NURS 5334 ADVANCED HEALTH ASSESSMENT EXAM –
GRADUATE NURSING PRACTICE QUESTIONS WITH
ANSWERS AND CLINICAL RATIONALES
A 59 year old patients tells the nurse practitioner that he thinks he must have ulcerative
colitis. He has been having "black stools" for the last 24 hours. How would the nurse
practitioner best document THE FACTS for his reason for seeking care?
A) JM is a 59 year old male here for having "black stools" for the past 24 hours.
B) JM came into the clinic complaining of black stools for the past 24 hours.
C) JM is a 59 year old male here for "ulcerative colitis."
D) JM, a 59 year old male, states he has ulcerative colitis and wants it checked.
A) JM is a 59 year old male here for having "black stools" for the past 24 hours.
Chief Complaint(s) The one or more symptoms or concerns causing the patient to seek
care. Make every effort to quote the patient's own words.
The NP knows that normal newborn lung sounds:
A) are harsh and loud in the upper airway of the infant because the stethoscope is closer to
the origin of the sounds
B) are vesicular
C) are easily auscultated without the stethoscope
D) are quiet in the infant compared to the adult
A) are harsh and loud in the upper airway of the infant because the stethoscope is closer to
the origin of the sounds
,Fine crackles are commonly heard in the immediate newborn period as a result of the
opening of the airways and learning of fluid. Persistent fine crackles would be noticed with
pneumonia, bronchiolitis, or atelectasis. (Bates, p 831)
During an assessment of an adult, the nurse practitioner has noted abnormally located
bronchovesicular breath sounds and asks the patient to say "ee" which sounds like "a."
Which of the following is true?
A) The NP suspects the patient has had a pneumothorax.
B) The NP suspects the patient is in the early phases of COPD.
C) The NP documents that there is positive egophony and he/she becomes highly
suspicious of pneumonia.
D) The NP concludes that there is only a low likelihood that the patient has pneumonia.
C) The NP documents that there is positive egophony and he/she becomes highly
suspicious of pneumonia.
If "ee" sounds like "a" then egophony is present and it could be a sign of pneumonia.
(Bates, p327).
A teenage patient comes to the emergency room with complaints of an "inability to breathe
and a sharp pain in my left chest." Your assessment findings include the following:
Cyanosis, tachypnea, tracheal deviation to the right, decreased tactile fremitus on the left,
hyperresonance on the left, and decreased breath sounds on the left. This description is
consistent with:
A) acute pneumonia
B) an asthmatic attack
C) a pneumothorax
D) bronchitis
,C) a pneumothorax
With a pneumothorax, free air in the pleural space causes partial or complete lung
collapse. If the pneumothorax is large then tachypnea and cyanosis are seen. Unequal
chest expansion, decreased or absent tactile fremitus, tracheal deviation to the unaffected
side, decreased chest expansion, hyperresonnant percussion tones, and decreased or
absent breath sounds are found with the presence of a pneumothorax. (Bates, p 340)
The diameter of the PMI is approximately:
A) 1-2.5 cm in diameter and any larger is evidence of mitral valve prolapse
B) 1-2.5 cm in diameter and any larger is evidence of left ventricular hypertrophy
C) .5-1 cm in diameter and any larger is evidence supporting left ventricular hypertrophy
D) .5-1 cm in diameter and any larger is evidence of mitral valve prolapse
B) 1-2.5 cm in diameter and any larger is evidence of left ventricular hypertrophy
(Bates p 344)
The direction of blood flow through the heart is best described by which of the following?
A) Aorta - R atrium - R ventricle - lungs - pulmonary vein - L atrium - L ventricle - vena cava
B) R atrium - R ventricle - pulmonary vein - lungs - pulmonary artery - L atrium - L ventricle
C) R atrium - R ventricle - pulmonary artery - lungs - pulmonary vein - L atrium - L ventricle
D) Vena cava - R atrium - R ventricle - lungs - pulmonary artery- L atrium - L ventricle
C) R atrium - R ventricle - pulmonary artery - lungs - pulmonary vein - L atrium - L ventricle
, Returning blood from the body empties into the R atrium and flows into the R ventricle,
then goes to the lungs through the pulmonary artery. The lungs oxygenate the blood and it
is then returned to the L atrium by the pulmonary vein. It goes from there to the L ventricle
and then out to the body through the aorta (Bates, pg 345)
When listening to heart sounds, the nurse knows that the valve closures that can be heard
for S2 is:
A) pulmonic
B) aortic
C) tricuspid
D) mitral
B) aortic
The second heart sound (S2) occurs with the closure of the aortic valve and signals the end
of systole. Although it is heard over all the precordium, S2 is loudest at the base of the
heart. (Bates, p347)
A 45-year-old man is in the clinic for a routine physical. During history the patient states he
has been having difficulty sleeping. "I'll be sleeping great and then I wake up and feel like I
can't catch my breath." His symptoms indicates sleep related symptoms of a certain type
of disease, so which question would the NP want to ask?
A) Have you had a recent sinus infection or URI?
B) Do you have any history of problems with your heart?
C) Do you think it is because it's been so hot at night?
D) When was your last electroencephalogram?
