NSG 500
EXAM 2
Advanced Health Assessment
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
➢160 Exam Questions w/ Answers
➢Expert Rationales included
➢Exam 2 Comprehensive Study Guide
, Preview Pages Below
Get the Complete PDF After Purchase
NSG 500 - EXAM 2 - Advanced Health Assessment
If you require further clarification
or in need of any study resources,
feel free to Message me.
EXAM PREVIEW STUDY GUIDE FULL PDF LINKED
,Table of Contents
NSG 500 EXAM 2 ............................................................................ 2
NSG 500 Exam 2 ........................................................................... 34
NSG 500 Exam 2 Study Guide .................................................... 66
NSG 500 EXAM 2
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 findings include sensory deficits (taste, smell, sight, hearing),
wrinkles with thinning skin, dry eyes, and thicker/coarse hair on the face (eyebrows, nose,
ear hair) with thinning on the scalp. Difficulty swallowing (dysphagia) and motor deficits
such as muscle atrophy and gait abnormalities are abnormal findings requiring further
evaluation, not normal age-related changes.
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 are characterized by a band-like tension around the head,
bilateral distribution, and pressure or throbbing sensation. Migraines are typically
unilateral with photosensitivity and nausea/vomiting. Cluster headaches present with
intense pain behind one eye with increased lacrimation. Sinus headaches involve pressure
around the frontal sinuses with URI symptoms.
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 characterized by unilateral pain, photosensitivity,
nausea/vomiting, and typically have onset in adolescence or early adulthood. Clients with
migraines often can distinguish their "normal" headache pattern from other types. The
unilateral nature, photophobia, and N/V differentiate this from tension (bilateral, band-
like) and cluster (periorbital, tearing) headaches.
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 characterized by intense pain behind one eye, increased
lacrimation of tear ducts, and nasal discharge (runny nose). The unilateral nature,
periorbital location, and autonomic symptoms (tearing, rhinorrhea) are pathognomonic for
cluster headaches. These typically occur in "clusters" or cycles over weeks.
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 pressure around the sinuses (frontal), tenderness
in the maxillary region, and URI symptoms including nasal congestion and sore throat. This
differentiates sinus headaches from tension (band-like), cluster (periorbital with tearing),
and migraine (unilateral with photophobia/N/V) headaches.
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: The best method to examine pupils is in a darkened room, one eye at a time,
using a penlight from the outer portion of one eye and working inward, then repeating on
the other eye from the outer portion inward. There should be no crossing of the light
between eyes. This technique allows accurate assessment of pupillary response, size, and
symmetry without consensual reflex interference.
,7. A client is asked to focus on a distant object, then the nurse practitioner brings a
finger closer to the client's face. The nurse practitioner observes that the pupils
constrict and the eyes converge. This assessment is evaluating:
A. Direct light reflex
B. Consensual light reflex
C. Accommodation
D. Convergence only
Correct Answer: C
Rationale: Accommodation is tested by having the client focus on a distant object, then
bringing an object closer to the face. Normal findings include pupil constriction as the
object approaches and convergence of the eyes toward each other. This assesses the
function of cranial nerve III (oculomotor) and the near-vision reflex arc.
8. The nurse practitioner is using a Snellen chart to assess a client's vision. The nurse
practitioner understands that the Snellen chart:
A. Measures near vision at 14 inches
B. Assesses distant vision
C. Is made up of 3's, X's, and O's
D. Is held 14 inches from the client's face
Correct Answer: B
Rationale: The Snellen chart is used to assess far sign (distant vision). The Rosenbaum
chart measures near vision, is made up of 3's, X's, and O's, and is held 14 inches from the
client's face. Understanding the purpose and proper use of each vision assessment tool is
essential for accurate visual acuity testing.
