South University NSG 6020 Advanced
Pathophysiology Exam Questions and Answers
Complete Study Guide, South University NSG6020
Test Bank, NSG 6020 Advanced Pathophysiology
Practice Exam, Verified Solutions with Detailed
Rationales, Graduate Nursing Pathophysiology
Exam Prep for South University Nursing Students
*Question 1: When performing a comprehensive health assessment on an adult client, which
technique should the advanced practice nurse use FIRST during the physical examination of the
abdomen?
A. Palpation
B. Percussion
C. Auscultation
D. Inspection
CORRECT ANSWER: C. Auscultation
RATIONALE: Auscultation of the abdomen must precede palpation and percussion because these latter
techniques can alter bowel sounds and motility, potentially leading to inaccurate assessment findings.
Inspection is typically performed first during the general survey, but when focusing specifically on
abdominal examination sequence, auscultation comes before palpation and percussion to preserve the
integrity of bowel sound assessment.
**Question 2: A 68-year-old client presents with new-onset confusion. Which assessment finding
would MOST strongly suggest delirium rather than dementia?
A. Gradual decline in cognitive function over 2 years
B. Fluctuating level of consciousness throughout the day
C. Inability to recall three objects after 5 minutes
D. Disorientation to time and place
CORRECT ANSWER: B. Fluctuating level of consciousness throughout the day
RATIONALE: Delirium is characterized by acute onset and fluctuating course, with alterations in
attention and level of consciousness that vary throughout the day. Dementia typically presents with
gradual, progressive cognitive decline. While memory impairment and disorientation can occur in both
conditions, the fluctuating consciousness is a hallmark differentiator of delirium, which is a medical
emergency requiring immediate intervention.
**Question 3: During a cardiac assessment, the advanced practice nurse hears a low-pitched, rumbling
sound at the apex during late diastole. This finding is MOST consistent with:
A. Aortic stenosis
B. Mitral regurgitation
,C. Mitral stenosis
D. Aortic regurgitation
CORRECT ANSWER: C. Mitral stenosis
RATIONALE: Mitral stenosis produces a low-pitched, rumbling diastolic murmur best heard at the apex
with the patient in left lateral decubitus position. The murmur occurs in late diastole as blood flows
through the narrowed mitral valve. Aortic stenosis produces a systolic murmur, mitral regurgitation
produces a holosystolic murmur at the apex radiating to the axilla, and aortic regurgitation produces a
high-pitched, blowing diastolic murmur at the left sternal border.
**Question 4: Which statement by a nursing student indicates understanding of culturally competent
health assessment practices?
A. "I should use the same assessment approach for all clients to ensure consistency."
B. "I will ask the client about their health beliefs and practices before beginning the assessment."
C. "I can rely on my knowledge of the client's ethnicity to guide my assessment questions."
D. "Cultural considerations are only important when the client speaks a different language."
CORRECT ANSWER: B. "I will ask the client about their health beliefs and practices before beginning
the assessment."
RATIONALE: Culturally competent assessment requires individualized inquiry about each client's
unique health beliefs, practices, and preferences rather than making assumptions based on ethnicity or
applying a standardized approach. Asking the client directly demonstrates respect, builds trust, and
ensures the assessment is relevant to their cultural context. Cultural competence is essential for all
clients regardless of language or apparent cultural differences.
**Question 5: A client reports experiencing "sharp, stabbing chest pain that worsens with deep
breathing and improves when leaning forward." These characteristics are MOST suggestive of:
A. Myocardial infarction
B. Pulmonary embolism
C. Pericarditis
D. Gastroesophageal reflux disease
CORRECT ANSWER: C. Pericarditis
RATIONALE: Pericarditis classically presents with sharp, pleuritic chest pain that worsens with
inspiration, coughing, or lying supine and improves when sitting up and leaning forward. Myocardial
infarction typically causes pressure-like, substernal pain radiating to the arm or jaw. Pulmonary
embolism may cause pleuritic pain but is often accompanied by dyspnea and tachycardia. GERD causes
burning epigastric pain related to meals and recumbency.
**Question 6: When assessing cranial nerve function, which test evaluates the function of cranial
nerve XII (hypoglossal)?
