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NURS 6512 ADVANCED HEALTH ASSESSMENT MIDTERM EXAM 2026-2027 (150
PRACTICE QUESTIONS WITH ANSWERS & RATIONALES) 100% CORRECT ALREADY
GRADED A+
1. A 56-year-old man presents with progressive shortness of breath and chronic
cough. On exam, you hear diminished breath sounds and hyperresonance on
percussion. Which condition is most consistent with these findings?
A. Pulmonary fibrosis
B. Emphysema
C. Pneumonia
D. Pleural effusion
Rationale: Hyperresonance and diminished breath sounds are hallmark findings of
emphysema, caused by alveolar overdistention. Fibrosis leads to crackles,
pneumonia has dullness, and effusion produces absent sounds.
2. A 22-year-old woman presents with left lower quadrant abdominal pain, fever,
and cervical motion tenderness. Which condition is most likely?
A. Ovarian cyst rupture
B. Appendicitis
C. Pelvic inflammatory disease (PID)
D. Irritable bowel syndrome
Rationale: PID is suggested by pelvic pain, fever, and cervical motion tenderness
(positive chandelier sign).
3. A 4-year-old presents with inspiratory stridor, barking cough, and hoarseness.
The nurse practitioner suspects:
A. Epiglottitis
B. Croup (laryngotracheobronchitis)
C. Foreign body aspiration
D. Asthma exacerbation
Rationale: Barking cough with stridor is classic for viral croup. Epiglottitis has
drooling/toxic appearance.
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4. When palpating the thyroid gland, the provider notes a firm, irregular, non-
tender nodule with enlarged cervical lymph nodes. Which is most concerning?
A. Goiter
B. Thyroiditis
C. Thyroid carcinoma
D. Thyrotoxicosis
Rationale: A solitary firm nodule with lymphadenopathy is suspicious for
malignancy.
5. A 70-year-old man presents with a new diastolic murmur, bounding pulses, and
widened pulse pressure. Which condition is suspected?
A. Aortic stenosis
B. Mitral regurgitation
C. Aortic regurgitation
D. Tricuspid stenosis
Rationale: Widened pulse pressure and bounding pulses suggest aortic
regurgitation.
6. In a patient with suspected appendicitis, which physical exam maneuver is most
reliable?
A. Psoas sign
B. Murphy’s sign
C. Rovsing’s sign
D. Rebound tenderness in RLQ
Rationale: Rebound tenderness in the right lower quadrant is the most consistent
sign of appendicitis.
7. A 40-year-old woman presents with polydipsia, polyuria, and unintentional
weight loss. The best initial diagnostic test is:
A. Hemoglobin A1C
B. Fasting plasma glucose
C. Urinalysis
D. Random glucose
Rationale: Fasting plasma glucose ≥126 mg/dL confirms diabetes; A1C supports
diagnosis but FPG is initial.
8. A 25-year-old presents with right upper quadrant pain after fatty meals,
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positive Murphy’s sign, and nausea. Which is most likely?
A. Hepatitis
B. Pancreatitis
C. Cholecystitis
D. Gastritis
Rationale: Murphy’s sign and RUQ tenderness after fatty meals indicate acute
cholecystitis.
9. During a cardiovascular exam, a fixed split of the second heart sound (S2) is
most consistent with:
A. Aortic stenosis
B. Atrial septal defect
C. Hypertrophic cardiomyopathy
D. Mitral stenosis
Rationale: Fixed S2 splitting is classic for atrial septal defect due to constant
volume overload.
10. A patient presents with a painless, hard breast mass with irregular borders.
Which is most concerning?
A. Fibroadenoma
B. Mastitis
C. Breast cancer
D. Cyst
Rationale: Hard, irregular, non-tender breast mass is suspicious for malignancy.
11. A 45-year-old man presents with hematemesis. He has a history of alcohol
abuse. Physical exam shows ascites and splenomegaly. The likely cause is:
A. Peptic ulcer disease
B. Esophageal varices
C. Mallory-Weiss tear
D. Gastritis
Rationale: Alcohol abuse with portal hypertension leads to varices and
hematemesis.
12. In an otoscopic exam of acute otitis media, the expected finding is:
A. Normal mobility of TM
B. Bulging, erythematous tympanic membrane with decreased mobility
C. Clear effusion without erythema
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D. Retracted, translucent TM
Rationale: Bulging erythematous TM with decreased mobility is diagnostic for
AOM.
13. A 67-year-old smoker presents with hematuria and weight loss. The provider
should suspect:
A. Kidney stones
B. Cystitis
C. Bladder cancer
D. Pyelonephritis
Rationale: Painless hematuria in an older smoker is classic for bladder cancer.
14. Which cranial nerve is tested when asking the patient to shrug shoulders
against resistance?
A. CN IX
B. CN V
C. CN XI (spinal accessory)
D. CN VII
Rationale: The spinal accessory nerve controls trapezius and sternocleidomastoid,
tested by shoulder shrug.
15. A patient reports unilateral facial droop with inability to close the eyelid. The
most likely diagnosis is:
A. Stroke
B. Trigeminal neuralgia
C. Bell’s palsy
D. Myasthenia gravis
Rationale: Bell’s palsy is peripheral CN VII palsy, affecting forehead and eyelid
closure. Stroke spares forehead.
16. A 2-year-old presents with ear tugging, fever, irritability. Exam shows bulging
TM. Which is the priority nursing action?
A. Warm compress
B. Pain management and antibiotics as ordered
C. Ear irrigation
D. Observe without treatment
Rationale: AOM requires analgesia and often antibiotics in symptomatic toddlers.
