NURS 5220 Exam 3 V3 | NURS 5220
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 3) |
The University of Texas at Arlington
1. When assessing a patient’s visual acuity using the Snellen eye chart, the patient reads the
20/40 line with two errors. What is the correct interpretation of this finding?
A. The patient can see at 40 feet what a normal eye sees at 20 feet.
B. The patient’s vision is twice as good as the average person.
C. The patient can see at 20 feet what a normal eye sees at 40 feet.
D. The patient has 20% vision in the tested eye.
Answer: C
Rationale: The first number indicates the distance from the chart, while the second
number represents the distance at which a normal eye can read that line. A result of 20/40
means the patient’s vision is poorer than normal. Documentation should also include the
number of errors made on that specific line.
2. During a fundoscopic examination, the practitioner observes a ratio of 2:3 or 4:5 when
comparing the diameter of the arterioles to the venules. This finding is considered:
A. A sign of hypertensive retinopathy.
,B. A normal clinical finding in the retinal vessels.
C. A symptom of increased intracranial pressure.
D. An indication of silver wire deformity.
Answer: B
Rationale: In a healthy retina, the arterioles are typically smaller than the venules by a
ratio of roughly 2:3 or 4:5. Arterioles also appear brighter red and have a narrow light
reflex. Any significant narrowing or change in this ratio may indicate vascular disease or
chronic hypertension.
3. A patient presents with ‘pins and needles’ sensations in the thumb, index, and middle
fingers. The practitioner taps over the median nerve at the wrist to elicit a tingling sensation.
What is this test called?
A. Phalen’s maneuver
B. Tinel’s sign
C. Finkelstein’s test
D. Allen’s test
Answer: B
Rationale: Tinel’s sign is performed by percussing lightly over the median nerve where it
enters the carpal tunnel. A positive test results in paresthesia in the distribution of the
, median nerve. This maneuver is used specifically to assist in the diagnosis of Carpal Tunnel
Syndrome.
4. To evaluate the function of Cranial Nerve VIII, the practitioner performs the Weber test. In
a patient with conductive hearing loss in the right ear, where will the sound lateralize?
A. To the right (affected) ear.
B. To the midline (no lateralization).
C. To the left ear.
D. The sound will not be heard at all.
Answer: A
Rationale: In the Weber test, sound lateralizes to the impaired ear in conductive hearing
loss because the ear is not distracted by room noise. Conversely, in sensorineural loss, the
sound lateralizes to the ‘good’ ear. This occurs because the damaged nerve in the affected
ear cannot process the vibration.
5. A 70-year-old patient reports a gradual loss of central vision, but peripheral vision remains
intact. This is most characteristic of which condition?
A. Open-angle glaucoma
B. Retinal detachment
C. Age-related macular degeneration
D. Cataracts
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 3) |
The University of Texas at Arlington
1. When assessing a patient’s visual acuity using the Snellen eye chart, the patient reads the
20/40 line with two errors. What is the correct interpretation of this finding?
A. The patient can see at 40 feet what a normal eye sees at 20 feet.
B. The patient’s vision is twice as good as the average person.
C. The patient can see at 20 feet what a normal eye sees at 40 feet.
D. The patient has 20% vision in the tested eye.
Answer: C
Rationale: The first number indicates the distance from the chart, while the second
number represents the distance at which a normal eye can read that line. A result of 20/40
means the patient’s vision is poorer than normal. Documentation should also include the
number of errors made on that specific line.
2. During a fundoscopic examination, the practitioner observes a ratio of 2:3 or 4:5 when
comparing the diameter of the arterioles to the venules. This finding is considered:
A. A sign of hypertensive retinopathy.
,B. A normal clinical finding in the retinal vessels.
C. A symptom of increased intracranial pressure.
D. An indication of silver wire deformity.
Answer: B
Rationale: In a healthy retina, the arterioles are typically smaller than the venules by a
ratio of roughly 2:3 or 4:5. Arterioles also appear brighter red and have a narrow light
reflex. Any significant narrowing or change in this ratio may indicate vascular disease or
chronic hypertension.
3. A patient presents with ‘pins and needles’ sensations in the thumb, index, and middle
fingers. The practitioner taps over the median nerve at the wrist to elicit a tingling sensation.
What is this test called?
A. Phalen’s maneuver
B. Tinel’s sign
C. Finkelstein’s test
D. Allen’s test
Answer: B
Rationale: Tinel’s sign is performed by percussing lightly over the median nerve where it
enters the carpal tunnel. A positive test results in paresthesia in the distribution of the
, median nerve. This maneuver is used specifically to assist in the diagnosis of Carpal Tunnel
Syndrome.
4. To evaluate the function of Cranial Nerve VIII, the practitioner performs the Weber test. In
a patient with conductive hearing loss in the right ear, where will the sound lateralize?
A. To the right (affected) ear.
B. To the midline (no lateralization).
C. To the left ear.
D. The sound will not be heard at all.
Answer: A
Rationale: In the Weber test, sound lateralizes to the impaired ear in conductive hearing
loss because the ear is not distracted by room noise. Conversely, in sensorineural loss, the
sound lateralizes to the ‘good’ ear. This occurs because the damaged nerve in the affected
ear cannot process the vibration.
5. A 70-year-old patient reports a gradual loss of central vision, but peripheral vision remains
intact. This is most characteristic of which condition?
A. Open-angle glaucoma
B. Retinal detachment
C. Age-related macular degeneration
D. Cataracts
