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NSG 5340 Health Assessment Didactic — Final EXAM
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR-JUST RELEASED
NSG 5340 Health Assessment Didactic — Final EXAM question set, written to your specifications.
First, the actual exam coverage in summarized point form based on advanced health assessment for
nurse practitioner students:
• Comprehensive Health History: Biographical data, chief complaint, history of present illness
(OLDCARTS), past medical history, family history, personal/social history, review of systems
(ROS), functional assessment (ADLs)
• Physical Examination Techniques: Inspection, palpation (light/deep), percussion
(direct/indirect, tympany vs dullness), auscultation (diaphragm/bell), order of examination
across body systems
• Vital Signs and General Survey: Normal ranges (temperature 36-38°C oral, pulse 60-100,
respirations 12-20, BP <120/80), orthostatic vitals, pulse oximetry (SpO2 >95%), pain assessment
(PQRST, numeric scale)
• Skin, Hair, and Nails: Lesion morphology (macule, papule, plaque, vesicle, bulla, pustule, nodule,
cyst, wheal, petechiae, ecchymosis), pressure injury staging (1-4, unstageable, deep tissue
injury), nail clubbing, splinter hemorrhages, pitting edema grading (1+ to 4+)
• Head, Eyes, Ears, Nose, Throat (HEENT): Visual acuity (Snellen chart, Rosenbaum near card),
confrontation visual fields, fundoscopic exam (optic disc, vessels, macula), otoscopic exam
(canal, tympanic membrane landmarks), Weber and Rinne tuning fork tests (512 Hz),
transillumination of sinuses, oral mucosa inspection, thyroid palpation (anterior/posterior
approach)
• Neurologic System: Cranial nerves I-XII, motor system (strength grading 0-5, muscle tone,
involuntary movements), sensory system (light touch, pain, vibration, proprioception,
stereognosis, graphesthesia), reflexes (0-4+, Babinski, Hoffman), coordination (finger-to-nose,
heel-to-shin, rapid alternating movements), gait (Romberg test, tandem gait), mental status
exam (MMSE, MoCA)
• Cardiovascular System: Jugular venous pressure (JVP) assessment, carotid upstroke,
auscultation of heart sounds (S1, S2, S3, S4), murmurs (systolic vs diastolic, timing, grade 1-6,
radiation), pericardial friction rub, peripheral vascular exam (pulses grading 0-3+), capillary refill
(<2 sec), ankle-brachial index (ABI)
• Respiratory System: Inspection (barrel chest, retractions, use of accessory muscles), palpation
(tactile fremitus), percussion (resonance, hyperresonance, dullness), auscultation (bronchial,
bronchiovesicular, vesicular breath sounds, adventitious sounds: crackles, wheezes, rhonchi,
pleural friction rub), egophony, bronchophony, whispered pectoriloquy
• Abdomen and Gastrointestinal: Inspection (contour, scars, distension, visible pulsations),
auscultation (bowel sounds, bruits), percussion (tympany, shifting dullness for ascites),
palpation (light then deep, hepatomegaly, splenomegaly, masses), Murphy sign, McBurney point
tenderness, rebound tenderness (Blumberg sign), guarding, rectal exam (fecal occult blood test,
prostate exam)
• Musculoskeletal System: Inspection (symmetry, alignment, muscle bulk), palpation (tenderness,
swelling, crepitus), range of motion (active vs passive, normal degrees), strength (0-5 scale),
special tests: Phalen, Tinel, drop arm test, Lachman, anterior drawer, McMurray, Trendelenburg
sign, scoliosis screening
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• Breasts and Axillae: Inspection (size, symmetry, skin changes, retraction, nipple discharge),
palpation (quadrant method, tail of Spence, axillary lymph nodes), Tanner staging for sexual
maturity
• Male and Female Genitalia: Inspection and palpation (penis, scrotum, testicles, epididymis,
inguinal canal for hernia; external genitalia, speculum exam, bimanual exam), Pap smear
guidelines, assessment for sexually transmitted infections, Tanner staging
• Older Adult Considerations: Age-related changes (presbyopia, presbycusis, decreased skin
turgor, orthostatic hypotension), functional assessment (Katz ADL, Lawton IADL), fall risk
assessment (Timed Up and Go, Get Up and Go), cognitive screening (MOCA, MMSE),
polypharmacy
• Cultural Competence in Assessment: Culturally sensitive communication, health beliefs and
practices (explanatory model), interpreter use, genetic predisposition in certain populations
(e.g., hypertension in African Americans, osteoporosis in Caucasians/Asians)
• Documentation and Clinical Reasoning: SOAP note format (Subjective, Objective, Assessment,
Plan), differential diagnosis generation, diagnostic reasoning (sensitivity, specificity, likelihood
ratios), evidence-based screening (USPSTF guidelines)
1. A 67-year-old patient reports feeling "lightheaded" when standing up from a seated position. The
most appropriate initial assessment is to measure:
A) Blood pressure in both arms simultaneously
B) Orthostatic vital signs (supine, sitting, standing)
C) Carotid bruits auscultation
D) Jugular venous pressure at 45 degrees
Correct: B – Orthostatic hypotension is defined by a drop in systolic BP ≥20 mmHg or diastolic ≥10
mmHg within 3 minutes of standing.