A. Asking the client to shrug shoulders against resistance
B. Observing tongue protrusion for midline alignment and movement
,C. Testing gag reflex with a tongue depressor
D. Asking the client to identify smells with eyes closed
CORRECT ANSWER: B. Observing tongue protrusion for midline alignment and movement
RATIONALE: Cranial nerve XII (hypoglossal) innervates the muscles of the tongue. Assessment involves
asking the client to protrude the tongue and observing for deviation from midline, atrophy, or
fasciculations. Shoulder shrugging tests cranial nerve XI (spinal accessory), gag reflex tests cranial nerves
IX and X (glossopharyngeal and vagus), and smell identification tests cranial nerve I (olfactory).
**Question 7: A 45-year-old client has a blood pressure reading of 138/88 mmHg on three separate
occasions. According to current guidelines, this classification is:
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
CORRECT ANSWER: C. Stage 1 hypertension
RATIONALE: According to the 2017 ACC/AHA guidelines, Stage 1 hypertension is defined as systolic
blood pressure 130-139 mmHg or diastolic blood pressure 80-89 mmHg. Elevated blood pressure is
systolic 120-129 and diastolic less than 80. Stage 2 hypertension is systolic ≥140 or diastolic ≥90. This
client's readings meet criteria for Stage 1 hypertension, warranting lifestyle modifications and possible
pharmacologic therapy based on cardiovascular risk assessment.
**Question 8: During a respiratory assessment, the advanced practice nurse notes that the client's
chest expands equally on both sides, breath sounds are vesicular throughout, and there is no use of
accessory muscles. These findings indicate:
A. Normal respiratory function
B. Early signs of chronic obstructive pulmonary disease
C. Compensated respiratory distress
D. Restrictive lung disease
CORRECT ANSWER: A. Normal respiratory function
RATIONALE: Equal chest expansion, vesicular breath sounds throughout lung fields, and absence of
accessory muscle use are all indicators of normal respiratory function. COPD typically presents with
decreased breath sounds, prolonged expiration, or use of accessory muscles. Respiratory distress would
show tachypnea, retractions, or accessory muscle use. Restrictive lung disease often demonstrates
decreased chest expansion and reduced lung volumes.
**Question 9: Which assessment finding in a newborn requires IMMEDIATE intervention by the
advanced practice nurse?
A. Acrocyanosis of hands and feet
B. Heart rate of 110 beats per minute while sleeping
, C. Grunting respirations with nasal flaring
D. Mild jaundice appearing at 48 hours of life
CORRECT ANSWER: C. Grunting respirations with nasal flaring
RATIONALE: Grunting respirations and nasal flaring are signs of respiratory distress in newborns and
require immediate assessment and intervention to ensure adequate oxygenation and ventilation.
Acrocyanosis is normal in the first 24-48 hours. A sleeping heart rate of 110 bpm is within normal range
(100-160 bpm). Physiologic jaundice appearing after 24 hours is common and typically managed with
monitoring and phototherapy if bilirubin levels rise significantly.
**Question 10: When documenting a client's health history using the SOAP format, which component
should include the client's subjective report of "I feel short of breath when climbing stairs"?
A. Subjective
B. Objective
C. Assessment
D. Plan
CORRECT ANSWER: A. Subjective
RATIONALE: The Subjective component of SOAP documentation includes the client's own words,
symptoms, feelings, and perceptions that cannot be directly measured by the clinician. "I feel short of
breath when climbing stairs" is the client's subjective experience. Objective data includes measurable
findings like vital signs or physical exam results. Assessment contains the clinician's diagnostic
impression, and Plan outlines interventions and follow-up.
**Question 11: A client presents with a rash that is described as "raised, red, and itchy with well-
defined borders." The advanced practice nurse documents this finding as:
A. Macule
B. Papule
C. Plaque
D. Wheal
CORRECT ANSWER: D. Wheal
RATIONALE: A wheal is a raised, erythematous, often pruritic lesion with irregular borders, typically
associated with allergic reactions or urticaria. Macules are flat, non-palpable color changes. Papules are
solid, elevated lesions less than 1 cm. Plaques are elevated, flat-topped lesions greater than 1 cm, often
formed by coalescing papules. The description of raised, red, itchy with well-defined borders is most
consistent with a wheal.
