NUR 612
FINAL EXAM
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 58-year-old man presents with intermittent chest pressure
when walking uphill, relieved by rest. He has hypertension and
hyperlipidemia. What is the most likely diagnosis?
A. Stable angina
B. Unstable angina
C. Pericarditis
D. Gastroesophageal reflux
Answer: A. Stable angina
Rationale: Stable angina is provoked by exertion and relieved by rest.
Unstable angina occurs at rest or with minimal exertion. Pericarditis pain
is positional. GERD is burning, not pressure.
2. A 72-year-old woman reports acute onset of severe left lower
quadrant pain, fever, and constipation. On exam, there is tenderness
in the LLQ without rebound. What is the most likely diagnosis?
A. Diverticulitis
B. Appendicitis
C. Ovarian torsion
D. Constipation
Answer: A. Diverticulitis
Rationale: Diverticulitis typically presents with LLQ pain, fever, and
,change in bowel habits in older adults. Appendicitis is RLQ. Ovarian
torsion is more acute and often associated with nausea.
3. A 45-year-old with obesity presents with right upper quadrant
pain after fatty meals, nausea, and a positive Murphy sign. What
test should be ordered first?
A. Abdominal CT
B. Right upper quadrant ultrasound
C. HIDA scan
D. Upper endoscopy
Answer: B. Right upper quadrant ultrasound
Rationale: Ultrasound is the initial test for suspected
cholelithiasis/cholecystitis. It is non-invasive, sensitive for gallstones, and
can assess gallbladder wall thickness and pericholecystic fluid.
4. A 35-year-old woman has a 3-day history of dysuria, frequency,
and suprapubic discomfort. Urinalysis shows positive leukocyte
esterase and nitrites. What is the most appropriate next step?
A. Empiric antibiotics for cystitis
B. Urine culture and sensitivity before treatment
, C. CT urogram
D. Pelvic ultrasound
Answer: A. Empiric antibiotics for cystitis
Rationale: Uncomplicated cystitis in a healthy woman can be treated
empirically based on urinalysis without culture, unless symptoms are
atypical or recurrent. Nitrite-positive dipstick is highly specific for
bacteriuria.
5. A 68-year-old man with a 50-pack-year smoking history presents
with a new, non-productive cough and weight loss. Chest x-ray
shows a solitary pulmonary nodule. What is the next best step?
A. CT chest with contrast
B. PET-CT
C. Bronchoscopy with biopsy
D. Repeat chest x-ray in 3 months
Answer: A. CT chest with contrast
Rationale: CT chest provides better characterization of the nodule (size,
margins, calcification) and helps guide further management (e.g., biopsy,
follow-up). PET-CT is often done after CT if malignancy is suspected.
FINAL EXAM
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 58-year-old man presents with intermittent chest pressure
when walking uphill, relieved by rest. He has hypertension and
hyperlipidemia. What is the most likely diagnosis?
A. Stable angina
B. Unstable angina
C. Pericarditis
D. Gastroesophageal reflux
Answer: A. Stable angina
Rationale: Stable angina is provoked by exertion and relieved by rest.
Unstable angina occurs at rest or with minimal exertion. Pericarditis pain
is positional. GERD is burning, not pressure.
2. A 72-year-old woman reports acute onset of severe left lower
quadrant pain, fever, and constipation. On exam, there is tenderness
in the LLQ without rebound. What is the most likely diagnosis?
A. Diverticulitis
B. Appendicitis
C. Ovarian torsion
D. Constipation
Answer: A. Diverticulitis
Rationale: Diverticulitis typically presents with LLQ pain, fever, and
,change in bowel habits in older adults. Appendicitis is RLQ. Ovarian
torsion is more acute and often associated with nausea.
3. A 45-year-old with obesity presents with right upper quadrant
pain after fatty meals, nausea, and a positive Murphy sign. What
test should be ordered first?
A. Abdominal CT
B. Right upper quadrant ultrasound
C. HIDA scan
D. Upper endoscopy
Answer: B. Right upper quadrant ultrasound
Rationale: Ultrasound is the initial test for suspected
cholelithiasis/cholecystitis. It is non-invasive, sensitive for gallstones, and
can assess gallbladder wall thickness and pericholecystic fluid.
4. A 35-year-old woman has a 3-day history of dysuria, frequency,
and suprapubic discomfort. Urinalysis shows positive leukocyte
esterase and nitrites. What is the most appropriate next step?
A. Empiric antibiotics for cystitis
B. Urine culture and sensitivity before treatment
, C. CT urogram
D. Pelvic ultrasound
Answer: A. Empiric antibiotics for cystitis
Rationale: Uncomplicated cystitis in a healthy woman can be treated
empirically based on urinalysis without culture, unless symptoms are
atypical or recurrent. Nitrite-positive dipstick is highly specific for
bacteriuria.
5. A 68-year-old man with a 50-pack-year smoking history presents
with a new, non-productive cough and weight loss. Chest x-ray
shows a solitary pulmonary nodule. What is the next best step?
A. CT chest with contrast
B. PET-CT
C. Bronchoscopy with biopsy
D. Repeat chest x-ray in 3 months
Answer: A. CT chest with contrast
Rationale: CT chest provides better characterization of the nodule (size,
margins, calcification) and helps guide further management (e.g., biopsy,
follow-up). PET-CT is often done after CT if malignancy is suspected.
