MN 576 UNIT 10 FINAL EXAM | ACTUAL
QUESTIONS AND ANSWERS | 2026
UPDATE | WITH COMPLETE SOLUTIONS.
SECTION 1: ADVANCED HEALTH ASSESSMENT & DIAGNOSTIC REASONING (15
Questions)
Q1: A 58-year-old male presents with chest pain. Using the OLDCARTS
framework, which component is correctly described?
A. Onset refers to the severity of the symptom on a 1-10 scale
B. Location is documented using the patient's own words only
C. Character describes the quality of the symptom (e.g., sharp, dull, burning)
D. Radiation indicates whether the symptom is constant or intermittent
Correct Answer: C
Rationale: Correct because OLDCARTS is a systematic mnemonic for symptom
analysis; Character specifically describes the quality or nature of the symptom,
which is essential for differential diagnosis in primary care.
Q2: During a comprehensive health history, a nurse practitioner documents a
three-generation pedigree. Which family history finding most significantly
increases cardiovascular risk assessment priority?
A. Maternal aunt with osteoporosis at age 72
B. Paternal grandfather with prostate cancer at age 80
C. Father with myocardial infarction at age 48
D. Sister with gestational diabetes at age 30
Correct Answer: C
Rationale: Correct because premature cardiovascular disease in a first-degree
male relative before age 55 significantly elevates ASCVD risk per AHA/ACC
guidelines and requires aggressive primary prevention.
Q3: A 45-year-old female presents for preventive care. Which element of the
social history using the 5 P's framework for sexual history is correctly identified?
,A. Partners, Practices, Protection from STIs, Past history of STIs, Pregnancy
prevention
B. Partners, Practices, Protection, Past STIs, Pregnancy intention
C. Partners, Preferences, Protection, Past history, Pregnancy
D. People, Practices, Prevention, Past problems, Plans
Correct Answer: B
Rationale: Correct because the CDC-recommended 5 P's framework includes
Partners, Practices, Protection, Past history of STIs, and Pregnancy intention to
comprehensively assess sexual health.
Q4: A 67-year-old patient reports difficulty managing finances, medications, and
transportation. Which assessment tool best evaluates these functional
limitations?
A. Mini-Mental State Examination (MMSE)
B. Geriatric Depression Scale (GDS)
C. Instrumental Activities of Daily Living (IADLs)
D. Activities of Daily Living (ADLs)
Correct Answer: C
Rationale: Correct because IADLs specifically assess complex functional tasks
including managing finances, medications, transportation, and telephone use,
which are critical for independent community living.
Q5: During a physical examination, the nurse practitioner percusses the abdomen
and notes a tympanic sound over the gastric bubble. Which technique is being
demonstrated?
A. Deep palpation to assess organ size
B. Indirect percussion to evaluate underlying structures
C. Auscultation for bowel sounds
D. Direct percussion to test deep tendon reflexes
Correct Answer: B
Rationale: Correct because indirect percussion uses the middle finger of one
hand as a pleximeter while the other hand strikes it, producing characteristic
sounds (tympany, dullness, resonance) that help identify underlying structures.
, Q6: A 35-year-old patient presents with fatigue and weight loss. The NP generates
three diagnostic hypotheses: hypothyroidism, diabetes mellitus, and depression.
Which cognitive strategy is being employed?
A. Availability heuristic
B. Hypothetico-deductive reasoning
C. Anchoring bias
D. Premature closure
Correct Answer: B
Rationale: Correct because hypothetico-deductive reasoning involves generating
multiple diagnostic hypotheses and then testing each through data collection,
which is the standard clinical reasoning approach for undifferentiated symptoms.
Q7: A screening test for a disease has a sensitivity of 95% and specificity of 90%.
If the disease prevalence is 10%, what is the approximate positive predictive
value?
A. 51%
B. 68%
C. 95%
D. 99%
Correct Answer: A
Rationale: Correct because using Bayes' theorem with 10% prevalence, 95%
sensitivity, and 90% specificity, PPV = (True Positives) / (True Positives + False
Positives) = (95) / (95 + 90) = 95/185 ≈ 51%, demonstrating that PPV decreases
with lower prevalence.
Q8: A 62-year-old male with chest pain has a pretest probability of coronary artery
disease of 60%. A stress test with a likelihood ratio positive of 5 is performed.
What is the approximate post-test probability?
