NUR 612 Advanced Health Assessment II Final Exam (Comprehensive Practice
Questions with Answers & Rationales)
Which of the following joints is most likely to be affected by OA?
A. Wrists
B. Elbows
C. metacarpophalangeal joint
D. DIP Joint
D. DIP Joint
Clinical finding of the knee in a patient with OA include which of the following (SATA)
A. Coarse crepitus
B. Joint Effusion
C. Warm joint
D. Knee often locks or a pop is heard
E. redness and heat over the anterior and posterior knee
A. Coarse crepitus
B. Joint Effusion
D. Knee often locks or pop is heard
A positive straight-leg raising test is indicative of which of the following?
A) Myasthenia gravis
B) Inflammation of the sciatic nerve/herniated disc
C) Multiple sclerosis
D) Parkinson's disease
B) Inflammation of the sciatic nerve/herniated disc
A lab technician has a 10.5-mm area of redness and induration in his left forearm after
getting a Mantoux test 72 hours ago. The last test, which was done 12 months ago, was
negative. He denies cough, night sweats, and weight loss. What is the next best
intervention?
A) Obtain a sputum culture and a chest x-ray
B) Obtain a chest x-ray
C) Obtain a sputum for C&S and an acid-fast stain
D) Obtain a CBC and chest x-ray
B) Obtain a chest x-ray
A lipid profile done on a newly diagnosed hypertensive patient shows a triglyceride level
of 650 mg/dL, total cholesterol 240 mg/dL, LDL 145 mg/dL, and an HDL of 35 mg/dL.
What is the best intervention for this patient?
A) Educate the patient about lifestyle changes that will help lower cholesterol levels
B) Initiate a prescription of pravastatin (Pravachol)
,C) Recommend that the patient exercise at least every other day and avoid eating fatty
or fried foods
D) Initiate a prescription of nicotinic acid (Niacin, Niaspan)
D) Initiate a prescription of nicotinic acid (Niacin, Niaspan)
Niacin is recommended for treatment of high triglyceride and cholesterol levels.
Exercise and healthy eating lifestyle is also recommended, but with the high level of
triglycerides at 650 mg/dL and total cholesterol 240 mg/dL, niacin is recommended.
A hypertensive middle-aged man who is Native American has recently been diagnosed
with mild renal insufficiency. He has been on lisinopril (Accupril) for many years. Which
of the following laboratory values should be carefully monitored?
A) Hemoglobin, hematocrit, and the MCV (mean corpuscular volume)
B) Serum creatinine and potassium levels
C) Aspartate aminotransferase and alanine aminotransferase
D) Serum sodium, potassium, and magnesium
B) Serum creatinine and potassium levels
Native Americans have a much higher rate of kidney disease and renal failure when
compared to other races. Native Americans have a 1 in 3 incidence of hypertension.
Hypertension is the second leading cause of kidney failure. BUN, creatinine, estimated
GFR, and urinalysis are performed to assess the function of the kidneys.
The best screening test for detecting and monitoring both hyperthyroidism and
hypothyroidism is:
A) The total T3-4
B) Thyroid-stimulating hormone (TSH)
C) Thyroid profile
D) Palpation of the thyroid gland
B) Thyroid-stimulating hormone (TSH)
The best "screening" test of hypothyroidism and hyperthyroidism is the TSH. If this
result is abnormal, then further diagnostic tests should be performed.
A 65-year-old Hispanic woman has a history of type 2 diabetes. A routine urinalysis
reveals a few epithelial cells and is negative for leukocytes, nitrites, and protein. Which
of the following would you recommend next?
A) Order a urine for C&S
B) Order a 24-hour urine for microalbumin
C) Because it is negative, no further tests are necessary
D) Recommend a screening IVP (intravenous pyelogram)
B) Order a 24-hour urine for microalbumin
, Epithelial cells are cells that are present on the inside lining of the organs. Few epithelial
cells can be normal; however, with her history of type 2 diabetes, a 24-hour urine for
microalbumin should be ordered to assess kidney function.
A neighbor's 14-year-old son, who is active in basketball, complains of pain and swelling
on both knees. On physical exam, there is tenderness over the tibial tuberosity of both
knees. Which of the following is most likely? A
) Chondromalacia patella
B) Left knee sprain
C) Osgood-Schlatter disease
D) Tear of the medial ligament
C) Osgood-Schlatter disease
Osgood-Schlatter disease is characterized by bilateral pain over the tibial tuberosity
upon palpation, along with knee pain and edema with exercise.
jane, a middle-aged nurse, complains of localized pain on the sole of her left foot that is
located between the third and fourth toes. The pain is aggravated by weight bearing and
feels like "a pebble in my shoe." During the physical examination, the nurse practitioner
palpates a tender nodule in the metatarsal interspace on the left foot. No redness or
swelling is noted. Which of the following conditions is being described?
A) Plantar wart
B) Foreign body
C) Morton's neuroma
D) Metatarsalgia
C) Morton's neuroma
Morton's neuroma is characterized by experiencing pain, burning, or numbness with
weight bearing between two toes. Some experience a sense or feeling like they are
walking on a pebble between two adjacent toes.
While reviewing some lab reports, the nurse practitioner notes that one of her teenage
male patient's lab results is abnormal. The liver function tests are all normal except for a
slight elevation in the alkaline phosphatase level. The patient is a member of a soccer
team and denies any recent injury. What is the next step in this patient's evaluation?
A) Order a liver ultrasound to rule out fatty liver
B) This is a normal finding for his age group
C) The patient needs to be evaluated further for pancreatic disease
D) Refer the patient to a pediatric rheumatologist
B) This is a normal finding for his age group
Elevated levels of alkaline phosphatase are commonly seen in growing children. Growth
of bone tissue elevates the alkaline phosphatase levels.
