NURS 6512
NURS 6512 Advanced Health
Assessment Midterm Review 2025
1. A 19-year-old man comes to your clinic with a red, irritated right eye for 24-48 hours.
He notes that when he woke up, his eyelids were "stuck together". Physical exam
findings: sclera is injected, vision is normal, and EOM are intact, purulent discharge is
noted. What is the most likely diagnosis?
A. Chemical exposure
B. Bacterial Conjunctivitis
C. Erythema nodosa
D. Trauma -Correct Answer ✔B. Bacterial Conjunctivitis
2. An 18-year-old female presents to the ER with 1-day history of severe sore throat,
malaise, and headache. The patient reports no history of cough or rhinitis. V.S.: T 101F,
P98, R22, BP 124/60. On skin inspection, the NP notices a fine sandpaper rash on the
chest. The throat examination reveals an inflamed uvula, pharynx, and tonsils with gray-
white exudate on the right tonsil. Neck examination reveals tender cervical
lymphadenopathy. The most likely diagnosis is:
A. Hand-foot-and-mouth disease
B. Acute herpetic pharyngitis
C. Group A beta-hemolytic streptococcal infection
D. Acute diphtherial infection -Correct Answer ✔C. Group A beta-hemolytic
streptococcal infection
3. The purpose of the health history is to:
A. Gather subjective data about the patient
B. Obtain a genetic history to determine susceptibility to disease
C. Gather past and current objective and subjective data about the patient
D. Obtain a genealogic record of familial diseases -Correct Answer ✔A. Gather
subjective data about the patient
4. A 67-year-old man with a 40 pack-year smoking history complains of shortness of
breath for the past 6 months and swelling in his legs. He often wakes up at night
gasping for breath and feels most comfortable sleeping on 3 pillows. He has no past
medical history of COPD or CHF, but he has diabetes and hypertension. What is the
most likely diagnosis?
A. Congestive heart failure
B. Chronic obstructive pulmonary disease
C. Asthma
D. Lung cancer -Correct Answer ✔A. Congestive heart failure
5. A 50-year-old woman comes to your office with a history of 2 episodes of coughing
blood. The quantity is estimated to be 2 to 3 tablespoons of bright blood on each
occasion. She has mild shortness of breath, but she feels comfortable at rest. She has
NURS 6512
,NURS 6512
never smoked, denies weight loss or fever, and has no other medical problems. What
would be the next step in her management?
A. Referral to a pulmonologist for bronchoscopy
B. Return to your clinic in the next several weeks to monitor her symptoms
C. Chest x-ray with an admission to the hospital for additional testing
D. Complete vital signs and physical examination -Correct Answer ✔D. Complete vital
signs and physical examination
6. During the central nervous system exam, the NP evaluates the patient's gait and
determines the patient is unable to perform a heel-walk. The differential diagnosis the
NP is most concerned about is damage to the:
A. Corticospinal tract
B. Spinocerebellar tract
C. Spinothalamic tract
D. Dorsal column-medial lemniscus tract -Correct Answer ✔A. Corticospinal tract
7. What is the best way to begin asking about the past medical history?
A. Have you had measles, mumps, rubella, chicken pox, scarlet fever, or rheumatic
fever?
B. Did you get all your shots growing up?
C. Were you hospitalized as a child?
D. How was your health as a child? -Correct Answer ✔D. How was your health as a
child?
8. The NP is conducting an ophthalmoscopic examination. Which statement by the NP
to the preceptor indicates correct understanding regarding ophthalmoscopic
examination:
A. I will look for the yellow tint in the patient's pupil to examine the fundus
B. I will look for the orange glow in the patient's pupil to examine the fundus
C. I will look for the light reflex in the patient's pupil to examine the fundus
D. I will look for the pink reflex in the patient's pupil to examine the fundus -Correct
Answer ✔B. I will look for the orange glow in the patient's pupil to examine the fundus
9. You are evaluating a 20-year-old male with 1-day history of left ear pain. On
otoscopic exam, the tympanic membrane appears reddened, bulging, and no
observable landmarks. The most likely diagnosis is:
A. Cholesteatoma
B. Otitis media
C. Otitis externa
D. Cerumen impaction -Correct Answer ✔B. Otitis media
10. The NP is conducting a cardiovascular examination. The NP knows to use the bell
of the stethoscope to auscultate for all the following except:
A. Pericardial friction rub
NURS 6512
, NURS 6512
B. S3 gallop
C. S4 gallop
D. Murmur of mitral stenosis -Correct Answer ✔A. Pericardial friction rub
11. When a patient gives an incomplete or one-word answer to a sensitive question, the
interviewer should:
A. Pause until the patient provides a more detailed answer
B. Assume that the issue is not important to the patient and move on
C. Gently ask the question in a different way
D. Demand to know why the patient is withholding information -Correct Answer ✔C.
Gently ask the question in a different way
12. A 65-year-old woman comes to your clinic with a history of coughing up 1 to 2
tablespoons of bright blood on 2 occasions. She has smoked heavily for the past 30
years and reports recent weight loss of 25 to 30 lbs. Her past medical history includes
diabetes, hypertension, and rheumatoid arthritis. Her medications include insulin,
atenolol, and lisinopril. What is/are the alarm features present in this patient?
A. Quantity of hemoptysis
B. Advanced age, weight loss, and history of smoking
C. History of diabetes, hypertension. and rheumatoid arthritis
D. Current medications -Correct Answer ✔B. Advanced age, weight loss, and history of
smoking
13. During the neurological examination, the patient does not sense vibration when the
NP applies a vibrating tuning fork to the patient's right big toe. A differential diagnosis
the NP should consider is:
A. Hyperthyroidism
B. Diabetes
C. Dermatitis
D. Lupus erythematosus -Correct Answer ✔B. Diabetes
14. Tobacco use is recorded in pack years. How do we calculate pack years?
A. # packs per week x 12
B. # packs per day x12
C. # packs per day x years a person has smoked
D. # packs per week x the number of years a person has smoked -Correct Answer ✔C.
# packs per day x years a person has smoked
15. The NP is called to evaluate a patient. The nursing staff grew concerned because
the patient appears agitated and insists he hears voices telling him people are going to
kill him. The NP knows that auditory hallucinations can occur in all the following except:
A. Schizophrenia
B. Alcohol withdrawal
C. Drug toxicity
D. Anxiety -Correct Answer ✔D. Anxiety
NURS 6512
NURS 6512 Advanced Health
Assessment Midterm Review 2025
1. A 19-year-old man comes to your clinic with a red, irritated right eye for 24-48 hours.
He notes that when he woke up, his eyelids were "stuck together". Physical exam
findings: sclera is injected, vision is normal, and EOM are intact, purulent discharge is
noted. What is the most likely diagnosis?
A. Chemical exposure
B. Bacterial Conjunctivitis
C. Erythema nodosa
D. Trauma -Correct Answer ✔B. Bacterial Conjunctivitis
2. An 18-year-old female presents to the ER with 1-day history of severe sore throat,
malaise, and headache. The patient reports no history of cough or rhinitis. V.S.: T 101F,
P98, R22, BP 124/60. On skin inspection, the NP notices a fine sandpaper rash on the
chest. The throat examination reveals an inflamed uvula, pharynx, and tonsils with gray-
white exudate on the right tonsil. Neck examination reveals tender cervical
lymphadenopathy. The most likely diagnosis is:
A. Hand-foot-and-mouth disease
B. Acute herpetic pharyngitis
C. Group A beta-hemolytic streptococcal infection
D. Acute diphtherial infection -Correct Answer ✔C. Group A beta-hemolytic
streptococcal infection
3. The purpose of the health history is to:
A. Gather subjective data about the patient
B. Obtain a genetic history to determine susceptibility to disease
C. Gather past and current objective and subjective data about the patient
D. Obtain a genealogic record of familial diseases -Correct Answer ✔A. Gather
subjective data about the patient
4. A 67-year-old man with a 40 pack-year smoking history complains of shortness of
breath for the past 6 months and swelling in his legs. He often wakes up at night
gasping for breath and feels most comfortable sleeping on 3 pillows. He has no past
medical history of COPD or CHF, but he has diabetes and hypertension. What is the
most likely diagnosis?
A. Congestive heart failure
B. Chronic obstructive pulmonary disease
C. Asthma
D. Lung cancer -Correct Answer ✔A. Congestive heart failure
5. A 50-year-old woman comes to your office with a history of 2 episodes of coughing
blood. The quantity is estimated to be 2 to 3 tablespoons of bright blood on each
occasion. She has mild shortness of breath, but she feels comfortable at rest. She has
NURS 6512
,NURS 6512
never smoked, denies weight loss or fever, and has no other medical problems. What
would be the next step in her management?
