NUR-641E ADVANCED HEALTH
ASSESSMENT COMPREHENSIVE EXAM
PREP
1. Which of the following findings is considered a ‘red flag’ during a headache assessment,
requiring immediate neuroimaging?
A. A sudden onset ‘thunderclap’ headache described as the worst of one’s life
B. A history of migraines since adolescence
C. Bilateral pressure-like pain occurring after a long workday
D. Unilateral pain associated with photophobia and nausea
Answer: A
Conceptual Explanation: A ‘thunderclap’ headache is a classic sign of subarachnoid
hemorrhage and is a critical red flag. Migraines and tension headaches are generally
primary, non-emergent headaches.
2. During a cardiac examination, a mid-systolic click followed by a late systolic murmur is
most characteristic of which condition?
A. Aortic stenosis
B. Mitral regurgitation
,C. Mitral valve prolapse
D. Tricuspid stenosis
Answer: C
Conceptual Explanation: Mitral valve prolapse (MVP) typically presents with a mid-
systolic click and a late systolic murmur as the valve leaflets bulge back into the left atrium.
3. When performing the Weber test on a patient with suspected conductive hearing loss in
the right ear, the sound will lateralize to:
A. The right ear
B. The left ear
C. Neither ear (remains midline)
D. Both ears equally
Answer: A
Conceptual Explanation: In conductive hearing loss, the Weber test lateralizes to the ‘bad’
ear because the affected ear is not distracted by ambient room noise.
4. A patient presents with right lower quadrant pain. Which maneuver involves internal
rotation of the flexed right hip to assess for appendicitis?
A. Psoas sign
B. Rovsing sign
C. Murphy sign
, D. Obturator sign
Answer: D
Conceptual Explanation: The Obturator sign is positive when internal rotation of the
flexed right hip causes hypogastric pain, suggesting an inflamed appendix.
5. In advanced health assessment, which percussion note is expected over a lung area with
consolidation, such as in lobar pneumonia?
A. Resonance
B. Dullness
C. Hyperresonance
D. Tympany
Answer: B
Conceptual Explanation: Dullness replaces resonance when fluid or solid tissue replaces
air-containing lung, such as in pneumonia or pleural effusion.
6. Which cranial nerve is being tested when the provider asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
ASSESSMENT COMPREHENSIVE EXAM
PREP
1. Which of the following findings is considered a ‘red flag’ during a headache assessment,
requiring immediate neuroimaging?
A. A sudden onset ‘thunderclap’ headache described as the worst of one’s life
B. A history of migraines since adolescence
C. Bilateral pressure-like pain occurring after a long workday
D. Unilateral pain associated with photophobia and nausea
Answer: A
Conceptual Explanation: A ‘thunderclap’ headache is a classic sign of subarachnoid
hemorrhage and is a critical red flag. Migraines and tension headaches are generally
primary, non-emergent headaches.
2. During a cardiac examination, a mid-systolic click followed by a late systolic murmur is
most characteristic of which condition?
A. Aortic stenosis
B. Mitral regurgitation
,C. Mitral valve prolapse
D. Tricuspid stenosis
Answer: C
Conceptual Explanation: Mitral valve prolapse (MVP) typically presents with a mid-
systolic click and a late systolic murmur as the valve leaflets bulge back into the left atrium.
3. When performing the Weber test on a patient with suspected conductive hearing loss in
the right ear, the sound will lateralize to:
A. The right ear
B. The left ear
C. Neither ear (remains midline)
D. Both ears equally
Answer: A
Conceptual Explanation: In conductive hearing loss, the Weber test lateralizes to the ‘bad’
ear because the affected ear is not distracted by ambient room noise.
4. A patient presents with right lower quadrant pain. Which maneuver involves internal
rotation of the flexed right hip to assess for appendicitis?
A. Psoas sign
B. Rovsing sign
C. Murphy sign
, D. Obturator sign
Answer: D
Conceptual Explanation: The Obturator sign is positive when internal rotation of the
flexed right hip causes hypogastric pain, suggesting an inflamed appendix.
5. In advanced health assessment, which percussion note is expected over a lung area with
consolidation, such as in lobar pneumonia?
A. Resonance
B. Dullness
C. Hyperresonance
D. Tympany
Answer: B
Conceptual Explanation: Dullness replaces resonance when fluid or solid tissue replaces
air-containing lung, such as in pneumonia or pleural effusion.
6. Which cranial nerve is being tested when the provider asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
