NURS 5220 Exam
2 Advanced Health
Assessment | UTA
1. During assessment of the cardiovascular system, which finding is most concerning
for left-sided heart failure?
A. Dependent ankle edema
B. Jugular venous distention
C. Bibasilar crackles
D. Hepatomegaly
Answer: C. Bibasilar crackles
Rationale: Pulmonary crackles can indicate pulmonary congestion caused by left
ventricular dysfunction.
2. A patient reports sudden, severe chest pain radiating to the back. Which
additional finding should raise concern for aortic dissection?
A. Symmetric peripheral pulses
B. Unequal blood pressures between the arms
C. Bilateral ankle edema
D. Bradycardia after exercise
Answer: B. Unequal blood pressures between the arms
,Rationale: Aortic dissection can compromise blood flow to a major branch vessel,
producing asymmetric pulses or blood pressures.
3. Which technique is appropriate when assessing for jugular venous pressure?
A. Place the patient completely prone
B. Position the patient at approximately 30–45 degrees
C. Have the patient stand upright
D. Place the patient flat with legs elevated
Answer: B. Position the patient at approximately 30–45 degrees
Rationale: Semi-Fowler positioning allows visualization of jugular venous pulsations
and estimation of venous pressure.
4. A patient has decreased tactile fremitus over the right lower lung field. Which
condition is most consistent with this finding?
A. Lobar pneumonia
B. Pleural effusion
C. Pulmonary consolidation
D. Atelectasis with an open airway
Answer: B. Pleural effusion
Rationale: Fluid in the pleural space decreases transmission of palpable vibrations.
5. Which percussion note is expected over a normal lung?
A. Flat
B. Dull
C. Resonant
D. Hyperresonant
Answer: C. Resonant
Rationale: Normal air-filled lung tissue produces a resonant percussion note.
,6. A patient with chronic obstructive pulmonary disease has an increased
anteroposterior chest diameter. This finding is commonly described as:
A. Funnel chest
B. Barrel chest
C. Pigeon chest
D. Kyphotic chest
Answer: B. Barrel chest
Rationale: Chronic hyperinflation can increase the AP diameter, producing a barrel-
shaped thorax.
7. Which finding during an abdominal examination requires the most immediate
attention?
A. Tympany over much of the abdomen
B. Mild borborygmi
C. Rigid, board-like abdomen
D. Mild tenderness after palpation
Answer: C. Rigid, board-like abdomen
Rationale: Rigidity can indicate peritoneal irritation and potentially serious intra-
abdominal pathology.
8. Which sequence is generally used for the physical examination of the abdomen?
A. Inspection → auscultation → percussion → palpation
B. Palpation → percussion → auscultation → inspection
C. Auscultation → inspection → palpation → percussion
D. Percussion → palpation → inspection → auscultation
Answer: A. Inspection → auscultation → percussion → palpation
Rationale: Auscultation is performed before percussion and palpation because
manipulation can alter bowel sounds.
, 9. A positive Murphy sign is most associated with:
A. Appendicitis
B. Cholecystitis
C. Pancreatitis
D. Diverticulitis
Answer: B. Cholecystitis
Rationale: Inspiratory arrest due to pain during palpation of the right upper quadrant
is characteristic of a positive Murphy sign.
10. Which symptom is most characteristic of peripheral arterial disease?
A. Leg pain relieved by dependency
B. Bilateral pitting edema
C. Intermittent claudication
D. Warm, flushed extremities
Answer: C. Intermittent claudication
Rationale: Arterial insufficiency commonly causes reproducible muscle pain with
exertion that improves with rest.
11. Which finding is most characteristic of peripheral venous disease?
A. Cool, hairless extremity
B. Diminished pedal pulses
C. Brownish skin pigmentation around the ankles
D. Pain relieved by elevating the legs
Answer: C. Brownish skin pigmentation around the ankles
Rationale: Chronic venous hypertension can cause hemosiderin deposition and
brown discoloration around the lower legs and ankles.
12. When evaluating a patient for a possible thyroid disorder, which finding is
particularly important?
