NUR 6001 – Advanced Health Assessment (West Coast
University – WPU) – Exams 1, 2 & 3 – 2026 Edition | Authentic
Exam Questions with Verified Answers and Detailed
Rationales | Comprehensive Test Bank for Final Exam
Preparation
EXAM 1
1. A 45-year-old male presents with a history of hypertension and new‑onset
headache. His blood pressure is 180/110 mm Hg. During the eye examination, you
note atrioventricular nicking and silver‑wiring of the retinal vessels. These findings
are most consistent with:
A) Diabetic retinopathy
B) Hypertensive retinopathy
C) Glaucoma
D) Optic neuritis
E) Macular degeneration
CORRECT ANSWER: B
RATIONALE: Hypertensive retinopathy features include arteriovenous (AV)
nicking, silver‑wiring, and flame hemorrhages. Diabetic retinopathy shows
microaneurysms and dot‑blot hemorrhages. Glaucoma involves optic disc
cupping. Optic neuritis causes disc swelling and vision loss. Macular degeneration
causes drusen and pigment changes.
2. When auscultating the lungs of a patient with suspected pneumonia, which
finding would be most consistent with consolidation?
A) Vesicular breath sounds with prolonged expiration
B) Bronchial breath sounds over peripheral lung fields
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,C) Diminished breath sounds with hyperresonance
D) Wheezing throughout all lung fields
E) Pleural friction rub
CORRECT ANSWER: B
RATIONALE: Consolidation transmits bronchial breath sounds to peripheral areas
where vesicular sounds are normally heard. Hyperresonance suggests
pneumothorax. Wheezing indicates airflow obstruction. Pleural friction rub
suggests pleural inflammation.
3. A 72-year-old woman reports dizziness when she stands up. Her supine blood
pressure is 130/80 mm Hg, and after standing for 2 minutes it is 90/60 mm Hg
with a heart rate increase from 72 to 88 bpm. This represents:
A) Orthostatic hypotension without compensatory tachycardia
B) Neurocardiogenic syncope
C) Postural orthostatic tachycardia syndrome (POTS)
D) Orthostatic hypotension with normal heart rate response
E) Dehydration only
CORRECT ANSWER: A
RATIONALE: Orthostatic hypotension is defined as a drop in systolic BP ≥20 mm
Hg or diastolic ≥10 mm Hg within 3 minutes of standing. The heart rate increase
here (16 bpm) is less than expected (typically >20 bpm), indicating inadequate
compensatory tachycardia, often due to autonomic dysfunction.
4. The presence of a positive Murphy’s sign is most indicative of:
A) Appendicitis
B) Cholecystitis
C) Pancreatitis
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,D) Peptic ulcer disease
E) Hepatitis
CORRECT ANSWER: B
RATIONALE: Murphy’s sign (inspiratory arrest during palpation of the right upper
quadrant) is highly sensitive for acute cholecystitis. It is not typically positive in
the other conditions listed.
5. When palpating the thyroid gland, a thrill is noted over the gland. This finding is
classically associated with:
A) Hypothyroidism
B) Simple goiter
C) Graves’ disease
D) Thyroiditis
E) Thyroid nodule
CORRECT ANSWER: C
RATIONALE: A thyroid thrill (palpable vibration) indicates increased vascularity,
most commonly in Graves’ disease (hyperthyroidism). Hypothyroidism and simple
goiter are not associated with thrills.
6. In a patient with chronic liver disease, you observe palmar erythema and spider
angiomas. These skin findings are due to:
A) Increased bilirubin
B) Hyperestrogenism
C) Coagulopathy
D) Portal hypertension
E) Vitamin K deficiency
3|Page
, CORRECT ANSWER: B
RATIONALE: In chronic liver disease, impaired estrogen metabolism leads to
hyperestrogenism, causing palmar erythema, spider angiomas, and gynecomastia.
Bilirubin causes jaundice. Coagulopathy causes bruising.
7. A 60-year-old man presents with a several‑month history of progressive
difficulty swallowing solids and liquids. He also regurgitates undigested food.
Barium swallow shows a dilated esophagus with a “bird‑beak” appearance at the
gastroesophageal junction. This is most consistent with:
A) Esophageal cancer
B) Achalasia
C) Diffuse esophageal spasm
D) Peptic stricture
E) Schatzki ring
CORRECT ANSWER: B
RATIONALE: Achalasia causes failure of LES relaxation and loss of peristalsis,
leading to proximal dilation and bird‑beak tapering. Dysphagia to both solids and
liquids is classic. Esophageal cancer typically causes progressive solid dysphagia.
Diffuse spasm shows a “corkscrew” esophagus.
8. During a cardiovascular examination, you hear a harsh, crescendo‑decrescendo
systolic murmur at the right second intercostal space that radiates to the carotids.
