2026 UPDATED QUESTIONS DOWNLOAD
NUR 634 Advanced Health Assessment Midterm Master Bank 2025/2026: 450 Q&A | Cardiac,
Respiratory, Neurological & Abdominal Exam Prep
Master the 2025/2026 NUR 634 Midterm with this ultimate exam bank featuring over 450+ high-yield
practice questions and verified rationales. This comprehensive study guide covers advanced diagnostic
reasoning, physical examination techniques across the lifespan, and critical differential diagnoses for
cardiac, respiratory, and neurological systems. Designed specifically for graduate nursing students,
these materials ensure you are fully prepared to excel in your Advanced Health Assessment course
and clinical rotations.
1. A patient presents with "rebound tenderness" in the LLQ. This finding is most
characteristic of:
A. Appendicitis
B. Diverticulitis
C. Cholecystitis
D. Splenic Rupture
Answer: B
Rationale: While appendicitis causes RLQ pain, acute diverticulitis typically presents with pain
and peritoneal signs (like rebound tenderness) in the Left Lower Quadrant (LLQ).
2. During a breast exam, you note a "fixed, stony-hard, non-tender" mass with "skin
dimpling." This is highly suspicious for:
A. Fibroadenoma
B. Breast Cyst
C. Breast Cancer
D. Mastitis
Answer: C
Rationale: Malignant tumors are usually fixed to underlying tissue (non-mobile), hard, and
painless. Skin dimpling (retraction) occurs as the tumor pulls on Cooper’s ligaments.
3. Which test is used to assess for "De Quervain’s Tenosynovitis"?
A. Phalen’s Test
B. Finkelstein’s Test
C. Tinel’s Sign
D. Allen’s Test
Answer: B
Rationale: Finkelstein’s test involves placing the thumb in the palm, closing the fingers over it,
and ulnar-deviating the wrist. Pain indicates inflammation of the thumb tendons.
, 2026 UPDATED QUESTIONS DOWNLOAD
4. A patient has a "positive Brudzinski’s sign." This is observed when:
A. The hip is flexed and the knee cannot be extended
B. The neck is flexed, causing involuntary flexion of the hips/knees
C. The patient cannot touch their chin to their chest
D. The patient feels a "shock" when the neck is flexed
Answer: B
Rationale: Brudzinski’s sign is a classic indicator of meningeal irritation (meningitis). Flexing
the neck stretches the inflamed meninges, causing a reflexive pull of the legs.
5. Which heart sound is often associated with "Left Ventricular Hypertrophy" and "Stiff
Ventricles"?
A. S1
B. S2
C. S3
D. S4
Answer: D
Rationale: S4 (Atrial Gallop) occurs at the end of diastole when the atria contract into a non-
compliant (stiff) ventricle, common in long-standing hypertension.
6. A patient describes "floaters" and "flashing lights" (photopsia) followed by a "dark
shadow" in their vision. This is:
A. Acute Glaucoma
B. Macular Degeneration
C. Retinal Detachment
D. Cataracts
Answer: C
Rationale: Flashing lights and new floaters are classic warning signs of a retinal tear or
detachment, which is an ocular emergency.
7. "Egophony" is heard during a lung exam. If the patient says "E-E-E" and it sounds
like "A-A-A" through the stethoscope, this indicates:
A. Pneumothorax
B. Lung Consolidation (Pneumonia)
C. Pleural Effusion
D. Normal lung tissue
Answer: B
Rationale: Sound travels better through solid/liquid medium than air. In pneumonia, the
consolidated lung transmits the "E" as a nasally "A" sound.
8. A patient has "painless" hematuria and a history of smoking. Which should be the top
differential?
A. Nephrolithiasis (Kidney Stones)
B. Urinary Tract Infection (UTI)
, 2026 UPDATED QUESTIONS DOWNLOAD
C. Bladder Cancer
D. Benign Prostatic Hyperplasia (BPH)
Answer: C
Rationale: Painless gross hematuria in an adult smoker is considered bladder or renal cancer
until proven otherwise.
9. When assessing the "Trigeminal Nerve" (CN V), which of the following are you
testing?
A. Facial symmetry (smiling)
B. Muscles of mastication (jaw clenching)
C. Shrugging the shoulders
D. Tongue protrusion
Answer: B
Rationale: CN V is responsible for facial sensation and the motor function of the muscles used
for chewing (mastication).
10. A "positive Lachman’s Test" indicates an injury to which structure?
A. Medial Collateral Ligament (MCL)
B. Posterior Cruciate Ligament (PCL)
C. Anterior Cruciate Ligament (ACL)
D. Meniscus
Answer: C
Rationale: Lachman’s is the most sensitive clinical test for an ACL tear, involving pulling the
tibia forward with the knee flexed at 20-30 degrees.