2. During auscultation of heart sounds, S4 is best heard with the bell of the stethoscope at which
location and patient position?
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A) Aortic area, patient sitting forward
B) Left lateral decubitus position, apex
C) Supine, right sternal border
D) Standing, pulmonic area
Correct: B – S4 (atrial gallop) is best heard at the apex in left lateral decubitus position using the bell.
3. A patient presents with a palpable raised lesion that is less than 0.5 cm in diameter. The correct term
for this primary skin lesion is:
A) Macule
B) Papule
C) Plaque
D) Nodule
Correct: B – A papule is a palpable, solid lesion <0.5 cm; a macule is flat, a plaque is >0.5 cm, a nodule is
deeper and larger.
4. When performing the Weber test using a 512 Hz tuning fork, the patient reports the sound is louder
in the right ear. This finding is consistent with:
A) Right sensorineural hearing loss
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B) Right conductive hearing loss or left sensorineural loss
C) Normal hearing in both ears
D) Left conductive hearing loss
Correct: B – Weber lateralizes to the ear with conductive loss (blocked sound) or away from ear with
sensorineural loss.
5. To assess for appendicitis, a nurse practitioner performs the Blumberg sign, which is positive when:
A) Pain is elicited upon deep palpation in the left lower quadrant
B) Pain worsens when the patient lifts the right leg against resistance
C) Rebound tenderness is elicited after rapid release of deep palpation
D) Palpation of the left lower quadrant causes pain in the right lower quadrant
Correct: C – Rebound tenderness (Blumberg sign) indicates peritoneal irritation, often associated with
appendicitis.
6. Which cranial nerve is being tested when a patient is asked to shrug their shoulders against
resistance?
A) Cranial nerve X (Vagus)
B) Cranial nerve XI (Spinal Accessory)
NSG 5340 Health Assessment Didactic — Final EXAM
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR-JUST RELEASED
NSG 5340 Health Assessment Didactic — Final EXAM question set, written to your specifications.
First, the actual exam coverage in summarized point form based on advanced health assessment for
nurse practitioner students:
• Comprehensive Health History: Biographical data, chief complaint, history of present illness
(OLDCARTS), past medical history, family history, personal/social history, review of systems
(ROS), functional assessment (ADLs)
• Physical Examination Techniques: Inspection, palpation (light/deep), percussion
(direct/indirect, tympany vs dullness), auscultation (diaphragm/bell), order of examination
across body systems
• Vital Signs and General Survey: Normal ranges (temperature 36-38°C oral, pulse 60-100,
respirations 12-20, BP <120/80), orthostatic vitals, pulse oximetry (SpO2 >95%), pain assessment
(PQRST, numeric scale)
• Skin, Hair, and Nails: Lesion morphology (macule, papule, plaque, vesicle, bulla, pustule, nodule,
cyst, wheal, petechiae, ecchymosis), pressure injury staging (1-4, unstageable, deep tissue
injury), nail clubbing, splinter hemorrhages, pitting edema grading (1+ to 4+)
• Head, Eyes, Ears, Nose, Throat (HEENT): Visual acuity (Snellen chart, Rosenbaum near card),
confrontation visual fields, fundoscopic exam (optic disc, vessels, macula), otoscopic exam
(canal, tympanic membrane landmarks), Weber and Rinne tuning fork tests (512 Hz),
transillumination of sinuses, oral mucosa inspection, thyroid palpation (anterior/posterior
approach)
• Neurologic System: Cranial nerves I-XII, motor system (strength grading 0-5, muscle tone,
involuntary movements), sensory system (light touch, pain, vibration, proprioception,
stereognosis, graphesthesia), reflexes (0-4+, Babinski, Hoffman), coordination (finger-to-nose,
heel-to-shin, rapid alternating movements), gait (Romberg test, tandem gait), mental status
exam (MMSE, MoCA)
• Cardiovascular System: Jugular venous pressure (JVP) assessment, carotid upstroke,
auscultation of heart sounds (S1, S2, S3, S4), murmurs (systolic vs diastolic, timing, grade 1-6,
radiation), pericardial friction rub, peripheral vascular exam (pulses grading 0-3+), capillary refill
(<2 sec), ankle-brachial index (ABI)
• Respiratory System: Inspection (barrel chest, retractions, use of accessory muscles), palpation
(tactile fremitus), percussion (resonance, hyperresonance, dullness), auscultation (bronchial,
bronchiovesicular, vesicular breath sounds, adventitious sounds: crackles, wheezes, rhonchi,
