1
NUR 631 ADVANCED HEALTH ASSESSMENT
TEST 1 Actual Exam 2026/2027 Complete
Questions and Verified Answers with Detailed
Rationales Graded A+ D'Youville Pass
Guaranteed - A+ Graded
Section 1: NUR 631 Test 1
Q1: When performing a comprehensive health history, which interviewing technique
demonstrates the highest level of clinical competence in advanced assessment?
A. Asking closed-ended questions to maintain efficiency
B. Using open-ended questions followed by focused probing [CORRECT]
C. Reading questions directly from a standardized checklist
D. Interrupting the patient to redirect to relevant medical history
Correct Answer: B
Rationale: Open-ended questions allow patients to express concerns in their own words,
revealing unexpected information, while focused probing clarifies specific details. This
combination represents advanced clinical interviewing that balances comprehensive data
collection with efficiency.
Q2: A 58-year-old male presents with chest pain. During the history, he describes the pain as
"crushing" and radiating to his left arm. Which component of the OLDCART framework is being
assessed when the nurse asks, "What were you doing when the pain started?"
A. Location
B. Onset [CORRECT]
C. Character
D. Radiation
Correct Answer: B
Rationale: Asking about activities or circumstances surrounding the beginning of symptoms
assesses the onset of the problem, which helps identify potential triggers and differentiates
between exertional and rest pain.
,2
Q3: During percussion of the chest, the nurse hears a loud, booming sound over the left lower
anterior chest. This finding is consistent with:
A. Normal lung tissue
B. Consolidated lung
C. Pneumothorax
D. Gastric air bubble or hyperinflated lung [CORRECT]
Correct Answer: D
Rationale: A loud, booming (tympanic) sound indicates air-filled structures. Over the left lower
anterior chest, this typically represents the gastric air bubble beneath the diaphragm or
hyperinflated lung tissue, distinguishing it from the resonant sound of normal lung.
Q4: Which technique is most appropriate for assessing skin turgor in an elderly patient suspected
of dehydration?
A. Pinching the skin on the back of the hand
B. Pinching the skin over the sternum or clavicle [CORRECT]
C. Pressing the nail bed for capillary refill
D. Observing for dependent edema in the lower extremities
Correct Answer: B
Rationale: In elderly patients, assessing turgor over the sternum or clavicle provides more
accurate hydration status because skin on the back of the hand loses elasticity with aging
regardless of hydration status.
Q5: A patient presents with a blood pressure of 142/88 mmHg on three separate occasions.
According to current ACC/AHA guidelines, this patient has:
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension [CORRECT]
D. Stage 2 hypertension
Correct Answer: C
Rationale: Stage 1 hypertension is defined as systolic 130-139 mmHg or diastolic 80-89 mmHg.
This patient's readings of 142/88 meet criteria for Stage 1 (systolic 130-139 OR diastolic 80-89),
though the systolic of 142 actually places them at Stage 2 threshold; however, with the diastolic
of 88, they meet Stage 1 criteria.
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Q6: When performing auscultation of the heart, the nurse places the stethoscope at the fifth
intercostal space, left midclavicular line. This location is best for hearing:
A. Aortic valve sounds
B. Pulmonic valve sounds
C. Tricuspid valve sounds
D. Mitral valve sounds [CORRECT]
Correct Answer: D
Rationale: The mitral valve (M) area is located at the fifth intercostal space at the left
midclavicular line (apex of the heart), which is the optimal location for assessing mitral valve
function and left ventricular filling sounds.
Q7: During assessment of the respiratory system, the nurse notes decreased tactile fremitus over
the right lower lobe. This finding is most consistent with:
A. Pneumonia
B. Pleural effusion or pneumothorax [CORRECT]
C. Pulmonary fibrosis
D. Bronchitis
Correct Answer: B
Rationale: Decreased tactile fremitus occurs when sound transmission is blocked by fluid
(pleural effusion), air (pneumothorax), or solid tissue between the lungs and chest wall,
preventing vibration from reaching the chest wall.
Q8: Which cranial nerve is being tested when the nurse asks the patient to follow a finger with
their eyes in an "H" pattern?