11. A 19-year-old college student presents with "exudative pharyngitis,"
"lymphadenopathy," and "splenomegaly." What is the most likely diagnosis?
A. Strep Throat
B. Infectious Mononucleosis
C. Influenza
D. Diphtheria
Answer: B
Rationale: The triad of sore throat, swollen glands, and an enlarged spleen (splenomegaly) is
hallmark for Mono (Epstein-Barr Virus).
12. Which maneuver is used to assess for "Carpal Tunnel Syndrome"?
A. Phalen’s Maneuver
B. McMurray’s Test
C. Drawer Test
D. Murphy’s Sign
Answer: A
Rationale: Phalen’s involves holding the backs of the hands together for 60 seconds to
compress the median nerve; numbness/tingling is a positive result.
, 2026 UPDATED QUESTIONS DOWNLOAD
13. A patient has a "systolic murmur" that radiates to the neck (carotids). This is most
likely:
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Stenosis
D. Tricuspid Regurgitation
Answer: B
Rationale: Aortic stenosis produces a harsh systolic murmur that classically radiates upward
into the carotid arteries.
14. A "positive Murphy’s Sign" is elicited by:
A. Tapping the costovertebral angle (CVA)
B. Palpating the RUQ during deep inspiration
C. Rotating the hip internally
D. Releasing pressure from the RLQ
Answer: B
Rationale: If the patient catches their breath (stops inspiration) due to pain when the
gallbladder is palpated, it suggests cholecystitis.
15. "Pulsus Alternans" (alternating strong and weak pulses) is a clinical sign of:
A. Severe Left-Sided Heart Failure
B. Cardiac Tamponade
C. Aortic Regurgitation
D. Dehydration
Answer: A
Rationale: Pulsus alternans indicates severe myocardial depression/failure and is often
accompanied by an S3 heart sound.
16. A "beefy red, smooth tongue" (glossitis) is commonly seen in which deficiency?
A. Vitamin C
B. Vitamin B12
C. Vitamin D
D. Vitamin K
Answer: B
Rationale: B12 (and Folate) deficiency can cause the tongue to lose its papillae, appearing
smooth and bright red.
17. Which term describes "difficulty swallowing"?
A. Dysphasia
B. Dysphagia
C. Dysarthria
D. Dyspnea
Answer: B
NUR 634 Advanced Health Assessment Midterm Master Bank 2025/2026: 450 Q&A | Cardiac,
Respiratory, Neurological & Abdominal Exam Prep
Master the 2025/2026 NUR 634 Midterm with this ultimate exam bank featuring over 450+ high-yield
practice questions and verified rationales. This comprehensive study guide covers advanced diagnostic
reasoning, physical examination techniques across the lifespan, and critical differential diagnoses for
cardiac, respiratory, and neurological systems. Designed specifically for graduate nursing students,
these materials ensure you are fully prepared to excel in your Advanced Health Assessment course
and clinical rotations.
1. A patient presents with "rebound tenderness" in the LLQ. This finding is most
characteristic of:
A. Appendicitis
B. Diverticulitis
C. Cholecystitis
D. Splenic Rupture
Answer: B
Rationale: While appendicitis causes RLQ pain, acute diverticulitis typically presents with pain
and peritoneal signs (like rebound tenderness) in the Left Lower Quadrant (LLQ).
2. During a breast exam, you note a "fixed, stony-hard, non-tender" mass with "skin
dimpling." This is highly suspicious for:
A. Fibroadenoma
B. Breast Cyst
C. Breast Cancer
D. Mastitis
Answer: C
Rationale: Malignant tumors are usually fixed to underlying tissue (non-mobile), hard, and
painless. Skin dimpling (retraction) occurs as the tumor pulls on Cooper’s ligaments.
3. Which test is used to assess for "De Quervain’s Tenosynovitis"?
A. Phalen’s Test
B. Finkelstein’s Test
C. Tinel’s Sign
D. Allen’s Test
Answer: B
Rationale: Finkelstein’s test involves placing the thumb in the palm, closing the fingers over it,
and ulnar-deviating the wrist. Pain indicates inflammation of the thumb tendons.
, 2026 UPDATED QUESTIONS DOWNLOAD
4. A patient has a "positive Brudzinski’s sign." This is observed when:
A. The hip is flexed and the knee cannot be extended
B. The neck is flexed, causing involuntary flexion of the hips/knees
C. The patient cannot touch their chin to their chest
D. The patient feels a "shock" when the neck is flexed
Answer: B
Rationale: Brudzinski’s sign is a classic indicator of meningeal irritation (meningitis). Flexing
the neck stretches the inflamed meninges, causing a reflexive pull of the legs.
