NUR 3069 – Advanced Health Assessment
Final Exam | Updated 2025/2026 Verified
Q&A with Complete Rationales
Question 1
A 45-year-old male presents with chest pain radiating to the left arm. The LPN notes
diaphoresis and a heart rate of 110 bpm. What is the priority assessment?
A. Auscultate lung sounds
B. Perform a 12-lead ECG
C. Check blood glucose levels
D. Assess peripheral pulses
Correct Answer: B
Rationale: Chest pain radiating to the left arm with diaphoresis and tachycardia are red-flag
symptoms of acute coronary syndrome (ACS), such as myocardial infarction. A 12-lead ECG is
the priority to identify ST-elevation or ischemic changes, per 2025 AHA guidelines. Lung sounds
(A) are secondary unless respiratory distress is present. Blood glucose (C) is relevant for
diabetic patients but not urgent. Peripheral pulses (D) are less critical than cardiac evaluation.
Prompt ECG ensures timely intervention.
Question 2
A 6-year-old child presents with a cough and fever. The LPN auscultates coarse crackles in the
right lower lobe. What is the most likely finding?
A. Asthma exacerbation
B. Pneumonia
C. Pulmonary edema
D. Bronchospasm
Correct Answer: B
Rationale: Coarse crackles in a pediatric patient with cough and fever suggest pneumonia,
characterized by alveolar fluid or infection, per 2025 AAP guidelines. Asthma (A) presents with
wheezing, not crackles. Pulmonary edema (C) is rare in children and associated with heart
,failure. Bronchospasm (D) causes expiratory wheezing. Crackles indicate consolidation,
requiring further evaluation (e.g., chest X-ray).
Question 3
An 80-year-old female reports dizziness when standing. The LPN notes a blood pressure drop
from 140/80 mmHg supine to 110/60 mmHg standing. What is the diagnosis?
A. Hypertension
B. Orthostatic hypotension
C. Dehydration
D. Syncope
Correct Answer: B
Rationale: A blood pressure drop of ≥20 mmHg systolic or ≥10 mmHg diastolic upon standing
indicates orthostatic hypotension, common in geriatric patients due to autonomic dysfunction or
medications, per 2025 AGS guidelines. Hypertension (A) involves elevated readings.
Dehydration (C) may contribute but is not the diagnosis. Syncope (D) is a symptom, not a
diagnosis. Assessment includes medication review and fall risk evaluation.
Question 4
During a neurological exam, a 30-year-old female has a positive Romberg sign. What does this
indicate?
A. Peripheral neuropathy
B. Cerebellar dysfunction
C. Stroke
D. Parkinson’s disease
Correct Answer: B
Rationale: A positive Romberg sign (swaying or falling with eyes closed) indicates cerebellar
dysfunction or proprioceptive loss, per 2025 AAN guidelines. Peripheral neuropathy (A) may
cause sensory loss but is less specific. Stroke (C) presents with focal deficits, not isolated
Romberg positivity. Parkinson’s (D) causes tremors and rigidity, not typically Romberg issues.
Further assessment includes coordination tests and imaging if needed.
Question 5
,A 25-year-old male presents with abdominal pain. The LPN notes rebound tenderness in the
right lower quadrant. What is the most likely diagnosis?
A. Gastritis
B. Appendicitis
C. Diverticulitis
D. Pancreatitis
Correct Answer: B
Rationale: Rebound tenderness in the right lower quadrant is a red-flag symptom of
appendicitis, indicating peritoneal irritation, per 2025 ACS guidelines. Gastritis (A) causes
epigastric pain without rebound. Diverticulitis (C) typically affects the left lower quadrant in older
adults. Pancreatitis (D) presents with epigastric pain radiating to the back. Assessment includes
McBurney’s point tenderness and urgent surgical referral.
Question 6
A 70-year-old male with a history of heart failure has a new systolic murmur at the apex. What is
the most likely cause?
A. Aortic stenosis
B. Mitral regurgitation
C. Pulmonic stenosis
D. Tricuspid regurgitation
Correct Answer: B
Rationale: A systolic murmur at the apex in heart failure suggests mitral regurgitation, where
blood flows back into the left atrium, per 2025 ACC guidelines. Aortic stenosis (A) causes a
harsh murmur at the right sternal border. Pulmonic stenosis (C) is rare and heard at the left
upper sternum. Tricuspid regurgitation (D) is heard at the lower sternum. Echocardiography
confirms the diagnosis.
