lOMoAR cPSD| 63316909
NR509 Week 3 Practice Questions
Questions, Answers, and In-Depth Rationales (with source citations)
Question 1
The NP is performing a comprehensive eye exam on a patient with
a new-onset headache and reports of blurred vision. Which action is most
critical for evaluating potential neurologic involvement?
Option Choice
A Inspecting the sclera for
signs of jaundice
or
irritation
B Using the ophthalmoscope to visualize the optic disc and
retinal vessels
C Testingcolor vision using Ishihara
plates
D Assessing pupillary response to
near
Correct answer: B
Rationale (why this is correct):
Headache plus blurred vision raises concern for increased intracranial
pressure, optic neuritis, papilledema, retinal hemorrhage, or other posterior
segment pathology. Direct visualization of the fundus—especially the optic
disc margins and retinal vessels—is the key bedside step because
it can reveal papilledema and other neuro-ophthalmic signs. Course materials
explicitly emphasize using the ophthalmoscope to inspect internal eye
structures, and note that limited views (e.g., without dilation) can miss
important neurologic findings.
Rationale (why the other choices are not correct):
A: Scleral inspection is useful for local/systemic issues (e.g., conjunctivitis,
jaundice), but it does not evaluate posterior structures where
neurologic clues (papilledema, hemorrhages) live.
, lOMoAR cPSD| 63316909
Question 2
C: Color vision can help detect optic nerve disease, but it is not
the most critical first step when neurologic involvement is suspected;
funduscopic assessment of the disc/vessels is higher-yield in this
presentation. D: Accommodation/near response is part of a pupil exam,
but it does not directlyassess the optic disc or retinal vessels and is
less sensitive for ruling in urgent neuro-ophthalmic pathology.
Sources: Week 3 sources.pdf, p. 6 (eye exam components; ophthalmoscope; neuro
findings note)
During a thoracic exam, the NP places both thumbsat the costal
margins and hands along the lateral rib cage, instructing the patient to
inhale deeply. This maneuver is performed to assess which of the
following?
Option Choice
A Chest expansion
B Percussion tone
Adventitious breath
C
sounds
D Tactile fremitus
Correct answer: A
Rationale (why this is correct):
Placing the hands on the posterolateral chest with thumbsmeeting near the
midline(often at the level of the 10th rib/costal margin) and
watching the thumbsseparate during deep inspiration assesses symmetric
thoracic expansion (respiratory excursion). Asymmetry can suggest unilateral
disease such as lobar collapse, pleural effusion, pneumothorax,or severe
pneumonia.
Rationale (why the other choices are not correct):
B: Percussion tone is assessed by tappingthe chest wall with a
finger-to-finger technique, not by placing thumbsat the costal margins.
C: Adventitious sounds (crackles, wheezes, rhonchi, pleural rub) are
detected by auscultation with the diaphragm of the stethoscope.
NR509 Week 3 Practice Questions
Questions, Answers, and In-Depth Rationales (with source citations)
Question 1
The NP is performing a comprehensive eye exam on a patient with
a new-onset headache and reports of blurred vision. Which action is most
critical for evaluating potential neurologic involvement?
Option Choice
A Inspecting the sclera for
signs of jaundice
or
irritation
B Using the ophthalmoscope to visualize the optic disc and
retinal vessels
C Testingcolor vision using Ishihara
plates
D Assessing pupillary response to
near
Correct answer: B
Rationale (why this is correct):
Headache plus blurred vision raises concern for increased intracranial
pressure, optic neuritis, papilledema, retinal hemorrhage, or other posterior
segment pathology. Direct visualization of the fundus—especially the optic
disc margins and retinal vessels—is the key bedside step because
it can reveal papilledema and other neuro-ophthalmic signs. Course materials
explicitly emphasize using the ophthalmoscope to inspect internal eye
structures, and note that limited views (e.g., without dilation) can miss
important neurologic findings.
Rationale (why the other choices are not correct):
A: Scleral inspection is useful for local/systemic issues (e.g., conjunctivitis,
jaundice), but it does not evaluate posterior structures where
neurologic clues (papilledema, hemorrhages) live.
, lOMoAR cPSD| 63316909
Question 2
C: Color vision can help detect optic nerve disease, but it is not
the most critical first step when neurologic involvement is suspected;
funduscopic assessment of the disc/vessels is higher-yield in this
presentation. D: Accommodation/near response is part of a pupil exam,
but it does not directlyassess the optic disc or retinal vessels and is
less sensitive for ruling in urgent neuro-ophthalmic pathology.
Sources: Week 3 sources.pdf, p. 6 (eye exam components; ophthalmoscope; neuro
findings note)
During a thoracic exam, the NP places both thumbsat the costal
margins and hands along the lateral rib cage, instructing the patient to
inhale deeply. This maneuver is performed to assess which of the
following?
Option Choice
A Chest expansion
B Percussion tone
Adventitious breath
C
sounds
D Tactile fremitus
Correct answer: A
Rationale (why this is correct):
Placing the hands on the posterolateral chest with thumbsmeeting near the
midline(often at the level of the 10th rib/costal margin) and
watching the thumbsseparate during deep inspiration assesses symmetric
thoracic expansion (respiratory excursion). Asymmetry can suggest unilateral
disease such as lobar collapse, pleural effusion, pneumothorax,or severe
pneumonia.
Rationale (why the other choices are not correct):
B: Percussion tone is assessed by tappingthe chest wall with a
finger-to-finger technique, not by placing thumbsat the costal margins.
C: Adventitious sounds (crackles, wheezes, rhonchi, pleural rub) are
detected by auscultation with the diaphragm of the stethoscope.
