NURS 5220 - Advanced Health Assessment and Diagnostic Reasoning University of Texas at Arlington
NURS 5220 - Advanced Health Assessment
and Diagnostic Reasoning
EXAM 2 TEST BANK | 2026/2027 ACADEMIC YEAR
University of Texas at Arlington
This exam consists of 50 multiple-choice questions covering advanced health assessment, diagnostic reasoning,
pathophysiology, and evidence-based management across the lifespan. Select the best answer for each question.
Rationales are provided for all correct answers to ensure comprehensive understanding.
QUESTIONS 1-10: CARDIOVASCULAR & RESPIRATORY ASSESSMENT
1. A 65-year-old male presents with shortness of breath and fatigue. On examination, you note jugular venous
distension (JVD), an S3 heart sound, and bilateral crackles in the lung bases. Which diagnosis is most consistent with
these findings?
A. Chronic Obstructive Pulmonary Disease (COPD)
B. Heart Failure with Reduced Ejection Fraction (HFrEF)
C. Pneumonia
D. Pulmonary Embolism
Correct Answer: B
Rationale: JVD, S3 gallop, and bibasilar crackles are classic signs of volume overload and systolic dysfunction associated with Heart
Failure. COPD typically presents with wheezing and hyperresonance; Pneumonia with fever and focal consolidation; PE with acute
onset pleuritic pain and hypoxia.
2. During a cardiac assessment, you hear a harsh, crescendo-decrescendo systolic murmur at the right second
intercostal space that radiates to the carotids. This finding is most indicative of:
A. Mitral Regurgitation
B. Aortic Stenosis
C. Tricuspid Regurgitation
D. Pulmonic Stenosis
Correct Answer: B
Rationale: Aortic stenosis produces a systolic ejection murmur best heard at the right upper sternal border (aortic area) and radiates to
the carotid arteries. Mitral regurgitation is holosystolic and radiates to the axilla.
3. A patient with a history of hypertension reports occasional palpitations. The ECG shows irregularly irregular rhythm
with no distinct P waves. What is the primary nursing concern for this patient?
A. Risk for decreased cardiac output due to bradycardia
B. Risk for stroke due to thrombus formation in the atria
C. Risk for myocardial infarction due to coronary occlusion
D. Risk for heart failure due to ventricular hypertrophy
Correct Answer: B
Rationale: The description is classic for Atrial Fibrillation. The lack of atrial contraction leads to blood stasis in the atria, increasing
the risk of thrombus formation and subsequent embolic stroke.
Page 1
NURS 5220 Exam 2 Test Bank | 2026/2027 Academic Year
, NURS 5220 - Advanced Health Assessment and Diagnostic Reasoning University of Texas at Arlington
4. Which physical examination finding is most specific for differentiating Cardiac Asthma (Heart Failure) from
Bronchial Asthma?
A. Presence of wheezing
B. Presence of an S3 heart sound
C. Use of accessory muscles
D. Response to albuterol
Correct Answer: B
Rationale: While both conditions can present with wheezing and use of accessory muscles, an S3 heart sound is specific to volume
overload and ventricular dysfunction seen in heart failure, not bronchial asthma.
5. A 55-year-old smoker presents with chronic cough and dyspnea. Pulmonary function tests show an FEV1/FVC ratio
of 0.65. What does this indicate?
A. Restrictive Lung Disease
B. Obstructive Lung Disease
C. Normal Lung Function
D. Mixed Lung Disease
Correct Answer: B
Rationale: An FEV1/FVC ratio less than 0.70 indicates airflow obstruction, characteristic of obstructive lung diseases like COPD or
Asthma. Restrictive diseases typically have a normal or increased ratio but reduced total lung capacity.
6. When assessing a patient for Deep Vein Thrombosis (DVT), which sign is considered unreliable and should not be
used alone for diagnosis?
A. Unilateral leg swelling
B. Homan's Sign (pain on dorsiflexion)
C. Warmth over the affected area
D. Erythema
Correct Answer: B
Rationale: Homan's sign has low sensitivity and specificity and is no longer recommended as a reliable diagnostic tool for DVT.
Diagnosis requires clinical probability scores (Wells Criteria) and imaging (Ultrasound).
7. A patient presents with sharp chest pain that worsens with inspiration and improves when sitting up and leaning
forward. Auscultation reveals a pericardial friction rub. What is the likely diagnosis?
A. Angina Pectoris
B. Acute Pericarditis
C. Myocardial Infarction
D. Pleurisy
Correct Answer: B
Rationale: Positional chest pain (relieved by leaning forward) and a pericardial friction rub are hallmark signs of acute pericarditis.
Angina/MI pain is usually pressure-like and not positional. Pleurisy lacks the friction rub.
8. Which finding during a peripheral vascular assessment suggests arterial insufficiency rather than venous
insufficiency?
A. Brownish discoloration of the lower legs
B. Pale, cool skin with diminished pulses
C. Edema that worsens at the end of the day
D. Varicose veins
Correct Answer: B
Rationale: Arterial insufficiency results in decreased blood flow, leading to pale, cool skin, hair loss, and diminished/absent pulses.
Venous insufficiency presents with edema, varicose veins, and brownish discoloration (stasis dermatitis).
