8/13/25, 5:45 PM WHNP NCC Exam
WHNP NCC STUDY GUIDE EXAM 2025 LATEST VERSION
WITH COMPLETE QUESTIONS AND ACCURATE DETAILED
ANSWERS \UPDATED VERSION
- Air flow through constricted passage
Wheezing - Chronic emphysema, asthma
- High pitch, louder during expiration, squeaky
- Inflammation of pleural tissue
Pleural friction rub - Pleuritis, pericarditis, heard with inspiration/expiration
- Dry, rubbing, grating
Apical impulse 4th-5h left intercostal space medial to midclavicular line
S1 Occurs at start of systole at apex
S2 Occurs at start of diastole at base
- Heard at inspiration at base, normal
Physiologic split S2
- Best heard w/ diaphragm
- Heard at inspiration and expiration at base
- Delayed closure of pulmonic valve - caused by atrial
Fixed split S2
septal defect, right ventricular failure
- Best heard w/ diaphragm
- Ventricular gallop, best heard at apex with bell
- Early diastole, low pitch, increases w/ inspiration
Increased S3 - Normal in young adults & late preg.
- Dec myocardial contractility/heart failure/volume
overload = rapid ventricular filling
- Atrialgallop, best heard at apex w/ bell
- Late diastole, low pitch, increases w/ inspiration
Increased S4 - Normal in athletes, old
- Aortic stenosis, HTN heart disease, & cardiomyopathy
= forceful atrial ejection into distended ventricle
- 2-4th left ICS bw left sternal border & apex
Physiologic murmur - Mid-systole, soft-medium pitch, improves/gone when sitting,
standing, valsalva
- Normal, common in pregnancy
1/86
,8/13/25, 5:45 PM WHNP NCC Exam
- Best heard at apex w/ bell
Murmur of mitral stenosis
- Early to late diastole, low-pitched
- Best heard at apex with diaphragm
Systolic click - Mid-to late systole, high pitch, inc w/ inspiration
- Mitral valve prolapse
- Smooth edge, sharp, nontender, </= 2 cm below right costal
Liver
margin
- Spans 6-12 cm at right MCL
Aorta Left of midline in upper abdomen, <3 cm wide
Splenic dullness 6-10th ICS posterior to midaxillary line - suspect splenomegaly
Peritonitis Guarding, rigidity, rebound tenderness is a sign of?
Appendicitis Mcburney's point, Rovsing, and Psoas/obturator are tests for
what?
McBurney localized RLQ tenderness
Referred rebound tenderness; RLQ pain when Left side
Rovsing
pressure is applied & withdrawn
Psoas/obturator Extension/rotation of thigh/hip causes right side muscle irritation
and pain
Cholecystitis + Murphy sign indicates what?
Sharp increase in tenderness and cessation of breathing
Murphy
when upward pressure placed under right costal
margin
2/86
,8/13/25, 5:45 PM WHNP NCC Exam
for all adults 45+ with structural (visual) or high sensitivity
stool test; screen until 75 y.o.
