NSG 6020 FINAL EXAM (Advanced Health
Assessment / Advanced Health & Physical Assessment)
Exam Up to Date 2025/2026 Latest Exam Questions And
Answers Complete Study Guide Exam.
1. A 62-year-old presents with sudden painless loss of vision in one eye described as a
"curtain coming down." Fundoscopy shows a pale retina with a cherry-red spot at the
macula. What is the diagnosis?
A) Central retinal vein occlusion
B) Central retinal artery occlusion
C) Optic neuritis
D) Retinal detachment
Answer: B
CRAO produces inner retinal ischemia while the fovea, supplied by the choroid, retains its
red appearance against pale ischemic retina — the cherry-red spot. CRVO shows a "blood
and thunder" fundus with hemorrhages. Optic neuritis is painful; detachment causes
flashes and a shadow.
2. A 28-year-old woman reports fatigue, weight gain, cold intolerance, and constipation.
TSH is elevated and free T4 is low. What is the diagnosis?
A) Subclinical hypothyroidism
B) Primary hypothyroidism
C) Central hypothyroidism
D) Hyperthyroidism
Answer: B
Elevated TSH with low free T4 indicates primary thyroid gland failure. Subclinical
hypothyroidism has elevated TSH with normal T4; central hypothyroidism has low/normal
TSH with low T4.
,3. Which physical exam finding is most consistent with acute otitis media?
A) Retracted tympanic membrane with a fluid level
B) Bulging, erythematous tympanic membrane with decreased mobility
C) Clear tympanic membrane with visible landmarks
D) Perforation with purulent drainage
Answer: B
Bulging, erythema, and reduced mobility indicate acute middle-ear inflammation and
pressure. Retraction with fluid suggests effusion without acute infection.
4. A 45-year-old presents with episodic palpitations, diaphoresis, headache, and
hypertension. Which diagnosis should be considered first?
A) Panic disorder
B) Pheochromocytoma
C) Hyperthyroidism
D) Carcinoid syndrome
Answer: B
The classic triad of episodic headache, sweating, and tachycardia with hypertension
suggests pheochromocytoma. Hyperthyroidism is more constant; carcinoid causes flushing
and diarrhea; panic disorder lacks sustained hypertension.
5. Which ECG finding is most indicative of hyperkalemia?
A) Prominent U waves
B) Prolonged QT interval
C) Peaked T waves
D) ST elevation
Answer: C
Peaked T waves are the classic early ECG sign of hyperkalemia. U waves and prolonged
QT suggest hypokalemia and hypocalcemia, respectively; ST elevation suggests ischemia.
,6. A patient with cirrhosis presents with confusion, asterixis, and elevated ammonia.
Which precipitant should be sought first?
A) Hypothyroidism
B) GI bleeding
C) Hyperkalemia
D) Iron deficiency
Answer: B
GI bleeding delivers a large protein load to the gut, increasing ammonia production and
precipitating hepatic encephalopathy. Infection, constipation, dehydration, and sedatives
are other triggers.
7. A 67-year-old presents with painless jaundice and a palpable, nontender gallbladder.
Which diagnosis is highest on the differential?
A) Acute cholecystitis
B) Choledocholithiasis
C) Pancreatic head carcinoma
D) Hepatitis A
Answer: C
Courvoisier's sign — palpable nontender gallbladder with painless jaundice — raises
concern for malignant distal bile duct obstruction, classically pancreatic head cancer.
8. Which finding best differentiates delirium from dementia?
A) Gradual progressive decline
B) Acute onset with fluctuating attention
C) Stable memory loss
D) Preserved attention
Answer: B
Delirium is acute with fluctuating attention and altered consciousness; dementia is chronic
and progressive.
, 9. A patient has a BP of 168/104 mmHg in both arms, no symptoms, and no end-organ
damage. What is the classification?
A) Hypertensive emergency
B) Hypertensive urgency
C) White coat hypertension
D) Normal variation
Answer: B
Hypertensive urgency is severe elevation without acute end-organ damage. Emergency
requires target-organ injury.
10. Which lab pattern fits iron deficiency anemia?
A) Low ferritin, low MCV, high TIBC
B) High ferritin, high MCV, low TIBC
C) Normal ferritin, normal MCV, low reticulocytes
D) High ferritin, low MCV, low TIBC
Answer: A
Iron deficiency shows low ferritin, microcytosis, and elevated TIBC. Anemia of chronic
disease shows high/normal ferritin and low TIBC.
11. A 55-year-old with long-standing GERD reports dysphagia and weight loss. What is
the priority next step?
A) Trial of PPI for 8 weeks
B) Upper endoscopy
C) Barium swallow only
D) Reassurance
Answer: B
Dysphagia and weight loss are alarm features requiring prompt endoscopy to evaluate for
stricture or malignancy.
