NUR 6001/NUR6001 Final Exam V3 |
Advanced Health Assessment Q&A with
Rationale | William Paterson University
1. During a cardiac assessment, the practitioner notes a low-pitched sound occurring in early
diastole at the apex. What is the most likely interpretation?
A. An S3 gallop, possibly indicating fluid overload
B. A normal S1 sound
C. An S4 sound, indicating stiff ventricles
D. A pericardial friction rub
Correct Answer: A
Expert Explanation: The S3 heart sound occurs early in diastole during the rapid
ventricular filling phase. It is often associated with conditions like heart failure where there
is excessive fluid volume. This sound is best heard with the bell of the stethoscope at the
apex while the patient is in the left lateral decubitus position.
2. When performing an abdominal assessment, the practitioner elicits pain when pressure is
applied to the gallbladder area during inspiration. This is known as:
A. Murphy’s sign
B. Psoas sign
C. Rovsing’s sign
,D. McBurney’s point tenderness
Correct Answer: A
Expert Explanation: Murphy’s sign is a clinical test for gallbladder disease or cholecystitis.
The patient is asked to inhale while the examiner’s fingers are hooked under the liver
border at the bottom of the rib cage. A positive test is indicated when the patient abruptly
stops inhaling due to sharp pain as the gallbladder descends onto the examiner’s fingers.
3. Which of the following physical exam findings is most consistent with a diagnosis of lobar
pneumonia?
A. Decreased tactile fremitus and hyperresonance
B. Increased tactile fremitus and dullness to percussion
C. Vesicular breath sounds throughout all lung fields
D. Tracheal deviation to the unaffected side
Correct Answer: B
Expert Explanation: Lobar pneumonia results in consolidation of lung tissue which
conducts sound vibrations better than air-filled lungs. This leads to increased tactile
fremitus over the affected area during palpation. Percussion will yield a dull note because
the solid or fluid-filled tissue replaces the normal resonant air-filled space.
4. A patient presents with a ‘drooping’ face on one side and an inability to close the eye on
that same side. Which cranial nerve is likely affected?
A. Cranial Nerve V (Trigeminal)
, B. Cranial Nerve VI (Abducens)
C. Cranial Nerve VII (Facial)
D. Cranial Nerve VIII (Vestibulocochlear)
Correct Answer: C
Expert Explanation: The facial nerve, or Cranial Nerve VII, controls the muscles of facial
expression. Damage to this nerve, as seen in Bell’s Palsy, results in weakness or paralysis of
one side of the face. This condition typically affects both the upper and lower portions of
the face, distinguishing it from a central stroke.
5. The Romberg test is used to assess which of the following?
A. Fine motor coordination
B. Cerebellar function and proprioception
C. Level of consciousness
D. Muscle strength in the lower extremities
Correct Answer: B
Expert Explanation: The Romberg test evaluates the patient’s ability to maintain an
upright position without visual cues. It primarily tests the integration of the vestibular
system, proprioception, and vision for balance. A positive result occurs when the patient
loses balance significantly after closing their eyes, suggesting sensory ataxia.
Advanced Health Assessment Q&A with
Rationale | William Paterson University
1. During a cardiac assessment, the practitioner notes a low-pitched sound occurring in early
diastole at the apex. What is the most likely interpretation?
A. An S3 gallop, possibly indicating fluid overload
B. A normal S1 sound
C. An S4 sound, indicating stiff ventricles
D. A pericardial friction rub
Correct Answer: A
Expert Explanation: The S3 heart sound occurs early in diastole during the rapid
ventricular filling phase. It is often associated with conditions like heart failure where there
is excessive fluid volume. This sound is best heard with the bell of the stethoscope at the
apex while the patient is in the left lateral decubitus position.
2. When performing an abdominal assessment, the practitioner elicits pain when pressure is
applied to the gallbladder area during inspiration. This is known as:
A. Murphy’s sign
B. Psoas sign
C. Rovsing’s sign
,D. McBurney’s point tenderness
Correct Answer: A
Expert Explanation: Murphy’s sign is a clinical test for gallbladder disease or cholecystitis.
The patient is asked to inhale while the examiner’s fingers are hooked under the liver
border at the bottom of the rib cage. A positive test is indicated when the patient abruptly
stops inhaling due to sharp pain as the gallbladder descends onto the examiner’s fingers.
3. Which of the following physical exam findings is most consistent with a diagnosis of lobar
pneumonia?
A. Decreased tactile fremitus and hyperresonance
B. Increased tactile fremitus and dullness to percussion
C. Vesicular breath sounds throughout all lung fields
D. Tracheal deviation to the unaffected side
Correct Answer: B
Expert Explanation: Lobar pneumonia results in consolidation of lung tissue which
conducts sound vibrations better than air-filled lungs. This leads to increased tactile
fremitus over the affected area during palpation. Percussion will yield a dull note because
the solid or fluid-filled tissue replaces the normal resonant air-filled space.
4. A patient presents with a ‘drooping’ face on one side and an inability to close the eye on
that same side. Which cranial nerve is likely affected?
A. Cranial Nerve V (Trigeminal)
, B. Cranial Nerve VI (Abducens)
C. Cranial Nerve VII (Facial)
D. Cranial Nerve VIII (Vestibulocochlear)
Correct Answer: C
Expert Explanation: The facial nerve, or Cranial Nerve VII, controls the muscles of facial
expression. Damage to this nerve, as seen in Bell’s Palsy, results in weakness or paralysis of
one side of the face. This condition typically affects both the upper and lower portions of
the face, distinguishing it from a central stroke.
5. The Romberg test is used to assess which of the following?
A. Fine motor coordination
B. Cerebellar function and proprioception
C. Level of consciousness
D. Muscle strength in the lower extremities
Correct Answer: B
Expert Explanation: The Romberg test evaluates the patient’s ability to maintain an
upright position without visual cues. It primarily tests the integration of the vestibular
system, proprioception, and vision for balance. A positive result occurs when the patient
loses balance significantly after closing their eyes, suggesting sensory ataxia.
