NU 518 Advanced Nursing Assessment: Final Exam
(Comprehensive)
50 questions
1. Which question best explores the 'timing' of a symptom?
A. 'Where does it hurt?'
B. 'How bad is it?'
C. 'Is the pain constant, or does it come and go?'
D. 'What does it feel like?'
Correct Answer: C. 'Is the pain constant, or does it come and go?'
Rationale: Timing describes frequency and pattern.
2. Which belongs in the past medical history?
A. Current symptom of cough for 3 days
B. Mother with breast cancer
C. Type 2 diabetes diagnosed in 2018
D. Smokes 1 pack per day
Correct Answer: C. Type 2 diabetes diagnosed in 2018
Rationale: These are past diagnoses; family and social history are separate.
3. Why should clinicians document pertinent negatives?
A. They make notes longer
B. They are required only by insurers
C. They replace positive findings
D. They show which important diagnoses were considered and argue against them
Correct Answer: D. They show which important diagnoses were considered and argue
against them
Rationale: They support clinical reasoning.
4. Availability bias occurs when a clinician:
A. Considers all possibilities
B. Overestimates a diagnosis because of a recent memorable case
C. Orders evidence-based tests
D. Uses clinical decision rules
Correct Answer: B. Overestimates a diagnosis because of a recent memorable case
Rationale: Recent experiences can distort judgment.
5. Which finding requires the patient to be examined in the supine position with knees bent?
A. Visual acuity
B. Hearing test
C. Romberg test
D. Abdominal palpation
Correct Answer: D. Abdominal palpation
Rationale: Bent knees relax the abdominal muscles.
6. Percussion over the thigh produces:
A. Tympany
B. Resonance
C. Hyperresonance
D. Flatness
Correct Answer: D. Flatness
Rationale: Dense muscle produces a flat note.
, 7. BP 158/102 in an adult is classified as:
A. Stage 1 hypertension
B. Elevated
C. Stage 2 hypertension
D. Hypertensive emergency always
Correct Answer: C. Stage 2 hypertension
Rationale: Emergency requires end-organ damage, not just numbers.
8. A purulent fluid-filled lesion is a:
A. Pustule
B. Vesicle
C. Bulla
D. Wheal
Correct Answer: A. Pustule
Rationale: Pustules contain pus.
9. Thickened, leathery skin from chronic scratching is called:
A. Erosion
B. Keloid
C. Fissure
D. Lichenification
Correct Answer: D. Lichenification
Rationale: It is a secondary lesion.
10. Beau's lines on the nails indicate:
A. Iron deficiency
B. Psoriasis only
C. A past temporary interruption of nail growth, such as severe illness
D. Endocarditis
Correct Answer: C. A past temporary interruption of nail growth, such as severe illness
Rationale: Horizontal grooves move out as the nail grows.
11. Which fundoscopic finding is associated with diabetes?
A. Microaneurysms and dot-blot hemorrhages
B. Papilledema only
C. Cupping only
D. Normal disc margins
Correct Answer: A. Microaneurysms and dot-blot hemorrhages
Rationale: Diabetic retinopathy causes vascular changes.
12. An enlarged optic cup-to-disc ratio suggests:
A. Cataract
B. Hypertension
C. Glaucoma
D. Conjunctivitis
Correct Answer: C. Glaucoma
Rationale: Increased cupping reflects optic nerve damage.
(Comprehensive)
50 questions
1. Which question best explores the 'timing' of a symptom?
A. 'Where does it hurt?'
B. 'How bad is it?'
C. 'Is the pain constant, or does it come and go?'
D. 'What does it feel like?'
Correct Answer: C. 'Is the pain constant, or does it come and go?'
Rationale: Timing describes frequency and pattern.
2. Which belongs in the past medical history?
A. Current symptom of cough for 3 days
B. Mother with breast cancer
C. Type 2 diabetes diagnosed in 2018
D. Smokes 1 pack per day
Correct Answer: C. Type 2 diabetes diagnosed in 2018
Rationale: These are past diagnoses; family and social history are separate.
3. Why should clinicians document pertinent negatives?
A. They make notes longer
B. They are required only by insurers
C. They replace positive findings
D. They show which important diagnoses were considered and argue against them
Correct Answer: D. They show which important diagnoses were considered and argue
against them
Rationale: They support clinical reasoning.
4. Availability bias occurs when a clinician:
A. Considers all possibilities
B. Overestimates a diagnosis because of a recent memorable case
C. Orders evidence-based tests
D. Uses clinical decision rules
Correct Answer: B. Overestimates a diagnosis because of a recent memorable case
Rationale: Recent experiences can distort judgment.
5. Which finding requires the patient to be examined in the supine position with knees bent?
A. Visual acuity
B. Hearing test
C. Romberg test
D. Abdominal palpation
Correct Answer: D. Abdominal palpation
Rationale: Bent knees relax the abdominal muscles.
6. Percussion over the thigh produces:
A. Tympany
B. Resonance
C. Hyperresonance
D. Flatness
Correct Answer: D. Flatness
Rationale: Dense muscle produces a flat note.
, 7. BP 158/102 in an adult is classified as:
A. Stage 1 hypertension
B. Elevated
C. Stage 2 hypertension
D. Hypertensive emergency always
Correct Answer: C. Stage 2 hypertension
Rationale: Emergency requires end-organ damage, not just numbers.
8. A purulent fluid-filled lesion is a:
A. Pustule
B. Vesicle
C. Bulla
D. Wheal
Correct Answer: A. Pustule
Rationale: Pustules contain pus.
9. Thickened, leathery skin from chronic scratching is called:
A. Erosion
B. Keloid
C. Fissure
D. Lichenification
Correct Answer: D. Lichenification
Rationale: It is a secondary lesion.
10. Beau's lines on the nails indicate:
A. Iron deficiency
B. Psoriasis only
C. A past temporary interruption of nail growth, such as severe illness
D. Endocarditis
Correct Answer: C. A past temporary interruption of nail growth, such as severe illness
Rationale: Horizontal grooves move out as the nail grows.
11. Which fundoscopic finding is associated with diabetes?
A. Microaneurysms and dot-blot hemorrhages
B. Papilledema only
C. Cupping only
D. Normal disc margins
Correct Answer: A. Microaneurysms and dot-blot hemorrhages
Rationale: Diabetic retinopathy causes vascular changes.
12. An enlarged optic cup-to-disc ratio suggests:
A. Cataract
B. Hypertension
C. Glaucoma
D. Conjunctivitis
Correct Answer: C. Glaucoma
Rationale: Increased cupping reflects optic nerve damage.
