NURS 6512 Final Exam V3 | NURS 6512
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Final
Exam) | Walden University
1. During a physical examination, the clinician notes a positive Murphy sign. This finding is
most suggestive of which clinical condition?
A. Acute appendicitis
B. Acute cholecystitis
C. Renal calculi
D. Splenic rupture
Answer: B
Rationale: A positive Murphy sign occurs when a patient experiences a sharp increase in
tenderness and a sudden stop in inspiratory effort during deep palpation of the right upper
quadrant. This clinical sign is highly sensitive for acute cholecystitis, as the inflamed
gallbladder comes into contact with the examiner’s hand during inspiration. The examiner
should document this finding specifically to assist in the differential diagnosis of abdominal
pain.
2. When performing a Weber test, a patient with conductive hearing loss in the right ear will
experience which of the following results?
A. Sound lateralizes to the left ear
,B. Sound is heard equally in both ears
C. Sound lateralizes to the right ear
D. Sound is not heard at all
Answer: C
Rationale: In conductive hearing loss, the sound lateralizes to the impaired ear because
the affected ear is not distracted by ambient room noise. The Weber test uses a vibrating
tuning fork placed on the midline of the skull to assess bone conduction. This assessment
helps clinicians differentiate between sensorineural and conductive hearing deficits during
a head and neck examination.
3. The clinician is assessing a patient’s deep tendon reflexes and finds them to be very brisk
with rhythmic oscillations (clonus). How should this be documented on a standard scale?
A. 1+
B. 2+
C. 4+
D. 3+
Answer: C
Rationale: A reflex grade of 4+ indicates a hyperactive response that is often associated
with disease and may include clonus. The standard grading scale ranges from 0 to 4+,
where 2+ is considered a normal or average response. Accurate documentation of reflex
, intensity is crucial for monitoring neurological status and identifying potential upper
motor neuron lesions.
4. Which heart sound is commonly associated with heart failure and is referred to as a
ventricular gallop?
A. S1
B. S2
C. S4
D. S3
Answer: D
Rationale: The S3 heart sound occurs during the early phase of diastole and is caused by
rapid ventricular filling into a non-compliant or overfilled chamber. It is frequently heard in
patients with fluid overload or congestive heart failure and is best auscultated with the bell
of the stethoscope at the apex. This finding is often physiologically normal in children and
young adults but pathological in older populations.
5. During a skin assessment, the clinician observes a lesion that is flat, non-palpable, and less
than 1 cm in diameter. Which term best describes this finding?
A. Macule
B. Papule
C. Plaque
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Final
Exam) | Walden University
1. During a physical examination, the clinician notes a positive Murphy sign. This finding is
most suggestive of which clinical condition?
A. Acute appendicitis
B. Acute cholecystitis
C. Renal calculi
D. Splenic rupture
Answer: B
Rationale: A positive Murphy sign occurs when a patient experiences a sharp increase in
tenderness and a sudden stop in inspiratory effort during deep palpation of the right upper
quadrant. This clinical sign is highly sensitive for acute cholecystitis, as the inflamed
gallbladder comes into contact with the examiner’s hand during inspiration. The examiner
should document this finding specifically to assist in the differential diagnosis of abdominal
pain.
2. When performing a Weber test, a patient with conductive hearing loss in the right ear will
experience which of the following results?
A. Sound lateralizes to the left ear
,B. Sound is heard equally in both ears
C. Sound lateralizes to the right ear
D. Sound is not heard at all
Answer: C
Rationale: In conductive hearing loss, the sound lateralizes to the impaired ear because
the affected ear is not distracted by ambient room noise. The Weber test uses a vibrating
tuning fork placed on the midline of the skull to assess bone conduction. This assessment
helps clinicians differentiate between sensorineural and conductive hearing deficits during
a head and neck examination.
3. The clinician is assessing a patient’s deep tendon reflexes and finds them to be very brisk
with rhythmic oscillations (clonus). How should this be documented on a standard scale?
A. 1+
B. 2+
C. 4+
D. 3+
Answer: C
Rationale: A reflex grade of 4+ indicates a hyperactive response that is often associated
with disease and may include clonus. The standard grading scale ranges from 0 to 4+,
where 2+ is considered a normal or average response. Accurate documentation of reflex
, intensity is crucial for monitoring neurological status and identifying potential upper
motor neuron lesions.
4. Which heart sound is commonly associated with heart failure and is referred to as a
ventricular gallop?
A. S1
B. S2
C. S4
D. S3
Answer: D
Rationale: The S3 heart sound occurs during the early phase of diastole and is caused by
rapid ventricular filling into a non-compliant or overfilled chamber. It is frequently heard in
patients with fluid overload or congestive heart failure and is best auscultated with the bell
of the stethoscope at the apex. This finding is often physiologically normal in children and
young adults but pathological in older populations.
5. During a skin assessment, the clinician observes a lesion that is flat, non-palpable, and less
than 1 cm in diameter. Which term best describes this finding?
A. Macule
B. Papule
C. Plaque
