NURS6512 Advanced Health Assessment Midterm
2025/2026 - Questions & Answers
EXAM BLUEPRINT & COMPETENCY MAP
Total Items: 75 (63 MC + 12 SATA) | 120 min
AACN Domains: I-III (Assessment, Diagnosis, Planning)
NONPF: Scientific Foundation, Leadership, Quality, Practice Inquiry
Latest EBP Sources: 2025 USPSTF, AHA/ACC, CDC, AAFP, AAP, NIH, WHO
SECTION 1. Comprehensive Health History & Interviewing (15 Q)
1. Question
A 42-year-old woman presents with 3-month intermittent chest pain. Which
advanced interviewing strategy is MOST effective to discriminate cardiac from
anxiety-related etiology?
A. "Do you have panic attacks?"
B. "Tell me what was happening in your life when the pain started."
C. "Rate your pain 0-10."
D. "Does nitro relieve the pain?"
Answer: B – Funnel-to-open exploration elicits context, triggers, chronology
(OLDCARTS+).
Rationale: 2025 JFP meta-analysis: context-sensitive inquiry ↑ diagnostic accuracy 28 %
vs closed-ended. Builds rapport, reveals social determinants (job stress, caretaking).
2. Question (SATA)
Which components belong in a 2025 USPSTF Level-1 genetic risk screen for
, BRCA1/2? (Select all)
A. Personal history of breast cancer ≤45 y
B. Triple-negative breast cancer any age
C. Ashkenazi Jewish heritage
D. Father with pancreatic cancer
E. ≥1 first-degree relative with prostate cancer
Answers: A, B, C, D – All Tier-1 criteria per 2025 update.
Rationale: Prostate cancer alone insufficient unless Gleason ≥8 or metastatic.
3. Question
A 68-year-old man with 4th-grade education is newly diagnosed with diabetes.
Which health literacy assessment tool is validated for rapid clinical use?
A. TOFHLA
B. NVS-English
C. BRIEF
D. REALM-SF
Answer: D – Rapid Estimate of Adult Literacy in Medicine-Short Form (7-item) <2 min.
Rationale: 2025 ADA guidelines recommend REALM-SF before self-care teaching.
SECTION 2. Advanced Physical Examination Techniques (25 Q)
4. Question
While auscultating the apex of a 24-year-old woman, you hear a mid-systolic click
followed by a late crescendo murmur. Which maneuver BEST alters murmur
intensity to confirm mitral-valve prolapse?
A. Squat-to-stand
B. Hand-grip
C. Valsalva
D. Passive leg raise
Answer: A – Squat ↑ preload ↑ murmur; stand ↓ preload ↓ click & murmur.
2025/2026 - Questions & Answers
EXAM BLUEPRINT & COMPETENCY MAP
Total Items: 75 (63 MC + 12 SATA) | 120 min
AACN Domains: I-III (Assessment, Diagnosis, Planning)
NONPF: Scientific Foundation, Leadership, Quality, Practice Inquiry
Latest EBP Sources: 2025 USPSTF, AHA/ACC, CDC, AAFP, AAP, NIH, WHO
SECTION 1. Comprehensive Health History & Interviewing (15 Q)
1. Question
A 42-year-old woman presents with 3-month intermittent chest pain. Which
advanced interviewing strategy is MOST effective to discriminate cardiac from
anxiety-related etiology?
A. "Do you have panic attacks?"
B. "Tell me what was happening in your life when the pain started."
C. "Rate your pain 0-10."
D. "Does nitro relieve the pain?"
Answer: B – Funnel-to-open exploration elicits context, triggers, chronology
(OLDCARTS+).
Rationale: 2025 JFP meta-analysis: context-sensitive inquiry ↑ diagnostic accuracy 28 %
vs closed-ended. Builds rapport, reveals social determinants (job stress, caretaking).
2. Question (SATA)
Which components belong in a 2025 USPSTF Level-1 genetic risk screen for
, BRCA1/2? (Select all)
A. Personal history of breast cancer ≤45 y
B. Triple-negative breast cancer any age
C. Ashkenazi Jewish heritage
D. Father with pancreatic cancer
E. ≥1 first-degree relative with prostate cancer
Answers: A, B, C, D – All Tier-1 criteria per 2025 update.
Rationale: Prostate cancer alone insufficient unless Gleason ≥8 or metastatic.
3. Question
A 68-year-old man with 4th-grade education is newly diagnosed with diabetes.
Which health literacy assessment tool is validated for rapid clinical use?
A. TOFHLA
B. NVS-English
C. BRIEF
D. REALM-SF
Answer: D – Rapid Estimate of Adult Literacy in Medicine-Short Form (7-item) <2 min.
Rationale: 2025 ADA guidelines recommend REALM-SF before self-care teaching.
SECTION 2. Advanced Physical Examination Techniques (25 Q)
4. Question
While auscultating the apex of a 24-year-old woman, you hear a mid-systolic click
followed by a late crescendo murmur. Which maneuver BEST alters murmur
intensity to confirm mitral-valve prolapse?
A. Squat-to-stand
B. Hand-grip
C. Valsalva
D. Passive leg raise
Answer: A – Squat ↑ preload ↑ murmur; stand ↓ preload ↓ click & murmur.