5. Which heart sound is often associated with "Left Ventricular Hypertrophy" and "Stiff
Ventricles"?
A. S1
B. S2
C. S3
D. S4
Answer: D
Rationale: S4 (Atrial Gallop) occurs at the end of diastole when the atria contract into a non-
compliant (stiff) ventricle, common in long-standing hypertension.
6. A patient describes "floaters" and "flashing lights" (photopsia) followed by a "dark
shadow" in their vision. This is:
A. Acute Glaucoma
B. Macular Degeneration
C. Retinal Detachment
D. Cataracts
Answer: C
Rationale: Flashing lights and new floaters are classic warning signs of a retinal tear or
detachment, which is an ocular emergency.
7. "Egophony" is heard during a lung exam. If the patient says "E-E-E" and it sounds
like "A-A-A" through the stethoscope, this indicates:
A. Pneumothorax
B. Lung Consolidation (Pneumonia)
C. Pleural Effusion
D. Normal lung tissue
Answer: B
Rationale: Sound travels better through solid/liquid medium than air. In pneumonia, the
consolidated lung transmits the "E" as a nasally "A" sound.
8. A patient has "painless" hematuria and a history of smoking. Which should be the top
differential?
A. Nephrolithiasis (Kidney Stones)
B. Urinary Tract Infection (UTI)
, 2026 UPDATED QUESTIONS DOWNLOAD
C. Bladder Cancer
D. Benign Prostatic Hyperplasia (BPH)
Answer: C
Rationale: Painless gross hematuria in an adult smoker is considered bladder or renal cancer
until proven otherwise.
9. When assessing the "Trigeminal Nerve" (CN V), which of the following are you
testing?
A. Facial symmetry (smiling)
B. Muscles of mastication (jaw clenching)
C. Shrugging the shoulders
D. Tongue protrusion
Answer: B
Rationale: CN V is responsible for facial sensation and the motor function of the muscles used
for chewing (mastication).
10. A "positive Lachman’s Test" indicates an injury to which structure?
A. Medial Collateral Ligament (MCL)
B. Posterior Cruciate Ligament (PCL)
C. Anterior Cruciate Ligament (ACL)
D. Meniscus
Answer: C
Rationale: Lachman’s is the most sensitive clinical test for an ACL tear, involving pulling the
tibia forward with the knee flexed at 20-30 degrees.
11. A 19-year-old college student presents with "exudative pharyngitis,"
"lymphadenopathy," and "splenomegaly." What is the most likely diagnosis?
A. Strep Throat
B. Infectious Mononucleosis
C. Influenza
D. Diphtheria
Answer: B
Rationale: The triad of sore throat, swollen glands, and an enlarged spleen (splenomegaly) is
hallmark for Mono (Epstein-Barr Virus).
12. Which maneuver is used to assess for "Carpal Tunnel Syndrome"?
A. Phalen’s Maneuver
B. McMurray’s Test
C. Drawer Test
D. Murphy’s Sign
Answer: A
Rationale: Phalen’s involves holding the backs of the hands together for 60 seconds to
compress the median nerve; numbness/tingling is a positive result.
, 2026 UPDATED QUESTIONS DOWNLOAD
13. A patient has a "systolic murmur" that radiates to the neck (carotids). This is most
likely:
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Stenosis
D. Tricuspid Regurgitation
Answer: B
Rationale: Aortic stenosis produces a harsh systolic murmur that classically radiates upward
into the carotid arteries.
14. A "positive Murphy’s Sign" is elicited by:
A. Tapping the costovertebral angle (CVA)
B. Palpating the RUQ during deep inspiration
C. Rotating the hip internally
D. Releasing pressure from the RLQ
Answer: B
Rationale: If the patient catches their breath (stops inspiration) due to pain when the
gallbladder is palpated, it suggests cholecystitis.
15. "Pulsus Alternans" (alternating strong and weak pulses) is a clinical sign of:
A. Severe Left-Sided Heart Failure
B. Cardiac Tamponade
C. Aortic Regurgitation
D. Dehydration
Answer: A
Rationale: Pulsus alternans indicates severe myocardial depression/failure and is often
accompanied by an S3 heart sound.
16. A "beefy red, smooth tongue" (glossitis) is commonly seen in which deficiency?
A. Vitamin C
B. Vitamin B12
C. Vitamin D
D. Vitamin K
Answer: B
Rationale: B12 (and Folate) deficiency can cause the tongue to lose its papillae, appearing
smooth and bright red.
17. Which term describes "difficulty swallowing"?
A. Dysphasia
B. Dysphagia
C. Dysarthria
D. Dyspnea
Answer: B
