NUR 507 Final Exam Priority One — Master Review
& Preparation Guide 2025/2026 <Latest Version>
Advanced Health Assessment & Diagnostic Reasoning (Questions 1-20)
1. A 65-year-old patient presents with shortness of breath and orthopnea. On auscultation,
you hear bibasilar crackles. What is your primary diagnostic consideration?
A) Chronic Obstructive Pulmonary Disease (COPD)
B) Pneumonia
C) Left-sided Heart Failure ✓
D) Asthma
2. When performing a neurological assessment, the Glasgow Coma Scale (GCS) is used to
assess:
A) Cognitive function and memory
B) Cranial nerve integrity
C) Level of consciousness ✓
D) Motor and sensory function
3. The most specific clinical sign for diagnosing appendicitis is:
A) McBurney's point tenderness ✓
B) Diffuse abdominal pain
C) Nausea and vomiting
D) Elevated white blood cell count
4. A patient with a history of hypertension complains of a sudden, severe, "tearing" back
pain. Your immediate concern is:
A) Musculoskeletal strain
B) Aortic Dissection ✓
C) Renal colic
D) Pancreatitis
5. The gold standard for diagnosing deep vein thrombosis (DVT) is:
A) D-dimer blood test
B) Doppler Ultrasound ✓
C) MRI
D) Clinical assessment (Homan's sign)
,6. When assessing a patient for meningitis, which sign is characterized by resistance and pain
with passive knee extension?
A) Brudzinski's sign ✓
B) Kernig's sign
C) Nuchal rigidity
D) Babinski's sign
7. In a patient with suspected pneumonia, the most definitive diagnostic test is:
A) Chest X-ray ✓
B) Sputum culture
C) Complete Blood Count (CBC)
D) Physical exam findings of egophony
8. A patient presents with palmar erythema, spider angiomas, and jaundice. This cluster of
findings is most suggestive of:
A) Renal failure
B) Chronic Liver Disease ✓
C) Cardiovascular disease
D) Thyroid disorder
9. The most common cause of community-acquired pneumonia in adults is:
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae ✓
D) Staphylococcus aureus
10. When evaluating a skin lesion, the "ABCDE" rule is used to screen for:
A) Basal cell carcinoma
B) Psoriasis
C) Malignant Melanoma ✓
D) Actinic keratosis
11. A blood pressure difference of more than 20 mmHg between arms may indicate:
A) Essential hypertension
B) Subclavian steal syndrome or aortic dissection ✓
C) Anemia
D) Faulty equipment
12. The best way to assess for peripheral arterial disease (PAD) is:
A) Capillary refill time
,B) Palpation of peripheral pulses
C) Ankle-Brachial Index (ABI) ✓
D) Asking about claudication
13. A patient with hyperreflexia, clonus, and bilateral Babinski signs likely has a lesion in the:
A) Cerebellum
B) Spinal cord ✓
C) Peripheral nerves
D) Basal ganglia
14. The most sensitive test for detecting ascites on physical exam is:
A) Inspection for a distended abdomen
B) Testing for shifting dullness ✓
C) Eliciting a fluid wave
D) Palpation for hepatomegaly
15. Cheyne-Stokes respirations are characterized by:
A) Deep, rapid breathing followed by apnea ✓
B) Irregular, shallow breaths
C) Prolonged expiratory phase
D) Inability to breathe lying down
16. The primary diagnostic test for confirming a pulmonary embolism is:
A) D-dimer
B) Ventilation-Perfusion (V/Q) scan
C) CT Pulmonary Angiography (CTPA) ✓
D) Arterial Blood Gas (ABG)
17. A positive Murphy's sign is associated with:
A) Appendicitis
B) Cholecystitis ✓
C) Pancreatitis
D) Diverticulitis
18. The most common type of thyroid cancer is:
A) Anaplastic
B) Medullary
C) Follicular
D) Papillary ✓
, 19. In a patient with diabetic ketoacidosis (DKA), the classic arterial blood gas (ABG) finding is:
A) Respiratory alkalosis
B) Metabolic alkalosis
C) Metabolic acidosis with an anion gap ✓
D) Fully compensated metabolic acidosis
20. The most accurate way to diagnose a peptic ulcer is with:
A) Upper GI series
B) Helicobacter pylori testing
C) Esophagogastroduodenoscopy (EGD) ✓
D) Clinical history of epigastric pain
Pharmacology & Therapeutic Management (Questions 21-40)
21. A patient on Lisinopril develops a dry, persistent cough. The appropriate action is to:
A) Prescribe a cough suppressant
B) Stop the Lisinopril and switch to an ARB (e.g., Losartan) ✓
C) Increase the dose
D) Do nothing; it is a common, harmless side effect
22. The first-line pharmacological treatment for uncomplicated hypertension in most patients
is:
A) Beta-blockers
B) Thiazide diuretics ✓
C) Calcium channel blockers
D) ACE inhibitors
23. Metformin should be temporarily held prior to procedures involving IV contrast dye to
prevent:
A) Hypoglycemia
B) Lactic Acidosis ✓
C) Acute kidney injury
D) Contrast allergy
24. The antidote for Warfarin (Coumadin) overdose is:
A) Protamine sulfate
B) Naloxone (Narcan)
C) Vitamin K ✓
D) Activated Charcoal
& Preparation Guide 2025/2026 <Latest Version>
Advanced Health Assessment & Diagnostic Reasoning (Questions 1-20)
1. A 65-year-old patient presents with shortness of breath and orthopnea. On auscultation,
you hear bibasilar crackles. What is your primary diagnostic consideration?
