NURS 5220 ADVANCED HEALTH ASSESSMENT COMPREHENSIVE ACTUAL FINAL EXAM PREP 2026 ALL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY A GRADED WITH EXPERT FEEDBACK |NEW AND REVISED

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NURS 5220 ADVANCED HEALTH ASSESSMENT
COMPREHENSIVE ACTUAL FINAL EXAM PREP
2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED



1. A 68-year-old male reports a 3-day history of substernal chest
pressure radiating to the left arm, associated with diaphoresis and
nausea. What is the most appropriate initial action?
A) Obtain a detailed cardiac history
B) Activate emergency medical services (EMS) immediately
C) Order a stat ECG
D) Administer sublingual nitroglycerin
Rationale: Chest pain with radiation, diaphoresis, and nausea suggests
acute coronary syndrome. The priority is immediate activation of EMS
for transport to emergency care; assessment and treatment occur en
route or in the emergency department.
2. When performing a comprehensive health history, which component
is typically assessed FIRST?
A) Past medical history
B) Review of systems
C) Chief complaint
D) Family history
Rationale: The chief complaint is the reason for the visit, stated in the
patient’s own words, and guides the entire history and physical
examination.

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3. A 45-year-old female presents with fatigue, weight gain, and cold
intolerance. On examination, the thyroid gland is non-palpable. Which
additional finding would most strongly support a diagnosis of
hypothyroidism?
A) Delayed relaxation phase of deep tendon reflexes
B) Exophthalmos
C) Thyroid bruit
D) Tachycardia
Rationale: Delayed reflex relaxation (hung-up reflexes) is a classic
sign of hypothyroidism. Exophthalmos and bruit suggest
hyperthyroidism (Graves’ disease). Hypothyroidism typically causes
bradycardia, not tachycardia.
4. During abdominal assessment, the correct order of techniques is:
A) Palpation, percussion, auscultation, inspection
B) Inspection, auscultation, percussion, palpation
C) Auscultation, inspection, palpation, percussion
D) Percussion, palpation, inspection, auscultation
Rationale: Auscultation is performed before percussion and palpation
to avoid altering bowel sounds. Inspection is always first, then
auscultation, then percussion, then palpation.
5. A 72-year-old male presents with a new onset of unilateral headache,
scalp tenderness, and jaw pain when chewing. The funduscopic
examination reveals pale, swollen optic discs. Which diagnosis is most
likely?
A) Migraine headache
B) Giant cell arteritis (temporal arteritis)
C) Trigeminal neuralgia
D) Acute glaucoma
Rationale: Giant cell arteritis presents with headache, scalp
tenderness, jaw claudication, and can cause anterior ischemic optic

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neuropathy (pale disc edema). ESR and CRP are elevated. Prompt
steroid therapy is needed to prevent blindness.
6. Which cranial nerve is assessed by asking the patient to shrug their
shoulders against resistance?
A) Cranial nerve X (vagus)
B) Cranial nerve XI (spinal accessory)
C) Cranial nerve XII (hypoglossal)
D) Cranial nerve IX (glossopharyngeal)
Rationale: CN XI innervates the trapezius and sternocleidomastoid
muscles. Shoulder shrug tests trapezius function. CN X is assessed by
phonation and gag reflex; CN XII by tongue movement; CN IX by gag
and palatal elevation.
7. A 55-year-old male with a 30-pack-year smoking history reports a
chronic cough and shortness of breath. On auscultation, you note
diminished breath sounds and prolonged expiration. What is the most
appropriate next step in the physical exam?
A) Assess for tactile fremitus
B) Measure forced expiratory time (FET)
C) Perform egophony
D) Check for bronchophony
Rationale: Prolonged forced expiratory time (>6 seconds) is a simple
bedside test for obstructive airway disease (COPD). Diminished breath
sounds and prolonged expiration are consistent with COPD.
8. The “sniffing position” is most useful for examining which
anatomical structure?
A) Thyroid gland
B) Larynx and upper airway
C) Carotid arteries
D) Trachea
Rationale: The sniffing position (neck flexion with head extension)

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aligns the oral, pharyngeal, and laryngeal axes for better visualization
of the upper airway during laryngoscopy or examination.
9. A 34-year-old female reports dizziness when standing up. Vital signs:
supine BP 120/80, HR 72; standing BP 90/60, HR 108. This finding is
consistent with:
A) Carotid sinus hypersensitivity
B) Orthostatic hypotension
C) Vasovagal syncope
D) Dehydration only
Rationale: Orthostatic hypotension is defined as a drop in systolic BP
≥20 mmHg or diastolic ≥10 mmHg within 3 minutes of standing, often
with reflex tachycardia. This can be caused by dehydration, autonomic
dysfunction, or medications.
10. When auscultating the heart, the S2 sound is best heard at which
area?
A) Apex (mitral area)
B) Left upper sternal border (pulmonic area) and right upper
sternal border (aortic area)
C) Left lower sternal border (tricuspid area)
D) Xiphoid process
Rationale: S2 (aortic and pulmonic valve closure) is best heard at the
base (2nd intercostal spaces left and right sternal border). The apex is
best for S1 and murmurs.
11. A 28-year-old pregnant patient at 32 weeks gestation reports bilateral
lower extremity swelling. On examination, there is 2+ pitting edema to
the knees, and blood pressure is 142/92 mmHg. Urinalysis shows 2+
protein. What is the most likely diagnosis?
A) Physiologic edema of pregnancy
B) Preeclampsia
C) Deep vein thrombosis
D) Heart failure