NURS 6512 ADVANCED HEALTH ASSESSMENT MIDTERM EXAM 2026-2027 (150
PRACTICE QUESTIONS WITH ANSWERS & RATIONALES) 100% CORRECT ALREADY
GRADED A+
1. A 56-year-old man presents with progressive shortness of breath and chronic
cough. On exam, you hear diminished breath sounds and hyperresonance on
percussion. Which condition is most consistent with these findings?
A. Pulmonary fibrosis
B. Emphysema
C. Pneumonia
D. Pleural effusion
Rationale: Hyperresonance and diminished breath sounds are hallmark findings of
emphysema, caused by alveolar overdistention. Fibrosis leads to crackles,
pneumonia has dullness, and effusion produces absent sounds.
2. A 22-year-old woman presents with left lower quadrant abdominal pain, fever,
and cervical motion tenderness. Which condition is most likely?
A. Ovarian cyst rupture
B. Appendicitis
C. Pelvic inflammatory disease (PID)
D. Irritable bowel syndrome
Rationale: PID is suggested by pelvic pain, fever, and cervical motion tenderness
(positive chandelier sign).
3. A 4-year-old presents with inspiratory stridor, barking cough, and hoarseness.
The nurse practitioner suspects:
A. Epiglottitis
B. Croup (laryngotracheobronchitis)
C. Foreign body aspiration
D. Asthma exacerbation
Rationale: Barking cough with stridor is classic for viral croup. Epiglottitis has
drooling/toxic appearance.
,2|Page
4. When palpating the thyroid gland, the provider notes a firm, irregular, non-
tender nodule with enlarged cervical lymph nodes. Which is most concerning?
A. Goiter
B. Thyroiditis
C. Thyroid carcinoma
D. Thyrotoxicosis
Rationale: A solitary firm nodule with lymphadenopathy is suspicious for
malignancy.
5. A 70-year-old man presents with a new diastolic murmur, bounding pulses, and
widened pulse pressure. Which condition is suspected?
A. Aortic stenosis
B. Mitral regurgitation
C. Aortic regurgitation
D. Tricuspid stenosis
Rationale: Widened pulse pressure and bounding pulses suggest aortic
regurgitation.
6. In a patient with suspected appendicitis, which physical exam maneuver is most
reliable?
A. Psoas sign
B. Murphy’s sign
C. Rovsing’s sign
D. Rebound tenderness in RLQ
Rationale: Rebound tenderness in the right lower quadrant is the most consistent
sign of appendicitis.
7. A 40-year-old woman presents with polydipsia, polyuria, and unintentional
weight loss. The best initial diagnostic test is:
A. Hemoglobin A1C
B. Fasting plasma glucose
C. Urinalysis
D. Random glucose
Rationale: Fasting plasma glucose ≥126 mg/dL confirms diabetes; A1C supports
diagnosis but FPG is initial.
8. A 25-year-old presents with right upper quadrant pain after fatty meals,
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positive Murphy’s sign, and nausea. Which is most likely?
A. Hepatitis
B. Pancreatitis
C. Cholecystitis
D. Gastritis
Rationale: Murphy’s sign and RUQ tenderness after fatty meals indicate acute
cholecystitis.
9. During a cardiovascular exam, a fixed split of the second heart sound (S2) is
most consistent with:
A. Aortic stenosis
B. Atrial septal defect
C. Hypertrophic cardiomyopathy
D. Mitral stenosis
Rationale: Fixed S2 splitting is classic for atrial septal defect due to constant
volume overload.
10. A patient presents with a painless, hard breast mass with irregular borders.
Which is most concerning?
A. Fibroadenoma
B. Mastitis
C. Breast cancer
D. Cyst
Rationale: Hard, irregular, non-tender breast mass is suspicious for malignancy.
11. A 45-year-old man presents with hematemesis. He has a history of alcohol
abuse. Physical exam shows ascites and splenomegaly. The likely cause is:
A. Peptic ulcer disease
B. Esophageal varices
C. Mallory-Weiss tear
D. Gastritis
Rationale: Alcohol abuse with portal hypertension leads to varices and
hematemesis.
12. In an otoscopic exam of acute otitis media, the expected finding is:
A. Normal mobility of TM
B. Bulging, erythematous tympanic membrane with decreased mobility
C. Clear effusion without erythema
, 4|Page
D. Retracted, translucent TM
Rationale: Bulging erythematous TM with decreased mobility is diagnostic for
AOM.
13. A 67-year-old smoker presents with hematuria and weight loss. The provider
should suspect:
A. Kidney stones
B. Cystitis
C. Bladder cancer
D. Pyelonephritis
Rationale: Painless hematuria in an older smoker is classic for bladder cancer.
14. Which cranial nerve is tested when asking the patient to shrug shoulders
against resistance?
A. CN IX
B. CN V
C. CN XI (spinal accessory)
D. CN VII
Rationale: The spinal accessory nerve controls trapezius and sternocleidomastoid,
tested by shoulder shrug.
15. A patient reports unilateral facial droop with inability to close the eyelid. The
most likely diagnosis is:
A. Stroke
B. Trigeminal neuralgia
C. Bell’s palsy
D. Myasthenia gravis
Rationale: Bell’s palsy is peripheral CN VII palsy, affecting forehead and eyelid
closure. Stroke spares forehead.
16. A 2-year-old presents with ear tugging, fever, irritability. Exam shows bulging
TM. Which is the priority nursing action?
A. Warm compress
B. Pain management and antibiotics as ordered
C. Ear irrigation
D. Observe without treatment
Rationale: AOM requires analgesia and often antibiotics in symptomatic toddlers.
