Advanced Health Assessment & Pathophysiology Examination – BSN
206 2025-2026 -Questions And Answers Latest Updates With Correct
Answers 100% With Complete Solutions Pass Guaranteed-Graded A+
Part A — Multiple Choice (60 questions)
1. A 68-year-old patient complains of progressive dyspnea on exertion. On auscultation you
hear bibasilar crackles. Which physiologic change most likely explains the crackles?
A. Bronchospasm of small airways
B. Fluid in alveolar airspaces from left ventricular failure
C. Thickened pleura restricting lung expansion
D. Collapse of large airways from mucus plugs
Answer: B. Crackles (rales) at bases commonly indicate fluid in alveoli, often from
left-sided heart failure.
2. Which assessment finding is most consistent with chronic hypoxemia?
A. Nail clubbing
B. Acute tachypnea
C. Hyporeflexia
D. Dry cough
Answer: A. Chronic hypoxemia leads to digital clubbing over time.
3. S1 is loudest at which location?
A. Aortic area
B. Pulmonic area
C. Left lower sternal border
D. Mitral (apical) area
Answer: D. S1 (mitral/tricuspid valve closure) is loudest at the apex (mitral area).
4. A patient has right upper quadrant pain and a positive Murphy’s sign. Which organ is
most likely involved?
A. Appendix
B. Gallbladder
C. Stomach
D. Spleen
Answer: B. Murphy’s sign suggests gallbladder inflammation (cholecystitis).
5. Which breath sound is described as low-pitched, continuous, and heard throughout
expiration and inspiration in asthma exacerbation?
A. Fine crackles
B. Coarse crackles
C. Wheeze
D. Pleural friction rub
Answer: C. Wheezes are musical, continuous, and common with airway narrowing in
asthma.
6. Which lab value reflects kidney filtration function?
A. AST
, B. Serum sodium
C. Creatinine clearance / GFR
D. Hemoglobin
Answer: C. GFR (or creatinine clearance) measures kidney filtration.
7. A patient presents with sudden, severe chest pain and unequal breath sounds. You suspect
a pneumothorax. Which exam finding supports that?
A. Increased tactile fremitus on affected side
B. Hyperresonance on percussion over affected side
C. Bronchial breath sounds over periphery
D. Crackles localized to the same side
Answer: B. Air in pleural space causes hyperresonance and decreased fremitus.
8. In a neurologic exam, pronator drift indicates possible lesion in the:
A. Cerebellum
B. Basal ganglia
C. Contralateral corticospinal tract (motor cortex)
D. Peripheral nerves
Answer: C. Pronator drift suggests upper motor neuron (corticospinal) weakness on
the contralateral side.
9. Which of the following pulses is palpated at the wrist?
A. Dorsalis pedis
B. Radial
C. Femoral
D. Brachial
Answer: B. Radial pulse is at the wrist.
10. A patient has hyperresonant percussion notes and decreased breath sounds on the left;
CXR shows flattened diaphragm. Likely diagnosis:
A. Pulmonary fibrosis
B. Atelectasis
C. Emphysema (COPD)
D. Pleural effusion
Answer: C. Hyperresonance and flattened diaphragm are characteristic of
emphysema/COPD.
11. Which heart murmur increases with Valsalva maneuver?
A. Mitral regurgitation
B. Aortic stenosis
C. Hypertrophic obstructive cardiomyopathy (HOCM)
D. Patent ductus arteriosus
Answer: C. HOCM murmur increases with decreased venous return (Valsalva).
12. A 25-year-old has inspiratory stridor and drooling after a throat infection — immediate
concern is:
A. Epiglottitis causing airway obstruction
B. Asthma exacerbation
C. Bronchitis
D. Pulmonary embolism
, Answer: A. Drooling + stridor suggest upper airway obstruction such as epiglottitis
— emergent airway management needed.
13. A nurse elicits a 3+ deep tendon reflex at the knee. This suggests:
A. Normal reflex
B. Diminished reflex
C. Hyperreflexia — possible upper motor neuron lesion
D. Absent reflex — peripheral neuropathy
Answer: C. 3+ is brisk/hyperreflexic — may indicate UMN pathology or
hyperexcitability.
14. A differential diagnosis for jaundice with elevated direct (conjugated) bilirubin includes:
A. Hemolytic anemia
B. Gilbert syndrome
C. Obstructive cholestasis (e.g., gallstone)
D. Physiologic neonatal jaundice
Answer: C. Conjugated hyperbilirubinemia suggests hepatocellular dysfunction or
biliary obstruction.
15. Which sign is most specific for peritonitis on physical exam?
A. Guarding
B. Positive psoas sign or rebound tenderness
C. Abdominal distension
D. Borborygmi
Answer: B. Rebound tenderness and positive psoas sign suggest peritoneal irritation.
16. A coarse, low-pitched rubbing sound synchronous with respiration suggests:
A. Wheeze
B. Pleural friction rub
C. Stridor
D. Fine crackles
Answer: B. Pleural friction rub is coarse and synchronous with breathing, caused by
inflamed pleura.
17. The Glasgow Coma Scale (GCS) measures:
A. Motor function only
B. Eye, verbal, and motor responses
C. Pupil reactivity and reflexes
D. Sensory and coordination tests
Answer: B. GCS assesses eye opening, verbal, and motor responses.
18. An S3 heart sound in an adult suggests:
A. Normal finding in young athletes only
B. Diastolic heart failure or increased left ventricular filling pressures
C. Aortic stenosis
D. Mitral stenosis
Answer: B. S3 in adults often indicates volume overload/ventricular dysfunction (heart
failure).
