NU 610
Advanced Health
Assessment
Midterm Mock Exam
(With Solutions)
2025
1
,1. A 68-year-old man presents with progressive dyspnea on exertion,
bilateral lower extremity edema, and jugular venous distention.
Which physical finding best differentiates right-sided heart failure
from left-sided heart failure?
A. Presence of S3 at the apex
B. Bibasilar crackles on lung auscultation
C. Hepatojugular reflux
D. Displaced point of maximal impulse (PMI)
ANS: C
Rationale: Hepatojugular reflux indicates elevated right atrial
pressure and right-sided failure. S3 and displaced PMI suggest left
ventricular dysfunction; crackles reflect pulmonary congestion from
left failure.
2. A 72-year-old woman with poorly controlled diabetes reports
numbness and tingling in her feet. On neurological examination,
which test most specifically assesses her proprioception?
A. Monofilament testing
B. Vibration sense with a tuning fork
C. Romberg test
D. Two-point discrimination
ANS: C
Rationale: The Romberg test isolates proprioceptive pathways by
assessing postural stability with eyes closed. Monofilament and
vibration test cutaneous and large-fiber function; two-point
discrimination evaluates tactile discrimination.
3. A 65-year-old smoker with unintentional weight loss and a non-
tender, firm supraclavicular lymph node requires imaging to evaluate
for malignancy. Which diagnostic study is most appropriate initially?
A. Chest radiograph
B. Contrast-enhanced CT scan of the chest
2
, C. PET scan of the torso
D. MRI of the neck
ANS: B
Rationale: Contrast CT provides high-resolution detail of thoracic
and mediastinal lymph nodes. Chest radiograph lacks sensitivity; PET
is used after CT to stage; MRI is less ideal for chest.
4. A 75-year-old man’s Mini-Cog test shows inability to recall three
words and fails the clock-drawing task. Which cognitive domain is
primarily assessed by the clock-drawing component?
A. Short-term memory
B. Visuospatial and executive function
C. Language fluency
D. Attention and concentration
ANS: B
Rationale: Clock drawing evaluates visuospatial skills and
planning (executive function). Memory recall assesses short-term
memory; language and attention are tested separately.
5. A 60-year-old male with a 40-pack-year smoking history presents
with chronic cough. On chest percussion you note hyperresonance.
Which condition does this finding most strongly suggest?
A. Pleural effusion
B. Pneumonia
C. Emphysema
D. Pulmonary fibrosis
ANS: C
Rationale: Hyperresonance indicates increased air trapping seen
in emphysema. Dullness is characteristic of effusions, consolidation,
or fibrosis.
6. A 70-year-old woman reports heat intolerance, palpitations, and
unintentional weight loss. On examination you note lid lag and a fine
tremor. Which sign is most specific for hyperthyroidism?
A. Lid lag
3
Advanced Health
Assessment
Midterm Mock Exam
(With Solutions)
2025
1
,1. A 68-year-old man presents with progressive dyspnea on exertion,
bilateral lower extremity edema, and jugular venous distention.
Which physical finding best differentiates right-sided heart failure
from left-sided heart failure?
A. Presence of S3 at the apex
B. Bibasilar crackles on lung auscultation
C. Hepatojugular reflux
D. Displaced point of maximal impulse (PMI)
ANS: C
Rationale: Hepatojugular reflux indicates elevated right atrial
pressure and right-sided failure. S3 and displaced PMI suggest left
ventricular dysfunction; crackles reflect pulmonary congestion from
left failure.
2. A 72-year-old woman with poorly controlled diabetes reports
numbness and tingling in her feet. On neurological examination,
which test most specifically assesses her proprioception?
A. Monofilament testing
B. Vibration sense with a tuning fork
C. Romberg test
D. Two-point discrimination
ANS: C
Rationale: The Romberg test isolates proprioceptive pathways by
assessing postural stability with eyes closed. Monofilament and
vibration test cutaneous and large-fiber function; two-point
discrimination evaluates tactile discrimination.
3. A 65-year-old smoker with unintentional weight loss and a non-
tender, firm supraclavicular lymph node requires imaging to evaluate
for malignancy. Which diagnostic study is most appropriate initially?
A. Chest radiograph
B. Contrast-enhanced CT scan of the chest
2
, C. PET scan of the torso
D. MRI of the neck
ANS: B
Rationale: Contrast CT provides high-resolution detail of thoracic
and mediastinal lymph nodes. Chest radiograph lacks sensitivity; PET
is used after CT to stage; MRI is less ideal for chest.
4. A 75-year-old man’s Mini-Cog test shows inability to recall three
words and fails the clock-drawing task. Which cognitive domain is
primarily assessed by the clock-drawing component?
A. Short-term memory
B. Visuospatial and executive function
C. Language fluency
D. Attention and concentration
ANS: B
Rationale: Clock drawing evaluates visuospatial skills and
planning (executive function). Memory recall assesses short-term
memory; language and attention are tested separately.
5. A 60-year-old male with a 40-pack-year smoking history presents
with chronic cough. On chest percussion you note hyperresonance.
Which condition does this finding most strongly suggest?
A. Pleural effusion
B. Pneumonia
C. Emphysema
D. Pulmonary fibrosis
ANS: C
Rationale: Hyperresonance indicates increased air trapping seen
in emphysema. Dullness is characteristic of effusions, consolidation,
or fibrosis.
6. A 70-year-old woman reports heat intolerance, palpitations, and
unintentional weight loss. On examination you note lid lag and a fine
tremor. Which sign is most specific for hyperthyroidism?
A. Lid lag
3
