NUR 612 ASSESSMENT II FINAL EXAM ACTUAL EXAM 2026 | ALL QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS) | UPDATED VERSION
Question 1
Which of the following is considered an absolute contraindication to performing an MRI in a
neurological patient?
A) Presence of a cerebral aneurysm clip
B) Claustrophobia
C) Metallic prosthetic heart valve
D) Implanted cardiac pacemaker
E) First-trimester pregnancy
Correct Answer: D) Implanted cardiac pacemaker
Rationale: An absolute contraindication is a condition that makes a particular treatment or
procedure absolutely inadvisable because it poses a life-threatening risk. Older cardiac
pacemakers and ICDs can malfunction, move, or heat up when exposed to the powerful
magnetic field of an MRI. While some modern pacemakers are "MRI-conditional," a
standard implanted pacemaker remains a classic absolute contraindication. In contrast,
aneurysm clips and heart valves are often relative contraindications, requiring
documentation of the specific model's compatibility before proceeding.
Question 2
A Nurse Practitioner (NP) is performing a physical exam on a patient with a swollen knee. The
NP compresses the suprapatellar pouch against the femur and then pushes the patella sharply
against the femur, looking for a fluid wave. Which maneuver is being performed?
A) Lachman Test
B) McMurray Test
) Ballottement Sign
D) Bulge Sign
E) Drawer Sign
Correct Answer: C) Ballottement Sign
Rationale: The Ballottement test is used to assess for large amounts of fluid (effusion) in the
knee joint. By compressing the suprapatellar pouch, the NP moves any fluid into the space
behind the patella. If fluid is present, the patella will "float" and the NP will feel it tap
, 2
against the femur when pressed. The Bulge sign is used for smaller amounts of fluid, while
Lachman, McMurray, and Drawer signs test for ligamentous or meniscal structural
integrity.
Question 3
A 60-year-old sculptor presents with hard, painless nodules on the dorsolateral aspects of the
proximal and distal interphalangeal joints of both hands. He reports a long history of joint
stiffness that is worse in the evening. Which diagnosis is most likely?
A) Rheumatoid Arthritis
B) Psoriatic Arthritis
C) Osteoarthritis
D) Gouty Arthritis
E) Systemic Lupus Erythematosus
Correct Answer: C) Osteoarthritis
Rationale: Osteoarthritis (OA) is a degenerative joint disease characterized by hard, bony,
painless nodules known as Heberden's nodules (at the distal interphalangeal joints) and
Bouchard's nodules (at the proximal interphalangeal joints). These represent osteophyte
formation. Rheumatoid arthritis typically presents with soft, warm, tender, and
symmetrical swelling of the joints, usually accompanied by morning stiffness that improves
with activity, unlike OA which worsens with use.
Question 4
A 16-year-old high school football player is evaluated for a right knee injury. The NP elicits a
positive anterior drawer sign. This clinical finding most likely indicates an injury to which
structure?
A) Medial Collateral Ligament (MCL)
B) Posterior Cruciate Ligament (PCL)
C) Lateral Meniscus
D) Anterior Cruciate Ligament (ACL)
E) Patellar Tendon
, 3
Correct Answer: D) Anterior Cruciate Ligament (ACL)
Rationale: The Drawer test assesses the stability of the cruciate ligaments. An anterior
drawer sign (where the tibia can be pulled forward significantly from under the femur)
indicates a tear or laxity in the Anterior Cruciate Ligament (ACL). A positive posterior
drawer sign (where the tibia can be pushed backward) indicates a Posterior Cruciate
Ligament (PCL) injury.
Question 5
A 20-year-old soccer player twisted his knee during a game. He tells the provider that the knee
"locks up" or "catches" when he tries to straighten his leg or walk. Which injury should the NP
suspect first?
A) Patellar subluxation
B) Medial collateral ligament tear
C) Meniscal injury
D) Osgood-Schlatter disease
E) Prepatellar bursitis
Correct Answer: C) Injury to meniscus
Rationale: The classic mechanical symptoms of a meniscal tear include "locking,"
"catching," or "giving way" of the knee joint. This occurs when a torn piece of the
fibrocartilage (meniscus) becomes displaced and physically interferes with the smooth
hinge motion of the knee. While ACL tears cause instability, they typically do not cause the
physical locking associated with meniscal fragments.