A. 60%
B. 75%
C. 88%
D. 95%
Correct Answer: C
QUESTIONS AND ANSWERS | 2026
UPDATE | WITH COMPLETE SOLUTIONS.
SECTION 1: ADVANCED HEALTH ASSESSMENT & DIAGNOSTIC REASONING (15
Questions)
Q1: A 58-year-old male presents with chest pain. Using the OLDCARTS
framework, which component is correctly described?
A. Onset refers to the severity of the symptom on a 1-10 scale
B. Location is documented using the patient's own words only
C. Character describes the quality of the symptom (e.g., sharp, dull, burning)
D. Radiation indicates whether the symptom is constant or intermittent
Correct Answer: C
Rationale: Correct because OLDCARTS is a systematic mnemonic for symptom
analysis; Character specifically describes the quality or nature of the symptom,
which is essential for differential diagnosis in primary care.
Q2: During a comprehensive health history, a nurse practitioner documents a
three-generation pedigree. Which family history finding most significantly
increases cardiovascular risk assessment priority?
A. Maternal aunt with osteoporosis at age 72
B. Paternal grandfather with prostate cancer at age 80
C. Father with myocardial infarction at age 48
D. Sister with gestational diabetes at age 30
Correct Answer: C
Rationale: Correct because premature cardiovascular disease in a first-degree
male relative before age 55 significantly elevates ASCVD risk per AHA/ACC
guidelines and requires aggressive primary prevention.
Q3: A 45-year-old female presents for preventive care. Which element of the
social history using the 5 P's framework for sexual history is correctly identified?
,A. Partners, Practices, Protection from STIs, Past history of STIs, Pregnancy
prevention
B. Partners, Practices, Protection, Past STIs, Pregnancy intention
C. Partners, Preferences, Protection, Past history, Pregnancy
D. People, Practices, Prevention, Past problems, Plans
Correct Answer: B
Rationale: Correct because the CDC-recommended 5 P's framework includes
Partners, Practices, Protection, Past history of STIs, and Pregnancy intention to
comprehensively assess sexual health.
Q4: A 67-year-old patient reports difficulty managing finances, medications, and
transportation. Which assessment tool best evaluates these functional
limitations?
A. Mini-Mental State Examination (MMSE)
B. Geriatric Depression Scale (GDS)
C. Instrumental Activities of Daily Living (IADLs)
D. Activities of Daily Living (ADLs)
Correct Answer: C
Rationale: Correct because IADLs specifically assess complex functional tasks
including managing finances, medications, transportation, and telephone use,
which are critical for independent community living.
Q5: During a physical examination, the nurse practitioner percusses the abdomen
and notes a tympanic sound over the gastric bubble. Which technique is being
demonstrated?
A. Deep palpation to assess organ size
B. Indirect percussion to evaluate underlying structures
C. Auscultation for bowel sounds
D. Direct percussion to test deep tendon reflexes
Correct Answer: B
Rationale: Correct because indirect percussion uses the middle finger of one
hand as a pleximeter while the other hand strikes it, producing characteristic
sounds (tympany, dullness, resonance) that help identify underlying structures.
, Q6: A 35-year-old patient presents with fatigue and weight loss. The NP generates
three diagnostic hypotheses: hypothyroidism, diabetes mellitus, and depression.
Which cognitive strategy is being employed?
A. Availability heuristic
B. Hypothetico-deductive reasoning
C. Anchoring bias
D. Premature closure
Correct Answer: B
Rationale: Correct because hypothetico-deductive reasoning involves generating
multiple diagnostic hypotheses and then testing each through data collection,
which is the standard clinical reasoning approach for undifferentiated symptoms.
Q7: A screening test for a disease has a sensitivity of 95% and specificity of 90%.
If the disease prevalence is 10%, what is the approximate positive predictive
value?
A. 51%
B. 68%
C. 95%
D. 99%
Correct Answer: A
Rationale: Correct because using Bayes' theorem with 10% prevalence, 95%
sensitivity, and 90% specificity, PPV = (True Positives) / (True Positives + False
Positives) = (95) / (95 + 90) = 95/185 ≈ 51%, demonstrating that PPV decreases
with lower prevalence.
Q8: A 62-year-old male with chest pain has a pretest probability of coronary artery
disease of 60%. A stress test with a likelihood ratio positive of 5 is performed.
What is the approximate post-test probability?
A. 60%
B. 75%
C. 88%
D. 95%
Correct Answer: C
