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MSN 674 FINAL Exam 2026-2027 BANK QUESTIONS
WITH DETAILED VERIFIED ANSWERS EXAM
QUESTIONS WILL COME FROM HERE (100% Latest
Already Graded A+
1. In the context of advanced health assessment, which of the following
best describes the primary purpose of a comprehensive health history?
A) To establish a therapeutic relationship with the patient
B) To gather subjective data that guides the physical examination and
diagnostic process
C) To fulfill legal documentation requirements for third-party payers
D) To identify the patient's primary language and cultural health beliefs
Answer: B) To gather subjective data that guides the physical
examination and diagnostic process
Explanation: The comprehensive health history is fundamentally a tool
for collecting subjective data from the patient, including their chief
complaint, history of present illness, past medical history, family history,
and social history. This information directly informs the clinician's
approach to the physical examination and selection of diagnostic tests.
While establishing rapport and cultural awareness are important
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components, they are secondary to the primary goal of data gathering
for clinical decision-making.
2. A 68-year-old patient presents with a new onset of fatigue and
unintentional weight loss. Which element of the review of systems is
most critical to explore in detail?
A) Musculoskeletal review for joint pain
B) Neurological review for memory changes
C) Hematologic and oncologic review for signs of bleeding, bruising, or
masses
D) Psychiatric review for depression screening
Answer: C) Hematologic and oncologic review for signs of bleeding,
bruising, or masses
Explanation: In an older adult with constitutional symptoms such as
fatigue and weight loss, the differential diagnosis must include
hematologic malignancies, such as leukemia or lymphoma, and solid
tumors. A detailed review of systems focusing on hematologic and
oncologic signs—including unexplained bruising, petechiae,
lymphadenopathy, or night sweats—is essential. While depression and
musculoskeletal issues may contribute, the urgency of ruling out
malignancy prioritizes this system.
3. During a cardiac examination, you note a sustained, diffuse point of
maximal impulse (PMI) displaced to the left midclavicular line in the
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sixth intercostal space. This finding is most consistent with which of the
following?
A) Aortic stenosis
B) Dilated cardiomyopathy
C) Pericardial effusion
D) Mitral valve prolapse
Answer: B) Dilated cardiomyopathy
Explanation: A displaced, sustained, and diffuse PMI indicates left
ventricular hypertrophy and dilation, commonly seen in dilated
cardiomyopathy. The PMI is typically located in the fifth intercostal
space at the midclavicular line; displacement to the left and downward
suggests enlargement of the left ventricle. Aortic stenosis can cause a
sustained PMI but usually without significant displacement. Pericardial
effusion often diminishes or obscures the PMI, and mitral valve prolapse
may produce a click but not a displaced PMI.
4. A 45-year-old female reports a history of Raynaud's phenomenon,
arthralgias, and a malar rash. On auscultation, you hear a pericardial
friction rub. Which autoimmune antibody is most specific for the likely
underlying diagnosis?
A) Anti-centromere antibody
B) Anti-dsDNA antibody
C) Anti-Jo-1 antibody
D) Anti-SSA/Ro antibody
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Answer: B) Anti-dsDNA antibody
Explanation: The constellation of Raynaud's, arthralgias, malar rash,
and pericarditis is classic for systemic lupus erythematosus (SLE). Anti-
dsDNA antibodies are highly specific for SLE and are associated with
disease activity, particularly lupus nephritis. Anti-centromere is more
specific for limited cutaneous systemic sclerosis, Anti-Jo-1 for
polymyositis, and Anti-SSA/Ro for Sjögren's syndrome and subacute
cutaneous lupus.
5. Which of the following represents the most appropriate initial
diagnostic test for a patient presenting with acute, unilateral vision loss
described as "a curtain coming down over the eye"?
A) Fundoscopic examination with dilation
B) Carotid Doppler ultrasound
C) CT scan of the head without contrast
D) Tonometry and slit-lamp examination
Answer: B) Carotid Doppler ultrasound
Explanation: The description of sudden, painless, unilateral vision loss as
"a curtain coming down" is classic for amaurosis fugax, which is often
caused by an embolus from the ipsilateral carotid artery. The initial
diagnostic test should evaluate for carotid artery stenosis, typically via
carotid Doppler ultrasound. While fundoscopy may show retinal emboli,
the underlying vascular pathology is best assessed with carotid imaging.
