NUR 631 ADVANCED HEALTH ASSESSMENT
EXAM 4 LATEST 2025 WITH 100 EXAM PREP
QUESTIONS AND CORRECT VERIFIED
ANSWERS/ NUR631 EXAM 4 ADV HEALTH
ASSESSMENT LATEST 2025 (BRAND NEW!)
A 46-year-old former salesman presents to the ER, complaining of black stools for
the past few weeks. His past medical history is significant for cirrhosis. He has
gained weight recently, especially around his abdomen. He has smoked two packs
of cigarettes a day for 30 years and has drunk approximately 10 alcoholic
beverages a day for 25 years. He has used IV heroin and smoked crack in the past.
He denies any recent use. He is currently unemployed and has never been married.
On examination you find a man appearing older than his stated age. His skin has a
yellowish tint and he is thin, with a prominent abdomen. You note multiple "spider
angiomas" at the base of his neck. Otherwise, his heart and lung examinations are
normal. On inspection he has dilated veins around his umbilicus. Increased bowel
sounds are heard during auscultation. Palpation reveals diffuse tenderness that is
more severe in the epigastric area. His liver is small and hard to palpation and he
has a positive fluid wave. He is positive for occult blood on his rectal examination.
What cause of black stools most likely describes his symptoms and signs?
A) Infectious diarrhea
B) Mallory-Weiss tear
C) Esophageal varices
C) Esophageal varices
A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea.
She states that the stools are very loose and there is some cramping beforehand.
She states this has occurred on and off since she was in high school. She denies
any nausea, vomiting, or blood in her stool. Occasionally she has periods of
constipation, but that is rare. She thinks the diarrhea is much worse when she is
nervous. Her past medical history is not significant. She is single and a junior in
college majoring in accounting. She smokes when she drinks alcohol but denies
using any illegal drugs. Both of her parents are healthy. Her entire physical
examination is unremarkable.
pg. 1
,What is most likely the etiology of her diarrhea?
A) Secretory infections
B) Inflammatory infections
C) Irritable bowel syndrome
D) Malabsorption syndrome
C) Irritable bowel syndrome
A 42-year-old florist comes to your office, complaining of chronic constipation for
the last 6 months. She has had no nausea, vomiting, or diarrhea and no abdominal
pain or cramping. She denies any recent illnesses or injuries. She denies any
changes to her diet or exercise program. She is on no new medications. During the
review of systems you note that she has felt fatigued, had some weight gain, has
irregular periods, and has cold intolerance. Her past medical history is significant
for one vaginal delivery and two cesarean sections. She is married, has three
children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her
mother has type 2 diabetes and her father has coronary artery disease. There is no
family history of cancers. On examination she appears her stated age. Her vital
signs are normal. Her head, eyes, ears, nose, throat, and neck examinations are
normal. Her cardiac, lung, and abdominal examinations are also unremarkable. Her
rectal occult blood test is negative. Her deep tendon reflexes are delayed in
response to a blow with the hammer, especially the Achilles tendons.
What is the best choice for the cause of her constipation?
A) Large bowel obstruction
B) Irritable bowel syndrome
C) Rectal cancer
D) Hypothyroidism 191
D) Hypothyroidism 191
A 22-year-old law student comes to your office, complaining of severe abdominal
pain radiating to his back. He states it began last night after hours of heavy
drinking. He has had abdominal pain and vomiting in the past after drinking but
never as bad as this. He cannot keep any food or water down, and these symptoms
have been going on for almost 12 hours. He has had no recent illnesses or injuries.
His past medical history is unremarkable. He denies smoking or using illegal drugs
but admits to drinking 6 to 10 beers per weekend night. He admits that last night he
drank something like 14 drinks. On examination you find a young male appearing
pg. 2
,his stated age in some distress. He is leaning over on the examination table and
holding his abdomen with his arms. His blood pressure is 90/60 and his pulse is
120. He is afebrile. His abdominal examination reveals normal bowel sounds, but
he is very tender in the left upper quadrant and epigastric area. He has no Murphy's
sign or tenderness in the right lower quadrant. The remainder of his abdominal
examination is normal. His rectal, prostate, penile, and testicular examinations are
normal. He has no inguinal hernias or tenderness with that examination. Blood
work is pending.
What etiology of abdominal pain is most likely causing his symptoms?
A) Peptic ulcer disease
B) Biliary colic
C) Acute cholecystitis
D) Acute pancreatitis
D) Acute pancreatitis
A 76-year-old retired farmer comes to your office complaining of abdominal pain,
constipation, and a low-grade fever for about 3 days. He denies any nausea,
vomiting, or diarrhea. The only unusual thing he remembers eating is two bags of
popcorn at the movies with his grandson, 3 days before his symptoms began. He
denies any other recent illnesses. His past medical history is significant for
coronary artery disease and high blood pressure. He has been married for over 50
years. He denies any tobacco, alcohol, or drug use. His mother died of colon
cancer and his father had a stroke. On examination he appears his stated age and is
in no acute distress. His temperature is 100.9 degrees and his other vital signs are
unremarkable. His head, cardiac, and pulmonary examinations are normal. He has
normal bowel sounds and is tender over the left lower quadrant. He has no rebound
or guarding. His rectal examination is unremarkable and his fecal occult blood test
is negative. His prostate is slightly enlarged but his testicular, penile, and inguinal
examinations are all normal. Blood work is pending.
