NR 602 Midterm Advanced Health Assessment & Clinical
Management – Midterm Exam 2026 | 150 Questions with
Answers & Rationales
Question 1
A 55-year-old male presents with chest discomfort that began while climbing stairs. He
describes the pain as pressure-like, lasting about 10 minutes, and relieved with rest. Which
finding most strongly supports a cardiac origin?
A. Pain worsens with deep inspiration
B. Pain is relieved by antacids
C. Pain radiates to the left arm
D. Pain increases with palpation
Correct Answer: C
Rationale: Cardiac chest pain (angina) is classically described as pressure-like and may
radiate to the left arm, neck, or jaw. Relief with rest further supports a cardiac etiology.
Question 2
During a cardiovascular exam, which finding is considered abnormal in a healthy adult?
A. S1 louder at the apex
B. S2 louder at the base
C. Presence of S3
D. Physiologic splitting of S2
Correct Answer: C
Rationale: An S3 heart sound in adults is usually abnormal and may indicate heart failure or
volume overload.
Question 3
,A patient reports shortness of breath when lying flat and uses three pillows to sleep. This
symptom is known as:
A. Dyspnea
B. Paroxysmal nocturnal dyspnea
C. Orthopnea
D. Hyperventilation
Correct Answer: C
Rationale: Orthopnea is shortness of breath occurring when lying flat and is commonly
associated with heart failure.
Question 4
Which lung sound is described as high-pitched, musical, and heard primarily on
expiration?
A. Crackles
B. Rhonchi
C. Wheezes
D. Pleural friction rub
Correct Answer: C
Rationale: Wheezes are high-pitched musical sounds caused by airway narrowing,
commonly heard in asthma or COPD.
Question 5
While assessing an older adult, which respiratory change is considered normal aging?
A. Increased vital capacity
B. Decreased chest wall compliance
C. Increased alveolar surface area
D. Increased oxygen diffusion
Correct Answer: B
,Rationale: With aging, chest wall compliance decreases due to calcification of costal
cartilage, contributing to reduced respiratory efficiency.
Question 6
A positive Murphy’s sign indicates inflammation of which organ?
A. Appendix
B. Pancreas
C. Gallbladder
D. Liver
Correct Answer: C
Rationale: Murphy’s sign is elicited during palpation of the right upper quadrant and
indicates gallbladder inflammation (cholecystitis).
Question 7
Which abdominal sound is considered abnormal?
A. Gurgling every 5–15 seconds
B. Hyperactive bowel sounds
C. Absence of bowel sounds after 5 minutes
D. Borborygmi after eating
Correct Answer: C
Rationale: Absent bowel sounds after listening for a full 5 minutes may indicate ileus or
bowel obstruction and is abnormal.
Question 8
A patient presents with unilateral leg swelling, warmth, and pain. Which condition is the
priority concern?
, A. Cellulitis
B. Chronic venous insufficiency
C. Deep vein thrombosis
D. Lymphedema
Correct Answer: C
Rationale: Unilateral swelling with warmth and pain raises concern for DVT, which is a
medical emergency due to risk of pulmonary embolism.
Question 9
Which neurological finding is considered normal?
A. Positive Babinski in adults
B. Brisk reflexes bilaterally
C. Unequal pupils
D. Clonus
Correct Answer: B
Rationale: Brisk but symmetric reflexes can be normal. Babinski, clonus, and unequal pupils
are abnormal findings in adults.
Question 10
The Romberg test assesses:
A. Cranial nerve function
B. Cerebellar function
C. Proprioception
D. Muscle strength
Correct Answer: C
Rationale: The Romberg test evaluates proprioception by assessing the patient’s ability to
maintain balance with eyes closed.
Management – Midterm Exam 2026 | 150 Questions with
Answers & Rationales
Question 1
A 55-year-old male presents with chest discomfort that began while climbing stairs. He
describes the pain as pressure-like, lasting about 10 minutes, and relieved with rest. Which
finding most strongly supports a cardiac origin?
A. Pain worsens with deep inspiration
B. Pain is relieved by antacids
C. Pain radiates to the left arm
D. Pain increases with palpation
Correct Answer: C
Rationale: Cardiac chest pain (angina) is classically described as pressure-like and may
radiate to the left arm, neck, or jaw. Relief with rest further supports a cardiac etiology.
Question 2
During a cardiovascular exam, which finding is considered abnormal in a healthy adult?
A. S1 louder at the apex
B. S2 louder at the base
C. Presence of S3
D. Physiologic splitting of S2
Correct Answer: C
Rationale: An S3 heart sound in adults is usually abnormal and may indicate heart failure or
volume overload.
Question 3
,A patient reports shortness of breath when lying flat and uses three pillows to sleep. This
symptom is known as:
A. Dyspnea
B. Paroxysmal nocturnal dyspnea
C. Orthopnea
D. Hyperventilation
Correct Answer: C
Rationale: Orthopnea is shortness of breath occurring when lying flat and is commonly
associated with heart failure.
Question 4
Which lung sound is described as high-pitched, musical, and heard primarily on
expiration?
A. Crackles
B. Rhonchi
C. Wheezes
D. Pleural friction rub
Correct Answer: C
Rationale: Wheezes are high-pitched musical sounds caused by airway narrowing,
commonly heard in asthma or COPD.
Question 5
While assessing an older adult, which respiratory change is considered normal aging?
A. Increased vital capacity
B. Decreased chest wall compliance
C. Increased alveolar surface area
D. Increased oxygen diffusion
Correct Answer: B
,Rationale: With aging, chest wall compliance decreases due to calcification of costal
cartilage, contributing to reduced respiratory efficiency.
Question 6
A positive Murphy’s sign indicates inflammation of which organ?
A. Appendix
B. Pancreas
C. Gallbladder
D. Liver
Correct Answer: C
Rationale: Murphy’s sign is elicited during palpation of the right upper quadrant and
indicates gallbladder inflammation (cholecystitis).
Question 7
Which abdominal sound is considered abnormal?
A. Gurgling every 5–15 seconds
B. Hyperactive bowel sounds
C. Absence of bowel sounds after 5 minutes
D. Borborygmi after eating
Correct Answer: C
Rationale: Absent bowel sounds after listening for a full 5 minutes may indicate ileus or
bowel obstruction and is abnormal.
Question 8
A patient presents with unilateral leg swelling, warmth, and pain. Which condition is the
priority concern?
, A. Cellulitis
B. Chronic venous insufficiency
C. Deep vein thrombosis
D. Lymphedema
Correct Answer: C
Rationale: Unilateral swelling with warmth and pain raises concern for DVT, which is a
medical emergency due to risk of pulmonary embolism.
Question 9
Which neurological finding is considered normal?
A. Positive Babinski in adults
B. Brisk reflexes bilaterally
C. Unequal pupils
D. Clonus
Correct Answer: B
Rationale: Brisk but symmetric reflexes can be normal. Babinski, clonus, and unequal pupils
are abnormal findings in adults.
Question 10
The Romberg test assesses:
A. Cranial nerve function
B. Cerebellar function
C. Proprioception
D. Muscle strength
Correct Answer: C
Rationale: The Romberg test evaluates proprioception by assessing the patient’s ability to
maintain balance with eyes closed.