9. The nurse practitioner is preparing to use an ophthalmoscope for a fundoscopic
examination. Which sequence represents the correct technique? (Select All That Apply)
A. Darken the room to dilate pupils
B. Turn the lens dial (diopter) to 0
C. Have the client look at the examiner's shoulder
D. Use the right eye to examine the client's right eye
E. Hold the ophthalmoscope 15 inches from the client's face at a 15-degree angle
F. Place the thumb on the client's eyebrow for stability
Correct Answers: A, B, D, E, F
, NSG 500 Exam 2
1. A 45-year-old patient reports difficulty seeing objects at a distance but has no
trouble reading close-up. The nurse practitioner recognizes this as:
A. Hyperopia
B. Myopia
C. Astigmatism
D. Presbyopia
Correct Answer: B. Myopia
Rationale: Myopia (nearsightedness) is defined as a condition where visual images come to
a focus in front of the retina, resulting in better vision for near objects than distant objects.
Hyperopia (A) is farsightedness where images focus behind the retina—better for distant
than near objects. Astigmatism (C) involves uneven corneal curvatures causing improper
focus at all distances. Presbyopia (D) is age-related farsightedness due to loss of lens
elasticity, typically occurring in middle and older age.
2. During a fundoscopic examination, the nurse practitioner notes a gray-white arc
around the limbus of the iris in a 70-year-old patient. This finding is consistent with:
A. Diabetic retinopathy
B. Arcus senilis
C. Papilledema
D. Retinal detachment
Correct Answer: B. Arcus senilis
Rationale: Arcus senilis is a gray-white arc or circle around the limbus of the iris that is
common with aging and typically benign in older adults. Diabetic retinopathy (A) presents
with microaneurysms, hemorrhages, and cotton wool spots. Papilledema (C) is swelling of
the optic disc with blurred margins caused by increased intracranial pressure. Retinal
detachment would show a different pattern of visual changes and fundoscopic findings.
,3. A patient presents with a raised yellowish plaque on the medial aspect of the
upper eyelid. The nurse practitioner should suspect:
A. Hordeolum
B. Chalazion
C. Xanthelasma
D. Blepharitis
Correct Answer: C. Xanthelasma
Rationale: Xanthelasma presents as raised yellowish plaques on the eyelids caused by lipid
disorders and may indicate hyperlipidemia. A hordeolum (A), or sty, is an acute
staphylococcal infection of a sebaceous gland. A chalazion (B) is a nodule or cyst caused by
obstruction of a meibomian gland. Blepharitis (D) is inflammation of the glands and eyelash
follicles along the eyelid margin with crusting.
4. During an ophthalmoscopic examination, the nurse practitioner identifies the
optic disc. Which of the following findings is considered NORMAL?
A. Cup-to-disc ratio of 1/2 the disc size
B. Blurred disc margins
C. Pale white coloration
D. Round or slightly oval shape with sharp margins
Correct Answer: D. Round or slightly oval shape with sharp margins
Rationale: The normal optic disc should be round or slightly oval with sharp margins and a
pinkish to yellow-orange color. The normal cup-to-disc ratio is 1/3 (not 1/2) of the disc size
(A). Blurred margins (B) suggest papilledema or optic neuritis. Pale white coloration (C)
indicates optic atrophy. An increased cup-to-disc ratio (>1/2) is characteristic of glaucoma.
5. A patient with a history of hypertension presents for a routine eye exam. The nurse
practitioner observes "cotton wool spots" on fundoscopic examination. These
represent:
A. Microaneurysms
B. Retinal hemorrhages
C. Microinfarcts in the retinal nerve fiber layer
D. Hard exudates
Correct Answer: C. Microinfarcts in the retinal nerve fiber layer
,Rationale: Cotton wool spots are white lesions caused by microinfarcts in the retinal nerve
fiber layer and are frequently associated with hypertension and diabetes. They represent
ischemic damage to the nerve fibers. Microaneurysms (A) are small red dots. Hemorrhages
(B) appear as red lesions. Hard exudates (D) are yellowish deposits of lipid and protein.
6. During assessment of extraocular movements, the nurse practitioner tests cranial
nerve III. Which movement would be impaired if this nerve is affected?