The murmur does not vary with respiration. This is most likely:
A) Mitral regurgitation
B) Aortic stenosis
C) Pulmonic stenosis
D) Hypertrophic cardiomyopathy
4|Page
University – WPU) – Exams 1, 2 & 3 – 2026 Edition | Authentic
Exam Questions with Verified Answers and Detailed
Rationales | Comprehensive Test Bank for Final Exam
Preparation
EXAM 1
1. A 45-year-old male presents with a history of hypertension and new‑onset
headache. His blood pressure is 180/110 mm Hg. During the eye examination, you
note atrioventricular nicking and silver‑wiring of the retinal vessels. These findings
are most consistent with:
A) Diabetic retinopathy
B) Hypertensive retinopathy
C) Glaucoma
D) Optic neuritis
E) Macular degeneration
CORRECT ANSWER: B
RATIONALE: Hypertensive retinopathy features include arteriovenous (AV)
nicking, silver‑wiring, and flame hemorrhages. Diabetic retinopathy shows
microaneurysms and dot‑blot hemorrhages. Glaucoma involves optic disc
cupping. Optic neuritis causes disc swelling and vision loss. Macular degeneration
causes drusen and pigment changes.
2. When auscultating the lungs of a patient with suspected pneumonia, which
finding would be most consistent with consolidation?
A) Vesicular breath sounds with prolonged expiration
B) Bronchial breath sounds over peripheral lung fields
1|Page
,C) Diminished breath sounds with hyperresonance
D) Wheezing throughout all lung fields
E) Pleural friction rub
CORRECT ANSWER: B
RATIONALE: Consolidation transmits bronchial breath sounds to peripheral areas
where vesicular sounds are normally heard. Hyperresonance suggests
pneumothorax. Wheezing indicates airflow obstruction. Pleural friction rub
suggests pleural inflammation.
3. A 72-year-old woman reports dizziness when she stands up. Her supine blood
pressure is 130/80 mm Hg, and after standing for 2 minutes it is 90/60 mm Hg
with a heart rate increase from 72 to 88 bpm. This represents:
A) Orthostatic hypotension without compensatory tachycardia
B) Neurocardiogenic syncope
C) Postural orthostatic tachycardia syndrome (POTS)
D) Orthostatic hypotension with normal heart rate response
E) Dehydration only
CORRECT ANSWER: A
RATIONALE: Orthostatic hypotension is defined as a drop in systolic BP ≥20 mm
Hg or diastolic ≥10 mm Hg within 3 minutes of standing. The heart rate increase
here (16 bpm) is less than expected (typically >20 bpm), indicating inadequate
compensatory tachycardia, often due to autonomic dysfunction.
4. The presence of a positive Murphy’s sign is most indicative of:
A) Appendicitis
B) Cholecystitis
C) Pancreatitis
2|Page
,D) Peptic ulcer disease
E) Hepatitis
CORRECT ANSWER: B
RATIONALE: Murphy’s sign (inspiratory arrest during palpation of the right upper
quadrant) is highly sensitive for acute cholecystitis. It is not typically positive in
the other conditions listed.
5. When palpating the thyroid gland, a thrill is noted over the gland. This finding is
classically associated with:
A) Hypothyroidism
B) Simple goiter
C) Graves’ disease
D) Thyroiditis
E) Thyroid nodule
CORRECT ANSWER: C
RATIONALE: A thyroid thrill (palpable vibration) indicates increased vascularity,
most commonly in Graves’ disease (hyperthyroidism). Hypothyroidism and simple
goiter are not associated with thrills.
6. In a patient with chronic liver disease, you observe palmar erythema and spider
angiomas. These skin findings are due to:
A) Increased bilirubin
B) Hyperestrogenism
C) Coagulopathy
D) Portal hypertension
E) Vitamin K deficiency
3|Page
, CORRECT ANSWER: B
RATIONALE: In chronic liver disease, impaired estrogen metabolism leads to
hyperestrogenism, causing palmar erythema, spider angiomas, and gynecomastia.
Bilirubin causes jaundice. Coagulopathy causes bruising.
7. A 60-year-old man presents with a several‑month history of progressive
difficulty swallowing solids and liquids. He also regurgitates undigested food.
Barium swallow shows a dilated esophagus with a “bird‑beak” appearance at the
gastroesophageal junction. This is most consistent with:
A) Esophageal cancer
B) Achalasia
C) Diffuse esophageal spasm
D) Peptic stricture
E) Schatzki ring
CORRECT ANSWER: B
RATIONALE: Achalasia causes failure of LES relaxation and loss of peristalsis,
leading to proximal dilation and bird‑beak tapering. Dysphagia to both solids and
liquids is classic. Esophageal cancer typically causes progressive solid dysphagia.
Diffuse spasm shows a “corkscrew” esophagus.
8. During a cardiovascular examination, you hear a harsh, crescendo‑decrescendo
systolic murmur at the right second intercostal space that radiates to the carotids.
The murmur does not vary with respiration. This is most likely:
A) Mitral regurgitation
B) Aortic stenosis
C) Pulmonic stenosis
D) Hypertrophic cardiomyopathy
4|Page