Question 6
A 14-year-old basketball player presents with swelling and pain in the left knee. On physical
exam, the NP notes localized tenderness and a prominent "bump" over the anterior tibial
tuberosity. What is the most likely diagnosis?
A) Chondromalacia patella
B) Osgood-Schlatter disease
C) Tibial stress fracture
, 4
D) Baker's cyst
E) ACL rupture
Correct Answer: B) Osgood-Schlatter disease
Rationale: Osgood-Schlatter disease is an osteochondritis or traction apophysitis of the
tibial tubercle. It is common in active adolescents during growth spurts. The repetitive
pulling of the patellar tendon on the immature tibial tuberosity causes inflammation, pain,
and sometimes a visible bony enlargement. Tenderness is strictly localized over the tibial
tuberosity, which is the hallmark of this condition.
Question 7
A patient presents with lower back pain. During the exam, the NP notes a decreased Achilles
deep tendon reflex and sensory loss in the great toe. Which maneuver would be most useful to
confirm a herniated disc?
A) McMurray Test
B) Drawer Test
C) Straight Leg Raise (SLR)
D) Phalen's Maneuver
E) Romberg Test
Correct Answer: C) Straight leg raise
Rationale: The Straight Leg Raise (SLR) test is used to detect nerve root irritation or
"radiculopathy," often caused by a herniated lumbar disc. A positive SLR occurs when the
patient experiences radiating pain down the leg (sciatica) when the leg is passively raised
between 30 and 70 degrees. Sensory loss in the great toe and a diminished Achilles reflex
(S1 nerve root) are common neurological correlates of lumbar disc pathology.
Question 8
When documenting a positive McMurray test in a patient with suspected meniscal trauma, which
of the following findings is required?
A) Visible swelling of the joint capsule
B) Palpated or audible "click" during rotation
C) Excessive forward motion of the tibia
AND CORRECT ANSWERS (VERIFIED ANSWERS) | UPDATED VERSION
Question 1
Which of the following is considered an absolute contraindication to performing an MRI in a
neurological patient?
A) Presence of a cerebral aneurysm clip
B) Claustrophobia
C) Metallic prosthetic heart valve
D) Implanted cardiac pacemaker
E) First-trimester pregnancy
Correct Answer: D) Implanted cardiac pacemaker
Rationale: An absolute contraindication is a condition that makes a particular treatment or
procedure absolutely inadvisable because it poses a life-threatening risk. Older cardiac
pacemakers and ICDs can malfunction, move, or heat up when exposed to the powerful
magnetic field of an MRI. While some modern pacemakers are "MRI-conditional," a
standard implanted pacemaker remains a classic absolute contraindication. In contrast,
aneurysm clips and heart valves are often relative contraindications, requiring
documentation of the specific model's compatibility before proceeding.
Question 2
A Nurse Practitioner (NP) is performing a physical exam on a patient with a swollen knee. The
NP compresses the suprapatellar pouch against the femur and then pushes the patella sharply
against the femur, looking for a fluid wave. Which maneuver is being performed?
A) Lachman Test
B) McMurray Test
) Ballottement Sign
D) Bulge Sign
E) Drawer Sign
Correct Answer: C) Ballottement Sign
Rationale: The Ballottement test is used to assess for large amounts of fluid (effusion) in the
knee joint. By compressing the suprapatellar pouch, the NP moves any fluid into the space
behind the patella. If fluid is present, the patella will "float" and the NP will feel it tap
, 2
against the femur when pressed. The Bulge sign is used for smaller amounts of fluid, while
Lachman, McMurray, and Drawer signs test for ligamentous or meniscal structural
integrity.
Question 3
A 60-year-old sculptor presents with hard, painless nodules on the dorsolateral aspects of the
proximal and distal interphalangeal joints of both hands. He reports a long history of joint
stiffness that is worse in the evening. Which diagnosis is most likely?