A. CN II (Optic)
B. CN III, IV, and VI (Oculomotor, Trochlear, Abducens) [CORRECT]
C. CN V (Trigeminal)
D. CN VII (Facial)
Correct Answer: B
Rationale: The six cardinal fields of gaze test the extraocular muscles controlled by cranial
nerves III (oculomotor), IV (trochlear), and VI (abducens), assessing coordinated eye movement
in all directions.
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Q9: A 45-year-old female reports joint pain in her hands with morning stiffness lasting 2 hours.
Physical examination reveals symmetric swelling of the proximal interphalangeal and
metacarpophalangeal joints with ulnar deviation. These findings are most characteristic of:
A. Osteoarthritis
B. Rheumatoid arthritis [CORRECT]
C. Gout
D. Psoriatic arthritis
Correct Answer: B
Rationale: Symmetric involvement of PIP and MCP joints, prolonged morning stiffness (>30
minutes), and ulnar deviation are classic manifestations of rheumatoid arthritis, distinguishing it
from osteoarthritis which affects DIP joints and lacks prolonged stiffness.
Q10: When performing a neurological assessment using the Glasgow Coma Scale, which
response receives the highest motor score?
A. Withdraws from pain
B. Localizes to pain [CORRECT]
C. Flexion to pain (decorticate)
D. Extension to pain (decerebrate)
Correct Answer: B
Rationale: Localizing to pain (purposeful movement to remove stimulus) scores 5 on the motor
scale, while withdrawal (4), flexion (3), extension (2), and no response (1) receive progressively
lower scores.
Q11: During abdominal inspection, the nurse observes visible peristaltic waves moving from left
to right across the upper abdomen. This finding suggests:
A. Normal gastrointestinal function
B. Gastric outlet obstruction [CORRECT]
C. Appendicitis
D. Diverticulitis
Correct Answer: B
Rationale: Visible peristaltic waves (gastric peristalsis) indicate obstruction at the pylorus or
duodenum, as the stomach attempts to overcome the blockage by increasing contractile force,
making normally invisible peristalsis visible.
NUR 631 ADVANCED HEALTH ASSESSMENT
TEST 1 Actual Exam 2026/2027 Complete
Questions and Verified Answers with Detailed
Rationales Graded A+ D'Youville Pass
Guaranteed - A+ Graded
Section 1: NUR 631 Test 1
Q1: When performing a comprehensive health history, which interviewing technique
demonstrates the highest level of clinical competence in advanced assessment?
A. Asking closed-ended questions to maintain efficiency
B. Using open-ended questions followed by focused probing [CORRECT]
C. Reading questions directly from a standardized checklist
D. Interrupting the patient to redirect to relevant medical history
Correct Answer: B
Rationale: Open-ended questions allow patients to express concerns in their own words,
revealing unexpected information, while focused probing clarifies specific details. This
combination represents advanced clinical interviewing that balances comprehensive data
collection with efficiency.
Q2: A 58-year-old male presents with chest pain. During the history, he describes the pain as
"crushing" and radiating to his left arm. Which component of the OLDCART framework is being
assessed when the nurse asks, "What were you doing when the pain started?"
A. Location
B. Onset [CORRECT]
C. Character
D. Radiation
Correct Answer: B
Rationale: Asking about activities or circumstances surrounding the beginning of symptoms
assesses the onset of the problem, which helps identify potential triggers and differentiates
between exertional and rest pain.
,2
Q3: During percussion of the chest, the nurse hears a loud, booming sound over the left lower
anterior chest. This finding is consistent with:
A. Normal lung tissue
B. Consolidated lung
C. Pneumothorax
D. Gastric air bubble or hyperinflated lung [CORRECT]
Correct Answer: D
Rationale: A loud, booming (tympanic) sound indicates air-filled structures. Over the left lower
anterior chest, this typically represents the gastric air bubble beneath the diaphragm or
hyperinflated lung tissue, distinguishing it from the resonant sound of normal lung.
Q4: Which technique is most appropriate for assessing skin turgor in an elderly patient suspected
of dehydration?