Assessment / Advanced Health & Physical Assessment)
Exam Up to Date 2025/2026 Latest Exam Questions And
Answers Complete Study Guide Exam.
1. A 62-year-old presents with sudden painless loss of vision in one eye described as a
"curtain coming down." Fundoscopy shows a pale retina with a cherry-red spot at the
macula. What is the diagnosis?
A) Central retinal vein occlusion
B) Central retinal artery occlusion
C) Optic neuritis
D) Retinal detachment
Answer: B
CRAO produces inner retinal ischemia while the fovea, supplied by the choroid, retains its
red appearance against pale ischemic retina — the cherry-red spot. CRVO shows a "blood
and thunder" fundus with hemorrhages. Optic neuritis is painful; detachment causes
flashes and a shadow.
2. A 28-year-old woman reports fatigue, weight gain, cold intolerance, and constipation.
TSH is elevated and free T4 is low. What is the diagnosis?
A) Subclinical hypothyroidism
B) Primary hypothyroidism
C) Central hypothyroidism
D) Hyperthyroidism
Answer: B
Elevated TSH with low free T4 indicates primary thyroid gland failure. Subclinical
hypothyroidism has elevated TSH with normal T4; central hypothyroidism has low/normal
TSH with low T4.
,3. Which physical exam finding is most consistent with acute otitis media?
A) Retracted tympanic membrane with a fluid level
B) Bulging, erythematous tympanic membrane with decreased mobility
C) Clear tympanic membrane with visible landmarks
D) Perforation with purulent drainage
Answer: B
Bulging, erythema, and reduced mobility indicate acute middle-ear inflammation and
pressure. Retraction with fluid suggests effusion without acute infection.
4. A 45-year-old presents with episodic palpitations, diaphoresis, headache, and
hypertension. Which diagnosis should be considered first?
A) Panic disorder
B) Pheochromocytoma
C) Hyperthyroidism
D) Carcinoid syndrome
Answer: B
The classic triad of episodic headache, sweating, and tachycardia with hypertension
suggests pheochromocytoma. Hyperthyroidism is more constant; carcinoid causes flushing
and diarrhea; panic disorder lacks sustained hypertension.
5. Which ECG finding is most indicative of hyperkalemia?
A) Prominent U waves
B) Prolonged QT interval
C) Peaked T waves
D) ST elevation
Answer: C
Peaked T waves are the classic early ECG sign of hyperkalemia. U waves and prolonged
QT suggest hypokalemia and hypocalcemia, respectively; ST elevation suggests ischemia.
,6. A patient with cirrhosis presents with confusion, asterixis, and elevated ammonia.
Which precipitant should be sought first?
A) Hypothyroidism
B) GI bleeding
C) Hyperkalemia
D) Iron deficiency
Answer: B
GI bleeding delivers a large protein load to the gut, increasing ammonia production and
precipitating hepatic encephalopathy. Infection, constipation, dehydration, and sedatives
are other triggers.
7. A 67-year-old presents with painless jaundice and a palpable, nontender gallbladder.
Which diagnosis is highest on the differential?
A) Acute cholecystitis
B) Choledocholithiasis
C) Pancreatic head carcinoma
D) Hepatitis A
Answer: C
Courvoisier's sign — palpable nontender gallbladder with painless jaundice — raises
concern for malignant distal bile duct obstruction, classically pancreatic head cancer.
8. Which finding best differentiates delirium from dementia?
A) Gradual progressive decline
B) Acute onset with fluctuating attention
C) Stable memory loss
D) Preserved attention
Answer: B
Delirium is acute with fluctuating attention and altered consciousness; dementia is chronic
and progressive.
, 9. A patient has a BP of 168/104 mmHg in both arms, no symptoms, and no end-organ
damage. What is the classification?
A) Hypertensive emergency
B) Hypertensive urgency
C) White coat hypertension
D) Normal variation
Answer: B
Hypertensive urgency is severe elevation without acute end-organ damage. Emergency
requires target-organ injury.
10. Which lab pattern fits iron deficiency anemia?
A) Low ferritin, low MCV, high TIBC
B) High ferritin, high MCV, low TIBC
C) Normal ferritin, normal MCV, low reticulocytes
D) High ferritin, low MCV, low TIBC
Answer: A
Iron deficiency shows low ferritin, microcytosis, and elevated TIBC. Anemia of chronic
disease shows high/normal ferritin and low TIBC.
11. A 55-year-old with long-standing GERD reports dysphagia and weight loss. What is
the priority next step?
A) Trial of PPI for 8 weeks
B) Upper endoscopy
C) Barium swallow only
D) Reassurance
Answer: B
Dysphagia and weight loss are alarm features requiring prompt endoscopy to evaluate for
stricture or malignancy.