What diagnosis for abdominal pain best describes his symptoms and signs?
A) Acute diverticulitis
B) Acute cholecystitis
C) Acute appendicitis
D) Mesenteric ischemia
A) Acute diverticulitis
pg. 3
, A 77-year-old retired bus driver comes to your clinic for a physical examination at
his wife's request. He has recently been losing weight and has felt very fatigued.
He has had no chest pain, shortness of breath, nausea, vomiting, or fever. His past
medical history includes colon cancer, for which he had surgery, and arthritis. He
has been married for over 40 years. He denies any tobacco or drug use and has not
drunk alcohol in over 40 years. His parents both died of cancer in their 60s. On
examination his vital signs are normal. His head, cardiac, and pulmonary
examinations are unremarkable. On abdominal examination you hear normal
bowel sounds, but when you palpate his liver it is abnormal. His rectal examination
is positive for occult blood.
What further abnormality of the liver was likely found on examination?
A) Smooth, large, nontender liver
B) Irregular, large liver
C) Smooth, large, tender liver
B) Irregular, large liver
A 26-year-old sports store manager comes to your clinic, complaining of severe
right-sided abdominal pain for 12 hours. He began having a stomachache
yesterday, with a decreased appetite, but today the pain seems to be just on the
lower right side. He has had some nausea and vomiting but no constipation or
diarrhea. His last bowel movement was last night and was normal. He has had no
fever or chills. He denies any recent illnesses or injuries. His past medical history
is unremarkable. He is engaged. He denies any tobacco or drug use and drinks four
to six beers per week. His mother has breast cancer and his father has coronary
artery disease. On examination he appears ill and is lying on his right side. His
temperature is 100.4 and his heart rate is 110. His bowel sounds are decreased and
he has rebound and involuntary guarding, one third of the way between the anterior
superior iliac spine and the umbilicus in the right lower quadrant. His rectal,
inguinal, prostate, penile, and testicular examinations are normal.
What is the most likely cause of his pain?
A) Acute appendicitis
B) Acute mechanical intestinal obstruction
C) Acute cholecystitis
D) Mesenteric ischemia
A) Acute appendicitis
pg. 4
EXAM 4 LATEST 2025 WITH 100 EXAM PREP
QUESTIONS AND CORRECT VERIFIED
ANSWERS/ NUR631 EXAM 4 ADV HEALTH
ASSESSMENT LATEST 2025 (BRAND NEW!)
A 46-year-old former salesman presents to the ER, complaining of black stools for
the past few weeks. His past medical history is significant for cirrhosis. He has
gained weight recently, especially around his abdomen. He has smoked two packs
of cigarettes a day for 30 years and has drunk approximately 10 alcoholic
beverages a day for 25 years. He has used IV heroin and smoked crack in the past.
He denies any recent use. He is currently unemployed and has never been married.
On examination you find a man appearing older than his stated age. His skin has a
yellowish tint and he is thin, with a prominent abdomen. You note multiple "spider
angiomas" at the base of his neck. Otherwise, his heart and lung examinations are
normal. On inspection he has dilated veins around his umbilicus. Increased bowel
sounds are heard during auscultation. Palpation reveals diffuse tenderness that is
more severe in the epigastric area. His liver is small and hard to palpation and he
has a positive fluid wave. He is positive for occult blood on his rectal examination.
What cause of black stools most likely describes his symptoms and signs?
A) Infectious diarrhea
B) Mallory-Weiss tear
C) Esophageal varices
C) Esophageal varices
A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea.
She states that the stools are very loose and there is some cramping beforehand.
She states this has occurred on and off since she was in high school. She denies
any nausea, vomiting, or blood in her stool. Occasionally she has periods of
constipation, but that is rare. She thinks the diarrhea is much worse when she is
nervous. Her past medical history is not significant. She is single and a junior in
college majoring in accounting. She smokes when she drinks alcohol but denies
using any illegal drugs. Both of her parents are healthy. Her entire physical
examination is unremarkable.
pg. 1
,What is most likely the etiology of her diarrhea?
A) Secretory infections
B) Inflammatory infections
C) Irritable bowel syndrome
D) Malabsorption syndrome
C) Irritable bowel syndrome
A 42-year-old florist comes to your office, complaining of chronic constipation for
the last 6 months. She has had no nausea, vomiting, or diarrhea and no abdominal
pain or cramping. She denies any recent illnesses or injuries. She denies any
changes to her diet or exercise program. She is on no new medications. During the
review of systems you note that she has felt fatigued, had some weight gain, has
irregular periods, and has cold intolerance. Her past medical history is significant
for one vaginal delivery and two cesarean sections. She is married, has three
children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her
mother has type 2 diabetes and her father has coronary artery disease. There is no
family history of cancers. On examination she appears her stated age. Her vital
signs are normal. Her head, eyes, ears, nose, throat, and neck examinations are
normal. Her cardiac, lung, and abdominal examinations are also unremarkable. Her
rectal occult blood test is negative. Her deep tendon reflexes are delayed in
response to a blow with the hammer, especially the Achilles tendons.
