Chamberlain Prediagnostic NR607 Advanced
Physical Assessment NR 607 Midterm and Finals
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Question 1
A 45-year-old male presents with chest tightness that occurs during exercise and is
relieved with rest. He reports no radiation of pain and no associated diaphoresis or
nausea. What is the most likely diagnosis?
A) Pericarditis
B) Hiatal hernia
C) Acute myocardial infarction
D) Angina pectoris
ANSWER>>>D
RATIONALE: Chest pain with activity and relieved at rest in a middle-aged adult
should prompt concern for myocardial ischemia (angina pectoris). This
presentation is classic for stable angina: chest tightness or pressure that occurs with
exertion (increased oxygen demand) and subsides with rest when myocardial
oxygen demand decreases. Angina may be substernal and can radiate to the left
arm, jaw, or back, though this patient had no radiation. Pericarditis pain is typically
pleuritic, worsened by lying flat, and improved by leaning forward—different from
this presentation. Acute myocardial infarction would present with more severe,
prolonged chest pain that does not subside with rest and is associated with
diaphoresis, nausea, and shortness of breath. Hiatal hernia may cause chest
discomfort but is not typically exertion-related and relieved by rest. This patient's
presentation requires further cardiac evaluation, including stress testing and risk
factor assessment.
Question 2
,A 68-year-old female with a chronic history of severe anxiety disorder presents
with mild shortness of breath, fine crackles in the right lower lobe on auscultation,
and a nonproductive cough. She recently "ran out of pills." Which medication
omission most likely led to her current presenting symptoms?
A) Metoprolol
B) Lorazepam
C) Furosemide
D) Metformin
ANSWER>>>C
RATIONALE: Furosemide is a loop diuretic used to manage fluid overload in
conditions such as heart failure. Omitting furosemide can lead to fluid
accumulation, resulting in pulmonary congestion, shortness of breath, and crackles
on lung auscultation. Fine crackles in the lung bases indicate interstitial or alveolar
fluid. Metoprolol is a beta-blocker used for hypertension and heart failure; its
omission could cause tachycardia or worsening heart failure symptoms but not
acute pulmonary crackles. Lorazepam omission in an anxiety disorder patient
would cause withdrawal symptoms (anxiety, agitation, seizures) but not respiratory
findings. Metformin omission in a diabetic patient would cause hyperglycemia but
not acute pulmonary findings.
Question 3
A 55-year-old male presents with chest pain described as "pressure" that is worse
with exertion and relieved by rest. What additional finding would support the
diagnosis of angina?
A) Relief of pain within 5 minutes with sublingual nitroglycerin
B) Pain that is sharp and pleuritic
C) Pain that worsens with deep inspiration
D) Pain that is relieved by leaning forward
E) Pain that is associated with a pericardial friction rub
ANSWER>>>A
RATIONALE: Relief of angina pain within 5 minutes with sublingual
nitroglycerin supports the diagnosis of angina pectoris. Nitroglycerin is a
vasodilator that reduces preload and afterload, decreasing myocardial oxygen
,demand. Pleuritic pain, pain worsened by inspiration, relief by leaning forward,
and pericardial friction rub are characteristic of pericarditis, not angina.
Question 4
A 72-year-old female presents with shortness of breath, orthopnea, and bilateral
lower extremity edema. On examination, she has an S3 gallop and jugular venous
distension. What is the most likely diagnosis?
A) Heart failure
B) COPD
C) Pneumonia
D) Pulmonary embolism
E) Pericarditis
ANSWER>>>A
RATIONALE: Heart failure presents with dyspnea, orthopnea, edema, S3 gallop
(ventricular gallop), and jugular venous distension. An S3 gallop is a hallmark of
volume overload in heart failure. COPD presents with wheezing and barrel chest.
Pneumonia presents with fever and productive cough. Pulmonary embolism
presents with pleuritic chest pain. Pericarditis presents with pericardial friction rub.
Question 5
A 60-year-old male presents with a systolic ejection murmur at the right upper
sternal border that radiates to the carotids. What is the most likely diagnosis?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Aortic regurgitation
E) Tricuspid regurgitation
ANSWER>>>A
RATIONALE: Aortic stenosis presents with a systolic ejection murmur at the
right upper sternal border (aortic area) that radiates to the carotids. It causes a
crescendo-decrescendo murmur. Mitral regurgitation is a holosystolic murmur at
, the apex radiating to the axilla. Aortic regurgitation is a diastolic decrescendo
murmur. Mitral stenosis is a diastolic rumbling murmur with an opening snap.
Question 6
A 45-year-old female presents with a holosystolic murmur at the apex that radiates
to the axilla. What is the most likely diagnosis?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Aortic regurgitation
E) Tricuspid regurgitation
ANSWER>>>B
RATIONALE: Mitral regurgitation presents with a holosystolic murmur at the
apex that radiates to the axilla. It is caused by incompetence of the mitral valve
allowing blood to flow backward from the left ventricle to the left atrium during
systole. Aortic stenosis radiates to the carotids. Mitral stenosis is a diastolic
murmur. Aortic regurgitation is a diastolic murmur.
Question 7
A 35-year-old female presents with a mid-diastolic rumbling murmur at the apex
with an opening snap. What is the most likely diagnosis?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Aortic regurgitation
E) Tricuspid regurgitation
ANSWER>>>C
RATIONALE: Mitral stenosis presents with a mid-diastolic rumbling murmur at
the apex with an opening snap. It is often due to rheumatic heart disease. The
opening snap occurs after S2 when the mitral valve opens. Mitral regurgitation is
Physical Assessment NR 607 Midterm and Finals
Examplify Online Proctored Exam Questions and
Answers WITH COMPLETE SOLUTIONS |
100% PASS GUARANTEED | GRADED A+
Question 1
A 45-year-old male presents with chest tightness that occurs during exercise and is
relieved with rest. He reports no radiation of pain and no associated diaphoresis or
nausea. What is the most likely diagnosis?