A. Referral to a pulmonologist for bronchoscopy
B. Return to your clinic in the next several weeks to monitor her symptoms
C. Chest x-ray with an admission to the hospital for additional testing
D. Complete vital signs and physical examination -Correct Answer ✔D. Complete vital
signs and physical examination
6. During the central nervous system exam, the NP evaluates the patient's gait and
determines the patient is unable to perform a heel-walk. The differential diagnosis the
NP is most concerned about is damage to the:
A. Corticospinal tract
B. Spinocerebellar tract
C. Spinothalamic tract
D. Dorsal column-medial lemniscus tract -Correct Answer ✔A. Corticospinal tract
7. What is the best way to begin asking about the past medical history?
A. Have you had measles, mumps, rubella, chicken pox, scarlet fever, or rheumatic
fever?
B. Did you get all your shots growing up?
C. Were you hospitalized as a child?
D. How was your health as a child? -Correct Answer ✔D. How was your health as a
child?
8. The NP is conducting an ophthalmoscopic examination. Which statement by the NP
to the preceptor indicates correct understanding regarding ophthalmoscopic
examination:
A. I will look for the yellow tint in the patient's pupil to examine the fundus
B. I will look for the orange glow in the patient's pupil to examine the fundus
C. I will look for the light reflex in the patient's pupil to examine the fundus
D. I will look for the pink reflex in the patient's pupil to examine the fundus -Correct
Answer ✔B. I will look for the orange glow in the patient's pupil to examine the fundus
9. You are evaluating a 20-year-old male with 1-day history of left ear pain. On
otoscopic exam, the tympanic membrane appears reddened, bulging, and no
observable landmarks. The most likely diagnosis is:
A. Cholesteatoma
B. Otitis media
C. Otitis externa
D. Cerumen impaction -Correct Answer ✔B. Otitis media
10. The NP is conducting a cardiovascular examination. The NP knows to use the bell
of the stethoscope to auscultate for all the following except:
A. Pericardial friction rub
NURS 6512
, NURS 6512
B. S3 gallop
C. S4 gallop
D. Murmur of mitral stenosis -Correct Answer ✔A. Pericardial friction rub
11. When a patient gives an incomplete or one-word answer to a sensitive question, the
interviewer should:
A. Pause until the patient provides a more detailed answer
B. Assume that the issue is not important to the patient and move on
C. Gently ask the question in a different way
D. Demand to know why the patient is withholding information -Correct Answer ✔C.
Gently ask the question in a different way
12. A 65-year-old woman comes to your clinic with a history of coughing up 1 to 2
tablespoons of bright blood on 2 occasions. She has smoked heavily for the past 30
years and reports recent weight loss of 25 to 30 lbs. Her past medical history includes
diabetes, hypertension, and rheumatoid arthritis. Her medications include insulin,
atenolol, and lisinopril. What is/are the alarm features present in this patient?
A. Quantity of hemoptysis
B. Advanced age, weight loss, and history of smoking
C. History of diabetes, hypertension. and rheumatoid arthritis
D. Current medications -Correct Answer ✔B. Advanced age, weight loss, and history of
smoking
13. During the neurological examination, the patient does not sense vibration when the
NP applies a vibrating tuning fork to the patient's right big toe. A differential diagnosis
the NP should consider is:
A. Hyperthyroidism
B. Diabetes
C. Dermatitis
D. Lupus erythematosus -Correct Answer ✔B. Diabetes
14. Tobacco use is recorded in pack years. How do we calculate pack years?
A. # packs per week x 12
B. # packs per day x12
C. # packs per day x years a person has smoked
D. # packs per week x the number of years a person has smoked -Correct Answer ✔C.
# packs per day x years a person has smoked
15. The NP is called to evaluate a patient. The nursing staff grew concerned because
the patient appears agitated and insists he hears voices telling him people are going to
kill him. The NP knows that auditory hallucinations can occur in all the following except:
A. Schizophrenia
B. Alcohol withdrawal
C. Drug toxicity
D. Anxiety -Correct Answer ✔D. Anxiety
NURS 6512
