NU 518 Advanced Nursing Practice Exam 1 Questions &Verified
Answers 2026|Complete Study Guide |A+ Grade
1. During a health assessment, which part of the patient interview should be
completed first?
A. Review of systems
B. Chief complaint
C. Past medical history
D. Physical examination
Answer: B. Chief complaint
Rationale: The chief complaint identifies the primary reason for seeking care and guides the
remainder of the health history and assessment.
2. A patient reports chest pain that worsens with deep inspiration. Which
question best explores the symptom?
A. "What medications are you taking?"
B. "When was your last physical?"
C. "Can you describe what makes the pain better or worse?"
D. "Do you have a family history of heart disease?"
Answer: C. "Can you describe what makes the pain better or worse?"
Rationale: Exploring aggravating and relieving factors is an essential component of symptom
analysis.
3. Which assessment technique should generally be performed first?
A. Percussion
B. Palpation
C. Inspection
D. Auscultation
Answer: C. Inspection
Rationale: Inspection provides initial visual information and precedes other examination
techniques.
,4. When assessing jugular venous pressure, the patient should be positioned at
approximately:
A. 0 degrees
B. 15 degrees
C. 30–45 degrees
D. 90 degrees
Answer: C. 30–45 degrees
Rationale: This position optimizes visualization of jugular venous distention.
5. Which finding is most suggestive of left-sided heart failure?
A. Hepatomegaly
B. Peripheral edema
C. Crackles in the lungs
D. Ascites
Answer: C. Crackles in the lungs
Rationale: Pulmonary congestion from left ventricular dysfunction commonly produces crackles.
6. A carotid bruit is best detected using:
A. Bell of the stethoscope
B. Diaphragm of the stethoscope
C. Percussion
D. Palpation
Answer: A. Bell of the stethoscope
Rationale: The bell is more sensitive for detecting low-pitched vascular sounds.
7. Which cranial nerve is primarily responsible for facial sensation?
A. CN III
B. CN V
,C. CN VII
D. CN XII
Answer: B. CN V
Rationale: The trigeminal nerve provides sensory innervation to the face.
8. A positive Romberg test indicates a problem with:
A. Visual acuity
B. Balance or proprioception
C. Hearing
D. Speech
Answer: B. Balance or proprioception
Rationale: The Romberg test evaluates proprioceptive and vestibular function.
9. Which assessment finding is most concerning in an adult patient?
A. Symmetric chest expansion
B. Respiratory rate of 16/min
C. Clubbing of the fingers
D. Vesicular breath sounds
Answer: C. Clubbing of the fingers
Rationale: Clubbing may indicate chronic cardiopulmonary disease.
10. The thyroid gland is normally palpated:
A. From the front of the patient only
B. From behind the patient
C. With the patient lying flat
D. During expiration only
Answer: B. From behind the patient
Rationale: Posterior positioning allows more effective palpation of thyroid lobes.
, 11. Which abdominal assessment sequence is correct?
A. Inspection, palpation, percussion, auscultation
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, percussion, palpation
D. Palpation, percussion, inspection, auscultation
Answer: B. Inspection, auscultation, percussion, palpation
Rationale: Auscultation precedes palpation and percussion to avoid altering bowel sounds.
12. Rebound tenderness is most commonly associated with:
A. Gastritis
B. Peritoneal irritation
C. Constipation
D. Gallstones
Answer: B. Peritoneal irritation
Rationale: Pain upon release of pressure suggests peritoneal inflammation.
13. Which finding is characteristic of appendicitis?
A. Murphy's sign
B. McBurney's point tenderness
C. Cullen's sign
D. Grey Turner's sign
Answer: B. McBurney's point tenderness
Rationale: Localized tenderness at McBurney's point is a classic finding in appendicitis.
14. Which heart sound is produced by closure of the mitral and tricuspid valves?
A. S1
B. S2
Answers 2026|Complete Study Guide |A+ Grade
1. During a health assessment, which part of the patient interview should be
completed first?
A. Review of systems
B. Chief complaint
C. Past medical history
D. Physical examination
Answer: B. Chief complaint
Rationale: The chief complaint identifies the primary reason for seeking care and guides the
remainder of the health history and assessment.
2. A patient reports chest pain that worsens with deep inspiration. Which
question best explores the symptom?
A. "What medications are you taking?"
B. "When was your last physical?"
C. "Can you describe what makes the pain better or worse?"
D. "Do you have a family history of heart disease?"
Answer: C. "Can you describe what makes the pain better or worse?"
Rationale: Exploring aggravating and relieving factors is an essential component of symptom
analysis.
3. Which assessment technique should generally be performed first?
A. Percussion
B. Palpation
C. Inspection
D. Auscultation
Answer: C. Inspection
Rationale: Inspection provides initial visual information and precedes other examination
techniques.
,4. When assessing jugular venous pressure, the patient should be positioned at
approximately:
A. 0 degrees
B. 15 degrees
C. 30–45 degrees
D. 90 degrees
Answer: C. 30–45 degrees
Rationale: This position optimizes visualization of jugular venous distention.
5. Which finding is most suggestive of left-sided heart failure?
A. Hepatomegaly
B. Peripheral edema
C. Crackles in the lungs
D. Ascites
Answer: C. Crackles in the lungs
Rationale: Pulmonary congestion from left ventricular dysfunction commonly produces crackles.
6. A carotid bruit is best detected using:
A. Bell of the stethoscope
B. Diaphragm of the stethoscope
C. Percussion
D. Palpation
Answer: A. Bell of the stethoscope
Rationale: The bell is more sensitive for detecting low-pitched vascular sounds.
7. Which cranial nerve is primarily responsible for facial sensation?
A. CN III
B. CN V
,C. CN VII
D. CN XII
Answer: B. CN V
Rationale: The trigeminal nerve provides sensory innervation to the face.
8. A positive Romberg test indicates a problem with:
A. Visual acuity
B. Balance or proprioception
C. Hearing
D. Speech
Answer: B. Balance or proprioception
Rationale: The Romberg test evaluates proprioceptive and vestibular function.
9. Which assessment finding is most concerning in an adult patient?
A. Symmetric chest expansion
B. Respiratory rate of 16/min
C. Clubbing of the fingers
D. Vesicular breath sounds
Answer: C. Clubbing of the fingers
Rationale: Clubbing may indicate chronic cardiopulmonary disease.
10. The thyroid gland is normally palpated:
A. From the front of the patient only
B. From behind the patient
C. With the patient lying flat
D. During expiration only
Answer: B. From behind the patient
Rationale: Posterior positioning allows more effective palpation of thyroid lobes.
, 11. Which abdominal assessment sequence is correct?
A. Inspection, palpation, percussion, auscultation
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, percussion, palpation
D. Palpation, percussion, inspection, auscultation
Answer: B. Inspection, auscultation, percussion, palpation
Rationale: Auscultation precedes palpation and percussion to avoid altering bowel sounds.
12. Rebound tenderness is most commonly associated with:
A. Gastritis
B. Peritoneal irritation
C. Constipation
D. Gallstones
Answer: B. Peritoneal irritation
Rationale: Pain upon release of pressure suggests peritoneal inflammation.
13. Which finding is characteristic of appendicitis?
A. Murphy's sign
B. McBurney's point tenderness
C. Cullen's sign
D. Grey Turner's sign
Answer: B. McBurney's point tenderness
Rationale: Localized tenderness at McBurney's point is a classic finding in appendicitis.
14. Which heart sound is produced by closure of the mitral and tricuspid valves?
A. S1
B. S2
