dizziness only after rising from bed. Which
finding would most directly help determine whether the symptom
has a hemodynamic component?
A) Visual acuity
B) Blood pressure and pulse measured with appropriate positional changes
C) Abdominal auscultation
D) Grip strength alone
Correct Answer: B) Blood pressure and pulse measured with appropriate
positional changes
Rationale: Position-dependent dizziness can reflect impaired cardiovascular
compensation with standing. Orthostatic vital-sign assessment can add
useful objective information when interpreted alongside hydration status,
medications, symptoms, and other possible causes.
Q7. Why are pertinent negative findings important when evaluating
a focused complaint?
A) Their absence can alter the likelihood of competing diagnoses when the
missing finding would otherwise be expected
B) They prove that a diagnosis is impossible
C) They eliminate the need for diagnostic testing
D) They should be documented for every body system regardless of
relevance
Correct Answer: A) Their absence can alter the likelihood of competing
diagnoses when the missing finding would otherwise be expected
Rationale: Pertinent negatives are diagnostically useful because they
address clinically relevant alternative explanations. They modify probability