pleural friction rub), egophony, bronchophony, whispered pectoriloquy
• Abdomen and Gastrointestinal: Inspection (contour, scars, distension, visible pulsations),
auscultation (bowel sounds, bruits), percussion (tympany, shifting dullness for ascites),
palpation (light then deep, hepatomegaly, splenomegaly, masses), Murphy sign, McBurney point
tenderness, rebound tenderness (Blumberg sign), guarding, rectal exam (fecal occult blood test,
prostate exam)
• Musculoskeletal System: Inspection (symmetry, alignment, muscle bulk), palpation (tenderness,
swelling, crepitus), range of motion (active vs passive, normal degrees), strength (0-5 scale),
special tests: Phalen, Tinel, drop arm test, Lachman, anterior drawer, McMurray, Trendelenburg
sign, scoliosis screening
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• Breasts and Axillae: Inspection (size, symmetry, skin changes, retraction, nipple discharge),
palpation (quadrant method, tail of Spence, axillary lymph nodes), Tanner staging for sexual
maturity
• Male and Female Genitalia: Inspection and palpation (penis, scrotum, testicles, epididymis,
inguinal canal for hernia; external genitalia, speculum exam, bimanual exam), Pap smear
guidelines, assessment for sexually transmitted infections, Tanner staging
• Older Adult Considerations: Age-related changes (presbyopia, presbycusis, decreased skin
turgor, orthostatic hypotension), functional assessment (Katz ADL, Lawton IADL), fall risk
assessment (Timed Up and Go, Get Up and Go), cognitive screening (MOCA, MMSE),
polypharmacy
• Cultural Competence in Assessment: Culturally sensitive communication, health beliefs and
practices (explanatory model), interpreter use, genetic predisposition in certain populations
(e.g., hypertension in African Americans, osteoporosis in Caucasians/Asians)
• Documentation and Clinical Reasoning: SOAP note format (Subjective, Objective, Assessment,
Plan), differential diagnosis generation, diagnostic reasoning (sensitivity, specificity, likelihood
ratios), evidence-based screening (USPSTF guidelines)
1. A 67-year-old patient reports feeling "lightheaded" when standing up from a seated position. The
most appropriate initial assessment is to measure:
A) Blood pressure in both arms simultaneously
B) Orthostatic vital signs (supine, sitting, standing)
C) Carotid bruits auscultation
D) Jugular venous pressure at 45 degrees
Correct: B – Orthostatic hypotension is defined by a drop in systolic BP ≥20 mmHg or diastolic ≥10
mmHg within 3 minutes of standing.
2. During auscultation of heart sounds, S4 is best heard with the bell of the stethoscope at which
location and patient position?
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A) Aortic area, patient sitting forward
B) Left lateral decubitus position, apex
C) Supine, right sternal border
D) Standing, pulmonic area
Correct: B – S4 (atrial gallop) is best heard at the apex in left lateral decubitus position using the bell.
3. A patient presents with a palpable raised lesion that is less than 0.5 cm in diameter. The correct term
for this primary skin lesion is:
A) Macule
B) Papule
C) Plaque
D) Nodule
Correct: B – A papule is a palpable, solid lesion <0.5 cm; a macule is flat, a plaque is >0.5 cm, a nodule is
deeper and larger.
4. When performing the Weber test using a 512 Hz tuning fork, the patient reports the sound is louder
in the right ear. This finding is consistent with:
A) Right sensorineural hearing loss
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B) Right conductive hearing loss or left sensorineural loss
C) Normal hearing in both ears
D) Left conductive hearing loss
Correct: B – Weber lateralizes to the ear with conductive loss (blocked sound) or away from ear with
sensorineural loss.
5. To assess for appendicitis, a nurse practitioner performs the Blumberg sign, which is positive when:
A) Pain is elicited upon deep palpation in the left lower quadrant
B) Pain worsens when the patient lifts the right leg against resistance
C) Rebound tenderness is elicited after rapid release of deep palpation
D) Palpation of the left lower quadrant causes pain in the right lower quadrant
Correct: C – Rebound tenderness (Blumberg sign) indicates peritoneal irritation, often associated with
appendicitis.
6. Which cranial nerve is being tested when a patient is asked to shrug their shoulders against
resistance?
A) Cranial nerve X (Vagus)
B) Cranial nerve XI (Spinal Accessory)