Question 7
A 10-year-old child presents with a sore throat and fever. The LPN notes tonsillar exudate and
cervical lymphadenopathy. What is the priority action?
A. Administer acetaminophen
B. Perform a rapid strep test
C. Auscultate lung sounds
D. Assess hydration status
, Correct Answer: B
Rationale: Tonsillar exudate and lymphadenopathy in a child with sore throat and fever suggest
streptococcal pharyngitis, requiring a rapid strep test to confirm, per 2025 AAP guidelines.
Acetaminophen (A) addresses symptoms but not diagnosis. Lung sounds (C) are irrelevant
unless respiratory symptoms are present. Hydration (D) is secondary. Positive results warrant
antibiotics.
Question 8
A 55-year-old female reports shortness of breath. The LPN auscultates bilateral wheezes. What
is the most likely diagnosis?
A. Pneumonia
B. Asthma exacerbation
C. Heart failure
D. Pulmonary embolism
Correct Answer: B
Rationale: Bilateral wheezes indicate bronchoconstriction, typical of asthma exacerbation, per
2025 NHLBI guidelines. Pneumonia (A) causes crackles or rhonchi. Heart failure (C) presents
with crackles and jugular venous distension. Pulmonary embolism (D) may cause clear lungs or
focal wheezes with tachycardia. Assessment includes peak flow measurement and oxygen
saturation.
Question 9
During a cultural assessment, a 40-year-old Hispanic female expresses distrust in healthcare
providers. What is the LPN’s best response?
A. Reassure her that all providers are trustworthy
B. Explore her concerns and build rapport
C. Refer her to a different provider
D. Document the distrust and proceed
Correct Answer: B
Rationale: Cultural competence requires exploring patient concerns, especially distrust rooted
in historical or personal experiences, to build trust, per 2025 ANA guidelines. Reassurance (A)
dismisses her feelings. Referral (C) avoids addressing the issue. Documentation alone (D)
neglects therapeutic communication. Active listening ensures patient-centered care.
Final Exam | Updated 2025/2026 Verified
Q&A with Complete Rationales
Question 1
A 45-year-old male presents with chest pain radiating to the left arm. The LPN notes
diaphoresis and a heart rate of 110 bpm. What is the priority assessment?
A. Auscultate lung sounds
B. Perform a 12-lead ECG
C. Check blood glucose levels
D. Assess peripheral pulses
Correct Answer: B
Rationale: Chest pain radiating to the left arm with diaphoresis and tachycardia are red-flag
symptoms of acute coronary syndrome (ACS), such as myocardial infarction. A 12-lead ECG is
the priority to identify ST-elevation or ischemic changes, per 2025 AHA guidelines. Lung sounds
(A) are secondary unless respiratory distress is present. Blood glucose (C) is relevant for
diabetic patients but not urgent. Peripheral pulses (D) are less critical than cardiac evaluation.
Prompt ECG ensures timely intervention.
Question 2
A 6-year-old child presents with a cough and fever. The LPN auscultates coarse crackles in the
right lower lobe. What is the most likely finding?
A. Asthma exacerbation
B. Pneumonia
C. Pulmonary edema
D. Bronchospasm
Correct Answer: B
Rationale: Coarse crackles in a pediatric patient with cough and fever suggest pneumonia,
characterized by alveolar fluid or infection, per 2025 AAP guidelines. Asthma (A) presents with
wheezing, not crackles. Pulmonary edema (C) is rare in children and associated with heart
,failure. Bronchospasm (D) causes expiratory wheezing. Crackles indicate consolidation,
requiring further evaluation (e.g., chest X-ray).
Question 3
An 80-year-old female reports dizziness when standing. The LPN notes a blood pressure drop
from 140/80 mmHg supine to 110/60 mmHg standing. What is the diagnosis?
A. Hypertension
B. Orthostatic hypotension
C. Dehydration
D. Syncope
Correct Answer: B
Rationale: A blood pressure drop of ≥20 mmHg systolic or ≥10 mmHg diastolic upon standing
indicates orthostatic hypotension, common in geriatric patients due to autonomic dysfunction or
medications, per 2025 AGS guidelines. Hypertension (A) involves elevated readings.