A. Lateral gaze
B. Upward gaze
C. Medial and downward gaze
D. Downward and inward gaze
Correct Answer: C. Medial and downward gaze
Rationale: Cranial nerve III (oculomotor) controls medial and downward eye movement,
pupillary constriction, and eyelid elevation (ptosis if impaired). Cranial nerve IV (trochlear)
controls upward gaze (B). Cranial nerve VI (abducens) controls lateral gaze (A). The
combination of impaired medial/downward movement with ptosis localizes to CN III.
7. A patient presents with an acute infection of a sebaceous gland of the eyelid
characterized by a painful, erythematous pustule at the lid margin. This is described
as:
A. Chalazion
B. Hordeolum
C. Entropion
D. Ectropion
Correct Answer: B. Hordeolum
Rationale: A hordeolum (sty) is an acute staphylococcal infection of a sebaceous gland of
the eyelid, presenting as a painful, erythematous pustule. A chalazion (A) is a chronic, non-
tender nodule from meibomian gland obstruction. Entropion (C) is inward turning of the
eyelid margin. Ectropion (D) is outward turning of the eyelid margin, often exposing the
conjunctiva.
8. The near reflex during eye examination is correctly described as:
, NSG 500 Exam 2 Study Guide
1. Fundoscopic exam
The use of an ophthalmoscope to look through the pupil and examine the interior
surface of the posterior eye
2. hyperopia
A condition in which visual images come to a focus behind the retina of the eye and vision is
better
for distant than for near objects -- called also farsightedness.
3. Myopia
nearsightedness; lack of foresight
4. Astigmatism
a condition in which the eye does not focus properly because of uneven curvatures of the
cornea
5. Presbyopia
farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and
old age.
6. Scotomata
a partial loss of vision or a blind spot in an otherwise normal visual field.
7. Near reflex
When the patient focuses on a near target after looking at something at a distance, the eyes
should converge and the pupils should constrict
EXAM 2
Advanced Health Assessment
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
➢160 Exam Questions w/ Answers
➢Expert Rationales included
➢Exam 2 Comprehensive Study Guide
, Preview Pages Below
Get the Complete PDF After Purchase
NSG 500 - EXAM 2 - Advanced Health Assessment
If you require further clarification
or in need of any study resources,
feel free to Message me.
EXAM PREVIEW STUDY GUIDE FULL PDF LINKED
,Table of Contents
NSG 500 EXAM 2 ............................................................................ 2
NSG 500 Exam 2 ........................................................................... 34
NSG 500 Exam 2 Study Guide .................................................... 66
NSG 500 EXAM 2
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 findings include sensory deficits (taste, smell, sight, hearing),
wrinkles with thinning skin, dry eyes, and thicker/coarse hair on the face (eyebrows, nose,
ear hair) with thinning on the scalp. Difficulty swallowing (dysphagia) and motor deficits
such as muscle atrophy and gait abnormalities are abnormal findings requiring further
evaluation, not normal age-related changes.
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 are characterized by a band-like tension around the head,
bilateral distribution, and pressure or throbbing sensation. Migraines are typically
unilateral with photosensitivity and nausea/vomiting. Cluster headaches present with
intense pain behind one eye with increased lacrimation. Sinus headaches involve pressure
around the frontal sinuses with URI symptoms.
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 characterized by unilateral pain, photosensitivity,
nausea/vomiting, and typically have onset in adolescence or early adulthood. Clients with
migraines often can distinguish their "normal" headache pattern from other types. The
unilateral nature, photophobia, and N/V differentiate this from tension (bilateral, band-
like) and cluster (periorbital, tearing) headaches.
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 characterized by intense pain behind one eye, increased
lacrimation of tear ducts, and nasal discharge (runny nose). The unilateral nature,
periorbital location, and autonomic symptoms (tearing, rhinorrhea) are pathognomonic for
cluster headaches. These typically occur in "clusters" or cycles over weeks.
