NUR 612 Exam 2 | 2026 Health Assessment & Diagnostic Reasoning | 200 Questions with Answers & Rationales | Advanced Nursing Practice PDF | Already Graded A+

This comprehensive resource provides 200 high-yield, exam-style questions with detailed rationales, designed for graduate-level nursing students (NUR 612) preparing for Exam 2 in Advanced Health Assessment and Diagnostic Reasoning. It covers the full spectrum of advanced clinical reasoning across all major medical specialties, with a focus on differential diagnosis, pathophysiology, physical examination findings, and evidence-based management at the graduate nursing level. Content Areas Covered: Cardiovascular Disorders Acute coronary syndrome (STEMI localization: inferior leads – RCA) Heart failure (HFrEF vs. HFpEF, S3 gallop, elevated BNP, pulmonary edema on CXR – Kerley B lines) Valvular heart disease (aortic regurgitation decrescendo diastolic murmur, mitral regurgitation holosystolic murmur, aortic stenosis pulsus parvus et tardus) Aortic dissection (CT angiography, blood pressure differential, widened mediastinum, intimal flap) Infective endocarditis (IV drug use, tricuspid valve, S. aureus, Duke criteria, TEE, septic emboli) Pericarditis (pericardial friction rub, positional chest pain) Pulmonary embolism (S1Q3T3, Wells criteria, D-dimer, CTPA, V/Q scan high probability) Hypertensive emergencies (retinopathy, IV nitroprusside, labetalol, end-organ damage) Jugular venous pressure (prominent a wave – pulmonary hypertension, RV hypertrophy) Carotid pulse assessment (pulsus parvus et tardus in aortic stenosis) Pulmonary Disorders COPD (acute vs. chronic respiratory acidosis, ABG interpretation, barrel chest, hyperresonance, cor pulmonale, hepatomegaly reflux) Asthma (acute exacerbation, PEFR, albuterol first-line, systemic corticosteroids) Pneumothorax (spontaneous pneumothorax, hyperresonance, decreased breath sounds, chest X-ray) Pleural effusion (dullness to percussion, decreased breath sounds) Community-acquired pneumonia (CURB-65, inpatient vs. outpatient management) Lung cancer (small cell – SIADH, Pancoast tumor – Horner syndrome) Gastrointestinal Disorders Acute pancreatitis (lipase, gallstone vs. alcoholic, Ranson criteria, hypocalcemia, Cullen sign, Grey Turner sign) Cholecystitis (Murphy sign) Appendicitis (McBurney point tenderness, psoas sign, obturator sign, Rovsing sign, CT scan) Cirrhosis and ascites (spontaneous bacterial peritonitis – PMN 250, SAAG 1.1, cefotaxime, lactulose, rifaximin) Hepatic encephalopathy (asterixis, ammonia, glutamine accumulation in astrocytes) Esophageal disorders (achalasia – bird-beak on barium) Renal & Genitourinary Disorders Acute kidney injury (prerenal vs. ATN: FENa 1% prerenal, 2% ATN, low urine sodium, high urine osmolality) Chronic kidney disease (secondary hyperparathyroidism, phosphate binders, calcitriol, eGFR staging, renal osteodystrophy, uremic neuropathy) Nephrolithiasis (calcium oxalate, ureteral stone, medical expulsive therapy with tamsulosin) Diabetic nephropathy (albuminuria, ACE inhibitors, SGLT2 inhibitors) Emphysematous pyelonephritis (gas within renal parenchyma on CT) Neurologic Disorders Stroke (acute ischemic stroke, tPA contraindications, NIHSS, hemispheric localization – eye deviation) Meningitis (bacterial vs. viral: CSF low glucose, high protein, neutrophils, Gram stain, empiric ceftriaxone + vancomycin) Subarachnoid hemorrhage (xanthochromia, CT head) Hepatic encephalopathy (elevated ammonia) Central vs. peripheral vertigo (central – vertical/direction-changing nystagmus, dysarthria, ataxia) Horner syndrome (Pancoast tumor – miosis, ptosis, anhidrosis) Romberg test (sensory ataxia) Endocrine & Metabolic Disorders