Dehydration (C) may contribute but is not the diagnosis. Syncope (D) is a symptom, not a
diagnosis. Assessment includes medication review and fall risk evaluation.
Question 4
During a neurological exam, a 30-year-old female has a positive Romberg sign. What does this
indicate?
A. Peripheral neuropathy
B. Cerebellar dysfunction
C. Stroke
D. Parkinson’s disease
Correct Answer: B
Rationale: A positive Romberg sign (swaying or falling with eyes closed) indicates cerebellar
dysfunction or proprioceptive loss, per 2025 AAN guidelines. Peripheral neuropathy (A) may
cause sensory loss but is less specific. Stroke (C) presents with focal deficits, not isolated
Romberg positivity. Parkinson’s (D) causes tremors and rigidity, not typically Romberg issues.
Further assessment includes coordination tests and imaging if needed.
Question 5
,A 25-year-old male presents with abdominal pain. The LPN notes rebound tenderness in the
right lower quadrant. What is the most likely diagnosis?
A. Gastritis
B. Appendicitis
C. Diverticulitis
D. Pancreatitis
Correct Answer: B
Rationale: Rebound tenderness in the right lower quadrant is a red-flag symptom of
appendicitis, indicating peritoneal irritation, per 2025 ACS guidelines. Gastritis (A) causes
epigastric pain without rebound. Diverticulitis (C) typically affects the left lower quadrant in older
adults. Pancreatitis (D) presents with epigastric pain radiating to the back. Assessment includes
McBurney’s point tenderness and urgent surgical referral.
Question 6
A 70-year-old male with a history of heart failure has a new systolic murmur at the apex. What is
the most likely cause?
A. Aortic stenosis
B. Mitral regurgitation
C. Pulmonic stenosis
D. Tricuspid regurgitation
Correct Answer: B
Rationale: A systolic murmur at the apex in heart failure suggests mitral regurgitation, where
blood flows back into the left atrium, per 2025 ACC guidelines. Aortic stenosis (A) causes a
harsh murmur at the right sternal border. Pulmonic stenosis (C) is rare and heard at the left
upper sternum. Tricuspid regurgitation (D) is heard at the lower sternum. Echocardiography
confirms the diagnosis.
Question 7
A 10-year-old child presents with a sore throat and fever. The LPN notes tonsillar exudate and
cervical lymphadenopathy. What is the priority action?
A. Administer acetaminophen
B. Perform a rapid strep test
C. Auscultate lung sounds
D. Assess hydration status
, Correct Answer: B
Rationale: Tonsillar exudate and lymphadenopathy in a child with sore throat and fever suggest
streptococcal pharyngitis, requiring a rapid strep test to confirm, per 2025 AAP guidelines.
Acetaminophen (A) addresses symptoms but not diagnosis. Lung sounds (C) are irrelevant
unless respiratory symptoms are present. Hydration (D) is secondary. Positive results warrant
antibiotics.
Question 8
A 55-year-old female reports shortness of breath. The LPN auscultates bilateral wheezes. What
is the most likely diagnosis?
A. Pneumonia
B. Asthma exacerbation
C. Heart failure
D. Pulmonary embolism
Correct Answer: B
Rationale: Bilateral wheezes indicate bronchoconstriction, typical of asthma exacerbation, per
2025 NHLBI guidelines. Pneumonia (A) causes crackles or rhonchi. Heart failure (C) presents
with crackles and jugular venous distension. Pulmonary embolism (D) may cause clear lungs or
focal wheezes with tachycardia. Assessment includes peak flow measurement and oxygen
saturation.
Question 9
During a cultural assessment, a 40-year-old Hispanic female expresses distrust in healthcare
providers. What is the LPN’s best response?
A. Reassure her that all providers are trustworthy
B. Explore her concerns and build rapport
C. Refer her to a different provider
D. Document the distrust and proceed
Correct Answer: B
Rationale: Cultural competence requires exploring patient concerns, especially distrust rooted
in historical or personal experiences, to build trust, per 2025 ANA guidelines. Reassurance (A)
dismisses her feelings. Referral (C) avoids addressing the issue. Documentation alone (D)
neglects therapeutic communication. Active listening ensures patient-centered care.
