NU 518 Advanced Health Assessment Final Exam Prep 2026 | USA
1. Which of the following techniques is performed first during a physical
examination of the abdomen?
A. Palpation
B. Percussion
C. Auscultation
D. Inspection
Answer: D
Rationale: Inspection is always the first step in abdominal assessment to observe for
symmetry, scars, and pulsations before bowel sounds are altered by manipulation.
2. When assessing the lungs, what sound is typically heard over most of the lung
fields in a healthy adult?
A. Dullness
B. Hyperresonance
C. Resonance
D. Tympany
Answer: C
Rationale: Resonance is the low-pitched, clear, hollow sound that predominates in healthy
adult lung tissue.
,3. Which cranial nerve is being tested when the nurse asks the patient to shrug
their shoulders against resistance?
A. CN X (Vagus)
B. CN XI (Spinal Accessory)
C. CN XII (Hypoglossal)
D. CN IX (Glossopharyngeal)
Answer: B
Rationale: CN XI innervates the trapezius and sternocleidomastoid muscles, which are
responsible for shoulder shrugging and head turning.
4. The nurse notes a ‘swishing’ sound when auscultating the carotid artery. This
finding is documented as a:
A. Bruit
B. Murmur
C. Thrill
D. Heave
Answer: A
Rationale: A bruit is a blowing or swishing sound indicating blood flow turbulence, often
due to narrowing of the vessel.
5. Which assessment finding is most indicative of a positive Romberg test?
A. Decreased sensation in the lower extremities
B. Asymmetrical facial expressions
C. Inability to walk heel-to-toe
D. Inability to maintain balance when the eyes are closed
Answer: D
Rationale: A positive Romberg sign occurs when a patient loses balance after closing their
eyes, suggesting sensory ataxia or vestibular dysfunction.
, 6. In the ABCDE mnemonic for assessing skin lesions, what does the ‘D’
represent?
A. Depth
B. Diameter
C. Density
D. Drainage
Answer: B
Rationale: Diameter (greater than 6mm) is one of the warning signs used to assess for
potential malignant melanoma.
7. When auscultating the heart, the S2 sound is loudest at which location?
A. Apex
B. Base
C. Left sternal border, 4th intercostal space
D. Erb’s point
Answer: B
Rationale: S2, caused by the closure of the semilunar valves, is loudest at the base of the
heart (aortic and pulmonic areas).
8. What is the correct way to pull the pinna when examining an adult’s ear with
an otoscope?
A. Down and back
B. Down and forward
C. Up and forward
D. Up and back
Answer: D
Rationale: In adults, pulling the pinna up and back helps straighten the ear canal for better
visualization.
1. Which of the following techniques is performed first during a physical
examination of the abdomen?
A. Palpation
B. Percussion
C. Auscultation
D. Inspection
Answer: D
Rationale: Inspection is always the first step in abdominal assessment to observe for
symmetry, scars, and pulsations before bowel sounds are altered by manipulation.
2. When assessing the lungs, what sound is typically heard over most of the lung
fields in a healthy adult?
A. Dullness
B. Hyperresonance
C. Resonance
D. Tympany
Answer: C
Rationale: Resonance is the low-pitched, clear, hollow sound that predominates in healthy
adult lung tissue.
,3. Which cranial nerve is being tested when the nurse asks the patient to shrug
their shoulders against resistance?
A. CN X (Vagus)
B. CN XI (Spinal Accessory)
C. CN XII (Hypoglossal)
D. CN IX (Glossopharyngeal)
Answer: B
Rationale: CN XI innervates the trapezius and sternocleidomastoid muscles, which are
responsible for shoulder shrugging and head turning.
4. The nurse notes a ‘swishing’ sound when auscultating the carotid artery. This
finding is documented as a:
A. Bruit
B. Murmur
C. Thrill
D. Heave
Answer: A
Rationale: A bruit is a blowing or swishing sound indicating blood flow turbulence, often
due to narrowing of the vessel.
5. Which assessment finding is most indicative of a positive Romberg test?
A. Decreased sensation in the lower extremities
B. Asymmetrical facial expressions
C. Inability to walk heel-to-toe
D. Inability to maintain balance when the eyes are closed
Answer: D
Rationale: A positive Romberg sign occurs when a patient loses balance after closing their
eyes, suggesting sensory ataxia or vestibular dysfunction.
, 6. In the ABCDE mnemonic for assessing skin lesions, what does the ‘D’
represent?
A. Depth
B. Diameter
C. Density
D. Drainage
Answer: B
Rationale: Diameter (greater than 6mm) is one of the warning signs used to assess for
potential malignant melanoma.
7. When auscultating the heart, the S2 sound is loudest at which location?
A. Apex
B. Base
C. Left sternal border, 4th intercostal space
D. Erb’s point
Answer: B
Rationale: S2, caused by the closure of the semilunar valves, is loudest at the base of the
heart (aortic and pulmonic areas).
8. What is the correct way to pull the pinna when examining an adult’s ear with
an otoscope?
A. Down and back
B. Down and forward
C. Up and forward
D. Up and back
Answer: D
Rationale: In adults, pulling the pinna up and back helps straighten the ear canal for better
visualization.
