NURS 5220 Exam 4 V3 | NURS 5220
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 4) |
The University of Texas at Arlington
1. When assessing the abdomen, which sequence of physical examination techniques should
the nurse practitioner follow?
A. Inspection, auscultation, percussion, palpation
B. Inspection, palpation, percussion, auscultation
C. Inspection, auscultation, palpation, percussion
D. Auscultation, inspection, percussion, palpation
Answer: A
Rationale: The correct sequence for abdominal assessment is inspection, followed by
auscultation, percussion, and finally palpation. This specific order is necessary because
percussion and palpation can increase peristalsis, which would result in false bowel sound
findings. Following this standardized procedure ensures the accuracy of the diagnostic
reasoning process.
,2. A patient presents with sharp pain in the right upper quadrant that worsens with deep
inspiration. During palpation under the right costal margin, the patient abruptly stops
inhaling due to pain. This finding is documented as:
A. A positive Rovsing sign
B. A positive Psoas sign
C. A positive Blumberg sign
D. A positive Murphy sign
Answer: D
Rationale: The Murphy sign is a specific clinical indicator for acute cholecystitis. As the
patient breathes in, the gallbladder descends and hits the examiner’s fingers, causing sharp
pain. A positive result is defined by the cessation of inspiration and is highly suggestive of
gallbladder inflammation.
3. Which maneuver is most appropriate for assessing the stability of the anterior cruciate
ligament (ACL) in the knee?
A. McMurray test
B. Thomas test
C. Bulge sign
D. Lachman test
Answer: D
, Rationale: The Lachman test is considered the most sensitive clinical maneuver for
detecting an ACL tear. The clinician stabilizes the femur and pulls the tibia forward to check
for excessive laxity. While the Anterior Drawer test is also used, the Lachman test is often
preferred due to its higher diagnostic accuracy.
4. During a neurological exam, the clinician asks the patient to identify a common object,
such as a key, placed in their hand while their eyes are closed. This is a test of:
A. Stereognosis
B. Graphesthesia
C. Two-point discrimination
D. Extinction
Answer: A
Rationale: Stereognosis is the ability to recognize the form and nature of an object by
touch without visual input. This test evaluates the higher cortical functions of the parietal
lobe. Graphesthesia, by contrast, involves identifying numbers or letters traced on the skin.
5. A patient reports localized pain at the right lower quadrant when the clinician palpates the
left lower quadrant. This finding is known as:
A. The Iliopsoas sign
B. The McBurney sign
C. The Obturator sign
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 4) |
The University of Texas at Arlington
1. When assessing the abdomen, which sequence of physical examination techniques should
the nurse practitioner follow?
A. Inspection, auscultation, percussion, palpation
B. Inspection, palpation, percussion, auscultation
C. Inspection, auscultation, palpation, percussion
D. Auscultation, inspection, percussion, palpation
Answer: A
Rationale: The correct sequence for abdominal assessment is inspection, followed by
auscultation, percussion, and finally palpation. This specific order is necessary because
percussion and palpation can increase peristalsis, which would result in false bowel sound
findings. Following this standardized procedure ensures the accuracy of the diagnostic
reasoning process.
,2. A patient presents with sharp pain in the right upper quadrant that worsens with deep
inspiration. During palpation under the right costal margin, the patient abruptly stops
inhaling due to pain. This finding is documented as:
A. A positive Rovsing sign
B. A positive Psoas sign
C. A positive Blumberg sign
D. A positive Murphy sign
Answer: D
Rationale: The Murphy sign is a specific clinical indicator for acute cholecystitis. As the
patient breathes in, the gallbladder descends and hits the examiner’s fingers, causing sharp
pain. A positive result is defined by the cessation of inspiration and is highly suggestive of
gallbladder inflammation.
3. Which maneuver is most appropriate for assessing the stability of the anterior cruciate
ligament (ACL) in the knee?
A. McMurray test
B. Thomas test
C. Bulge sign
D. Lachman test
Answer: D
, Rationale: The Lachman test is considered the most sensitive clinical maneuver for
detecting an ACL tear. The clinician stabilizes the femur and pulls the tibia forward to check
for excessive laxity. While the Anterior Drawer test is also used, the Lachman test is often
preferred due to its higher diagnostic accuracy.
4. During a neurological exam, the clinician asks the patient to identify a common object,
such as a key, placed in their hand while their eyes are closed. This is a test of:
A. Stereognosis
B. Graphesthesia
C. Two-point discrimination
D. Extinction
Answer: A
Rationale: Stereognosis is the ability to recognize the form and nature of an object by
touch without visual input. This test evaluates the higher cortical functions of the parietal
lobe. Graphesthesia, by contrast, involves identifying numbers or letters traced on the skin.
5. A patient reports localized pain at the right lower quadrant when the clinician palpates the
left lower quadrant. This finding is known as:
A. The Iliopsoas sign
B. The McBurney sign
C. The Obturator sign
