NSG 500 EXAM 3 (WILKES) NEWEST 2026 ACTUAL
EXAM| NSG500 ADVANCED HEALTH ASSESSMENT
EXAM 3 REVIEW WITH 200 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+ (MOST RECENT!!)
1. A patient presents with sudden, painless vision loss in one eye
described as a “curtain coming down.” The most likely diagnosis
is:
A) Optic neuritis
B) Retinal detachment
C) Central retinal artery occlusion
D) Migraine with aura
Correct Answer: B) Retinal detachment
Rationale: Retinal detachment often presents as a sudden
painless “curtain” or shadow over part of the visual field. Central
retinal artery occlusion causes sudden complete monocular vision
loss; optic neuritis has pain with eye movement.
2. On fundoscopic exam, you note a yellow spot with a red
center in a patient with hypertension. This is called:
1
, A) Cotton wool spot
B) Roth spot
C) Cherry-red spot
D) Hard exudate
Correct Answer: B) Roth spot
Rationale: Roth spots are retinal hemorrhages with a white or
yellow center (fibrin-platelet aggregate), seen in endocarditis,
leukemia, or diabetic retinopathy. Cherry-red spot is in central
retinal artery occlusion.
3. A 65-year-old reports a “hollow” feeling in the left ear and
hearing loss. On otoscopy, the tympanic membrane is retracted
with visible ossicles. This suggests:
A) Serous otitis media
B) Cholesteatoma
C) Tympanic membrane perforation
D) Otosclerosis
Correct Answer: A) Serous otitis media
Rationale: Retracted TM with visible ossicles indicates negative
2
,middle ear pressure (eustachian tube dysfunction).
Cholesteatoma shows a white pearl-like mass behind TM.
4. A patient reports seeing flashing lights and floaters. The most
important next step is:
A) Reassure and schedule routine eye exam
B) Urgent dilated fundoscopic exam to rule out retinal tear
or detachment
C) Check blood pressure
D) Order CT head
Correct Answer: B) Urgent dilated fundoscopic exam to rule out
retinal tear or detachment
Rationale: New onset of flashes (photopsia) and floaters,
especially in a myopic patient or after trauma, may indicate
posterior vitreous detachment with retinal tear, which can lead to
detachment.
5. A patient cannot adduct the left eye and has nystagmus in the
right eye when looking to the right. This is:
A) Internuclear ophthalmoplegia (INO)
B) CN III palsy
3
, C) CN VI palsy
D) Myasthenia gravis
Correct Answer: A) Internuclear ophthalmoplegia (INO)
Rationale: INO (failure of adduction of one eye with nystagmus
of the abducting eye) is caused by a medial longitudinal
fasciculus lesion, often multiple sclerosis.
6. On otoscopy, you see a white, pearly lesion behind an intact
tympanic membrane. This is most likely:
A) Cholesteatoma
B) Glomus tumor
C) Cerumen impaction
D) Tympanosclerosis
Correct Answer: A) Cholesteatoma
Rationale: Cholesteatoma is a keratinizing squamous epithelial
cyst that appears as a white pearly lesion behind the TM, often
causing conductive hearing loss and bony erosion.
7. A 45-year-old has a painless, firm, fixed left supraclavicular
node (Virchow’s node). This suggests:
A) Infectious mononucleosis
4
EXAM| NSG500 ADVANCED HEALTH ASSESSMENT
EXAM 3 REVIEW WITH 200 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+ (MOST RECENT!!)
1. A patient presents with sudden, painless vision loss in one eye
described as a “curtain coming down.” The most likely diagnosis
is:
A) Optic neuritis
B) Retinal detachment
C) Central retinal artery occlusion
D) Migraine with aura
Correct Answer: B) Retinal detachment
Rationale: Retinal detachment often presents as a sudden
painless “curtain” or shadow over part of the visual field. Central
retinal artery occlusion causes sudden complete monocular vision
loss; optic neuritis has pain with eye movement.
2. On fundoscopic exam, you note a yellow spot with a red
center in a patient with hypertension. This is called:
1
, A) Cotton wool spot
B) Roth spot
C) Cherry-red spot
D) Hard exudate
Correct Answer: B) Roth spot
Rationale: Roth spots are retinal hemorrhages with a white or
yellow center (fibrin-platelet aggregate), seen in endocarditis,
leukemia, or diabetic retinopathy. Cherry-red spot is in central
retinal artery occlusion.
3. A 65-year-old reports a “hollow” feeling in the left ear and
hearing loss. On otoscopy, the tympanic membrane is retracted
with visible ossicles. This suggests:
A) Serous otitis media
B) Cholesteatoma
C) Tympanic membrane perforation
D) Otosclerosis
Correct Answer: A) Serous otitis media
Rationale: Retracted TM with visible ossicles indicates negative
2
,middle ear pressure (eustachian tube dysfunction).
Cholesteatoma shows a white pearl-like mass behind TM.
4. A patient reports seeing flashing lights and floaters. The most
important next step is:
A) Reassure and schedule routine eye exam
B) Urgent dilated fundoscopic exam to rule out retinal tear
or detachment
C) Check blood pressure
D) Order CT head
Correct Answer: B) Urgent dilated fundoscopic exam to rule out
retinal tear or detachment
Rationale: New onset of flashes (photopsia) and floaters,
especially in a myopic patient or after trauma, may indicate
posterior vitreous detachment with retinal tear, which can lead to
detachment.
5. A patient cannot adduct the left eye and has nystagmus in the
right eye when looking to the right. This is:
A) Internuclear ophthalmoplegia (INO)
B) CN III palsy
3
, C) CN VI palsy
D) Myasthenia gravis
Correct Answer: A) Internuclear ophthalmoplegia (INO)
Rationale: INO (failure of adduction of one eye with nystagmus
of the abducting eye) is caused by a medial longitudinal
fasciculus lesion, often multiple sclerosis.
6. On otoscopy, you see a white, pearly lesion behind an intact
tympanic membrane. This is most likely:
A) Cholesteatoma
B) Glomus tumor
C) Cerumen impaction
D) Tympanosclerosis
Correct Answer: A) Cholesteatoma
Rationale: Cholesteatoma is a keratinizing squamous epithelial
cyst that appears as a white pearly lesion behind the TM, often
causing conductive hearing loss and bony erosion.
7. A 45-year-old has a painless, firm, fixed left supraclavicular
node (Virchow’s node). This suggests:
A) Infectious mononucleosis
4
