This comprehensive test bank contains 200 multiple-choice questions covering NSG 500
Exam 2 for Wilkes University Advanced Health Assessment (2026). Topics include
Neurologic, HEENT, Cardiovascular, Respiratory, Abdominal, Musculoskeletal, and
Integumentary assessments. Each question includes the correct answer and a concise
rationale for evidence-based learning. Perfect for exam preparation, this study guide
follows actual test bank format with Select All That Apply and standard multiple-choice
questions. Updated for 2026 curriculum. Master advanced health assessment and
guarantee your success on the NSG 500 Exam 2.
SECTION 1: NEUROLOGIC ASSESSMENT (Questions 1-40)
1. A 72-year-old client presents for a routine physical examination. The nurse
practitioner notes normal age-related changes. Which findings are consistent
with normal aging? (Select All That Apply)
A. Decreased taste sensation
B. Thinning skin with wrinkles
C. Difficulty swallowing (dysphagia)
D. Dry eyes
E. Thicker, coarse hair on eyebrows, nose, and ears
F. Muscle atrophy and gait abnormalities
Correct Answers: A, B, D, E
Rationale: Normal aging includes sensory deficits, skin thinning/wrinkles, dry
eyes, and coarse facial hair. Dysphagia and motor deficits are abnormal.
2. A 45-year-old client reports a "band-like" pressure sensation around the
entire head that is bilateral and non-throbbing. The nurse practitioner
recognizes this as most consistent with which type of headache?
A. Migraine
B. Cluster
C. Tension
D. Sinus
Correct Answer: C
,Rationale: Tension headaches feature bilateral band-like pressure, non-
throbbing. Migraines are unilateral with photophobia/N/V; cluster presents
with periorbital pain and autonomic symptoms; sinus involves facial pressure.
3. A 16-year-old adolescent reports unilateral head pain accompanied by nausea,
vomiting, and sensitivity to light. The client states, "I know what my normal
headache feels like, and this is different." The nurse practitioner recognizes
these findings as most consistent with:
A. Tension headache
B. Cluster headache
C. Migraine
D. Sinus headache
Correct Answer: C
Rationale: Migraines are unilateral with photophobia, N/V, and onset in
adolescence. Clients can distinguish their migraine pattern from other types.
4. A 50-year-old male presents with severe, stabbing pain behind his right eye,
accompanied by tearing and a runny nose on the same side. The episodes occur
daily for two weeks. The nurse practitioner recognizes this as:
A. Tension headache
B. Migraine
C. Cluster headache
D. Sinus headache
Correct Answer: C
Rationale: Cluster headaches are periorbital with autonomic symptoms (tearing,
rhinorrhea). They occur in clusters over weeks, typically in males.
5. A client presents with facial pressure, tenderness in the maxillary region,
nasal congestion, and sore throat. The nurse practitioner recognizes these
symptoms as consistent with:
A. Tension headache
B. Cluster headache
C. Migraine
D. Sinus headache
Correct Answer: D
Rationale: Sinus headaches present with facial pressure, maxillary tenderness,
and URI symptoms. Differentiates from tension (band-like) and cluster
(periorbital with tearing).
,6. The nurse practitioner is preparing to examine a client's pupils. Which
technique represents the BEST method for this examination?
A. Examine both pupils simultaneously with room lights on
B. Examine in a darkened room, one eye at a time, using a penlight from the
outer portion inward
C. Examine both pupils simultaneously in a brightly lit room
D. Cross the penlight from one eye to the other while examining both eyes
together
Correct Answer: B
Rationale: Best technique is darkened room, one eye at a time, penlight from
outer to inner. Avoids consensual reflex interference and allows accurate
assessment.
7. A client presents with sudden onset of severe headache described as "the
worst headache of my life." The nurse practitioner's priority action is:
A. Administer analgesic medication
B. Order a non-contrast CT head stat
C. Perform a thorough neurologic exam
D. Reassure the client and schedule follow-up
Correct Answer: B
Rationale: "Worst headache of life" suggests subarachnoid hemorrhage. Non-
contrast CT is the priority to rule out bleeding. Time is critical.