A) Rheumatoid Arthritis
B) Psoriatic Arthritis
C) Osteoarthritis
D) Gouty Arthritis
E) Systemic Lupus Erythematosus
Correct Answer: C) Osteoarthritis
Rationale: Osteoarthritis (OA) is a degenerative joint disease characterized by hard, bony,
painless nodules known as Heberden's nodules (at the distal interphalangeal joints) and
Bouchard's nodules (at the proximal interphalangeal joints). These represent osteophyte
formation. Rheumatoid arthritis typically presents with soft, warm, tender, and
symmetrical swelling of the joints, usually accompanied by morning stiffness that improves
with activity, unlike OA which worsens with use.
Question 4
A 16-year-old high school football player is evaluated for a right knee injury. The NP elicits a
positive anterior drawer sign. This clinical finding most likely indicates an injury to which
structure?
A) Medial Collateral Ligament (MCL)
B) Posterior Cruciate Ligament (PCL)
C) Lateral Meniscus
D) Anterior Cruciate Ligament (ACL)
E) Patellar Tendon
, 3
Correct Answer: D) Anterior Cruciate Ligament (ACL)
Rationale: The Drawer test assesses the stability of the cruciate ligaments. An anterior
drawer sign (where the tibia can be pulled forward significantly from under the femur)
indicates a tear or laxity in the Anterior Cruciate Ligament (ACL). A positive posterior
drawer sign (where the tibia can be pushed backward) indicates a Posterior Cruciate
Ligament (PCL) injury.
Question 5
A 20-year-old soccer player twisted his knee during a game. He tells the provider that the knee
"locks up" or "catches" when he tries to straighten his leg or walk. Which injury should the NP
suspect first?
A) Patellar subluxation
B) Medial collateral ligament tear
C) Meniscal injury
D) Osgood-Schlatter disease
E) Prepatellar bursitis
Correct Answer: C) Injury to meniscus
Rationale: The classic mechanical symptoms of a meniscal tear include "locking,"
"catching," or "giving way" of the knee joint. This occurs when a torn piece of the
fibrocartilage (meniscus) becomes displaced and physically interferes with the smooth
hinge motion of the knee. While ACL tears cause instability, they typically do not cause the
physical locking associated with meniscal fragments.
Question 6
A 14-year-old basketball player presents with swelling and pain in the left knee. On physical
exam, the NP notes localized tenderness and a prominent "bump" over the anterior tibial
tuberosity. What is the most likely diagnosis?
A) Chondromalacia patella
B) Osgood-Schlatter disease
C) Tibial stress fracture
, 4
D) Baker's cyst
E) ACL rupture
Correct Answer: B) Osgood-Schlatter disease
Rationale: Osgood-Schlatter disease is an osteochondritis or traction apophysitis of the
tibial tubercle. It is common in active adolescents during growth spurts. The repetitive
pulling of the patellar tendon on the immature tibial tuberosity causes inflammation, pain,
and sometimes a visible bony enlargement. Tenderness is strictly localized over the tibial
tuberosity, which is the hallmark of this condition.
Question 7
A patient presents with lower back pain. During the exam, the NP notes a decreased Achilles
deep tendon reflex and sensory loss in the great toe. Which maneuver would be most useful to
confirm a herniated disc?
A) McMurray Test
B) Drawer Test
C) Straight Leg Raise (SLR)
D) Phalen's Maneuver
E) Romberg Test
Correct Answer: C) Straight leg raise
Rationale: The Straight Leg Raise (SLR) test is used to detect nerve root irritation or
"radiculopathy," often caused by a herniated lumbar disc. A positive SLR occurs when the
patient experiences radiating pain down the leg (sciatica) when the leg is passively raised
between 30 and 70 degrees. Sensory loss in the great toe and a diminished Achilles reflex
(S1 nerve root) are common neurological correlates of lumbar disc pathology.
Question 8
When documenting a positive McMurray test in a patient with suspected meniscal trauma, which
of the following findings is required?
A) Visible swelling of the joint capsule
B) Palpated or audible "click" during rotation
C) Excessive forward motion of the tibia