19. A well-circumscribed, movable, firm breast lump in a 22-year-old most likely is:
A. Suspicious for carcinoma
B. Fibroadenoma
206 2025-2026 -Questions And Answers Latest Updates With Correct
Answers 100% With Complete Solutions Pass Guaranteed-Graded A+
Part A — Multiple Choice (60 questions)
1. A 68-year-old patient complains of progressive dyspnea on exertion. On auscultation you
hear bibasilar crackles. Which physiologic change most likely explains the crackles?
A. Bronchospasm of small airways
B. Fluid in alveolar airspaces from left ventricular failure
C. Thickened pleura restricting lung expansion
D. Collapse of large airways from mucus plugs
Answer: B. Crackles (rales) at bases commonly indicate fluid in alveoli, often from
left-sided heart failure.
2. Which assessment finding is most consistent with chronic hypoxemia?
A. Nail clubbing
B. Acute tachypnea
C. Hyporeflexia
D. Dry cough
Answer: A. Chronic hypoxemia leads to digital clubbing over time.
3. S1 is loudest at which location?
A. Aortic area
B. Pulmonic area
C. Left lower sternal border
D. Mitral (apical) area
Answer: D. S1 (mitral/tricuspid valve closure) is loudest at the apex (mitral area).
4. A patient has right upper quadrant pain and a positive Murphy’s sign. Which organ is
most likely involved?
A. Appendix
B. Gallbladder
C. Stomach
D. Spleen
Answer: B. Murphy’s sign suggests gallbladder inflammation (cholecystitis).
5. Which breath sound is described as low-pitched, continuous, and heard throughout
expiration and inspiration in asthma exacerbation?
A. Fine crackles
B. Coarse crackles
C. Wheeze
D. Pleural friction rub
Answer: C. Wheezes are musical, continuous, and common with airway narrowing in
asthma.
6. Which lab value reflects kidney filtration function?
A. AST
, B. Serum sodium
C. Creatinine clearance / GFR
D. Hemoglobin
Answer: C. GFR (or creatinine clearance) measures kidney filtration.
7. A patient presents with sudden, severe chest pain and unequal breath sounds. You suspect
a pneumothorax. Which exam finding supports that?
A. Increased tactile fremitus on affected side
B. Hyperresonance on percussion over affected side
C. Bronchial breath sounds over periphery
D. Crackles localized to the same side
Answer: B. Air in pleural space causes hyperresonance and decreased fremitus.
8. In a neurologic exam, pronator drift indicates possible lesion in the:
A. Cerebellum
B. Basal ganglia
C. Contralateral corticospinal tract (motor cortex)
D. Peripheral nerves
Answer: C. Pronator drift suggests upper motor neuron (corticospinal) weakness on
the contralateral side.
9. Which of the following pulses is palpated at the wrist?
A. Dorsalis pedis
B. Radial
C. Femoral
D. Brachial
Answer: B. Radial pulse is at the wrist.
10. A patient has hyperresonant percussion notes and decreased breath sounds on the left;
CXR shows flattened diaphragm. Likely diagnosis:
A. Pulmonary fibrosis
B. Atelectasis
C. Emphysema (COPD)
D. Pleural effusion
Answer: C. Hyperresonance and flattened diaphragm are characteristic of
emphysema/COPD.
11. Which heart murmur increases with Valsalva maneuver?
A. Mitral regurgitation
B. Aortic stenosis
C. Hypertrophic obstructive cardiomyopathy (HOCM)
D. Patent ductus arteriosus
Answer: C. HOCM murmur increases with decreased venous return (Valsalva).
12. A 25-year-old has inspiratory stridor and drooling after a throat infection — immediate
concern is:
A. Epiglottitis causing airway obstruction
B. Asthma exacerbation
C. Bronchitis
D. Pulmonary embolism
, Answer: A. Drooling + stridor suggest upper airway obstruction such as epiglottitis
— emergent airway management needed.
13. A nurse elicits a 3+ deep tendon reflex at the knee. This suggests:
A. Normal reflex
B. Diminished reflex
C. Hyperreflexia — possible upper motor neuron lesion
D. Absent reflex — peripheral neuropathy
Answer: C. 3+ is brisk/hyperreflexic — may indicate UMN pathology or
hyperexcitability.
14. A differential diagnosis for jaundice with elevated direct (conjugated) bilirubin includes:
A. Hemolytic anemia
B. Gilbert syndrome
C. Obstructive cholestasis (e.g., gallstone)
D. Physiologic neonatal jaundice
Answer: C. Conjugated hyperbilirubinemia suggests hepatocellular dysfunction or
biliary obstruction.
15. Which sign is most specific for peritonitis on physical exam?
A. Guarding
B. Positive psoas sign or rebound tenderness
C. Abdominal distension
D. Borborygmi
Answer: B. Rebound tenderness and positive psoas sign suggest peritoneal irritation.
16. A coarse, low-pitched rubbing sound synchronous with respiration suggests:
A. Wheeze
B. Pleural friction rub
C. Stridor
D. Fine crackles
Answer: B. Pleural friction rub is coarse and synchronous with breathing, caused by
inflamed pleura.
17. The Glasgow Coma Scale (GCS) measures:
A. Motor function only
B. Eye, verbal, and motor responses
C. Pupil reactivity and reflexes
D. Sensory and coordination tests
Answer: B. GCS assesses eye opening, verbal, and motor responses.
18. An S3 heart sound in an adult suggests:
A. Normal finding in young athletes only
B. Diastolic heart failure or increased left ventricular filling pressures
C. Aortic stenosis
D. Mitral stenosis
Answer: B. S3 in adults often indicates volume overload/ventricular dysfunction (heart
failure).
19. A well-circumscribed, movable, firm breast lump in a 22-year-old most likely is:
A. Suspicious for carcinoma
B. Fibroadenoma