Diabetes mellitus (DKA vs. HHS, hyperkalemia peaked T waves, calcium gluconate) Thyroid disorders (hyperthyroidism – levothyroxine overtreatment) Pheochromocytoma (paroxysmal hypertension, plasma metanephrines, MIBG scintigraphy) Primary hyperaldosteronism (hypokalemia, low renin, high aldosterone) Secondary hyperparathyroidism (CKD, hyperphosphatemia, hypocalcemia, elevated PTH) Cushing syndrome (elevated cortisol, ACTH suppression test) Addison disease (hyperpigmentation, hyponatremia, hyperkalemia, elevated ACTH) Hematologic Disorders Anemia of chronic kidney disease (low erythropoietin, normocytic anemia) Deep vein thrombosis (Wells criteria, palpable cord, D-dimer, compression ultrasound) Warfarin (therapeutic INR, pharmacogenetics – CYP2C9, VKORC1) Hemophilia (prolonged aPTT, corrects with mixing study) Myelodysplastic syndrome (dysplastic neutrophils, pseudo-Pelger-Huet anomaly) Infectious Diseases Infective endocarditis (Duke criteria, TEE, vegetation, septic emboli) Spontaneous bacterial peritonitis (PMN 250, cefotaxime, albumin) Meningitis (bacterial – Gram stain, CSF profile) Septic arthritis (S. aureus, joint aspiration, Gram stain) Pneumocystis jirovecii pneumonia (HIV, CD4 200, TMP-SMX plus prednisone) ESBL UTI (ertapenem, meropenem) Diagnostic Reasoning & Clinical Decision Rules Wells criteria for DVT and PE CURB-65 for pneumonia severity Ranson criteria for pancreatitis severity Duke criteria for infective endocarditis BISAP score for pancreatitis APACHE II for critical illness CT severity index for pancreatitis Hypothetico-deductive reasoning (multiple hypotheses, systematic testing) Inductive vs. deductive reasoning Bayesian reasoning (post-test probability, likelihood ratios) Abduction (plausible explanation generation) Health Assessment & Physical Examination Techniques Jugular venous pressure (prominent a wave, Kussmaul sign) Psoas sign and obturator sign (appendicitis) Murphy sign (cholecystitis) Kernig and Brudzinski signs (meningeal irritation) Romberg test (sensory ataxia) Fluid wave test (ascites) Homans sign (unreliable for DVT – no longer recommended) Palpable cord (thrombosed vein – specific for DVT) Cranial nerve examination (CN VI palsy, INO) Visual acuity (Snellen chart interpretation) Barrel chest (COPD) Pulsus parvus et tardus (aortic stenosis) Pulsus alternans (heart failure) Bounding pulse (aortic regurgitation) Diagnostic Test Interpretation ABG interpretation (acute vs. chronic respiratory acidosis, compensation, metabolic alkalosis) ECG interpretation (STEMI localization, S1Q3T3 for PE, pericarditis) CSF analysis (glucose, protein, WBC differential, Gram stain, xanthochromia) Urinalysis (pyuria, bacteriuria, nitrites, leukocyte esterase) 24-hour urine (calcium, oxalate, citrate) Pulmonary function tests (FEV1/FVC, DLCO) Ankle-brachial index (ABI) Chest X-ray (Kerley B lines, pneumothorax, widened mediastinum) CT (emphysematous pyelonephritis – gas in renal parenchyma) Special Features: High-complexity diagnostic reasoning questions at graduate nursing level Pathophysiology-based rationales ECG, ABG, CSF, and urinalysis interpretation Differentiation of similar presentations (e.g., prerenal vs. ATN, bacterial vs. viral meningitis, aortic dissection vs. MI) Evidence-based guidelines (ACLS, AHA/ACC, IDSA, GOLD, GINA) Clinical decision rules (Wells, CURB-65, Ranson, Duke) Correct answer + detailed rationale for each question Focus on clinical judgment, differential diagnosis, cognitive bias recognition, and decision-making Perfect for NUR 612 Exam 2 preparation, graduate nursing diagnostic reasoning courses, nurse practitioner (NP) programs, advanced health assessment courses, and clinical rotation readiness