LATEST NURS 5220 MODULE 4 -
ADVANCED ASSESSMENT EXAM |
COMPLETE EXAM WITH CORRECT
ANSWERS AND RATIONALES. A+
GUARANTEED SUCCESS
1. A nurse practitioner is performing a
comprehensive cardiovascular assessment on a 72-
year-old male. Which finding is most indicative of
heart failure?
A) A split S2 that widens during inspiration
B) An S3 gallop at the apex
C) A grade 2/6 systolic ejection murmur at the right
second intercostal space
D) A pulse of 2+ in all four extremities
Correct answer: B
Rationale: An S3 gallop in an older adult is a sign of
heart failure (volume overload). Physiologic splitting
of S2 is normal. A grade 2/6 systolic ejection murmur
may be benign (aortic sclerosis). 2+ pulses are
normal.
,2. A 45-year-old female presents with episodic
palpitations, headache, sweating, and hypertension.
These episodes last 15-20 minutes and resolve
spontaneously. Which diagnosis is most likely?
A) Panic disorder
B) Pheochromocytoma
C) Hyperthyroidism
D) Mitral valve prolapse
Correct answer: B
Rationale: Paroxysmal episodes of hypertension,
palpitations, headache, and diaphoresis are classic
for pheochromocytoma, a catecholamine-secreting
tumor. Panic attacks may mimic but do not typically
cause hypertension.
3. A nurse practitioner is performing an abdominal
assessment. Which sequence is correct?
A) Auscultation, inspection, percussion, palpation
B) Inspection, auscultation, percussion, palpation
C) Inspection, percussion, auscultation, palpation
D) Palpation, auscultation, percussion, inspection
Correct answer: B
,Rationale: The correct sequence for abdominal
assessment is inspection, auscultation, percussion,
palpation. Auscultation is performed before
percussion and palpation because these maneuvers
can alter bowel sounds.
4. A 55-year-old male with a history of hypertension
presents with acute onset of severe, tearing chest
pain radiating to the back. Blood pressure is 160/90
in the right arm and 110/70 in the left arm. Which
diagnosis must be ruled out first?
A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Correct answer: B
Rationale: Tearing chest pain radiating to the back
with unequal blood pressures between arms is
classic for aortic dissection, a life-threatening
emergency requiring immediate CT aortogram.
5. A nurse practitioner is assessing a patient's
respiratory system. Which finding is most consistent
with chronic obstructive pulmonary disease (COPD)?
, A) Bronchophony
B) Egophony
C) Prolonged expiration
D) Crackles in the lung bases
Correct answer: C
Rationale: COPD is characterized by prolonged
expiration due to airflow obstruction. Bronchophony
and egophony suggest consolidation (pneumonia).
Crackles in the lung bases suggest heart failure or
interstitial lung disease.
6. A 32-year-old female presents with recurrent,
unexpected panic attacks followed by persistent
worry about having additional attacks. She has
changed her behavior (avoiding exercise). Which
diagnosis is most likely?
A) Generalized anxiety disorder
B) Panic disorder
C) Social anxiety disorder
D) Post-traumatic stress disorder
Correct answer: B
Rationale: Panic disorder is characterized by
recurrent unexpected panic attacks followed by ≥1
ADVANCED ASSESSMENT EXAM |
COMPLETE EXAM WITH CORRECT
ANSWERS AND RATIONALES. A+
GUARANTEED SUCCESS
1. A nurse practitioner is performing a
comprehensive cardiovascular assessment on a 72-
year-old male. Which finding is most indicative of
heart failure?
A) A split S2 that widens during inspiration
B) An S3 gallop at the apex
C) A grade 2/6 systolic ejection murmur at the right
second intercostal space
D) A pulse of 2+ in all four extremities
Correct answer: B
Rationale: An S3 gallop in an older adult is a sign of
heart failure (volume overload). Physiologic splitting
of S2 is normal. A grade 2/6 systolic ejection murmur
may be benign (aortic sclerosis). 2+ pulses are
normal.
,2. A 45-year-old female presents with episodic
palpitations, headache, sweating, and hypertension.
These episodes last 15-20 minutes and resolve
spontaneously. Which diagnosis is most likely?
A) Panic disorder
B) Pheochromocytoma
C) Hyperthyroidism
D) Mitral valve prolapse
Correct answer: B
Rationale: Paroxysmal episodes of hypertension,
palpitations, headache, and diaphoresis are classic
for pheochromocytoma, a catecholamine-secreting
tumor. Panic attacks may mimic but do not typically
cause hypertension.
3. A nurse practitioner is performing an abdominal
assessment. Which sequence is correct?
A) Auscultation, inspection, percussion, palpation
B) Inspection, auscultation, percussion, palpation
C) Inspection, percussion, auscultation, palpation
D) Palpation, auscultation, percussion, inspection
Correct answer: B
,Rationale: The correct sequence for abdominal
assessment is inspection, auscultation, percussion,
palpation. Auscultation is performed before
percussion and palpation because these maneuvers
can alter bowel sounds.
4. A 55-year-old male with a history of hypertension
presents with acute onset of severe, tearing chest
pain radiating to the back. Blood pressure is 160/90
in the right arm and 110/70 in the left arm. Which
diagnosis must be ruled out first?
A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Correct answer: B
Rationale: Tearing chest pain radiating to the back
with unequal blood pressures between arms is
classic for aortic dissection, a life-threatening
emergency requiring immediate CT aortogram.
5. A nurse practitioner is assessing a patient's
respiratory system. Which finding is most consistent
with chronic obstructive pulmonary disease (COPD)?
, A) Bronchophony
B) Egophony
C) Prolonged expiration
D) Crackles in the lung bases
Correct answer: C
Rationale: COPD is characterized by prolonged
expiration due to airflow obstruction. Bronchophony
and egophony suggest consolidation (pneumonia).
Crackles in the lung bases suggest heart failure or
interstitial lung disease.
6. A 32-year-old female presents with recurrent,
unexpected panic attacks followed by persistent
worry about having additional attacks. She has
changed her behavior (avoiding exercise). Which
diagnosis is most likely?
A) Generalized anxiety disorder
B) Panic disorder
C) Social anxiety disorder
D) Post-traumatic stress disorder
Correct answer: B
Rationale: Panic disorder is characterized by
recurrent unexpected panic attacks followed by ≥1
