Nurs 612 Exam 3 Advanced Health Assessment | 200+
Actual Exam Q&As & Verified Rationales | Maryville
University (Newest 2026/2027 Version)
Question 1
During a cranial nerve assessment, the advanced practice nurse asks the patient
to tightly close their eyes, smile, frown, and puff out their cheeks. The nurse
notes asymmetry on the right side of the face. Which cranial nerve is most
likely impaired?
,A) Cranial Nerve V (Trigeminal)
B) Cranial Nerve VII (Facial)
C) Cranial Nerve XII (Hypoglossal)
D) Cranial Nerve IX (Glossopharyngeal)
VERIFIED ANSWER: B) Cranial Nerve VII (Facial)
EXPLANATION: Cranial Nerve VII (the Facial nerve) is responsible for
regulating motor functions of the face, including voluntary expressions such
as smiling, frowning, closing the eyes, and puffing out the cheeks. Asymmetry
or weakness during these maneuvers indicates an upper or lower motor
neuron lesion affecting CN VII, such as Bell's Palsy. Cranial Nerve V
primarily handles facial sensation and mastication, while CN XII governs
tongue movement.
Question 2
While performing an abdominal examination on a 45-year-old patient, the nurse
practitioner notes a distinct, sharp pain and sudden arrest of inspiration when
deep palpation is applied under the right costal margin. This finding is
documented as a positive:
A) McBurney’s Sign
B) Murphy’s Sign
C) Rovsing’s Sign
D) Psoas Sign
VERIFIED ANSWER: B) Murphy’s Sign
EXPLANATION: A positive Murphy's sign is highly specific for acute
cholecystitis. It occurs when the descent of the diaphragm forces an inflamed
gallbladder against the examiner's palpating fingers under the right costal
margin, causing severe pain and an abrupt halt in inspiration. McBurney's,
Rovsing's, and Psoas signs are structural indicators used to evaluate acute
appendicitis.
Question 3
A patient presents with complaints of numbness and tingling in the thumb,
index finger, and middle finger of the right hand. The nurse practitioner taps
lightly over the median nerve at the volar aspect of the wrist, which reproduces
the patient's symptoms. This technique is known as:
,A) Phalen’s Test
B) Tinel’s Sign
C) Finkelstein’s Test
D) Allen’s Test
VERIFIED ANSWER: B) Tinel’s Sign
EXPLANATION: Tinel's sign involves percussing or lightly tapping over the
median nerve pathway at the wrist. A positive result is indicated by a tingling
sensation radiating into the median nerve distribution (thumb, index, and
middle fingers), signifying Carpal Tunnel Syndrome. Phalen's test achieves a
similar diagnostic goal by flexing the wrists at 90 degrees for 60 seconds,
whereas Finkelstein's evaluates De Quervain's tenosynovitis.
Question 4
When assessing the musculoskeletal system of a 68-year-old female patient with
osteoarthritis, the clinician observes hard, painless bony enlargements located
specifically at the distal interphalangeal (DIP) joints of the fingers. These are
documented as:
A) Bouchard’s Nodes
B) Heberden’s Nodes
C) Rheumatoid Nodules
D) Tophi
VERIFIED ANSWER: B) Heberden’s Nodes
EXPLANATION: Heberden's nodes are characteristic bony overgrowths
located at the distal interphalangeal (DIP) joints, secondary to osteophyte
formation in osteoarthritis. Bouchard's nodes structurally occur at the
proximal interphalangeal (PIP) joints. Rheumatoid nodules are inflammatory
subcutaneous lumps associated with rheumatoid arthritis, and tophi are uric
acid deposits seen in chronic gout.
Question 5
During a comprehensive neurological examination, the nurse clinician brushes a
cotton wisp gently across the patient’s cornea. The expected response is
bilateral blinking. This reflex tests the sensory component of which cranial
nerve?
A) Cranial Nerve III (Oculomotor)
, B) Cranial Nerve V (Trigeminal)
C) Cranial Nerve VII (Facial)
D) Cranial Nerve VIII (Vestibulocochlear)
VERIFIED ANSWER: B) Cranial Nerve V (Trigeminal)
EXPLANATION: The corneal reflex evaluates the integrity of both Cranial
Nerve V (Trigeminal) and Cranial Nerve VII (Facial). The sensory limb
(afferent pathway) of the reflex is mediated by the ophthalmic branch of
Cranial Nerve V, which senses the touch of the cotton wisp. The motor
response (efferent pathway) is mediated by Cranial Nerve VII, causing the
orbicularis oculi muscles to contract and blink.
Question 6
A 60-year-old male patient presents to the clinic with progressive, painless loss
of central vision over the past year. He notes that straight lines now appear
wavy or distorted when he reads. The advanced practice nurse should suspect:
A) Acute Angle-Closure Glaucoma
B) Cataracts
C) Macular Degeneration
D) Retinal Detachment
VERIFIED ANSWER: C) Macular Degeneration
EXPLANATION: Age-related macular degeneration (AMD) is characterized
by the deterioration of the macula, leading to a progressive loss of central
vision while peripheral vision remains intact. Metamorphopsia (straight lines
appearing wavy) is a classic early presentation of AMD. Glaucoma presents
with elevated intraocular pressure and peripheral vision loss, whereas
cataracts cause generalized, blurry lens opacification.