Questions with Answers & Rationales)
Which of the following joints is most likely to be affected by OA?
A. Wrists
B. Elbows
C. metacarpophalangeal joint
D. DIP Joint
D. DIP Joint
Clinical finding of the knee in a patient with OA include which of the following (SATA)
A. Coarse crepitus
B. Joint Effusion
C. Warm joint
D. Knee often locks or a pop is heard
E. redness and heat over the anterior and posterior knee
A. Coarse crepitus
B. Joint Effusion
D. Knee often locks or pop is heard
A positive straight-leg raising test is indicative of which of the following?
A) Myasthenia gravis
B) Inflammation of the sciatic nerve/herniated disc
C) Multiple sclerosis
D) Parkinson's disease
B) Inflammation of the sciatic nerve/herniated disc
A lab technician has a 10.5-mm area of redness and induration in his left forearm after
getting a Mantoux test 72 hours ago. The last test, which was done 12 months ago, was
negative. He denies cough, night sweats, and weight loss. What is the next best
intervention?
A) Obtain a sputum culture and a chest x-ray
B) Obtain a chest x-ray
C) Obtain a sputum for C&S and an acid-fast stain
D) Obtain a CBC and chest x-ray
B) Obtain a chest x-ray
A lipid profile done on a newly diagnosed hypertensive patient shows a triglyceride level
of 650 mg/dL, total cholesterol 240 mg/dL, LDL 145 mg/dL, and an HDL of 35 mg/dL.
What is the best intervention for this patient?
A) Educate the patient about lifestyle changes that will help lower cholesterol levels
B) Initiate a prescription of pravastatin (Pravachol)
,C) Recommend that the patient exercise at least every other day and avoid eating fatty
or fried foods
D) Initiate a prescription of nicotinic acid (Niacin, Niaspan)
D) Initiate a prescription of nicotinic acid (Niacin, Niaspan)
Niacin is recommended for treatment of high triglyceride and cholesterol levels.
Exercise and healthy eating lifestyle is also recommended, but with the high level of
triglycerides at 650 mg/dL and total cholesterol 240 mg/dL, niacin is recommended.
A hypertensive middle-aged man who is Native American has recently been diagnosed
with mild renal insufficiency. He has been on lisinopril (Accupril) for many years. Which
of the following laboratory values should be carefully monitored?
A) Hemoglobin, hematocrit, and the MCV (mean corpuscular volume)
B) Serum creatinine and potassium levels
C) Aspartate aminotransferase and alanine aminotransferase
D) Serum sodium, potassium, and magnesium
B) Serum creatinine and potassium levels
Native Americans have a much higher rate of kidney disease and renal failure when
compared to other races. Native Americans have a 1 in 3 incidence of hypertension.
Hypertension is the second leading cause of kidney failure. BUN, creatinine, estimated
GFR, and urinalysis are performed to assess the function of the kidneys.
The best screening test for detecting and monitoring both hyperthyroidism and
hypothyroidism is:
A) The total T3-4
B) Thyroid-stimulating hormone (TSH)
C) Thyroid profile
D) Palpation of the thyroid gland
B) Thyroid-stimulating hormone (TSH)
The best "screening" test of hypothyroidism and hyperthyroidism is the TSH. If this
result is abnormal, then further diagnostic tests should be performed.
A 65-year-old Hispanic woman has a history of type 2 diabetes. A routine urinalysis
reveals a few epithelial cells and is negative for leukocytes, nitrites, and protein. Which
of the following would you recommend next?
A) Order a urine for C&S
B) Order a 24-hour urine for microalbumin
C) Because it is negative, no further tests are necessary
D) Recommend a screening IVP (intravenous pyelogram)
B) Order a 24-hour urine for microalbumin
, Epithelial cells are cells that are present on the inside lining of the organs. Few epithelial
cells can be normal; however, with her history of type 2 diabetes, a 24-hour urine for
microalbumin should be ordered to assess kidney function.
A neighbor's 14-year-old son, who is active in basketball, complains of pain and swelling
on both knees. On physical exam, there is tenderness over the tibial tuberosity of both
knees. Which of the following is most likely? A
) Chondromalacia patella
B) Left knee sprain
C) Osgood-Schlatter disease
D) Tear of the medial ligament
C) Osgood-Schlatter disease
Osgood-Schlatter disease is characterized by bilateral pain over the tibial tuberosity
upon palpation, along with knee pain and edema with exercise.
jane, a middle-aged nurse, complains of localized pain on the sole of her left foot that is
located between the third and fourth toes. The pain is aggravated by weight bearing and
feels like "a pebble in my shoe." During the physical examination, the nurse practitioner
palpates a tender nodule in the metatarsal interspace on the left foot. No redness or
swelling is noted. Which of the following conditions is being described?
A) Plantar wart
B) Foreign body
C) Morton's neuroma
D) Metatarsalgia
C) Morton's neuroma
Morton's neuroma is characterized by experiencing pain, burning, or numbness with
weight bearing between two toes. Some experience a sense or feeling like they are
walking on a pebble between two adjacent toes.
While reviewing some lab reports, the nurse practitioner notes that one of her teenage
male patient's lab results is abnormal. The liver function tests are all normal except for a
slight elevation in the alkaline phosphatase level. The patient is a member of a soccer
team and denies any recent injury. What is the next step in this patient's evaluation?
A) Order a liver ultrasound to rule out fatty liver
B) This is a normal finding for his age group
C) The patient needs to be evaluated further for pancreatic disease
D) Refer the patient to a pediatric rheumatologist
B) This is a normal finding for his age group
Elevated levels of alkaline phosphatase are commonly seen in growing children. Growth
of bone tissue elevates the alkaline phosphatase levels.