A) Pericarditis
B) Hiatal hernia
C) Acute myocardial infarction
D) Angina pectoris
ANSWER>>>D
RATIONALE: Chest pain with activity and relieved at rest in a middle-aged adult
should prompt concern for myocardial ischemia (angina pectoris). This
presentation is classic for stable angina: chest tightness or pressure that occurs with
exertion (increased oxygen demand) and subsides with rest when myocardial
oxygen demand decreases. Angina may be substernal and can radiate to the left
arm, jaw, or back, though this patient had no radiation. Pericarditis pain is typically
pleuritic, worsened by lying flat, and improved by leaning forward—different from
this presentation. Acute myocardial infarction would present with more severe,
prolonged chest pain that does not subside with rest and is associated with
diaphoresis, nausea, and shortness of breath. Hiatal hernia may cause chest
discomfort but is not typically exertion-related and relieved by rest. This patient's
presentation requires further cardiac evaluation, including stress testing and risk
factor assessment.
Question 2
,A 68-year-old female with a chronic history of severe anxiety disorder presents
with mild shortness of breath, fine crackles in the right lower lobe on auscultation,
and a nonproductive cough. She recently "ran out of pills." Which medication
omission most likely led to her current presenting symptoms?
A) Metoprolol
B) Lorazepam
C) Furosemide
D) Metformin
ANSWER>>>C
RATIONALE: Furosemide is a loop diuretic used to manage fluid overload in
conditions such as heart failure. Omitting furosemide can lead to fluid
accumulation, resulting in pulmonary congestion, shortness of breath, and crackles
on lung auscultation. Fine crackles in the lung bases indicate interstitial or alveolar
fluid. Metoprolol is a beta-blocker used for hypertension and heart failure; its
omission could cause tachycardia or worsening heart failure symptoms but not
acute pulmonary crackles. Lorazepam omission in an anxiety disorder patient
would cause withdrawal symptoms (anxiety, agitation, seizures) but not respiratory
findings. Metformin omission in a diabetic patient would cause hyperglycemia but
not acute pulmonary findings.
Question 3
A 55-year-old male presents with chest pain described as "pressure" that is worse
with exertion and relieved by rest. What additional finding would support the
diagnosis of angina?
A) Relief of pain within 5 minutes with sublingual nitroglycerin
B) Pain that is sharp and pleuritic
C) Pain that worsens with deep inspiration
D) Pain that is relieved by leaning forward
E) Pain that is associated with a pericardial friction rub
ANSWER>>>A
RATIONALE: Relief of angina pain within 5 minutes with sublingual
nitroglycerin supports the diagnosis of angina pectoris. Nitroglycerin is a
vasodilator that reduces preload and afterload, decreasing myocardial oxygen
,demand. Pleuritic pain, pain worsened by inspiration, relief by leaning forward,
and pericardial friction rub are characteristic of pericarditis, not angina.
Question 4
A 72-year-old female presents with shortness of breath, orthopnea, and bilateral
lower extremity edema. On examination, she has an S3 gallop and jugular venous
distension. What is the most likely diagnosis?
A) Heart failure
B) COPD
C) Pneumonia
D) Pulmonary embolism
E) Pericarditis
ANSWER>>>A
RATIONALE: Heart failure presents with dyspnea, orthopnea, edema, S3 gallop
(ventricular gallop), and jugular venous distension. An S3 gallop is a hallmark of
volume overload in heart failure. COPD presents with wheezing and barrel chest.
Pneumonia presents with fever and productive cough. Pulmonary embolism
presents with pleuritic chest pain. Pericarditis presents with pericardial friction rub.
Question 5
A 60-year-old male presents with a systolic ejection murmur at the right upper
sternal border that radiates to the carotids. What is the most likely diagnosis?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Aortic regurgitation
E) Tricuspid regurgitation
ANSWER>>>A
RATIONALE: Aortic stenosis presents with a systolic ejection murmur at the
right upper sternal border (aortic area) that radiates to the carotids. It causes a
crescendo-decrescendo murmur. Mitral regurgitation is a holosystolic murmur at
, the apex radiating to the axilla. Aortic regurgitation is a diastolic decrescendo
murmur. Mitral stenosis is a diastolic rumbling murmur with an opening snap.
Question 6
A 45-year-old female presents with a holosystolic murmur at the apex that radiates
to the axilla. What is the most likely diagnosis?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Aortic regurgitation
E) Tricuspid regurgitation
ANSWER>>>B
RATIONALE: Mitral regurgitation presents with a holosystolic murmur at the
apex that radiates to the axilla. It is caused by incompetence of the mitral valve
allowing blood to flow backward from the left ventricle to the left atrium during
systole. Aortic stenosis radiates to the carotids. Mitral stenosis is a diastolic
murmur. Aortic regurgitation is a diastolic murmur.
Question 7
A 35-year-old female presents with a mid-diastolic rumbling murmur at the apex
with an opening snap. What is the most likely diagnosis?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Aortic regurgitation
E) Tricuspid regurgitation
ANSWER>>>C
RATIONALE: Mitral stenosis presents with a mid-diastolic rumbling murmur at
the apex with an opening snap. It is often due to rheumatic heart disease. The
opening snap occurs after S2 when the mitral valve opens. Mitral regurgitation is