8. Which cranial nerve is assessed by testing the client's ability to shrug
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
Correct Answer: C
Rationale: CN XI (Spinal Accessory) innervates the sternocleidomastoid and
trapezius muscles for shoulder shrug and head rotation. CN IX/X for swallowing
and gag; CN XII for tongue movement.
9. A client has difficulty understanding spoken language but can speak fluently.
The nurse practitioner suspects damage to which area of the brain?
A. Broca's area
B. Wernicke's area
, C. Primary motor cortex
D. Cerebellum
Correct Answer: B
Rationale: Wernicke's area (temporal lobe) is responsible for language
comprehension. Damage causes fluent but meaningless speech with poor
comprehension. Broca's affects speech production.
10. Which finding is an EARLY sign of increased intracranial pressure (ICP)?
A. Papilledema
B. Cushing's triad
C. Change in level of consciousness
D. Decorticate posturing
Correct Answer: C
Rationale: Altered LOC is the earliest and most sensitive sign of increased ICP.
Papilledema, Cushing's triad (HTN, bradycardia, irregular respirations), and
posturing are LATE signs.
11. The nurse practitioner is performing a neurologic exam on a client with
peripheral neuropathy. Which finding would be expected?
A. Hyperreflexia
B. Positive Babinski sign
C. Diminished deep tendon reflexes
D. Spasticity
Correct Answer: C
Rationale: Peripheral neuropathy causes diminished or absent reflexes due to
lower motor neuron damage. Hyperreflexia, Babinski, and spasticity indicate
upper motor neuron lesions.
12. A client presents with weakness of the lower face on the right side but can
wrinkle the forehead bilaterally. The nurse practitioner suspects:
A. Bell's palsy
B. CVA (stroke)
C. Trigeminal neuralgia
D. Myasthenia gravis
Correct Answer: B
Rationale: Upper motor neuron lesions (stroke) spare forehead because of
bilateral innervation. Bell's palsy (lower motor neuron) affects entire half of
face including forehead.
Exam 2 for Wilkes University Advanced Health Assessment (2026). Topics include
Neurologic, HEENT, Cardiovascular, Respiratory, Abdominal, Musculoskeletal, and
Integumentary assessments. Each question includes the correct answer and a concise
rationale for evidence-based learning. Perfect for exam preparation, this study guide
follows actual test bank format with Select All That Apply and standard multiple-choice
questions. Updated for 2026 curriculum. Master advanced health assessment and
guarantee your success on the NSG 500 Exam 2.
SECTION 1: NEUROLOGIC ASSESSMENT (Questions 1-40)
1. A 72-year-old client presents for a routine physical examination. The nurse
practitioner notes normal age-related changes. Which findings are consistent
with normal aging? (Select All That Apply)
A. Decreased taste sensation
B. Thinning skin with wrinkles
C. Difficulty swallowing (dysphagia)
D. Dry eyes
E. Thicker, coarse hair on eyebrows, nose, and ears
F. Muscle atrophy and gait abnormalities
Correct Answers: A, B, D, E
Rationale: Normal aging includes sensory deficits, skin thinning/wrinkles, dry
eyes, and coarse facial hair. Dysphagia and motor deficits are abnormal.
2. A 45-year-old client reports a "band-like" pressure sensation around the
entire head that is bilateral and non-throbbing. The nurse practitioner
recognizes this as most consistent with which type of headache?
A. Migraine
B. Cluster
C. Tension
D. Sinus
Correct Answer: C
,Rationale: Tension headaches feature bilateral band-like pressure, non-
throbbing. Migraines are unilateral with photophobia/N/V; cluster presents
with periorbital pain and autonomic symptoms; sinus involves facial pressure.
3. A 16-year-old adolescent reports unilateral head pain accompanied by nausea,
vomiting, and sensitivity to light. The client states, "I know what my normal
headache feels like, and this is different." The nurse practitioner recognizes
these findings as most consistent with:
A. Tension headache
B. Cluster headache
C. Migraine
D. Sinus headache
Correct Answer: C
Rationale: Migraines are unilateral with photophobia, N/V, and onset in
adolescence. Clients can distinguish their migraine pattern from other types.