**Question 12: During a neurological assessment, the advanced practice nurse tests the client's ability
to identify an object placed in their hand with eyes closed. This test assesses:
A. Graphesthesia
B. Stereognosis
Pathophysiology Exam Questions and Answers
Complete Study Guide, South University NSG6020
Test Bank, NSG 6020 Advanced Pathophysiology
Practice Exam, Verified Solutions with Detailed
Rationales, Graduate Nursing Pathophysiology
Exam Prep for South University Nursing Students
*Question 1: When performing a comprehensive health assessment on an adult client, which
technique should the advanced practice nurse use FIRST during the physical examination of the
abdomen?
A. Palpation
B. Percussion
C. Auscultation
D. Inspection
CORRECT ANSWER: C. Auscultation
RATIONALE: Auscultation of the abdomen must precede palpation and percussion because these latter
techniques can alter bowel sounds and motility, potentially leading to inaccurate assessment findings.
Inspection is typically performed first during the general survey, but when focusing specifically on
abdominal examination sequence, auscultation comes before palpation and percussion to preserve the
integrity of bowel sound assessment.
**Question 2: A 68-year-old client presents with new-onset confusion. Which assessment finding
would MOST strongly suggest delirium rather than dementia?
A. Gradual decline in cognitive function over 2 years
B. Fluctuating level of consciousness throughout the day
C. Inability to recall three objects after 5 minutes
D. Disorientation to time and place
CORRECT ANSWER: B. Fluctuating level of consciousness throughout the day
RATIONALE: Delirium is characterized by acute onset and fluctuating course, with alterations in
attention and level of consciousness that vary throughout the day. Dementia typically presents with
gradual, progressive cognitive decline. While memory impairment and disorientation can occur in both
conditions, the fluctuating consciousness is a hallmark differentiator of delirium, which is a medical
emergency requiring immediate intervention.
**Question 3: During a cardiac assessment, the advanced practice nurse hears a low-pitched, rumbling
sound at the apex during late diastole. This finding is MOST consistent with:
A. Aortic stenosis
B. Mitral regurgitation
,C. Mitral stenosis
D. Aortic regurgitation
CORRECT ANSWER: C. Mitral stenosis
RATIONALE: Mitral stenosis produces a low-pitched, rumbling diastolic murmur best heard at the apex
with the patient in left lateral decubitus position. The murmur occurs in late diastole as blood flows
through the narrowed mitral valve. Aortic stenosis produces a systolic murmur, mitral regurgitation
produces a holosystolic murmur at the apex radiating to the axilla, and aortic regurgitation produces a
high-pitched, blowing diastolic murmur at the left sternal border.
**Question 4: Which statement by a nursing student indicates understanding of culturally competent
health assessment practices?
A. "I should use the same assessment approach for all clients to ensure consistency."
B. "I will ask the client about their health beliefs and practices before beginning the assessment."
C. "I can rely on my knowledge of the client's ethnicity to guide my assessment questions."
D. "Cultural considerations are only important when the client speaks a different language."
CORRECT ANSWER: B. "I will ask the client about their health beliefs and practices before beginning
the assessment."
RATIONALE: Culturally competent assessment requires individualized inquiry about each client's
unique health beliefs, practices, and preferences rather than making assumptions based on ethnicity or
applying a standardized approach. Asking the client directly demonstrates respect, builds trust, and
ensures the assessment is relevant to their cultural context. Cultural competence is essential for all
clients regardless of language or apparent cultural differences.
**Question 5: A client reports experiencing "sharp, stabbing chest pain that worsens with deep
breathing and improves when leaning forward." These characteristics are MOST suggestive of:
A. Myocardial infarction
B. Pulmonary embolism
C. Pericarditis
D. Gastroesophageal reflux disease
CORRECT ANSWER: C. Pericarditis
RATIONALE: Pericarditis classically presents with sharp, pleuritic chest pain that worsens with
inspiration, coughing, or lying supine and improves when sitting up and leaning forward. Myocardial
infarction typically causes pressure-like, substernal pain radiating to the arm or jaw. Pulmonary
embolism may cause pleuritic pain but is often accompanied by dyspnea and tachycardia. GERD causes
burning epigastric pain related to meals and recumbency.
**Question 6: When assessing cranial nerve function, which test evaluates the function of cranial
nerve XII (hypoglossal)?
