NU 518 Advanced Nursing Assessment: Exam 3
50 questions
1. A 58-year-old man reports pressure-like chest pain radiating to the left arm for 30 minutes,
with sweating. The priority is to:
A. Treat as possible acute coronary syndrome: obtain an ECG immediately and activate emergency
care
B. Complete a full head-to-toe exam first
C. Schedule a stress test next week
D. Advise antacids
Correct Answer: A. Treat as possible acute coronary syndrome: obtain an ECG immediately
and activate emergency care
Rationale: Time-sensitive conditions require immediate action.
2. A 45-year-old woman smoked 0.5 packs per day for 30 years. Her pack-years are:
A. 30
B. 15
C. 60
D. 7.5
Correct Answer: B. 15
Rationale: 0.5 x 30 = 15 pack-years.
3. Using the patient above (age 45, 15 pack-years), is she eligible for lung cancer screening?
A. No: she is under 50 and has fewer than 20 pack-years
B. Yes, immediately
C. Yes, if she has a cough
D. Only if she quit 20 years ago
Correct Answer: A. No: she is under 50 and has fewer than 20 pack-years
Rationale: USPSTF: ages 50-80 with 20+ pack-years.
4. A patient is 1.70 m tall and weighs 52 kg. BMI and category?
A. 18.0, underweight
B. 22.0, normal
C. 25.5, overweight
D. 30.6, obese
Correct Answer: A. 18.0, underweight
Rationale: .89 is about 18.0.
5. Seated BP readings are 138/86 and 136/84 at two visits. Classification?
A. Elevated
B. Stage 1 hypertension
C. Stage 2 hypertension
D. Normal
Correct Answer: B. Stage 1 hypertension
Rationale: Systolic 130-139 or diastolic 80-89.
, 6. A 30-year-old reports dizziness on standing. Supine BP 118/74, HR 72; standing BP 96/68, HR
104. Interpretation?
A. Normal response
B. Hypertensive crisis
C. Orthostatic hypotension, possibly from volume depletion
D. Bradycardia
Correct Answer: C. Orthostatic hypotension, possibly from volume depletion
Rationale: Systolic dropped 22 mm Hg with compensatory tachycardia.
7. A 66-year-old has a 9-mm mole on her back with blue-black and brown areas and an irregular
border. Best action?
A. Reassure and recheck in 2 years
B. Apply topical steroid
C. Urgent referral for excisional biopsy
D. Freeze it in the office without biopsy
Correct Answer: C. Urgent referral for excisional biopsy
Rationale: Multiple ABCDE features suggest melanoma.
8. A child has honey-colored crusted lesions around the nose and mouth. The most likely
diagnosis is:
A. Psoriasis
B. Melanoma
C. Contact dermatitis only
D. Impetigo
Correct Answer: D. Impetigo
Rationale: Honey-colored crusts are classic for impetigo.
9. A patient has well-demarcated, warm, red, tender, spreading skin on the lower leg with fever.
This suggests:
A. Venous stasis dermatitis only
B. Cellulitis
C. Psoriasis
D. Normal finding
Correct Answer: B. Cellulitis
Rationale: Mark borders to track spread.
10. A 70-year-old reports gradual blurred vision and glare at night; the red reflex is diminished.
Likely cause?
A. Cataract
B. Acute glaucoma
C. Retinal detachment
D. Conjunctivitis
Correct Answer: A. Cataract
Rationale: Lens opacity reduces the red reflex.
11. A patient reports sudden flashes of light, new floaters and a 'curtain' over part of the vision.
The nurse practitioner should:
A. Prescribe eye drops
B. Recheck in 3 months
C. Recommend new glasses
D. Refer emergently for possible retinal detachment
Correct Answer: D. Refer emergently for possible retinal detachment
Rationale: Retinal detachment threatens vision.
50 questions
1. A 58-year-old man reports pressure-like chest pain radiating to the left arm for 30 minutes,
with sweating. The priority is to:
A. Treat as possible acute coronary syndrome: obtain an ECG immediately and activate emergency
care
B. Complete a full head-to-toe exam first
C. Schedule a stress test next week
D. Advise antacids
Correct Answer: A. Treat as possible acute coronary syndrome: obtain an ECG immediately
and activate emergency care
Rationale: Time-sensitive conditions require immediate action.
2. A 45-year-old woman smoked 0.5 packs per day for 30 years. Her pack-years are:
A. 30
B. 15
C. 60
D. 7.5
Correct Answer: B. 15
Rationale: 0.5 x 30 = 15 pack-years.
3. Using the patient above (age 45, 15 pack-years), is she eligible for lung cancer screening?
A. No: she is under 50 and has fewer than 20 pack-years
B. Yes, immediately
C. Yes, if she has a cough
D. Only if she quit 20 years ago
Correct Answer: A. No: she is under 50 and has fewer than 20 pack-years
Rationale: USPSTF: ages 50-80 with 20+ pack-years.
4. A patient is 1.70 m tall and weighs 52 kg. BMI and category?
A. 18.0, underweight
B. 22.0, normal
C. 25.5, overweight
D. 30.6, obese
Correct Answer: A. 18.0, underweight
Rationale: .89 is about 18.0.
5. Seated BP readings are 138/86 and 136/84 at two visits. Classification?
A. Elevated
B. Stage 1 hypertension
C. Stage 2 hypertension
D. Normal
Correct Answer: B. Stage 1 hypertension
Rationale: Systolic 130-139 or diastolic 80-89.
, 6. A 30-year-old reports dizziness on standing. Supine BP 118/74, HR 72; standing BP 96/68, HR
104. Interpretation?
A. Normal response
B. Hypertensive crisis
C. Orthostatic hypotension, possibly from volume depletion
D. Bradycardia
Correct Answer: C. Orthostatic hypotension, possibly from volume depletion
Rationale: Systolic dropped 22 mm Hg with compensatory tachycardia.
7. A 66-year-old has a 9-mm mole on her back with blue-black and brown areas and an irregular
border. Best action?
A. Reassure and recheck in 2 years
B. Apply topical steroid
C. Urgent referral for excisional biopsy
D. Freeze it in the office without biopsy
Correct Answer: C. Urgent referral for excisional biopsy
Rationale: Multiple ABCDE features suggest melanoma.
8. A child has honey-colored crusted lesions around the nose and mouth. The most likely
diagnosis is:
A. Psoriasis
B. Melanoma
C. Contact dermatitis only
D. Impetigo
Correct Answer: D. Impetigo
Rationale: Honey-colored crusts are classic for impetigo.
9. A patient has well-demarcated, warm, red, tender, spreading skin on the lower leg with fever.
This suggests:
A. Venous stasis dermatitis only
B. Cellulitis
C. Psoriasis
D. Normal finding
Correct Answer: B. Cellulitis
Rationale: Mark borders to track spread.
10. A 70-year-old reports gradual blurred vision and glare at night; the red reflex is diminished.
Likely cause?
A. Cataract
B. Acute glaucoma
C. Retinal detachment
D. Conjunctivitis
Correct Answer: A. Cataract
Rationale: Lens opacity reduces the red reflex.
11. A patient reports sudden flashes of light, new floaters and a 'curtain' over part of the vision.
The nurse practitioner should:
A. Prescribe eye drops
B. Recheck in 3 months
C. Recommend new glasses
D. Refer emergently for possible retinal detachment
Correct Answer: D. Refer emergently for possible retinal detachment
Rationale: Retinal detachment threatens vision.