A) Chronic Obstructive Pulmonary Disease (COPD)
B) Pneumonia
C) Left-sided Heart Failure ✓
D) Asthma
2. When performing a neurological assessment, the Glasgow Coma Scale (GCS) is used to
assess:
A) Cognitive function and memory
B) Cranial nerve integrity
C) Level of consciousness ✓
D) Motor and sensory function
3. The most specific clinical sign for diagnosing appendicitis is:
A) McBurney's point tenderness ✓
B) Diffuse abdominal pain
C) Nausea and vomiting
D) Elevated white blood cell count
4. A patient with a history of hypertension complains of a sudden, severe, "tearing" back
pain. Your immediate concern is:
A) Musculoskeletal strain
B) Aortic Dissection ✓
C) Renal colic
D) Pancreatitis
5. The gold standard for diagnosing deep vein thrombosis (DVT) is:
A) D-dimer blood test
B) Doppler Ultrasound ✓
C) MRI
D) Clinical assessment (Homan's sign)
,6. When assessing a patient for meningitis, which sign is characterized by resistance and pain
with passive knee extension?
A) Brudzinski's sign ✓
B) Kernig's sign
C) Nuchal rigidity
D) Babinski's sign
7. In a patient with suspected pneumonia, the most definitive diagnostic test is:
A) Chest X-ray ✓
B) Sputum culture
C) Complete Blood Count (CBC)
D) Physical exam findings of egophony
8. A patient presents with palmar erythema, spider angiomas, and jaundice. This cluster of
findings is most suggestive of:
A) Renal failure
B) Chronic Liver Disease ✓
C) Cardiovascular disease
D) Thyroid disorder
9. The most common cause of community-acquired pneumonia in adults is:
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae ✓
D) Staphylococcus aureus
10. When evaluating a skin lesion, the "ABCDE" rule is used to screen for:
A) Basal cell carcinoma
B) Psoriasis
C) Malignant Melanoma ✓
D) Actinic keratosis
11. A blood pressure difference of more than 20 mmHg between arms may indicate:
A) Essential hypertension
B) Subclavian steal syndrome or aortic dissection ✓
C) Anemia
D) Faulty equipment
12. The best way to assess for peripheral arterial disease (PAD) is:
A) Capillary refill time
,B) Palpation of peripheral pulses
C) Ankle-Brachial Index (ABI) ✓
D) Asking about claudication
13. A patient with hyperreflexia, clonus, and bilateral Babinski signs likely has a lesion in the:
A) Cerebellum
B) Spinal cord ✓
C) Peripheral nerves
D) Basal ganglia
14. The most sensitive test for detecting ascites on physical exam is:
A) Inspection for a distended abdomen
B) Testing for shifting dullness ✓
C) Eliciting a fluid wave
D) Palpation for hepatomegaly
15. Cheyne-Stokes respirations are characterized by:
A) Deep, rapid breathing followed by apnea ✓
B) Irregular, shallow breaths
C) Prolonged expiratory phase
D) Inability to breathe lying down
16. The primary diagnostic test for confirming a pulmonary embolism is:
A) D-dimer
B) Ventilation-Perfusion (V/Q) scan
C) CT Pulmonary Angiography (CTPA) ✓
D) Arterial Blood Gas (ABG)
17. A positive Murphy's sign is associated with:
A) Appendicitis
B) Cholecystitis ✓
C) Pancreatitis
D) Diverticulitis
18. The most common type of thyroid cancer is:
A) Anaplastic
B) Medullary
C) Follicular
D) Papillary ✓
, 19. In a patient with diabetic ketoacidosis (DKA), the classic arterial blood gas (ABG) finding is:
A) Respiratory alkalosis
B) Metabolic alkalosis
C) Metabolic acidosis with an anion gap ✓
D) Fully compensated metabolic acidosis
20. The most accurate way to diagnose a peptic ulcer is with:
A) Upper GI series
B) Helicobacter pylori testing
C) Esophagogastroduodenoscopy (EGD) ✓
D) Clinical history of epigastric pain
Pharmacology & Therapeutic Management (Questions 21-40)
21. A patient on Lisinopril develops a dry, persistent cough. The appropriate action is to:
A) Prescribe a cough suppressant
B) Stop the Lisinopril and switch to an ARB (e.g., Losartan) ✓
C) Increase the dose
D) Do nothing; it is a common, harmless side effect
22. The first-line pharmacological treatment for uncomplicated hypertension in most patients
is:
A) Beta-blockers
B) Thiazide diuretics ✓
C) Calcium channel blockers
D) ACE inhibitors
23. Metformin should be temporarily held prior to procedures involving IV contrast dye to
prevent:
A) Hypoglycemia
B) Lactic Acidosis ✓
C) Acute kidney injury
D) Contrast allergy
24. The antidote for Warfarin (Coumadin) overdose is:
A) Protamine sulfate
B) Naloxone (Narcan)
C) Vitamin K ✓
D) Activated Charcoal