A. Asking the client to shrug shoulders against resistance
B. Observing tongue protrusion for midline alignment and movement
,C. Testing gag reflex with a tongue depressor
D. Asking the client to identify smells with eyes closed
CORRECT ANSWER: B. Observing tongue protrusion for midline alignment and movement
RATIONALE: Cranial nerve XII (hypoglossal) innervates the muscles of the tongue. Assessment involves
asking the client to protrude the tongue and observing for deviation from midline, atrophy, or
fasciculations. Shoulder shrugging tests cranial nerve XI (spinal accessory), gag reflex tests cranial nerves
IX and X (glossopharyngeal and vagus), and smell identification tests cranial nerve I (olfactory).
**Question 7: A 45-year-old client has a blood pressure reading of 138/88 mmHg on three separate
occasions. According to current guidelines, this classification is:
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
CORRECT ANSWER: C. Stage 1 hypertension
RATIONALE: According to the 2017 ACC/AHA guidelines, Stage 1 hypertension is defined as systolic
blood pressure 130-139 mmHg or diastolic blood pressure 80-89 mmHg. Elevated blood pressure is
systolic 120-129 and diastolic less than 80. Stage 2 hypertension is systolic ≥140 or diastolic ≥90. This
client's readings meet criteria for Stage 1 hypertension, warranting lifestyle modifications and possible
pharmacologic therapy based on cardiovascular risk assessment.
**Question 8: During a respiratory assessment, the advanced practice nurse notes that the client's
chest expands equally on both sides, breath sounds are vesicular throughout, and there is no use of
accessory muscles. These findings indicate:
A. Normal respiratory function
B. Early signs of chronic obstructive pulmonary disease
C. Compensated respiratory distress
D. Restrictive lung disease
CORRECT ANSWER: A. Normal respiratory function
RATIONALE: Equal chest expansion, vesicular breath sounds throughout lung fields, and absence of
accessory muscle use are all indicators of normal respiratory function. COPD typically presents with
decreased breath sounds, prolonged expiration, or use of accessory muscles. Respiratory distress would
show tachypnea, retractions, or accessory muscle use. Restrictive lung disease often demonstrates
decreased chest expansion and reduced lung volumes.
**Question 9: Which assessment finding in a newborn requires IMMEDIATE intervention by the
advanced practice nurse?
A. Acrocyanosis of hands and feet
B. Heart rate of 110 beats per minute while sleeping
, C. Grunting respirations with nasal flaring
D. Mild jaundice appearing at 48 hours of life
CORRECT ANSWER: C. Grunting respirations with nasal flaring
RATIONALE: Grunting respirations and nasal flaring are signs of respiratory distress in newborns and
require immediate assessment and intervention to ensure adequate oxygenation and ventilation.
Acrocyanosis is normal in the first 24-48 hours. A sleeping heart rate of 110 bpm is within normal range
(100-160 bpm). Physiologic jaundice appearing after 24 hours is common and typically managed with
monitoring and phototherapy if bilirubin levels rise significantly.
**Question 10: When documenting a client's health history using the SOAP format, which component
should include the client's subjective report of "I feel short of breath when climbing stairs"?
A. Subjective
B. Objective
C. Assessment
D. Plan
CORRECT ANSWER: A. Subjective
RATIONALE: The Subjective component of SOAP documentation includes the client's own words,
symptoms, feelings, and perceptions that cannot be directly measured by the clinician. "I feel short of
breath when climbing stairs" is the client's subjective experience. Objective data includes measurable
findings like vital signs or physical exam results. Assessment contains the clinician's diagnostic
impression, and Plan outlines interventions and follow-up.
**Question 11: A client presents with a rash that is described as "raised, red, and itchy with well-
defined borders." The advanced practice nurse documents this finding as:
A. Macule
B. Papule
C. Plaque
D. Wheal
CORRECT ANSWER: D. Wheal
RATIONALE: A wheal is a raised, erythematous, often pruritic lesion with irregular borders, typically
associated with allergic reactions or urticaria. Macules are flat, non-palpable color changes. Papules are
solid, elevated lesions less than 1 cm. Plaques are elevated, flat-topped lesions greater than 1 cm, often
formed by coalescing papules. The description of raised, red, itchy with well-defined borders is most
consistent with a wheal.
**Question 12: During a neurological assessment, the advanced practice nurse tests the client's ability
to identify an object placed in their hand with eyes closed. This test assesses:
A. Graphesthesia
B. Stereognosis
