NURS 5220 EXAM 2
UNIVERSITY OF TEXAS AT ARLINGTON (UTA)
ADVANCED HEALTH ASSESSMENT
(CARDIO, PERIPHERAL VASCULAR, GI, GU, NEURO, HEENT INTEGRATION)
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES || 100% GUARANTEED PASS!!
<LATEST >
1.
A 58-year-old male reports chest discomfort and shortness of breath. During
assessment, the nurse locates the apical impulse in the 6th intercostal space at the
anterior axillary line. What is the most likely interpretation?
A. Normal apical impulse location
B. Right ventricular hypertrophy
C. Left ventricular enlargement
D. Pericardial effusion
Answer: C
Rationale: A displaced apical impulse laterally and inferiorly suggests left
ventricular enlargement, commonly due to chronic pressure overload such as
hypertension or heart failure.
,2.
A patient presents with suspected aortic stenosis. Which murmur characteristic is
expected?
A. Diastolic blowing murmur at the apex
B. Systolic crescendo-decrescendo at the right upper sternal border
C. Continuous machinery-like murmur
D. High-pitched holosystolic murmur at the left lower sternal border
Answer: B
Rationale: Aortic stenosis produces a systolic crescendo-decrescendo murmur best
heard at the right upper sternal border, often radiating to the carotids.
3.
While assessing jugular venous pressure, the nurse observes pulsation 5 cm above
the sternal angle at 45 degrees. This finding indicates:
A. Hypovolemia
B. Normal venous pressure
C. Elevated central venous pressure
D. Carotid artery insufficiency
Answer: C
Rationale: Elevated JVP suggests increased right-sided heart pressures, commonly
seen in heart failure or fluid overload.
4.
A patient reports sudden, sharp scrotal pain. On exam, the cremasteric reflex is
absent. What is the priority action?
A. Administer antibiotics
B. Apply warm compress
C. Immediate surgical referral
D. Elevate scrotum and reassess in 1 hour
,Answer: C
Rationale: Absence of cremasteric reflex with acute pain strongly suggests
testicular torsion, a surgical emergency requiring immediate intervention.
5.
Which abdominal assessment technique should be performed first?
A. Deep palpation
B. Light palpation
C. Percussion
D. Auscultation
Answer: D
Rationale: Auscultation must precede palpation and percussion to avoid altering
bowel sounds.
6.
A patient presents with RLQ pain and rebound tenderness at McBurney’s point.
This finding suggests:
A. Cholecystitis
B. Appendicitis
C. Pancreatitis
D. Diverticulitis
Answer: B
Rationale: McBurney’s point tenderness and rebound pain are classic signs of
appendicitis.
, 7.
Which bowel sound pattern is considered hyperactive and prolonged?
A. Borborygmi
B. Absent sounds
C. Hypoactive tinkling
D. Friction rubs
Answer: A
Rationale: Borborygmi are loud, prolonged gurgling bowel sounds often
associated with diarrhea or early obstruction.
8.
A nurse percusses the abdomen and notes tympany over most areas. This is
expected over:
A. Liver
B. Spleen
C. Stomach
D. Kidneys
Answer: C
Rationale: Tympany is normally heard over air-filled structures such as the
stomach and intestines.
9.
A patient has CVA tenderness on percussion. The nurse suspects:
A. Hepatitis
B. Pyelonephritis
C. Appendicitis
D. Cystitis
UNIVERSITY OF TEXAS AT ARLINGTON (UTA)
ADVANCED HEALTH ASSESSMENT
(CARDIO, PERIPHERAL VASCULAR, GI, GU, NEURO, HEENT INTEGRATION)
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES || 100% GUARANTEED PASS!!
<LATEST >
1.
A 58-year-old male reports chest discomfort and shortness of breath. During
assessment, the nurse locates the apical impulse in the 6th intercostal space at the
anterior axillary line. What is the most likely interpretation?
A. Normal apical impulse location
B. Right ventricular hypertrophy
C. Left ventricular enlargement
D. Pericardial effusion
Answer: C
Rationale: A displaced apical impulse laterally and inferiorly suggests left
ventricular enlargement, commonly due to chronic pressure overload such as
hypertension or heart failure.
,2.
A patient presents with suspected aortic stenosis. Which murmur characteristic is
expected?
A. Diastolic blowing murmur at the apex
B. Systolic crescendo-decrescendo at the right upper sternal border
C. Continuous machinery-like murmur
D. High-pitched holosystolic murmur at the left lower sternal border
Answer: B
Rationale: Aortic stenosis produces a systolic crescendo-decrescendo murmur best
heard at the right upper sternal border, often radiating to the carotids.
3.
While assessing jugular venous pressure, the nurse observes pulsation 5 cm above
the sternal angle at 45 degrees. This finding indicates:
A. Hypovolemia
B. Normal venous pressure
C. Elevated central venous pressure
D. Carotid artery insufficiency
Answer: C
Rationale: Elevated JVP suggests increased right-sided heart pressures, commonly
seen in heart failure or fluid overload.
4.
A patient reports sudden, sharp scrotal pain. On exam, the cremasteric reflex is
absent. What is the priority action?
A. Administer antibiotics
B. Apply warm compress
C. Immediate surgical referral
D. Elevate scrotum and reassess in 1 hour
,Answer: C
Rationale: Absence of cremasteric reflex with acute pain strongly suggests
testicular torsion, a surgical emergency requiring immediate intervention.
5.
Which abdominal assessment technique should be performed first?
A. Deep palpation
B. Light palpation
C. Percussion
D. Auscultation
Answer: D
Rationale: Auscultation must precede palpation and percussion to avoid altering
bowel sounds.
6.
A patient presents with RLQ pain and rebound tenderness at McBurney’s point.
This finding suggests:
A. Cholecystitis
B. Appendicitis
C. Pancreatitis
D. Diverticulitis
Answer: B
Rationale: McBurney’s point tenderness and rebound pain are classic signs of
appendicitis.
, 7.
Which bowel sound pattern is considered hyperactive and prolonged?
A. Borborygmi
B. Absent sounds
C. Hypoactive tinkling
D. Friction rubs
Answer: A
Rationale: Borborygmi are loud, prolonged gurgling bowel sounds often
associated with diarrhea or early obstruction.
8.
A nurse percusses the abdomen and notes tympany over most areas. This is
expected over:
A. Liver
B. Spleen
C. Stomach
D. Kidneys
Answer: C
Rationale: Tympany is normally heard over air-filled structures such as the
stomach and intestines.
9.
A patient has CVA tenderness on percussion. The nurse suspects:
A. Hepatitis
B. Pyelonephritis
C. Appendicitis
D. Cystitis