2 Advanced Health
Assessment | UTA
1. During assessment of the cardiovascular system, which finding is most concerning
for left-sided heart failure?
A. Dependent ankle edema
B. Jugular venous distention
C. Bibasilar crackles
D. Hepatomegaly
Answer: C. Bibasilar crackles
Rationale: Pulmonary crackles can indicate pulmonary congestion caused by left
ventricular dysfunction.
2. A patient reports sudden, severe chest pain radiating to the back. Which
additional finding should raise concern for aortic dissection?
A. Symmetric peripheral pulses
B. Unequal blood pressures between the arms
C. Bilateral ankle edema
D. Bradycardia after exercise
Answer: B. Unequal blood pressures between the arms
,Rationale: Aortic dissection can compromise blood flow to a major branch vessel,
producing asymmetric pulses or blood pressures.
3. Which technique is appropriate when assessing for jugular venous pressure?
A. Place the patient completely prone
B. Position the patient at approximately 30–45 degrees
C. Have the patient stand upright
D. Place the patient flat with legs elevated
Answer: B. Position the patient at approximately 30–45 degrees
Rationale: Semi-Fowler positioning allows visualization of jugular venous pulsations
and estimation of venous pressure.
4. A patient has decreased tactile fremitus over the right lower lung field. Which
condition is most consistent with this finding?
A. Lobar pneumonia
B. Pleural effusion
C. Pulmonary consolidation
D. Atelectasis with an open airway
Answer: B. Pleural effusion
Rationale: Fluid in the pleural space decreases transmission of palpable vibrations.
5. Which percussion note is expected over a normal lung?
A. Flat
B. Dull
C. Resonant
D. Hyperresonant
Answer: C. Resonant
Rationale: Normal air-filled lung tissue produces a resonant percussion note.
,6. A patient with chronic obstructive pulmonary disease has an increased
anteroposterior chest diameter. This finding is commonly described as:
A. Funnel chest
B. Barrel chest
C. Pigeon chest
D. Kyphotic chest
Answer: B. Barrel chest
Rationale: Chronic hyperinflation can increase the AP diameter, producing a barrel-
shaped thorax.
7. Which finding during an abdominal examination requires the most immediate
attention?
A. Tympany over much of the abdomen
B. Mild borborygmi
C. Rigid, board-like abdomen
D. Mild tenderness after palpation
Answer: C. Rigid, board-like abdomen
Rationale: Rigidity can indicate peritoneal irritation and potentially serious intra-
abdominal pathology.
8. Which sequence is generally used for the physical examination of the abdomen?
A. Inspection → auscultation → percussion → palpation
B. Palpation → percussion → auscultation → inspection
C. Auscultation → inspection → palpation → percussion
D. Percussion → palpation → inspection → auscultation
Answer: A. Inspection → auscultation → percussion → palpation
Rationale: Auscultation is performed before percussion and palpation because
manipulation can alter bowel sounds.
, 9. A positive Murphy sign is most associated with:
A. Appendicitis
B. Cholecystitis
C. Pancreatitis
D. Diverticulitis
Answer: B. Cholecystitis
Rationale: Inspiratory arrest due to pain during palpation of the right upper quadrant
is characteristic of a positive Murphy sign.
10. Which symptom is most characteristic of peripheral arterial disease?
A. Leg pain relieved by dependency
B. Bilateral pitting edema
C. Intermittent claudication
D. Warm, flushed extremities
Answer: C. Intermittent claudication
Rationale: Arterial insufficiency commonly causes reproducible muscle pain with
exertion that improves with rest.
11. Which finding is most characteristic of peripheral venous disease?
A. Cool, hairless extremity
B. Diminished pedal pulses
C. Brownish skin pigmentation around the ankles
D. Pain relieved by elevating the legs
Answer: C. Brownish skin pigmentation around the ankles
Rationale: Chronic venous hypertension can cause hemosiderin deposition and
brown discoloration around the lower legs and ankles.
12. When evaluating a patient for a possible thyroid disorder, which finding is
particularly important?