Page 2
NURS 5220 Exam 2 Test Bank | 2026/2027 Academic Year
NURS 5220 - Advanced Health Assessment
and Diagnostic Reasoning
EXAM 2 TEST BANK | 2026/2027 ACADEMIC YEAR
University of Texas at Arlington
This exam consists of 50 multiple-choice questions covering advanced health assessment, diagnostic reasoning,
pathophysiology, and evidence-based management across the lifespan. Select the best answer for each question.
Rationales are provided for all correct answers to ensure comprehensive understanding.
QUESTIONS 1-10: CARDIOVASCULAR & RESPIRATORY ASSESSMENT
1. A 65-year-old male presents with shortness of breath and fatigue. On examination, you note jugular venous
distension (JVD), an S3 heart sound, and bilateral crackles in the lung bases. Which diagnosis is most consistent with
these findings?
A. Chronic Obstructive Pulmonary Disease (COPD)
B. Heart Failure with Reduced Ejection Fraction (HFrEF)
C. Pneumonia
D. Pulmonary Embolism
Correct Answer: B
Rationale: JVD, S3 gallop, and bibasilar crackles are classic signs of volume overload and systolic dysfunction associated with Heart
Failure. COPD typically presents with wheezing and hyperresonance; Pneumonia with fever and focal consolidation; PE with acute
onset pleuritic pain and hypoxia.
2. During a cardiac assessment, you hear a harsh, crescendo-decrescendo systolic murmur at the right second
intercostal space that radiates to the carotids. This finding is most indicative of:
A. Mitral Regurgitation
B. Aortic Stenosis
C. Tricuspid Regurgitation
D. Pulmonic Stenosis
Correct Answer: B
Rationale: Aortic stenosis produces a systolic ejection murmur best heard at the right upper sternal border (aortic area) and radiates to
the carotid arteries. Mitral regurgitation is holosystolic and radiates to the axilla.
3. A patient with a history of hypertension reports occasional palpitations. The ECG shows irregularly irregular rhythm
with no distinct P waves. What is the primary nursing concern for this patient?
A. Risk for decreased cardiac output due to bradycardia
B. Risk for stroke due to thrombus formation in the atria
C. Risk for myocardial infarction due to coronary occlusion
D. Risk for heart failure due to ventricular hypertrophy
Correct Answer: B
Rationale: The description is classic for Atrial Fibrillation. The lack of atrial contraction leads to blood stasis in the atria, increasing
the risk of thrombus formation and subsequent embolic stroke.
Page 1
NURS 5220 Exam 2 Test Bank | 2026/2027 Academic Year
, NURS 5220 - Advanced Health Assessment and Diagnostic Reasoning University of Texas at Arlington
4. Which physical examination finding is most specific for differentiating Cardiac Asthma (Heart Failure) from
Bronchial Asthma?
A. Presence of wheezing
B. Presence of an S3 heart sound
C. Use of accessory muscles
D. Response to albuterol
Correct Answer: B
Rationale: While both conditions can present with wheezing and use of accessory muscles, an S3 heart sound is specific to volume
overload and ventricular dysfunction seen in heart failure, not bronchial asthma.
5. A 55-year-old smoker presents with chronic cough and dyspnea. Pulmonary function tests show an FEV1/FVC ratio
of 0.65. What does this indicate?
A. Restrictive Lung Disease
B. Obstructive Lung Disease
C. Normal Lung Function
D. Mixed Lung Disease
Correct Answer: B
Rationale: An FEV1/FVC ratio less than 0.70 indicates airflow obstruction, characteristic of obstructive lung diseases like COPD or
Asthma. Restrictive diseases typically have a normal or increased ratio but reduced total lung capacity.
6. When assessing a patient for Deep Vein Thrombosis (DVT), which sign is considered unreliable and should not be
used alone for diagnosis?
A. Unilateral leg swelling
B. Homan's Sign (pain on dorsiflexion)
C. Warmth over the affected area
D. Erythema
Correct Answer: B
Rationale: Homan's sign has low sensitivity and specificity and is no longer recommended as a reliable diagnostic tool for DVT.
Diagnosis requires clinical probability scores (Wells Criteria) and imaging (Ultrasound).
7. A patient presents with sharp chest pain that worsens with inspiration and improves when sitting up and leaning
forward. Auscultation reveals a pericardial friction rub. What is the likely diagnosis?
A. Angina Pectoris
B. Acute Pericarditis
C. Myocardial Infarction
D. Pleurisy
Correct Answer: B
Rationale: Positional chest pain (relieved by leaning forward) and a pericardial friction rub are hallmark signs of acute pericarditis.
Angina/MI pain is usually pressure-like and not positional. Pleurisy lacks the friction rub.
8. Which finding during a peripheral vascular assessment suggests arterial insufficiency rather than venous
insufficiency?
A. Brownish discoloration of the lower legs
B. Pale, cool skin with diminished pulses
C. Edema that worsens at the end of the day
D. Varicose veins
Correct Answer: B
Rationale: Arterial insufficiency results in decreased blood flow, leading to pale, cool skin, hair loss, and diminished/absent pulses.
Venous insufficiency presents with edema, varicose veins, and brownish discoloration (stasis dermatitis).
Page 2
NURS 5220 Exam 2 Test Bank | 2026/2027 Academic Year
