NUR 612
EXAM 3
Health Assessment & Diagnostic
Reasoning
Questions And Answers Plus Rationales 2026
Instant Pdf Download
CHAMBERLAIN
This exam consists of 100 NCLEX-style multiple-
choice questions, each with one correct Answer
and a detailed rationale.
,1. A nurse is assessing a patient with suspected aortic regurgitation.
Which peripheral finding is most characteristic?
A. Water-hammer (bounding) pulse
B. Pulsus alternans
C. Pulsus paradoxus
D. Bisferiens pulse
Answer: A. Water-hammer (bounding) pulse
Rationale: Aortic regurgitation causes a widened pulse pressure and a
bounding, rapidly rising and collapsing pulse (Corrigan’s or
water-hammer pulse). Pulsus alternans suggests left ventricular failure;
pulsus paradoxus is seen in tamponade.
2. A patient presents with a blood pressure of 150/100 in the right
arm and 110/80 in the left arm. The nurse also notes a delayed right
radial pulse. These findings suggest:
A. Subclavian artery stenosis (left side)
B. Aortic dissection
C. Coarctation of the aorta
D. Thoracic outlet syndrome
Answer: B. Aortic dissection
Rationale: Aortic dissection can cause differential BP and pulse deficits
between arms. Subclavian stenosis usually affects one arm but is less
,acute. Coarctation causes upper extremity hypertension and delayed
femoral pulses.
3. The nurse is assessing a patient’s cranial nerve XI (spinal
accessory). Which muscle is primarily tested?
A. Sternocleidomastoid and trapezius
B. Masseter and temporalis
C. Tongue muscles
D. Extraocular muscles
Answer: A. Sternocleidomastoid and trapezius
Rationale: CN XI innervates the sternocleidomastoid (head rotation) and
trapezius (shoulder shrug). Weakness indicates nerve or muscle
pathology.
4. A patient with chronic obstructive pulmonary disease (COPD) has
a low, flat diaphragm on chest x-ray. This is due to:
A. Chronic hyperinflation flattening the diaphragm
B. Pleural effusion
C. Phrenic nerve palsy
D. Pneumothorax
, Answer: A. Chronic hyperinflation flattening the diaphragm
Rationale: Hyperinflation from COPD pushes the diaphragm downward,
flattening it. This reduces the zone of apposition and impairs respiratory
mechanics.
5. The nurse is performing a fundoscopic exam. Which finding is
consistent with hypertensive retinopathy (Grade III)?
A. Arteriovenous nicking and copper wire arterioles
B. Cotton-wool spots and flame-shaped hemorrhages
C. Papilledema
D. Microaneurysms
Answer: B. Cotton-wool spots and flame-shaped hemorrhages
Rationale: Grade III hypertensive retinopathy includes cotton-wool spots
(soft exudates) and hemorrhages. Grade II has AV nicking and copper
wiring. Grade IV adds papilledema. Microaneurysms are diabetic.
6. A patient with a history of falls and osteoporosis has a new,
painful thoracic kyphosis. The nurse should suspect:
A. Vertebral compression fracture
B. Osteoarthritis
EXAM 3
Health Assessment & Diagnostic
Reasoning
Questions And Answers Plus Rationales 2026
Instant Pdf Download
CHAMBERLAIN
This exam consists of 100 NCLEX-style multiple-
choice questions, each with one correct Answer
and a detailed rationale.
,1. A nurse is assessing a patient with suspected aortic regurgitation.
Which peripheral finding is most characteristic?
A. Water-hammer (bounding) pulse
B. Pulsus alternans
C. Pulsus paradoxus
D. Bisferiens pulse
Answer: A. Water-hammer (bounding) pulse
Rationale: Aortic regurgitation causes a widened pulse pressure and a
bounding, rapidly rising and collapsing pulse (Corrigan’s or
water-hammer pulse). Pulsus alternans suggests left ventricular failure;
pulsus paradoxus is seen in tamponade.
2. A patient presents with a blood pressure of 150/100 in the right
arm and 110/80 in the left arm. The nurse also notes a delayed right
radial pulse. These findings suggest:
A. Subclavian artery stenosis (left side)
B. Aortic dissection
C. Coarctation of the aorta
D. Thoracic outlet syndrome
Answer: B. Aortic dissection
Rationale: Aortic dissection can cause differential BP and pulse deficits
between arms. Subclavian stenosis usually affects one arm but is less
,acute. Coarctation causes upper extremity hypertension and delayed
femoral pulses.
3. The nurse is assessing a patient’s cranial nerve XI (spinal
accessory). Which muscle is primarily tested?
A. Sternocleidomastoid and trapezius
B. Masseter and temporalis
C. Tongue muscles
D. Extraocular muscles
Answer: A. Sternocleidomastoid and trapezius
Rationale: CN XI innervates the sternocleidomastoid (head rotation) and
trapezius (shoulder shrug). Weakness indicates nerve or muscle
pathology.
4. A patient with chronic obstructive pulmonary disease (COPD) has
a low, flat diaphragm on chest x-ray. This is due to:
A. Chronic hyperinflation flattening the diaphragm
B. Pleural effusion
C. Phrenic nerve palsy
D. Pneumothorax
, Answer: A. Chronic hyperinflation flattening the diaphragm
Rationale: Hyperinflation from COPD pushes the diaphragm downward,
flattening it. This reduces the zone of apposition and impairs respiratory
mechanics.
5. The nurse is performing a fundoscopic exam. Which finding is
consistent with hypertensive retinopathy (Grade III)?
A. Arteriovenous nicking and copper wire arterioles
B. Cotton-wool spots and flame-shaped hemorrhages
C. Papilledema
D. Microaneurysms
Answer: B. Cotton-wool spots and flame-shaped hemorrhages
Rationale: Grade III hypertensive retinopathy includes cotton-wool spots
(soft exudates) and hemorrhages. Grade II has AV nicking and copper
wiring. Grade IV adds papilledema. Microaneurysms are diabetic.
6. A patient with a history of falls and osteoporosis has a new,
painful thoracic kyphosis. The nurse should suspect:
A. Vertebral compression fracture
B. Osteoarthritis
