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NU 673 HEALTH ASSESSMENT MIDTERM
EXAM 2025-2026 QUESTIONS AND ANSWERS
GRADED A+ TJU
A patient is suspected to have COPD. The APRN instructs the patient to take a deep breath in, and then with his mouth open, breathe out as fast and completely as he can. For what is the APRN checking?
A. Whispered pectoriloquy
B. Forced expiratory time
C. Egophony
D. Tactile fremitus
B. Forced expiratory time
A pt presents to the clinic with severe right sided abdominal pain for 12 hours. He began having a "stomach ache" yesterday, with decreased appetite, but today the pain seems to be just on the lower right side. He has had some nausea & vomiting, but no constipation or diarrhea. His last BM was last night and was normal. He has had no fever or chills. He denies any recent illness or injuries. His PMH is unremarkable. He denies any tobacco or drug use and drinks 4-6 beers/week. on exam, he appears ill and is lying on his right side. His temp is 100.4 F and HR is
- His bowel sounds are decreased and he has rebound pain and guarding one
third of the way between anterior superior iliac spine and the umbilicus in the right lower quadrant. What is the most likely cause of his pain?
A. Acute appendicitis
B. Mesenteric ischemia
C. Acute mechanical intestinal obstruction
D. Acute cholecystitis
A. Acute appendicitis
An APRN notes a 12 mm Hg difference in systolic BP during inspiration. How should the APRN document this finding?
A. Acute stenosis
B. Carotid arterial disease
C. Paradoxical pulse
D. Pulsus alternans
C. Paradoxical pulse
Which of the following percussion notes is obtained over a gastric bubble?
B. It is a splenic rub
C. Vascular noise
D. It represents borborygmi
B. It is a splenic rub
An elderly pt with a history of smoking 2 packs/day for 50 years reports to the APRN prolonged shortness of breath. On cardiac exam, the APRN feels the most prominent palpable impulse to be in the xiphoid area. This is most likely a result of what condition?
A. COPD
B. Aortic stenosis
C. Mitral regurgitation
D. Pulmonary hypertension
D. Pulmonary hypertension
A pt reports "chest pain" during a visit to the APRN. The pt describes it as "severe" and "sharp" and worse when taking a deep breath. PMH is unremarkable and there is no history of tobacco use. VS are normal. Pt appears comfortable. Cardiac and respiratory exam are unremarkable. What is the most likely diagnosis?
A. GERD
B. Aortic dissection
C. Myocardial infarction
D. Pleuritic pain
D. Pleuritic pain
The APRN would anticipate a bounding radial pulse in:
A. Aortic regurgitation
B. Arterial embolism
C. Mitral stenosis
D. Hyperthyroidism
A. Aortic regurgitation
A pt with longstanding COPD reports that he was told his liver was enlarged. The APRN needs to assess the pt. Which of the following should the APRN do first?
A. Order a hepatitis panel
B. Measure the span of the liver
C. Obtain an ultrasound of the liver
D. Percuss the lower border of the liver
D. Percuss the lower border of the liver
A 26 year old female pt presents to the office with unilateral pain during chewing, which is chronic. She does not have facial tenderness or tenderness of the scalp. The APRN suspects:
A. Tumor of the mandible
B. Trigeminal neuralgia
C. Temporal arthritis
D. TMJ syndrome
D. TMJ syndrome
An APRN evaluating a pt for valvular competency in the communicating veins of the saphenous system, starts with the patient supine, then elevates on leg to about 90 deg to empty it of venous blood. Next, the great saphenous vein in the upper part of the thigh is occluded with manual compression, and the pt stands. The APRN keeps the vein occluded while watching for venous filling in the leg. Which test is being performed?
A. Allen
B. Ankle-brachial index
C. Romberg
D. Trendelenberg
D. Trendelenberg
An APRN notes a large wound on the distal calf of a pt. The wound is irregularly shaped with copious amounts of clear drainage. What type of wound is this?
A. Arterial ulcer
B. Venous ulcer
B. Venous ulcer
A 31 year old day care worker presents with a worsening stiff, painful neck. On inspection, the pt's head is laterally deviated toward the shoulder and rotated. At this point of the exam, what is the most likely diagnosis?
A. Torticolis
B. Osteoarthritis
C. Spondylolisthesis
D. Anklylosing spondylitis
A. Torticolis
the APRN is assessing a pt for peripheral vascular disease in the arms, s/t pt reporting increasing weakness and a history of CAD and diabetes. The APRN assesses the brachial and radial pulses and they are bounding. This would be recorded as:
B. Lethargic
C. Obtunded
D. Alert
B. Lethargic
A 21 year old construction worker presents for evaluation of a rash. The pt notes that it started on their back with a multitude of spots and is also on their upper chest and arms. It itches a little. The patient also reports sweating more than before because being outdoors is part of their new job. On exam, you note hyperpigmented, oval macules scattered more prominently around the upper back, chest, neck, and upper arms as well as under the arms. What is the most likely diagnosis?