4. A 50-year-old male presents with severe, stabbing pain behind his right eye,
accompanied by tearing and a runny nose on the same side. The episodes occur
daily for two weeks. The nurse practitioner recognizes this as:
A. Tension headache
B. Migraine
C. Cluster headache
D. Sinus headache
Correct Answer: C
Rationale: Cluster headaches are periorbital with autonomic symptoms (tearing,
rhinorrhea). They occur in clusters over weeks, typically in males.
5. A client presents with facial pressure, tenderness in the maxillary region,
nasal congestion, and sore throat. The nurse practitioner recognizes these
symptoms as consistent with:
A. Tension headache
B. Cluster headache
C. Migraine
D. Sinus headache
Correct Answer: D
Rationale: Sinus headaches present with facial pressure, maxillary tenderness,
and URI symptoms. Differentiates from tension (band-like) and cluster
(periorbital with tearing).
,6. The nurse practitioner is preparing to examine a client's pupils. Which
technique represents the BEST method for this examination?
A. Examine both pupils simultaneously with room lights on
B. Examine in a darkened room, one eye at a time, using a penlight from the
outer portion inward
C. Examine both pupils simultaneously in a brightly lit room
D. Cross the penlight from one eye to the other while examining both eyes
together
Correct Answer: B
Rationale: Best technique is darkened room, one eye at a time, penlight from
outer to inner. Avoids consensual reflex interference and allows accurate
assessment.
7. A client presents with sudden onset of severe headache described as "the
worst headache of my life." The nurse practitioner's priority action is:
A. Administer analgesic medication
B. Order a non-contrast CT head stat
C. Perform a thorough neurologic exam
D. Reassure the client and schedule follow-up
Correct Answer: B
Rationale: "Worst headache of life" suggests subarachnoid hemorrhage. Non-
contrast CT is the priority to rule out bleeding. Time is critical.
8. Which cranial nerve is assessed by testing the client's ability to shrug
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
Correct Answer: C
Rationale: CN XI (Spinal Accessory) innervates the sternocleidomastoid and
trapezius muscles for shoulder shrug and head rotation. CN IX/X for swallowing
and gag; CN XII for tongue movement.
9. A client has difficulty understanding spoken language but can speak fluently.
The nurse practitioner suspects damage to which area of the brain?
A. Broca's area
B. Wernicke's area
, C. Primary motor cortex
D. Cerebellum
Correct Answer: B
Rationale: Wernicke's area (temporal lobe) is responsible for language
comprehension. Damage causes fluent but meaningless speech with poor
comprehension. Broca's affects speech production.
10. Which finding is an EARLY sign of increased intracranial pressure (ICP)?
A. Papilledema
B. Cushing's triad
C. Change in level of consciousness
D. Decorticate posturing
Correct Answer: C
Rationale: Altered LOC is the earliest and most sensitive sign of increased ICP.
Papilledema, Cushing's triad (HTN, bradycardia, irregular respirations), and
posturing are LATE signs.
11. The nurse practitioner is performing a neurologic exam on a client with
peripheral neuropathy. Which finding would be expected?
A. Hyperreflexia
B. Positive Babinski sign
C. Diminished deep tendon reflexes
D. Spasticity
Correct Answer: C
Rationale: Peripheral neuropathy causes diminished or absent reflexes due to
lower motor neuron damage. Hyperreflexia, Babinski, and spasticity indicate
upper motor neuron lesions.
12. A client presents with weakness of the lower face on the right side but can
wrinkle the forehead bilaterally. The nurse practitioner suspects:
A. Bell's palsy
B. CVA (stroke)
C. Trigeminal neuralgia
D. Myasthenia gravis
Correct Answer: B
Rationale: Upper motor neuron lesions (stroke) spare forehead because of
bilateral innervation. Bell's palsy (lower motor neuron) affects entire half of
face including forehead.