-guaiac fecal occult: multiple stools, at home, annual
-stool DNA - 1 sample, at home, cancer/polyp DNA, q3y
-colonoscopy q10y
Colorectal screen
-flexible sigmoidoscopy q5y
-CT colonography q5y
start younger if risks like inflammatory bowel disease,
hx/fhx colon polyps/colon cancer, lynch syndrome,
1945-1965 Anyone born between these years or with risk factors should be
tested for Hep C
screen for this q3 years
starting at 45 y.o. hx GDM
DM - screen q3y for life
Dx made by:
- sx hyperglycemia & random non-fasting glucose 200+
- fasting glucose 126+
- 2 hour GTT - 200+
Must be repeated on another day to confirm
Lipids should be screened starting at what age; (or
starting at 20 if risk factors for CV disease)
40-75
done q5y
3/86
, 8/13/25, 5:45 PM WHNP NCC Exam
-I - olfactory; familiar smells
- II - optic; acuity, peripheral vision, optic disc
- III, IV, VI - oculomotor/trochlear/abducens - PERRLA, EOM
function, ptosis
- V - trigeminal - palpate temporal/masseter muscle
strength, sharp/dull touch on forehead/cheeks/chin
Cranial nerves
- VII - facial - weakness, asymmetry, abnormal movement
- VIII - acoustic - auditory acuity
- IX & X - glossopharyngeal & vagus - swallow,
soft palate symmetry, uvula movement w/
"ah", gag, voice
- XI - spinal accessory - strength/symmetry, trapezius &
sternocleidomastoid muscles XII - Hypoglossal -
tongue deviation, asymmetry
Cerebellum Coordination, gait, walk heel-toe, Romberg, rapid alternating
movement
Romberg test balance with eyes closed
- Straight-sided
Pederson speculum
- Comes in pediatric, narrow, and regular sizes
- Duck-billed shape, used for lax musculature
Graves speculum
- Submucosal fat impedes visualization
5.5-8 cm; 2-3 cm Normal uterus size; usually this much larger in parous women
Normal adnexa Fallopian non-palpable, ovoid ovaries
epididymis posterolateral surface of tests, comma shape
spermatic cord from lower end of epididymis and extends to external inguinal
ring
surrounds urethra at bladder neck, heart shaped, 4x3x2
prostate gland
cm, smooth, rubbery, nontender
Hypospadias congenital displacement of urethral meatus to inferior (ventral)
surface of penis
palpable nontender hard plaque under skin along
peyronie's
dorsum of penis, crooked/painful erections
- abnormal dilation of peritesticular veins causing
varicocele varicose veins of spermatic cord; bag of worms
feeling separate from testes
- assoc w/ infertility
- acutely inflamed, tender, swollen epididymis, scrotum red, low
acute epididymitis
grade fever
- usually caused by CT/GC
4/86
WHNP NCC STUDY GUIDE EXAM 2025 LATEST VERSION
WITH COMPLETE QUESTIONS AND ACCURATE DETAILED
ANSWERS \UPDATED VERSION
- Air flow through constricted passage
Wheezing - Chronic emphysema, asthma
- High pitch, louder during expiration, squeaky
- Inflammation of pleural tissue
Pleural friction rub - Pleuritis, pericarditis, heard with inspiration/expiration
- Dry, rubbing, grating
Apical impulse 4th-5h left intercostal space medial to midclavicular line
S1 Occurs at start of systole at apex
S2 Occurs at start of diastole at base
- Heard at inspiration at base, normal
Physiologic split S2
- Best heard w/ diaphragm
- Heard at inspiration and expiration at base
- Delayed closure of pulmonic valve - caused by atrial
Fixed split S2
septal defect, right ventricular failure
- Best heard w/ diaphragm
- Ventricular gallop, best heard at apex with bell
- Early diastole, low pitch, increases w/ inspiration
Increased S3 - Normal in young adults & late preg.
- Dec myocardial contractility/heart failure/volume
overload = rapid ventricular filling
- Atrialgallop, best heard at apex w/ bell
- Late diastole, low pitch, increases w/ inspiration
Increased S4 - Normal in athletes, old
- Aortic stenosis, HTN heart disease, & cardiomyopathy
= forceful atrial ejection into distended ventricle
- 2-4th left ICS bw left sternal border & apex
Physiologic murmur - Mid-systole, soft-medium pitch, improves/gone when sitting,
standing, valsalva
- Normal, common in pregnancy
1/86
,8/13/25, 5:45 PM WHNP NCC Exam
- Best heard at apex w/ bell
Murmur of mitral stenosis
- Early to late diastole, low-pitched
- Best heard at apex with diaphragm
Systolic click - Mid-to late systole, high pitch, inc w/ inspiration
- Mitral valve prolapse
- Smooth edge, sharp, nontender, </= 2 cm below right costal
Liver
margin
- Spans 6-12 cm at right MCL
Aorta Left of midline in upper abdomen, <3 cm wide
Splenic dullness 6-10th ICS posterior to midaxillary line - suspect splenomegaly
Peritonitis Guarding, rigidity, rebound tenderness is a sign of?
