NSG 500 Exam 2 V2 | NSG 500 Advanced
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 2 2026)
1. When conducting a funduscopic examination, the practitioner identifies the optic disc.
Which characteristic is considered a normal finding?
A. A yellowish-orange to creamy pink color with sharp margins.
B. A blurred or fuzzy margin around the entire disc.
C. The presence of white, cotton-wool patches on the disc surface.
D. A cup-to-disc ratio that exceeds 0.5 in both eyes.
Answer: A
Rationale: A healthy optic disc typically appears as a yellowish-orange or creamy pink
color with clearly defined, sharp margins. Blurred margins may indicate papilledema,
which is often a result of increased intracranial pressure. Cotton-wool patches and an
enlarged cup-to-disc ratio are abnormal findings associated with hypertension or glaucoma
respectively.
2. A patient presents with a ‘clogged’ sensation in the ear and decreased hearing. Otoscopic
inspection reveals a dense, white patch on the tympanic membrane. How should the
practitioner interpret this?
A. The patient has an active infection of the middle ear.
,B. This is a normal variation of the ear drum in older adults.
C. The patch indicates a fungal infection of the external canal.
D. This represents tympanosclerosis, which is scarring from prior infections.
Answer: D
Rationale: Tympanosclerosis appears as chalky white patches on the tympanic membrane
and is generally a result of scarring from previous ear infections or tympanostomy tubes.
While it can affect the mobility of the membrane, it is often a benign finding noted during
routine assessment. This should not be confused with the redness and bulging associated
with acute otitis media.
3. During a breast examination, the practitioner palpates a firm, non-tender, fixed mass in the
upper outer quadrant of the right breast. Which action is most appropriate?
A. Advise the patient to monitor the mass for changes during her next cycle.
B. Document the finding as a likely fibroadenoma and schedule a six-month follow-up.
C. Inform the patient that fixed masses are almost always benign cysts.
D. Perform a detailed assessment of the axillary and supraclavicular lymph nodes.
Answer: D
Rationale: A firm, fixed, and non-tender mass is highly suspicious for malignancy and
requires immediate further evaluation, including a comprehensive nodal assessment. The
upper outer quadrant, including the Tail of Spence, is the most common site for breast
, cancer. The practitioner must document the exact location and characteristics before
referring the patient for diagnostic imaging like a mammogram or ultrasound.
4. The practitioner is assessing a patient’s thyroid gland using the posterior approach. What
instruction should be given to the patient to facilitate palpation of the thyroid lobes?
A. ‘Please tilt your head back as far as possible.’
B. ‘Please rotate your head from side to side rapidly.’
C. ‘Please take several deep breaths and hold the last one.’
D. ‘Please take a sip of water and swallow while I hold my fingers here.’
Answer: D
Rationale: Swallowing causes the thyroid gland and the cricoid cartilage to move upward,
allowing the lobes to pass under the practitioner’s fingers. This technique is essential for
identifying the size, shape, and consistency of the gland. The patient should slightly flex the
neck forward to relax the sternocleidomastoid muscles during this procedure.
5. When auscultating the lungs of a patient with pleuritis, the practitioner hears a low-
pitched, coarse, grating sound during both inspiration and expiration. What is this sound
called?
A. Pleural friction rub
B. Coarse crackles
C. Sibilant wheezes
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 2 2026)
1. When conducting a funduscopic examination, the practitioner identifies the optic disc.
Which characteristic is considered a normal finding?
A. A yellowish-orange to creamy pink color with sharp margins.
B. A blurred or fuzzy margin around the entire disc.
C. The presence of white, cotton-wool patches on the disc surface.
D. A cup-to-disc ratio that exceeds 0.5 in both eyes.
Answer: A
Rationale: A healthy optic disc typically appears as a yellowish-orange or creamy pink
color with clearly defined, sharp margins. Blurred margins may indicate papilledema,
which is often a result of increased intracranial pressure. Cotton-wool patches and an
enlarged cup-to-disc ratio are abnormal findings associated with hypertension or glaucoma
respectively.
2. A patient presents with a ‘clogged’ sensation in the ear and decreased hearing. Otoscopic
inspection reveals a dense, white patch on the tympanic membrane. How should the
practitioner interpret this?
A. The patient has an active infection of the middle ear.
,B. This is a normal variation of the ear drum in older adults.
C. The patch indicates a fungal infection of the external canal.
D. This represents tympanosclerosis, which is scarring from prior infections.
Answer: D
Rationale: Tympanosclerosis appears as chalky white patches on the tympanic membrane
and is generally a result of scarring from previous ear infections or tympanostomy tubes.
While it can affect the mobility of the membrane, it is often a benign finding noted during
routine assessment. This should not be confused with the redness and bulging associated
with acute otitis media.
3. During a breast examination, the practitioner palpates a firm, non-tender, fixed mass in the
upper outer quadrant of the right breast. Which action is most appropriate?
A. Advise the patient to monitor the mass for changes during her next cycle.
B. Document the finding as a likely fibroadenoma and schedule a six-month follow-up.
C. Inform the patient that fixed masses are almost always benign cysts.
D. Perform a detailed assessment of the axillary and supraclavicular lymph nodes.
Answer: D
Rationale: A firm, fixed, and non-tender mass is highly suspicious for malignancy and
requires immediate further evaluation, including a comprehensive nodal assessment. The
upper outer quadrant, including the Tail of Spence, is the most common site for breast
, cancer. The practitioner must document the exact location and characteristics before
referring the patient for diagnostic imaging like a mammogram or ultrasound.
4. The practitioner is assessing a patient’s thyroid gland using the posterior approach. What
instruction should be given to the patient to facilitate palpation of the thyroid lobes?
A. ‘Please tilt your head back as far as possible.’
B. ‘Please rotate your head from side to side rapidly.’
C. ‘Please take several deep breaths and hold the last one.’
D. ‘Please take a sip of water and swallow while I hold my fingers here.’
Answer: D
Rationale: Swallowing causes the thyroid gland and the cricoid cartilage to move upward,
allowing the lobes to pass under the practitioner’s fingers. This technique is essential for
identifying the size, shape, and consistency of the gland. The patient should slightly flex the
neck forward to relax the sternocleidomastoid muscles during this procedure.
5. When auscultating the lungs of a patient with pleuritis, the practitioner hears a low-
pitched, coarse, grating sound during both inspiration and expiration. What is this sound
called?
A. Pleural friction rub
B. Coarse crackles
C. Sibilant wheezes