A. Psoriasis
B. Pityriasis rosea
C. Tinea versicolor
D. Atopic eczema
C. Tinea versicolor
A 28 year old pt comes to the office for evaluation of a rash. At first there was only one large patch, but more lesions erupted suddenly on the back and torso; the lesions itch. On exam, the APRN notes that the pattern of eruption is a herald patch and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this, what is the most likely diagnosis?
A. Tinea versicolor
B. Atopic eczema
C. Psoriasis
D. Pityriasis rosea
D. Pityriasis rosea
The APRN is testing a pt for aphasia. All the following are appropriate questions to test for aphasia except:
A. Ask the pt to name the parts of a watch
B. Ask the pt to read a paragraph aloud
C. Ask the pt to stand with their arms at their side and close their eyes
D. Ask the pt to "point to your nose"
C. Ask the pt to stand with their arms at their side and close their eyes
A 33 year old female presents with history of weight gain, decreased energy, and menorrhagia over the past several months. Review of her family history reveals Hashimoto thyroiditis and hypothyroidism in four female first degree relatives (mother and 3 sisters). Which of the following skin findings best supports a diagnosis of clinical hypothyroidism?
B. Perceptions
C. Mood
D. Level of Consciousness
A. Affect
The APRN is seeing a 20 year old in the primary care office for a routine physical exam. The pt reports suicidal thoughts. What is the APRNs next appropriate step
A. Refer the pt to a psychologist
B. Notify the pt's family of the findings
C. Ask the pt if they have a specific plan as to when, where, or how
D. Prescribe the pt a SSRI
C. Ask the pt if they have a specific plan as to when, where, or how
An APRN is performing a physical exam on an older adult. The APRN notes a 0. cm nodule on the helix of the ear with central scabbed ulceration. the edges are firm to palpation. What is the most likely diagnosis?
A. Actinic keratosis
B. Melanoma
C. Squamous cell carcinoma
D. Basal cell carcinoma
C. Squamous cell carcinoma
A middle aged man comes in bc he noticed a small, fiery red lesion on his anterior chest. It is not panful and he has not noticed any bleeding or bruising. On exam, there is a 1 cm slightly raised lesion with a central body and radiating legs. Which diagnosis is most likely?
A. Petechia
B. Spider angioma
C. Spider vein
D. Cherry angioma
B. Spider angioma
Coordination of muscle movement requires that 4 areas of the nervous system function in an integrated way. Coordinating eye, head, and body movements applies to which area of the nervous system?
A. Vestibular
B. Motor
C. Cerebellar
D. Sensory
A. Vestibular
In manual BP, which if the following provides the best estimate of the true diastolic BP?
A. Disappearance of Korotkoff sounds following initial muffling.
B. Average between highest and lowest points of auscultatory gap.
C. Point at which Korotkoff sounds first muffle after systolic BP is discerned
D. Recommencement of Korotkoff sounds following lower point of auscultatory gap.
A. Disappearance of Korotkoff sounds following initial muffling
In evaluating patients who are overweight, which of the following best defines obesity?
A. Patient consuming >1.5x recommended caloric intake
B. Patient with BMI less than 24
C. Patient with BMI greater than or equal to 30
D. Patient with waist-to-hip (WHR) ratio >1.
C. Patient with BMI greater than or equal to 30
20-24 normal, 25-29 overweight, over 30 obese
Which of the following is a normal finding when performing an exam with the otoscope?
A. Macula
B. Cone of light
C. Optic disc
D. Red reflex
B. Cone of light
Other options are findings with an ophthalmoscope.
The APRN is reviewing a chart on a patient they are about to see. THe previous provider noted the patient had otorrhea. The APRN knows this to mean the patient had:
A. ringing in ears
B. ear drainage
C. earache
D. inflammation of ear
B. Ear drainage
A college student comes to the urgent care center, having been hit in the right eye with a plastic baseball during a family reunion. She complains of a painful, watery, red right eye and sensitivity to light. She has normal visual acuity in both eyes, no diplopia, and can open and close her eyes normally. The pupils are unequal in size
- 3mm on left and 5mm on right. Which CN would be implicated as the cause of photosensitivity and pupil asymmetry?
A. CN III
B. CN V
C. CN IV
D. CN II
A. CN III (oculomotor)
The APRN is assessing cranial nerves during exam. Choose what the APRN will use from the options below to test CN II.
A. Flashlight
B. Cotton swab
C. Snellen chart
D. Tuning fork
C. Snellen chart
CN II = oculomotor
A positive Romberg test is best described as:
A. loss of balance when eyes are closed.
B. No loss of balance when eyes are closed.
C. Falling during the test.
D. Feeling dizzy during the test.
A. loss of balance when eyes are closed.
Which of the following is consistent with a positive obturator sign?
A. Pain distant from site used to check rebound tenderness
B. Right hypogastric pain with right hip and knee flexed and hip internally rotated
C. Pain with extension of right thigh while patient on left side OR while pressing her knee against your hand with thigh flexion
D. Pain that stops inhalation in the RUQ
B. Right hypogastric pain with right hip and knee flexed and hip internally rotated
Irritation of obturator muscle from inflamed appendix
