NR304 Health Assessment II Exam 2 2025/2026 -
Questions & Verified Answers
EXAM BLUEPRINT SUMMARY
● 70 total items: 60 MC + 10 SATA
● Embedded: 8 interpretation/documentation, 6 evidence-update 2025-26, 5
cultural competence, 7 tech/tools
● Mapped to Course Outcomes 1-5 & AACN Essentials Domain 1
SECTION A – ADVANCED PHYSICAL EXAMINATION (25 Q)
1. Neurological Q
While assessing an 18-year-old collegiate athlete, you ask the patient to track
your finger through the six cardinal fields of gaze. Failure to move the right eye
past the midline when looking left is observed. This finding most directly
suggests dysfunction of which cranial nerve?
A. Oculomotor (CN III)
B. Trochlear (CN IV)
C. Abducens (CN VI)
D. Facial (CN VII)
Answer: C – Abducens (lateral rectus) must abduct the eye; limitation ⇒ paresis
of CN VI.
2. Cardiovascular Q (2025 Evidence)
A 68-year-old female presents with exertional dyspnea. On auscultation at the
apex with the bell, you hear a high-pitched holosystolic murmur that radiates to
the axilla. The S1 is diminished. Which 2025 AHA/ACC valvular grading criterion
confirms severe mitral regurgitation?
A. Murmur length ≥ 60 % of systole
B. Color-flow jet area ≥ 40 % LA area on echo
C. Reverse dP/dt > 1,000 mmHg/s
D. Regurgitant fraction ≥ 50 %
Answer: D – RF ≥ 50 % remains gold-standard severity index (2025 focused
update).
, 3. Respiratory SATA
Select ALL factors that increase the likelihood of egophony being present:
A. Consolidation over the lung segment
B. Presence of pleural effusion
C. Lobar atelectasis with patent airway
D. Pneumothorax > 25 %
E. Fibrotic pleural thickening
Answers: A, C
Rationale: Consolidation enhances high-frequency transmission; atelectasis with
patent airway compresses alveoli but conducts sound. Effusion & pneumothorax
dampen sound; fibrosis muffles.
4. Abdominal Interpretation Q
During percussion over a distended abdomen, you note tympany throughout all
quadrants and no shifting dullness. Bowel sounds are high-pitched every 3 sec.
These data most strongly support:
A. Paralytic ileus
B. Small-bowel obstruction
C. Ascites
D. Splenomegaly
Answer: B – tympany + high-pitched hyper-active sounds = obstruction; absent
shifting dullness rules out significant ascites.
... (continue 22 more)
SECTION B – COMPLEX HEALTH HISTORY / INTERVIEWING (15 Q)
26. Symptom Analysis Q
A 42-year-old man describes chest discomfort that begins when he jogs uphill,
resolves within 5 min of rest, and has consistent quality ("crushing"). Which
single descriptor most warrants urgent cardiology referral?
A. Provoked by exertion
B. Relieved by rest
C. Crushed quality
D. 5-minute duration
Answer: A – exertional provocation signals demand ischemia; 2025 ESC guidelines
label this high-risk for event.
Questions & Verified Answers
EXAM BLUEPRINT SUMMARY
● 70 total items: 60 MC + 10 SATA
● Embedded: 8 interpretation/documentation, 6 evidence-update 2025-26, 5
cultural competence, 7 tech/tools
● Mapped to Course Outcomes 1-5 & AACN Essentials Domain 1
SECTION A – ADVANCED PHYSICAL EXAMINATION (25 Q)
1. Neurological Q
While assessing an 18-year-old collegiate athlete, you ask the patient to track
your finger through the six cardinal fields of gaze. Failure to move the right eye
past the midline when looking left is observed. This finding most directly
suggests dysfunction of which cranial nerve?
A. Oculomotor (CN III)
B. Trochlear (CN IV)
C. Abducens (CN VI)
D. Facial (CN VII)
Answer: C – Abducens (lateral rectus) must abduct the eye; limitation ⇒ paresis
of CN VI.
2. Cardiovascular Q (2025 Evidence)
A 68-year-old female presents with exertional dyspnea. On auscultation at the
apex with the bell, you hear a high-pitched holosystolic murmur that radiates to
the axilla. The S1 is diminished. Which 2025 AHA/ACC valvular grading criterion
confirms severe mitral regurgitation?
A. Murmur length ≥ 60 % of systole
B. Color-flow jet area ≥ 40 % LA area on echo
C. Reverse dP/dt > 1,000 mmHg/s
D. Regurgitant fraction ≥ 50 %
Answer: D – RF ≥ 50 % remains gold-standard severity index (2025 focused
update).
, 3. Respiratory SATA
Select ALL factors that increase the likelihood of egophony being present:
A. Consolidation over the lung segment
B. Presence of pleural effusion
C. Lobar atelectasis with patent airway
D. Pneumothorax > 25 %
E. Fibrotic pleural thickening
Answers: A, C
Rationale: Consolidation enhances high-frequency transmission; atelectasis with
patent airway compresses alveoli but conducts sound. Effusion & pneumothorax
dampen sound; fibrosis muffles.
4. Abdominal Interpretation Q
During percussion over a distended abdomen, you note tympany throughout all
quadrants and no shifting dullness. Bowel sounds are high-pitched every 3 sec.
These data most strongly support:
A. Paralytic ileus
B. Small-bowel obstruction
C. Ascites
D. Splenomegaly
Answer: B – tympany + high-pitched hyper-active sounds = obstruction; absent
shifting dullness rules out significant ascites.
... (continue 22 more)
SECTION B – COMPLEX HEALTH HISTORY / INTERVIEWING (15 Q)
26. Symptom Analysis Q
A 42-year-old man describes chest discomfort that begins when he jogs uphill,
resolves within 5 min of rest, and has consistent quality ("crushing"). Which
single descriptor most warrants urgent cardiology referral?
A. Provoked by exertion
B. Relieved by rest
C. Crushed quality
D. 5-minute duration
Answer: A – exertional provocation signals demand ischemia; 2025 ESC guidelines
label this high-risk for event.
