NUR600/NUR 600 Exam 4 V3 | Advanced
Health Assess Q&A with Rationale |
William Paterson University
1. When assessing the musculoskeletal system, which test is most appropriate to evaluate for
a torn anterior cruciate ligament (ACL)?
A. McMurray test
B. Lachman test
C. Bulge sign
D. Phalen test
Correct Answer: B
Expert Explanation: The Lachman test is widely considered the most sensitive clinical
assessment tool for identifying an ACL tear. To perform this test, the knee is flexed to 20 or
30 degrees while the examiner pulls the tibia forward. A positive result is indicated by
excessive forward movement of the tibia and a lack of a firm endpoint.
2. A patient presents with numbness and tingling in the first three fingers of the hand. Which
maneuver should the nurse practitioner perform to assess for carpal tunnel syndrome?
A. Phalen test
B. Allen test
C. Drawer test
,D. Finkelstein test
Correct Answer: A
Expert Explanation: The Phalen test involves asking the patient to hold their wrists in a
position of forced flexion for 60 seconds. Numbness or tingling in the distribution of the
median nerve constitutes a positive finding for carpal tunnel syndrome. This maneuver
increases the pressure within the carpal tunnel to elicit symptoms.
3. Which cranial nerve is being assessed when the examiner asks the patient to shrug their
shoulders against resistance?
A. Cranial Nerve IX (Glossopharyngeal)
B. Cranial Nerve X (Vagus)
C. Cranial Nerve XII (Hypoglossal)
D. Cranial Nerve XI (Spinal Accessory)
Correct Answer: D
Expert Explanation: Cranial Nerve XI, the spinal accessory nerve, innervates the trapezius
and sternocleidomastoid muscles. Shrugging the shoulders evaluates the strength and
symmetry of the trapezius muscles. Weakness or asymmetry during this maneuver
suggests a lesion or dysfunction of this specific cranial nerve.
4. During a neurological examination, the patient is unable to identify a familiar object, like a
key, placed in their hand with their eyes closed. This finding is documented as:
A. Anosognosia
, B. Aphasia
C. Astereognosis
D. Ataxia
Correct Answer: C
Expert Explanation: Astereognosis is the inability to recognize objects by touch in the
absence of visual and auditory information. This test evaluates the sensory cortex and its
ability to process tactile information. A positive finding usually indicates a lesion in the
sensory cortex or posterior column of the spinal cord.
5. A 65-year-old male presents with difficulty starting his urinary stream and a feeling of
incomplete emptying. On digital rectal exam (DRE), the prostate is found to be symmetrically
enlarged, firm, and smooth. This most likely indicates:
A. Prostate cancer
B. Prostatic abscess
C. Acute prostatitis
D. Benign prostatic hyperplasia (BPH)
Correct Answer: D
Expert Explanation: Benign prostatic hyperplasia typically presents as a smooth, rubbery,
and symmetrically enlarged prostate on examination. Prostate cancer is more likely to
Health Assess Q&A with Rationale |
William Paterson University
1. When assessing the musculoskeletal system, which test is most appropriate to evaluate for
a torn anterior cruciate ligament (ACL)?
A. McMurray test
B. Lachman test
C. Bulge sign
D. Phalen test
Correct Answer: B
Expert Explanation: The Lachman test is widely considered the most sensitive clinical
assessment tool for identifying an ACL tear. To perform this test, the knee is flexed to 20 or
30 degrees while the examiner pulls the tibia forward. A positive result is indicated by
excessive forward movement of the tibia and a lack of a firm endpoint.
2. A patient presents with numbness and tingling in the first three fingers of the hand. Which
maneuver should the nurse practitioner perform to assess for carpal tunnel syndrome?
A. Phalen test
B. Allen test
C. Drawer test
,D. Finkelstein test
Correct Answer: A
Expert Explanation: The Phalen test involves asking the patient to hold their wrists in a
position of forced flexion for 60 seconds. Numbness or tingling in the distribution of the
median nerve constitutes a positive finding for carpal tunnel syndrome. This maneuver
increases the pressure within the carpal tunnel to elicit symptoms.
3. Which cranial nerve is being assessed when the examiner asks the patient to shrug their
shoulders against resistance?
A. Cranial Nerve IX (Glossopharyngeal)
B. Cranial Nerve X (Vagus)
C. Cranial Nerve XII (Hypoglossal)
D. Cranial Nerve XI (Spinal Accessory)
Correct Answer: D
Expert Explanation: Cranial Nerve XI, the spinal accessory nerve, innervates the trapezius
and sternocleidomastoid muscles. Shrugging the shoulders evaluates the strength and
symmetry of the trapezius muscles. Weakness or asymmetry during this maneuver
suggests a lesion or dysfunction of this specific cranial nerve.
4. During a neurological examination, the patient is unable to identify a familiar object, like a
key, placed in their hand with their eyes closed. This finding is documented as:
A. Anosognosia
, B. Aphasia
C. Astereognosis
D. Ataxia
Correct Answer: C
Expert Explanation: Astereognosis is the inability to recognize objects by touch in the
absence of visual and auditory information. This test evaluates the sensory cortex and its
ability to process tactile information. A positive finding usually indicates a lesion in the
sensory cortex or posterior column of the spinal cord.
5. A 65-year-old male presents with difficulty starting his urinary stream and a feeling of
incomplete emptying. On digital rectal exam (DRE), the prostate is found to be symmetrically
enlarged, firm, and smooth. This most likely indicates:
A. Prostate cancer
B. Prostatic abscess
C. Acute prostatitis
D. Benign prostatic hyperplasia (BPH)
Correct Answer: D
Expert Explanation: Benign prostatic hyperplasia typically presents as a smooth, rubbery,
and symmetrically enlarged prostate on examination. Prostate cancer is more likely to
