NURS 629 Exam 2 MVU – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified – Pass Guaranteed –
A+ Graded
Candidate Instructions: Select the best answer. Use evidence-based clinical reasoning
and current practice guidelines. Apply differential diagnosis and advanced
pharmacology principles. Suggested time: 90–120 minutes.
SECTION A: ADVANCED HEALTH ASSESSMENT (12 Questions)
A1. [MCQ – Understanding] A 45-year-old patient presents for an annual wellness visit
with no complaints. According to advanced practice assessment principles, which
approach is most appropriate?
A. Focused history and physical examination targeting only cardiovascular and
metabolic systems
B. Comprehensive health history and complete physical examination
C. Problem-focused examination limited to skin and musculoskeletal assessment
D. Emergency assessment with immediate diagnostic testing
Correct Answer: B
Rationale: A comprehensive health history and complete physical examination are
indicated for new patients, annual wellness visits, and comprehensive geriatric
assessments to establish baseline health status and identify occult conditions.
,Distractor A represents a focused assessment, which is inappropriate for an
asymptomatic patient presenting for preventive care.
A2. [MCQ – Remembering] During the review of systems for a 62-year-old male with
new-onset fatigue, which symptom cluster constitutes a red flag requiring immediate
diagnostic evaluation?
A. Mild ankle edema and occasional dry cough
B. Intermittent palpitations after caffeine intake
C. Early satiety, progressive weight loss, and hematochezia
D. Chronic low back pain worsening with activity
Correct Answer: C
Rationale: Early satiety, progressive unintentional weight loss, and hematochezia
constitute a red flag cluster suggestive of gastrointestinal malignancy requiring urgent
endoscopic evaluation and imaging. Distractor B represents benign, explainable
symptoms that do not warrant immediate workup in the absence of other concerning
features.
A3. [MCQ – Understanding] A nurse practitioner is assessing a patient with suspected
chronic obstructive pulmonary disease. Which sequence of physical examination
techniques adheres to the standard inspection-palpation-percussion-auscultation
framework for the thorax?
A. Observe respiratory pattern, assess tactile fremitus, determine diaphragmatic
excursion, listen for adventitious sounds
,B. Auscultate first to localize pathology, then percuss, palpate, and inspect
C. Percuss the anterior chest, inspect posterior chest, palpate for lymphadenopathy,
auscultate lung bases
D. Inspect skin color, palpate apical impulse, percuss cardiac borders, auscultate carotid
arteries
Correct Answer: A
Rationale: The correct sequence for thoracic examination is inspection (respiratory
pattern, chest wall configuration), palpation (tactile fremitus, chest expansion),
percussion (diaphragmatic excursion, dullness), and auscultation (breath sounds,
adventitious sounds). Distractor B reverses the logical sequence and violates the
principle of minimizing patient disturbance before auscultation.
A4. [MCQ – Applying] A 78-year-old woman is found on the floor at home by her
daughter. She denies syncope but reports bilateral knee pain. Her vital signs are stable.
Which assessment component is the highest priority before implementing a falls
prevention plan?
A. Timed Up and Go (TUG) test
B. Orthostatic blood pressure measurement
C. Functional reach test
D. Berg Balance Scale
Correct Answer: B
, Rationale: Orthostatic hypotension is a common, reversible cause of falls in older adults
and must be assessed immediately in any patient presenting after a fall to identify acute
cardiovascular contributors before functional testing. Distractor A is a valid functional
assessment but should be performed after reversible medical causes of falling have
been evaluated.
A5. [MCQ – Remembering] A nurse practitioner administers the Mini-Cog to an
82-year-old patient. The patient correctly recalls one of three words and draws an
abnormal clock with missing numbers and incorrect hand placement. How should the
Mini-Cog be scored and interpreted?
A. Score of 2; normal cognition
B. Score of 3; mild cognitive impairment
C. Score of 1; positive screen for cognitive impairment
D. Score of 4; severe dementia
Correct Answer: C
Rationale: The Mini-Cog awards 1 point per word recalled (maximum 3) and 2 points for
a normal clock draw (0 points if abnormal); a total score of 2 or less indicates a positive
screen requiring further neuropsychological evaluation. Distractor A incorrectly
assumes that partial word recall alone excludes significant cognitive impairment
without considering the clock draw component.
