NSG 500 Exam 4 V2 | NSG 500 Advanced
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 4 2026)
1. During a neurological examination, the nurse practitioner asks the patient to stick out their
tongue and move it from side to side. Which cranial nerve is being primarily assessed?
A. Cranial Nerve IX (Glossopharyngeal)
B. Cranial Nerve XII (Hypoglossal)
C. Cranial Nerve X (Vagus)
D. Cranial Nerve VII (Facial)
Answer: B
Rationale: Cranial Nerve XII, the hypoglossal nerve, is responsible for the motor
movement of the tongue. Evaluation involves observing for midline protrusion and
strength against resistance. Weakness or deviation may indicate a lower motor neuron
lesion on the side the tongue deviates toward.
2. A 75-year-old patient presents with difficulty performing Instrumental Activities of Daily
Living (IADLs). Which of the following is considered an IADL?
A. Managing finances
B. Bathing
,C. Toileting
D. Dressing
Answer: A
Rationale: IADLs refer to complex skills needed to live independently in the community,
such as managing finances, shopping, or using a telephone. In contrast, basic ADLs focus on
fundamental self-care tasks like bathing, dressing, and toileting. Distinguishing between the
two is vital for determining the level of support a geriatric patient requires.
3. When assessing an infant, the practitioner notes a positive Ortolani sign. This finding is
indicative of which condition?
A. Developmental dysplasia of the hip
B. Spina bifida
C. Clubfoot
D. Tibial torsion
Answer: A
Rationale: The Ortolani maneuver is used to identify a dislocated hip that can be reduced
back into the acetabulum. A positive test is felt as a ‘clunk’ as the femoral head slides over
the posterior acetabular rim. This is a critical screening tool in newborn and infant
musculoskeletal assessments.
, 4. An elderly patient reports a gradual loss of peripheral vision, but central vision remains
intact. This clinical presentation is most consistent with:
A. Glaucoma
B. Macular degeneration
C. Cataracts
D. Retinal detachment
Answer: A
Rationale: Glaucoma typically involves increased intraocular pressure that damages the
optic nerve, leading to a loss of peripheral vision, often described as tunnel vision. Macular
degeneration conversely affects central vision while sparing the periphery. Cataracts
generally cause a global blurring of vision rather than specific field loss.
5. Which of the following findings is considered abnormal during a physical assessment of the
male genitalia?
A. The left testicle hangs lower than the right
B. A painless, heavy feeling in the scrotum with a ‘bag of worms’ appearance
C. Testes that are oval and firm to palpation
D. A prepuce that easily retracts in an uncircumcised male
Answer: B
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 4 2026)
1. During a neurological examination, the nurse practitioner asks the patient to stick out their
tongue and move it from side to side. Which cranial nerve is being primarily assessed?
A. Cranial Nerve IX (Glossopharyngeal)
B. Cranial Nerve XII (Hypoglossal)
C. Cranial Nerve X (Vagus)
D. Cranial Nerve VII (Facial)
Answer: B
Rationale: Cranial Nerve XII, the hypoglossal nerve, is responsible for the motor
movement of the tongue. Evaluation involves observing for midline protrusion and
strength against resistance. Weakness or deviation may indicate a lower motor neuron
lesion on the side the tongue deviates toward.
2. A 75-year-old patient presents with difficulty performing Instrumental Activities of Daily
Living (IADLs). Which of the following is considered an IADL?
A. Managing finances
B. Bathing
,C. Toileting
D. Dressing
Answer: A
Rationale: IADLs refer to complex skills needed to live independently in the community,
such as managing finances, shopping, or using a telephone. In contrast, basic ADLs focus on
fundamental self-care tasks like bathing, dressing, and toileting. Distinguishing between the
two is vital for determining the level of support a geriatric patient requires.
3. When assessing an infant, the practitioner notes a positive Ortolani sign. This finding is
indicative of which condition?
A. Developmental dysplasia of the hip
B. Spina bifida
C. Clubfoot
D. Tibial torsion
Answer: A
Rationale: The Ortolani maneuver is used to identify a dislocated hip that can be reduced
back into the acetabulum. A positive test is felt as a ‘clunk’ as the femoral head slides over
the posterior acetabular rim. This is a critical screening tool in newborn and infant
musculoskeletal assessments.
, 4. An elderly patient reports a gradual loss of peripheral vision, but central vision remains
intact. This clinical presentation is most consistent with:
A. Glaucoma
B. Macular degeneration
C. Cataracts
D. Retinal detachment
Answer: A
Rationale: Glaucoma typically involves increased intraocular pressure that damages the
optic nerve, leading to a loss of peripheral vision, often described as tunnel vision. Macular
degeneration conversely affects central vision while sparing the periphery. Cataracts
generally cause a global blurring of vision rather than specific field loss.
5. Which of the following findings is considered abnormal during a physical assessment of the
male genitalia?
A. The left testicle hangs lower than the right
B. A painless, heavy feeling in the scrotum with a ‘bag of worms’ appearance
C. Testes that are oval and firm to palpation
D. A prepuce that easily retracts in an uncircumcised male
Answer: B