B) Do you have any history of problems with your heart?
GRADUATE NURSING PRACTICE QUESTIONS WITH
ANSWERS AND CLINICAL RATIONALES
A 59 year old patients tells the nurse practitioner that he thinks he must have ulcerative
colitis. He has been having "black stools" for the last 24 hours. How would the nurse
practitioner best document THE FACTS for his reason for seeking care?
A) JM is a 59 year old male here for having "black stools" for the past 24 hours.
B) JM came into the clinic complaining of black stools for the past 24 hours.
C) JM is a 59 year old male here for "ulcerative colitis."
D) JM, a 59 year old male, states he has ulcerative colitis and wants it checked.
A) JM is a 59 year old male here for having "black stools" for the past 24 hours.
Chief Complaint(s) The one or more symptoms or concerns causing the patient to seek
care. Make every effort to quote the patient's own words.
The NP knows that normal newborn lung sounds:
A) are harsh and loud in the upper airway of the infant because the stethoscope is closer to
the origin of the sounds
B) are vesicular
C) are easily auscultated without the stethoscope
D) are quiet in the infant compared to the adult
A) are harsh and loud in the upper airway of the infant because the stethoscope is closer to
the origin of the sounds
,Fine crackles are commonly heard in the immediate newborn period as a result of the
opening of the airways and learning of fluid. Persistent fine crackles would be noticed with
pneumonia, bronchiolitis, or atelectasis. (Bates, p 831)
During an assessment of an adult, the nurse practitioner has noted abnormally located
bronchovesicular breath sounds and asks the patient to say "ee" which sounds like "a."
Which of the following is true?
A) The NP suspects the patient has had a pneumothorax.
B) The NP suspects the patient is in the early phases of COPD.
C) The NP documents that there is positive egophony and he/she becomes highly
suspicious of pneumonia.
D) The NP concludes that there is only a low likelihood that the patient has pneumonia.
C) The NP documents that there is positive egophony and he/she becomes highly
suspicious of pneumonia.
If "ee" sounds like "a" then egophony is present and it could be a sign of pneumonia.
(Bates, p327).
A teenage patient comes to the emergency room with complaints of an "inability to breathe
and a sharp pain in my left chest." Your assessment findings include the following:
Cyanosis, tachypnea, tracheal deviation to the right, decreased tactile fremitus on the left,
hyperresonance on the left, and decreased breath sounds on the left. This description is
consistent with:
A) acute pneumonia
B) an asthmatic attack
C) a pneumothorax
D) bronchitis
,C) a pneumothorax
With a pneumothorax, free air in the pleural space causes partial or complete lung
collapse. If the pneumothorax is large then tachypnea and cyanosis are seen. Unequal
chest expansion, decreased or absent tactile fremitus, tracheal deviation to the unaffected
side, decreased chest expansion, hyperresonnant percussion tones, and decreased or
absent breath sounds are found with the presence of a pneumothorax. (Bates, p 340)
The diameter of the PMI is approximately:
A) 1-2.5 cm in diameter and any larger is evidence of mitral valve prolapse
B) 1-2.5 cm in diameter and any larger is evidence of left ventricular hypertrophy
C) .5-1 cm in diameter and any larger is evidence supporting left ventricular hypertrophy
D) .5-1 cm in diameter and any larger is evidence of mitral valve prolapse
B) 1-2.5 cm in diameter and any larger is evidence of left ventricular hypertrophy
(Bates p 344)
The direction of blood flow through the heart is best described by which of the following?
A) Aorta - R atrium - R ventricle - lungs - pulmonary vein - L atrium - L ventricle - vena cava
B) R atrium - R ventricle - pulmonary vein - lungs - pulmonary artery - L atrium - L ventricle
C) R atrium - R ventricle - pulmonary artery - lungs - pulmonary vein - L atrium - L ventricle
D) Vena cava - R atrium - R ventricle - lungs - pulmonary artery- L atrium - L ventricle
C) R atrium - R ventricle - pulmonary artery - lungs - pulmonary vein - L atrium - L ventricle
, Returning blood from the body empties into the R atrium and flows into the R ventricle,
then goes to the lungs through the pulmonary artery. The lungs oxygenate the blood and it
is then returned to the L atrium by the pulmonary vein. It goes from there to the L ventricle
and then out to the body through the aorta (Bates, pg 345)
When listening to heart sounds, the nurse knows that the valve closures that can be heard
for S2 is:
A) pulmonic
B) aortic
C) tricuspid
D) mitral
B) aortic
The second heart sound (S2) occurs with the closure of the aortic valve and signals the end
of systole. Although it is heard over all the precordium, S2 is loudest at the base of the
heart. (Bates, p347)
A 45-year-old man is in the clinic for a routine physical. During history the patient states he
has been having difficulty sleeping. "I'll be sleeping great and then I wake up and feel like I
can't catch my breath." His symptoms indicates sleep related symptoms of a certain type
of disease, so which question would the NP want to ask?
A) Have you had a recent sinus infection or URI?
B) Do you have any history of problems with your heart?
C) Do you think it is because it's been so hot at night?
D) When was your last electroencephalogram?
B) Do you have any history of problems with your heart?
