NURS 190 PHYSICAL ASSESSMENT
WEEK 8: MUSCULOSKELETAL AND
NEUROLOGICAL SYSTEMS
1. When assessing a patient’s muscle strength, the nurse notes the patient can complete full
range of motion against gravity but not against resistance. How should this be documented?
A. Grade 2
B. Grade 3
C. Grade 4
D. Grade 5
Answer: B
Conceptual Explanation: Grade 3 indicates full range of motion with gravity but no
resistance. Grade 2 is full ROM with gravity eliminated, and Grade 4 is full ROM with some
resistance.
2. Which cranial nerve is being tested when the nurse asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
,B. CN X (Vagus)
C. CN XII (Hypoglossal)
D. CN XI (Spinal Accessory)
Answer: D
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; testing shoulder shrug and head turning assesses its motor function.
3. A patient presents with a positive Phalen’s test. The nurse suspects which of the following
conditions?
A. Rotator cuff tear
B. Carpal tunnel syndrome
C. Herniated nucleus pulposus
D. Rheumatoid arthritis
Answer: B
Conceptual Explanation: Phalen’s test involves holding the wrists in acute flexion for 60
seconds; numbness or burning suggests carpal tunnel syndrome affecting the median
nerve.
4. During a neurological exam, the nurse asks the patient to identify a common object, like a
key, placed in their hand with eyes closed. This tests:
A. Graphesthesia
, B. Extinction
C. Two-point discrimination
D. Stereognosis
Answer: D
Conceptual Explanation: Stereognosis is the ability to recognize objects by feeling their
form, size, and weight while the eyes are closed.
5. Which finding is considered normal when testing the plantar reflex in a healthy 30-year-old
adult?
A. Dorsiflexion of the big toe
B. Plantar flexion of the toes
C. Fanning of all toes
D. No response
Answer: B
Conceptual Explanation: In adults, the normal response is plantar flexion (curling) of the
toes. Dorsiflexion (Babinski sign) is abnormal in adults and indicates upper motor neuron
disease.
6. A patient exhibits ‘decerebrate posturing.’ This involves which of the following positions?
A. Extension of arms and legs, pronation of arms, and plantar flexion
B. Adduction of arms, flexion of elbows, and internal rotation of hands
WEEK 8: MUSCULOSKELETAL AND
NEUROLOGICAL SYSTEMS
1. When assessing a patient’s muscle strength, the nurse notes the patient can complete full
range of motion against gravity but not against resistance. How should this be documented?
A. Grade 2
B. Grade 3
C. Grade 4
D. Grade 5
Answer: B
Conceptual Explanation: Grade 3 indicates full range of motion with gravity but no
resistance. Grade 2 is full ROM with gravity eliminated, and Grade 4 is full ROM with some
resistance.
2. Which cranial nerve is being tested when the nurse asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
,B. CN X (Vagus)
C. CN XII (Hypoglossal)
D. CN XI (Spinal Accessory)
Answer: D
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; testing shoulder shrug and head turning assesses its motor function.
3. A patient presents with a positive Phalen’s test. The nurse suspects which of the following
conditions?
A. Rotator cuff tear
B. Carpal tunnel syndrome
C. Herniated nucleus pulposus
D. Rheumatoid arthritis
Answer: B
Conceptual Explanation: Phalen’s test involves holding the wrists in acute flexion for 60
seconds; numbness or burning suggests carpal tunnel syndrome affecting the median
nerve.
4. During a neurological exam, the nurse asks the patient to identify a common object, like a
key, placed in their hand with eyes closed. This tests:
A. Graphesthesia
, B. Extinction
C. Two-point discrimination
D. Stereognosis
Answer: D
Conceptual Explanation: Stereognosis is the ability to recognize objects by feeling their
form, size, and weight while the eyes are closed.
5. Which finding is considered normal when testing the plantar reflex in a healthy 30-year-old
adult?
A. Dorsiflexion of the big toe
B. Plantar flexion of the toes
C. Fanning of all toes
D. No response
Answer: B
Conceptual Explanation: In adults, the normal response is plantar flexion (curling) of the
toes. Dorsiflexion (Babinski sign) is abnormal in adults and indicates upper motor neuron
disease.
6. A patient exhibits ‘decerebrate posturing.’ This involves which of the following positions?
A. Extension of arms and legs, pronation of arms, and plantar flexion
B. Adduction of arms, flexion of elbows, and internal rotation of hands
