NUR 6001/NUR6001 Exam 4 V1 | Advanced
Health Assessment Q&A with Rationale |
William Paterson University
1. When assessing the deep tendon reflexes of a patient, the nurse practitioner notes a
hyperactive response with clonus. How should this finding be graded on the standard scale?
A. 2+
B. 1+
C. 4+
D. 3+
Correct Answer: C
Expert Explanation: A grade of 4+ indicates a very brisk or hyperactive reflex with clonus,
which is often associated with upper motor neuron disease. In contrast, a 2+ grade is
considered normal or average for a healthy adult. A 3+ grade is brisker than average but
not necessarily indicative of disease unless it is asymmetrical.
2. A 45-year-old female presents with complaints of numbness and tingling in her thumb and
first two fingers. The nurse practitioner performs the Phalen test. Which finding would
indicate a positive result for carpal tunnel syndrome?
A. Numbness and burning after holding the backs of the hands together for 60 seconds
B. Pain during percussion over the median nerve
,C. Weakness when squeezing the examiner’s fingers
D. Visible atrophy of the thenar eminence
Correct Answer: A
Expert Explanation: The Phalen test requires the patient to hold the backs of their hands
together at a 90-degree angle for 60 seconds. A positive test is characterized by numbness
and paresthesia in the distribution of the median nerve. This maneuver increases pressure
within the carpal tunnel to elicit symptoms of nerve compression.
3. During a musculoskeletal examination, the nurse practitioner asks the patient to move
their arm away from the midline of the body. What is the correct medical term for this
movement?
A. Adduction
B. Circumduction
C. Flexion
D. Abduction
Correct Answer: D
Expert Explanation: Abduction is the movement of a limb away from the midline of the
body in the frontal plane. Adduction refers to moving the limb toward the midline, which is
the opposite of abduction. Understanding these terms is essential for documenting range of
motion during a physical assessment.
, 4. A patient presents with sudden onset of severe scrotal pain, nausea, and a high-riding
testis. The cremasteric reflex is absent on the affected side. What is the most likely diagnosis?
A. Testicular torsion
B. Acute epididymitis
C. Hydrocele
D. Inguinal hernia
Correct Answer: A
Expert Explanation: Testicular torsion is a surgical emergency characterized by the
twisting of the spermatic cord, which cuts off blood supply. The absence of the cremasteric
reflex is a highly sensitive clinical sign for torsion in the pediatric and young adult
population. Prompt recognition is critical to prevent permanent loss of the testicle.
5. Which cranial nerve is being assessed when the nurse practitioner asks the patient to shrug
their shoulders against resistance?
A. CN X (Vagus)
B. CN IX (Glossopharyngeal)
C. CN XII (Hypoglossal)
D. CN XI (Spinal Accessory)
Correct Answer: D
Health Assessment Q&A with Rationale |
William Paterson University
1. When assessing the deep tendon reflexes of a patient, the nurse practitioner notes a
hyperactive response with clonus. How should this finding be graded on the standard scale?
A. 2+
B. 1+
C. 4+
D. 3+
Correct Answer: C
Expert Explanation: A grade of 4+ indicates a very brisk or hyperactive reflex with clonus,
which is often associated with upper motor neuron disease. In contrast, a 2+ grade is
considered normal or average for a healthy adult. A 3+ grade is brisker than average but
not necessarily indicative of disease unless it is asymmetrical.
2. A 45-year-old female presents with complaints of numbness and tingling in her thumb and
first two fingers. The nurse practitioner performs the Phalen test. Which finding would
indicate a positive result for carpal tunnel syndrome?
A. Numbness and burning after holding the backs of the hands together for 60 seconds
B. Pain during percussion over the median nerve
,C. Weakness when squeezing the examiner’s fingers
D. Visible atrophy of the thenar eminence
Correct Answer: A
Expert Explanation: The Phalen test requires the patient to hold the backs of their hands
together at a 90-degree angle for 60 seconds. A positive test is characterized by numbness
and paresthesia in the distribution of the median nerve. This maneuver increases pressure
within the carpal tunnel to elicit symptoms of nerve compression.
3. During a musculoskeletal examination, the nurse practitioner asks the patient to move
their arm away from the midline of the body. What is the correct medical term for this
movement?
A. Adduction
B. Circumduction
C. Flexion
D. Abduction
Correct Answer: D
Expert Explanation: Abduction is the movement of a limb away from the midline of the
body in the frontal plane. Adduction refers to moving the limb toward the midline, which is
the opposite of abduction. Understanding these terms is essential for documenting range of
motion during a physical assessment.
, 4. A patient presents with sudden onset of severe scrotal pain, nausea, and a high-riding
testis. The cremasteric reflex is absent on the affected side. What is the most likely diagnosis?
A. Testicular torsion
B. Acute epididymitis
C. Hydrocele
D. Inguinal hernia
Correct Answer: A
Expert Explanation: Testicular torsion is a surgical emergency characterized by the
twisting of the spermatic cord, which cuts off blood supply. The absence of the cremasteric
reflex is a highly sensitive clinical sign for torsion in the pediatric and young adult
population. Prompt recognition is critical to prevent permanent loss of the testicle.
5. Which cranial nerve is being assessed when the nurse practitioner asks the patient to shrug
their shoulders against resistance?
A. CN X (Vagus)
B. CN IX (Glossopharyngeal)
C. CN XII (Hypoglossal)
D. CN XI (Spinal Accessory)
Correct Answer: D