What is the best choice for the cause of her constipation?
A) Large bowel obstruction
B) Irritable bowel syndrome
C) Rectal cancer
D) Hypothyroidism 191
D) Hypothyroidism 191
A 22-year-old law student comes to your office, complaining of severe abdominal
pain radiating to his back. He states it began last night after hours of heavy
drinking. He has had abdominal pain and vomiting in the past after drinking but
never as bad as this. He cannot keep any food or water down, and these symptoms
have been going on for almost 12 hours. He has had no recent illnesses or injuries.
His past medical history is unremarkable. He denies smoking or using illegal drugs
but admits to drinking 6 to 10 beers per weekend night. He admits that last night he
drank something like 14 drinks. On examination you find a young male appearing
pg. 2
,his stated age in some distress. He is leaning over on the examination table and
holding his abdomen with his arms. His blood pressure is 90/60 and his pulse is
120. He is afebrile. His abdominal examination reveals normal bowel sounds, but
he is very tender in the left upper quadrant and epigastric area. He has no Murphy's
sign or tenderness in the right lower quadrant. The remainder of his abdominal
examination is normal. His rectal, prostate, penile, and testicular examinations are
normal. He has no inguinal hernias or tenderness with that examination. Blood
work is pending.
What etiology of abdominal pain is most likely causing his symptoms?
A) Peptic ulcer disease
B) Biliary colic
C) Acute cholecystitis
D) Acute pancreatitis
D) Acute pancreatitis
A 76-year-old retired farmer comes to your office complaining of abdominal pain,
constipation, and a low-grade fever for about 3 days. He denies any nausea,
vomiting, or diarrhea. The only unusual thing he remembers eating is two bags of
popcorn at the movies with his grandson, 3 days before his symptoms began. He
denies any other recent illnesses. His past medical history is significant for
coronary artery disease and high blood pressure. He has been married for over 50
years. He denies any tobacco, alcohol, or drug use. His mother died of colon
cancer and his father had a stroke. On examination he appears his stated age and is
in no acute distress. His temperature is 100.9 degrees and his other vital signs are
unremarkable. His head, cardiac, and pulmonary examinations are normal. He has
normal bowel sounds and is tender over the left lower quadrant. He has no rebound
or guarding. His rectal examination is unremarkable and his fecal occult blood test
is negative. His prostate is slightly enlarged but his testicular, penile, and inguinal
examinations are all normal. Blood work is pending.
What diagnosis for abdominal pain best describes his symptoms and signs?
A) Acute diverticulitis
B) Acute cholecystitis
C) Acute appendicitis
D) Mesenteric ischemia
A) Acute diverticulitis
pg. 3
, A 77-year-old retired bus driver comes to your clinic for a physical examination at
his wife's request. He has recently been losing weight and has felt very fatigued.
He has had no chest pain, shortness of breath, nausea, vomiting, or fever. His past
medical history includes colon cancer, for which he had surgery, and arthritis. He
has been married for over 40 years. He denies any tobacco or drug use and has not
drunk alcohol in over 40 years. His parents both died of cancer in their 60s. On
examination his vital signs are normal. His head, cardiac, and pulmonary
examinations are unremarkable. On abdominal examination you hear normal
bowel sounds, but when you palpate his liver it is abnormal. His rectal examination
is positive for occult blood.
What further abnormality of the liver was likely found on examination?
A) Smooth, large, nontender liver
B) Irregular, large liver
C) Smooth, large, tender liver
B) Irregular, large liver
A 26-year-old sports store manager comes to your clinic, complaining of severe
right-sided abdominal pain for 12 hours. He began having a stomachache
yesterday, with a decreased appetite, but today the pain seems to be just on the
lower right side. He has had some nausea and vomiting but no constipation or
diarrhea. His last bowel movement was last night and was normal. He has had no
fever or chills. He denies any recent illnesses or injuries. His past medical history
is unremarkable. He is engaged. He denies any tobacco or drug use and drinks four
to six beers per week. His mother has breast cancer and his father has coronary
artery disease. On examination he appears ill and is lying on his right side. His
temperature is 100.4 and his heart rate is 110. His bowel sounds are decreased and
he has rebound and involuntary guarding, one third of the way between the anterior
superior iliac spine and the umbilicus in the right lower quadrant. His rectal,
inguinal, prostate, penile, and testicular examinations are normal.
What is the most likely cause of his pain?
A) Acute appendicitis
B) Acute mechanical intestinal obstruction
C) Acute cholecystitis
D) Mesenteric ischemia
A) Acute appendicitis
pg. 4