Appendicitis Mcburney's point, Rovsing, and Psoas/obturator are tests for
what?
McBurney localized RLQ tenderness
Referred rebound tenderness; RLQ pain when Left side
Rovsing
pressure is applied & withdrawn
Psoas/obturator Extension/rotation of thigh/hip causes right side muscle irritation
and pain
Cholecystitis + Murphy sign indicates what?
Sharp increase in tenderness and cessation of breathing
Murphy
when upward pressure placed under right costal
margin
2/86
,8/13/25, 5:45 PM WHNP NCC Exam
for all adults 45+ with structural (visual) or high sensitivity
stool test; screen until 75 y.o.
-guaiac fecal occult: multiple stools, at home, annual
-stool DNA - 1 sample, at home, cancer/polyp DNA, q3y
-colonoscopy q10y
Colorectal screen
-flexible sigmoidoscopy q5y
-CT colonography q5y
start younger if risks like inflammatory bowel disease,
hx/fhx colon polyps/colon cancer, lynch syndrome,
1945-1965 Anyone born between these years or with risk factors should be
tested for Hep C
screen for this q3 years
starting at 45 y.o. hx GDM
DM - screen q3y for life
Dx made by:
- sx hyperglycemia & random non-fasting glucose 200+
- fasting glucose 126+
- 2 hour GTT - 200+
Must be repeated on another day to confirm
Lipids should be screened starting at what age; (or
starting at 20 if risk factors for CV disease)
40-75
done q5y
3/86
, 8/13/25, 5:45 PM WHNP NCC Exam
-I - olfactory; familiar smells
- II - optic; acuity, peripheral vision, optic disc
- III, IV, VI - oculomotor/trochlear/abducens - PERRLA, EOM
function, ptosis
- V - trigeminal - palpate temporal/masseter muscle
strength, sharp/dull touch on forehead/cheeks/chin
Cranial nerves
- VII - facial - weakness, asymmetry, abnormal movement
- VIII - acoustic - auditory acuity
- IX & X - glossopharyngeal & vagus - swallow,
soft palate symmetry, uvula movement w/
"ah", gag, voice
- XI - spinal accessory - strength/symmetry, trapezius &
sternocleidomastoid muscles XII - Hypoglossal -
tongue deviation, asymmetry
Cerebellum Coordination, gait, walk heel-toe, Romberg, rapid alternating
movement
Romberg test balance with eyes closed
- Straight-sided
Pederson speculum
- Comes in pediatric, narrow, and regular sizes
- Duck-billed shape, used for lax musculature
Graves speculum
- Submucosal fat impedes visualization
5.5-8 cm; 2-3 cm Normal uterus size; usually this much larger in parous women
Normal adnexa Fallopian non-palpable, ovoid ovaries
epididymis posterolateral surface of tests, comma shape
spermatic cord from lower end of epididymis and extends to external inguinal
ring
surrounds urethra at bladder neck, heart shaped, 4x3x2
prostate gland
cm, smooth, rubbery, nontender
Hypospadias congenital displacement of urethral meatus to inferior (ventral)
surface of penis
palpable nontender hard plaque under skin along
peyronie's
dorsum of penis, crooked/painful erections
- abnormal dilation of peritesticular veins causing
varicocele varicose veins of spermatic cord; bag of worms
feeling separate from testes
- assoc w/ infertility
- acutely inflamed, tender, swollen epididymis, scrotum red, low
acute epididymitis
grade fever
- usually caused by CT/GC
4/86