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 pressure around the sinuses (frontal), tenderness
in the maxillary region, and URI symptoms including nasal congestion and sore throat. This
differentiates sinus headaches from tension (band-like), cluster (periorbital with tearing),
and migraine (unilateral with photophobia/N/V) headaches.
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: The best method to examine pupils is in a darkened room, one eye at a time,
using a penlight from the outer portion of one eye and working inward, then repeating on
the other eye from the outer portion inward. There should be no crossing of the light
between eyes. This technique allows accurate assessment of pupillary response, size, and
symmetry without consensual reflex interference.
,7. A client is asked to focus on a distant object, then the nurse practitioner brings a
finger closer to the client's face. The nurse practitioner observes that the pupils
constrict and the eyes converge. This assessment is evaluating:
A. Direct light reflex
B. Consensual light reflex
C. Accommodation
D. Convergence only
Correct Answer: C
Rationale: Accommodation is tested by having the client focus on a distant object, then
bringing an object closer to the face. Normal findings include pupil constriction as the
object approaches and convergence of the eyes toward each other. This assesses the
function of cranial nerve III (oculomotor) and the near-vision reflex arc.
8. The nurse practitioner is using a Snellen chart to assess a client's vision. The nurse
practitioner understands that the Snellen chart:
A. Measures near vision at 14 inches
B. Assesses distant vision
C. Is made up of 3's, X's, and O's
D. Is held 14 inches from the client's face
Correct Answer: B
Rationale: The Snellen chart is used to assess far sign (distant vision). The Rosenbaum
chart measures near vision, is made up of 3's, X's, and O's, and is held 14 inches from the
client's face. Understanding the purpose and proper use of each vision assessment tool is
essential for accurate visual acuity testing.
9. The nurse practitioner is preparing to use an ophthalmoscope for a fundoscopic
examination. Which sequence represents the correct technique? (Select All That Apply)
A. Darken the room to dilate pupils
B. Turn the lens dial (diopter) to 0
C. Have the client look at the examiner's shoulder
D. Use the right eye to examine the client's right eye
E. Hold the ophthalmoscope 15 inches from the client's face at a 15-degree angle
F. Place the thumb on the client's eyebrow for stability
Correct Answers: A, B, D, E, F
, NSG 500 Exam 2
1. A 45-year-old patient reports difficulty seeing objects at a distance but has no
trouble reading close-up. The nurse practitioner recognizes this as:
A. Hyperopia
B. Myopia
C. Astigmatism
D. Presbyopia
Correct Answer: B. Myopia
Rationale: Myopia (nearsightedness) is defined as a condition where visual images come to
a focus in front of the retina, resulting in better vision for near objects than distant objects.
Hyperopia (A) is farsightedness where images focus behind the retina—better for distant
than near objects. Astigmatism (C) involves uneven corneal curvatures causing improper
focus at all distances. Presbyopia (D) is age-related farsightedness due to loss of lens
elasticity, typically occurring in middle and older age.
2. During a fundoscopic examination, the nurse practitioner notes a gray-white arc
around the limbus of the iris in a 70-year-old patient. This finding is consistent with:
A. Diabetic retinopathy
B. Arcus senilis
C. Papilledema
D. Retinal detachment
Correct Answer: B. Arcus senilis
Rationale: Arcus senilis is a gray-white arc or circle around the limbus of the iris that is
common with aging and typically benign in older adults. Diabetic retinopathy (A) presents
with microaneurysms, hemorrhages, and cotton wool spots. Papilledema (C) is swelling of
the optic disc with blurred margins caused by increased intracranial pressure. Retinal
detachment would show a different pattern of visual changes and fundoscopic findings.