Question 7
The nurse practitioner is evaluating a patient with a suspected neurological
lesion. When flexing the patient's neck toward the chest, the patient
involuntarily flexes both hips and knees. This clinical sign is identified as:
A) Kernig’s Sign
B) Brudzinski’s Sign
C) Babinski’s Reflex
D) Romberg’s Sign
Actual Exam Q&As & Verified Rationales | Maryville
University (Newest 2026/2027 Version)
Question 1
During a cranial nerve assessment, the advanced practice nurse asks the patient
to tightly close their eyes, smile, frown, and puff out their cheeks. The nurse
notes asymmetry on the right side of the face. Which cranial nerve is most
likely impaired?
,A) Cranial Nerve V (Trigeminal)
B) Cranial Nerve VII (Facial)
C) Cranial Nerve XII (Hypoglossal)
D) Cranial Nerve IX (Glossopharyngeal)
VERIFIED ANSWER: B) Cranial Nerve VII (Facial)
EXPLANATION: Cranial Nerve VII (the Facial nerve) is responsible for
regulating motor functions of the face, including voluntary expressions such
as smiling, frowning, closing the eyes, and puffing out the cheeks. Asymmetry
or weakness during these maneuvers indicates an upper or lower motor
neuron lesion affecting CN VII, such as Bell's Palsy. Cranial Nerve V
primarily handles facial sensation and mastication, while CN XII governs
tongue movement.
Question 2
While performing an abdominal examination on a 45-year-old patient, the nurse
practitioner notes a distinct, sharp pain and sudden arrest of inspiration when
deep palpation is applied under the right costal margin. This finding is
documented as a positive:
A) McBurney’s Sign
B) Murphy’s Sign
C) Rovsing’s Sign
D) Psoas Sign
VERIFIED ANSWER: B) Murphy’s Sign
EXPLANATION: A positive Murphy's sign is highly specific for acute
cholecystitis. It occurs when the descent of the diaphragm forces an inflamed
gallbladder against the examiner's palpating fingers under the right costal
margin, causing severe pain and an abrupt halt in inspiration. McBurney's,
Rovsing's, and Psoas signs are structural indicators used to evaluate acute
appendicitis.
Question 3
A patient presents with complaints of numbness and tingling in the thumb,
index finger, and middle finger of the right hand. The nurse practitioner taps
lightly over the median nerve at the volar aspect of the wrist, which reproduces
the patient's symptoms. This technique is known as:
,A) Phalen’s Test
B) Tinel’s Sign
C) Finkelstein’s Test
D) Allen’s Test
VERIFIED ANSWER: B) Tinel’s Sign
EXPLANATION: Tinel's sign involves percussing or lightly tapping over the
median nerve pathway at the wrist. A positive result is indicated by a tingling
sensation radiating into the median nerve distribution (thumb, index, and
middle fingers), signifying Carpal Tunnel Syndrome. Phalen's test achieves a
similar diagnostic goal by flexing the wrists at 90 degrees for 60 seconds,
whereas Finkelstein's evaluates De Quervain's tenosynovitis.
Question 4
When assessing the musculoskeletal system of a 68-year-old female patient with
osteoarthritis, the clinician observes hard, painless bony enlargements located
specifically at the distal interphalangeal (DIP) joints of the fingers. These are
documented as:
A) Bouchard’s Nodes
B) Heberden’s Nodes
C) Rheumatoid Nodules
D) Tophi
VERIFIED ANSWER: B) Heberden’s Nodes
EXPLANATION: Heberden's nodes are characteristic bony overgrowths
located at the distal interphalangeal (DIP) joints, secondary to osteophyte
formation in osteoarthritis. Bouchard's nodes structurally occur at the
proximal interphalangeal (PIP) joints. Rheumatoid nodules are inflammatory
subcutaneous lumps associated with rheumatoid arthritis, and tophi are uric
acid deposits seen in chronic gout.
Question 5
During a comprehensive neurological examination, the nurse clinician brushes a
cotton wisp gently across the patient’s cornea. The expected response is
bilateral blinking. This reflex tests the sensory component of which cranial
nerve?
A) Cranial Nerve III (Oculomotor)
, B) Cranial Nerve V (Trigeminal)
C) Cranial Nerve VII (Facial)
D) Cranial Nerve VIII (Vestibulocochlear)
VERIFIED ANSWER: B) Cranial Nerve V (Trigeminal)
EXPLANATION: The corneal reflex evaluates the integrity of both Cranial
Nerve V (Trigeminal) and Cranial Nerve VII (Facial). The sensory limb
(afferent pathway) of the reflex is mediated by the ophthalmic branch of
Cranial Nerve V, which senses the touch of the cotton wisp. The motor
response (efferent pathway) is mediated by Cranial Nerve VII, causing the
orbicularis oculi muscles to contract and blink.
Question 6
A 60-year-old male patient presents to the clinic with progressive, painless loss
of central vision over the past year. He notes that straight lines now appear
wavy or distorted when he reads. The advanced practice nurse should suspect:
A) Acute Angle-Closure Glaucoma
B) Cataracts
C) Macular Degeneration
D) Retinal Detachment
VERIFIED ANSWER: C) Macular Degeneration
EXPLANATION: Age-related macular degeneration (AMD) is characterized
by the deterioration of the macula, leading to a progressive loss of central
vision while peripheral vision remains intact. Metamorphopsia (straight lines
appearing wavy) is a classic early presentation of AMD. Glaucoma presents
with elevated intraocular pressure and peripheral vision loss, whereas
cataracts cause generalized, blurry lens opacification.
Question 7
The nurse practitioner is evaluating a patient with a suspected neurological
lesion. When flexing the patient's neck toward the chest, the patient
involuntarily flexes both hips and knees. This clinical sign is identified as:
A) Kernig’s Sign
B) Brudzinski’s Sign
C) Babinski’s Reflex
D) Romberg’s Sign