A6. [MCQ – Remembering] During a well-child visit for a 24-month-old, the nurse
practitioner notes the child's weight crosses from the 50th percentile to below the 10th
with Detailed Rationales | 100% Verified – Pass Guaranteed –
A+ Graded
Candidate Instructions: Select the best answer. Use evidence-based clinical reasoning
and current practice guidelines. Apply differential diagnosis and advanced
pharmacology principles. Suggested time: 90–120 minutes.
SECTION A: ADVANCED HEALTH ASSESSMENT (12 Questions)
A1. [MCQ – Understanding] A 45-year-old patient presents for an annual wellness visit
with no complaints. According to advanced practice assessment principles, which
approach is most appropriate?
A. Focused history and physical examination targeting only cardiovascular and
metabolic systems
B. Comprehensive health history and complete physical examination
C. Problem-focused examination limited to skin and musculoskeletal assessment
D. Emergency assessment with immediate diagnostic testing
Correct Answer: B
Rationale: A comprehensive health history and complete physical examination are
indicated for new patients, annual wellness visits, and comprehensive geriatric
assessments to establish baseline health status and identify occult conditions.
,Distractor A represents a focused assessment, which is inappropriate for an
asymptomatic patient presenting for preventive care.
A2. [MCQ – Remembering] During the review of systems for a 62-year-old male with
new-onset fatigue, which symptom cluster constitutes a red flag requiring immediate
diagnostic evaluation?
A. Mild ankle edema and occasional dry cough
B. Intermittent palpitations after caffeine intake
C. Early satiety, progressive weight loss, and hematochezia
D. Chronic low back pain worsening with activity
Correct Answer: C
Rationale: Early satiety, progressive unintentional weight loss, and hematochezia
constitute a red flag cluster suggestive of gastrointestinal malignancy requiring urgent
endoscopic evaluation and imaging. Distractor B represents benign, explainable
symptoms that do not warrant immediate workup in the absence of other concerning
features.
A3. [MCQ – Understanding] A nurse practitioner is assessing a patient with suspected
chronic obstructive pulmonary disease. Which sequence of physical examination
techniques adheres to the standard inspection-palpation-percussion-auscultation
framework for the thorax?
A. Observe respiratory pattern, assess tactile fremitus, determine diaphragmatic
excursion, listen for adventitious sounds
,B. Auscultate first to localize pathology, then percuss, palpate, and inspect
C. Percuss the anterior chest, inspect posterior chest, palpate for lymphadenopathy,
auscultate lung bases
D. Inspect skin color, palpate apical impulse, percuss cardiac borders, auscultate carotid
arteries
Correct Answer: A
Rationale: The correct sequence for thoracic examination is inspection (respiratory
pattern, chest wall configuration), palpation (tactile fremitus, chest expansion),
percussion (diaphragmatic excursion, dullness), and auscultation (breath sounds,
adventitious sounds). Distractor B reverses the logical sequence and violates the
principle of minimizing patient disturbance before auscultation.
A4. [MCQ – Applying] A 78-year-old woman is found on the floor at home by her
daughter. She denies syncope but reports bilateral knee pain. Her vital signs are stable.
Which assessment component is the highest priority before implementing a falls
prevention plan?
A. Timed Up and Go (TUG) test
B. Orthostatic blood pressure measurement
C. Functional reach test
D. Berg Balance Scale
Correct Answer: B
, Rationale: Orthostatic hypotension is a common, reversible cause of falls in older adults
and must be assessed immediately in any patient presenting after a fall to identify acute
cardiovascular contributors before functional testing. Distractor A is a valid functional
assessment but should be performed after reversible medical causes of falling have
been evaluated.
A5. [MCQ – Remembering] A nurse practitioner administers the Mini-Cog to an
82-year-old patient. The patient correctly recalls one of three words and draws an
abnormal clock with missing numbers and incorrect hand placement. How should the
Mini-Cog be scored and interpreted?
A. Score of 2; normal cognition
B. Score of 3; mild cognitive impairment
C. Score of 1; positive screen for cognitive impairment
D. Score of 4; severe dementia
Correct Answer: C
Rationale: The Mini-Cog awards 1 point per word recalled (maximum 3) and 2 points for
a normal clock draw (0 points if abnormal); a total score of 2 or less indicates a positive
screen requiring further neuropsychological evaluation. Distractor A incorrectly
assumes that partial word recall alone excludes significant cognitive impairment
without considering the clock draw component.
A6. [MCQ – Remembering] During a well-child visit for a 24-month-old, the nurse
practitioner notes the child's weight crosses from the 50th percentile to below the 10th