,3. A patient presents with a raised yellowish plaque on the medial aspect of the
upper eyelid. The nurse practitioner should suspect:
A. Hordeolum
B. Chalazion
C. Xanthelasma
D. Blepharitis
Correct Answer: C. Xanthelasma
Rationale: Xanthelasma presents as raised yellowish plaques on the eyelids caused by lipid
disorders and may indicate hyperlipidemia. A hordeolum (A), or sty, is an acute
staphylococcal infection of a sebaceous gland. A chalazion (B) is a nodule or cyst caused by
obstruction of a meibomian gland. Blepharitis (D) is inflammation of the glands and eyelash
follicles along the eyelid margin with crusting.
4. During an ophthalmoscopic examination, the nurse practitioner identifies the
optic disc. Which of the following findings is considered NORMAL?
A. Cup-to-disc ratio of 1/2 the disc size
B. Blurred disc margins
C. Pale white coloration
D. Round or slightly oval shape with sharp margins
Correct Answer: D. Round or slightly oval shape with sharp margins
Rationale: The normal optic disc should be round or slightly oval with sharp margins and a
pinkish to yellow-orange color. The normal cup-to-disc ratio is 1/3 (not 1/2) of the disc size
(A). Blurred margins (B) suggest papilledema or optic neuritis. Pale white coloration (C)
indicates optic atrophy. An increased cup-to-disc ratio (>1/2) is characteristic of glaucoma.
5. A patient with a history of hypertension presents for a routine eye exam. The nurse
practitioner observes "cotton wool spots" on fundoscopic examination. These
represent:
A. Microaneurysms
B. Retinal hemorrhages
C. Microinfarcts in the retinal nerve fiber layer
D. Hard exudates
Correct Answer: C. Microinfarcts in the retinal nerve fiber layer
,Rationale: Cotton wool spots are white lesions caused by microinfarcts in the retinal nerve
fiber layer and are frequently associated with hypertension and diabetes. They represent
ischemic damage to the nerve fibers. Microaneurysms (A) are small red dots. Hemorrhages
(B) appear as red lesions. Hard exudates (D) are yellowish deposits of lipid and protein.
6. During assessment of extraocular movements, the nurse practitioner tests cranial
nerve III. Which movement would be impaired if this nerve is affected?
A. Lateral gaze
B. Upward gaze
C. Medial and downward gaze
D. Downward and inward gaze
Correct Answer: C. Medial and downward gaze
Rationale: Cranial nerve III (oculomotor) controls medial and downward eye movement,
pupillary constriction, and eyelid elevation (ptosis if impaired). Cranial nerve IV (trochlear)
controls upward gaze (B). Cranial nerve VI (abducens) controls lateral gaze (A). The
combination of impaired medial/downward movement with ptosis localizes to CN III.
7. A patient presents with an acute infection of a sebaceous gland of the eyelid
characterized by a painful, erythematous pustule at the lid margin. This is described
as:
A. Chalazion
B. Hordeolum
C. Entropion
D. Ectropion
Correct Answer: B. Hordeolum
Rationale: A hordeolum (sty) is an acute staphylococcal infection of a sebaceous gland of
the eyelid, presenting as a painful, erythematous pustule. A chalazion (A) is a chronic, non-
tender nodule from meibomian gland obstruction. Entropion (C) is inward turning of the
eyelid margin. Ectropion (D) is outward turning of the eyelid margin, often exposing the
conjunctiva.
8. The near reflex during eye examination is correctly described as:
, NSG 500 Exam 2 Study Guide
1. Fundoscopic exam
The use of an ophthalmoscope to look through the pupil and examine the interior
surface of the posterior eye
2. hyperopia
A condition in which visual images come to a focus behind the retina of the eye and vision is
better
for distant than for near objects -- called also farsightedness.
3. Myopia
nearsightedness; lack of foresight
4. Astigmatism
a condition in which the eye does not focus properly because of uneven curvatures of the
cornea
5. Presbyopia
farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and
old age.
6. Scotomata
a partial loss of vision or a blind spot in an otherwise normal visual field.
7. Near reflex
When the patient focuses on a near target after looking at something at a distance, the eyes
should converge and the pupils should constrict