MSN 674 FINAL Exam 2026-2027 BANK QUESTIONS
WITH DETAILED VERIFIED ANSWERS EXAM
QUESTIONS WILL COME FROM HERE (100% Latest
Already Graded A+
1. In the context of advanced health assessment, which of the following
best describes the primary purpose of a comprehensive health history?
A) To establish a therapeutic relationship with the patient
B) To gather subjective data that guides the physical examination and
diagnostic process
C) To fulfill legal documentation requirements for third-party payers
D) To identify the patient's primary language and cultural health beliefs
Answer: B) To gather subjective data that guides the physical
examination and diagnostic process
Explanation: The comprehensive health history is fundamentally a tool
for collecting subjective data from the patient, including their chief
complaint, history of present illness, past medical history, family history,
and social history. This information directly informs the clinician's
approach to the physical examination and selection of diagnostic tests.
While establishing rapport and cultural awareness are important
,2|Page
components, they are secondary to the primary goal of data gathering
for clinical decision-making.
2. A 68-year-old patient presents with a new onset of fatigue and
unintentional weight loss. Which element of the review of systems is
most critical to explore in detail?
A) Musculoskeletal review for joint pain
B) Neurological review for memory changes
C) Hematologic and oncologic review for signs of bleeding, bruising, or
masses
D) Psychiatric review for depression screening
Answer: C) Hematologic and oncologic review for signs of bleeding,
bruising, or masses
Explanation: In an older adult with constitutional symptoms such as
fatigue and weight loss, the differential diagnosis must include
hematologic malignancies, such as leukemia or lymphoma, and solid
tumors. A detailed review of systems focusing on hematologic and
oncologic signs—including unexplained bruising, petechiae,
lymphadenopathy, or night sweats—is essential. While depression and
musculoskeletal issues may contribute, the urgency of ruling out
malignancy prioritizes this system.
3. During a cardiac examination, you note a sustained, diffuse point of
maximal impulse (PMI) displaced to the left midclavicular line in the
,3|Page
sixth intercostal space. This finding is most consistent with which of the
following?
A) Aortic stenosis
B) Dilated cardiomyopathy
C) Pericardial effusion
D) Mitral valve prolapse
Answer: B) Dilated cardiomyopathy
Explanation: A displaced, sustained, and diffuse PMI indicates left
ventricular hypertrophy and dilation, commonly seen in dilated
cardiomyopathy. The PMI is typically located in the fifth intercostal
space at the midclavicular line; displacement to the left and downward
suggests enlargement of the left ventricle. Aortic stenosis can cause a
sustained PMI but usually without significant displacement. Pericardial
effusion often diminishes or obscures the PMI, and mitral valve prolapse
may produce a click but not a displaced PMI.
4. A 45-year-old female reports a history of Raynaud's phenomenon,
arthralgias, and a malar rash. On auscultation, you hear a pericardial
friction rub. Which autoimmune antibody is most specific for the likely
underlying diagnosis?
A) Anti-centromere antibody
B) Anti-dsDNA antibody
C) Anti-Jo-1 antibody
D) Anti-SSA/Ro antibody
, 4|Page
Answer: B) Anti-dsDNA antibody
Explanation: The constellation of Raynaud's, arthralgias, malar rash,
and pericarditis is classic for systemic lupus erythematosus (SLE). Anti-
dsDNA antibodies are highly specific for SLE and are associated with
disease activity, particularly lupus nephritis. Anti-centromere is more
specific for limited cutaneous systemic sclerosis, Anti-Jo-1 for
polymyositis, and Anti-SSA/Ro for Sjögren's syndrome and subacute
cutaneous lupus.
5. Which of the following represents the most appropriate initial
diagnostic test for a patient presenting with acute, unilateral vision loss
described as "a curtain coming down over the eye"?
A) Fundoscopic examination with dilation
B) Carotid Doppler ultrasound
C) CT scan of the head without contrast
D) Tonometry and slit-lamp examination
Answer: B) Carotid Doppler ultrasound
Explanation: The description of sudden, painless, unilateral vision loss as
"a curtain coming down" is classic for amaurosis fugax, which is often
caused by an embolus from the ipsilateral carotid artery. The initial
diagnostic test should evaluate for carotid artery stenosis, typically via
carotid Doppler ultrasound. While fundoscopy may show retinal emboli,
the underlying vascular pathology is best assessed with carotid imaging.