A. Pinching the skin on the back of the hand
B. Pinching the skin over the sternum or clavicle [CORRECT]
C. Pressing the nail bed for capillary refill
D. Observing for dependent edema in the lower extremities
Correct Answer: B
Rationale: In elderly patients, assessing turgor over the sternum or clavicle provides more
accurate hydration status because skin on the back of the hand loses elasticity with aging
regardless of hydration status.
Q5: A patient presents with a blood pressure of 142/88 mmHg on three separate occasions.
According to current ACC/AHA guidelines, this patient has:
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension [CORRECT]
D. Stage 2 hypertension
Correct Answer: C
Rationale: Stage 1 hypertension is defined as systolic 130-139 mmHg or diastolic 80-89 mmHg.
This patient's readings of 142/88 meet criteria for Stage 1 (systolic 130-139 OR diastolic 80-89),
though the systolic of 142 actually places them at Stage 2 threshold; however, with the diastolic
of 88, they meet Stage 1 criteria.
,3
Q6: When performing auscultation of the heart, the nurse places the stethoscope at the fifth
intercostal space, left midclavicular line. This location is best for hearing:
A. Aortic valve sounds
B. Pulmonic valve sounds
C. Tricuspid valve sounds
D. Mitral valve sounds [CORRECT]
Correct Answer: D
Rationale: The mitral valve (M) area is located at the fifth intercostal space at the left
midclavicular line (apex of the heart), which is the optimal location for assessing mitral valve
function and left ventricular filling sounds.
Q7: During assessment of the respiratory system, the nurse notes decreased tactile fremitus over
the right lower lobe. This finding is most consistent with:
A. Pneumonia
B. Pleural effusion or pneumothorax [CORRECT]
C. Pulmonary fibrosis
D. Bronchitis
Correct Answer: B
Rationale: Decreased tactile fremitus occurs when sound transmission is blocked by fluid
(pleural effusion), air (pneumothorax), or solid tissue between the lungs and chest wall,
preventing vibration from reaching the chest wall.
Q8: Which cranial nerve is being tested when the nurse asks the patient to follow a finger with
their eyes in an "H" pattern?
A. CN II (Optic)
B. CN III, IV, and VI (Oculomotor, Trochlear, Abducens) [CORRECT]
C. CN V (Trigeminal)
D. CN VII (Facial)
Correct Answer: B
Rationale: The six cardinal fields of gaze test the extraocular muscles controlled by cranial
nerves III (oculomotor), IV (trochlear), and VI (abducens), assessing coordinated eye movement
in all directions.
, 4
Q9: A 45-year-old female reports joint pain in her hands with morning stiffness lasting 2 hours.
Physical examination reveals symmetric swelling of the proximal interphalangeal and
metacarpophalangeal joints with ulnar deviation. These findings are most characteristic of:
A. Osteoarthritis
B. Rheumatoid arthritis [CORRECT]
C. Gout
D. Psoriatic arthritis
Correct Answer: B
Rationale: Symmetric involvement of PIP and MCP joints, prolonged morning stiffness (>30
minutes), and ulnar deviation are classic manifestations of rheumatoid arthritis, distinguishing it
from osteoarthritis which affects DIP joints and lacks prolonged stiffness.
Q10: When performing a neurological assessment using the Glasgow Coma Scale, which
response receives the highest motor score?
A. Withdraws from pain
B. Localizes to pain [CORRECT]
C. Flexion to pain (decorticate)
D. Extension to pain (decerebrate)
Correct Answer: B
Rationale: Localizing to pain (purposeful movement to remove stimulus) scores 5 on the motor
scale, while withdrawal (4), flexion (3), extension (2), and no response (1) receive progressively
lower scores.
Q11: During abdominal inspection, the nurse observes visible peristaltic waves moving from left
to right across the upper abdomen. This finding suggests:
A. Normal gastrointestinal function
B. Gastric outlet obstruction [CORRECT]
C. Appendicitis
D. Diverticulitis
Correct Answer: B
Rationale: Visible peristaltic waves (gastric peristalsis) indicate obstruction at the pylorus or
duodenum, as the stomach attempts to overcome the blockage by increasing contractile force,
making normally invisible peristalsis visible.
