NSG 500 ADVANCED HEALTH
ASSESSMENT FINAL EXAM STUDY
GUIDE
1. When assessing a patient for tactile fremitus, the nurse practitioner notes increased
vibrations over the right lower lobe. Which condition is most likely associated with this
finding?
A. Pleural effusion
B. Chronic obstructive pulmonary disease
C. Pneumothorax
D. Lobar pneumonia
Answer: D
Conceptual Explanation: Increased tactile fremitus occurs with lung consolidation, such
as in lobar pneumonia, where fluid-filled tissue transmits sound better than air. Pleural
effusion and pneumothorax decrease fremitus by blocking sound transmission.
,2. A 68-year-old male presents with a harsh, mid-systolic crescendo-decrescendo murmur
heard best at the second right intercostal space, radiating to the neck. What is the most likely
diagnosis?
A. Mitral regurgitation
B. Aortic stenosis
C. Aortic regurgitation
D. Mitral stenosis
Answer: B
Conceptual Explanation: Aortic stenosis presents as a systolic ejection murmur at the
right upper sternal border that radiates to the carotids. Mitral regurgitation is holosystolic
at the apex.
3. During a musculoskeletal exam, you perform the McMurray test. A click and palpable pop
are felt. This indicates an injury to which structure?
A. Anterior cruciate ligament
B. Medial meniscus
C. Posterior cruciate ligament
D. Medial collateral ligament
Answer: B
, Conceptual Explanation: The McMurray test is used to evaluate the meniscus. A click or
pop during the maneuver suggests a meniscal tear, most commonly the medial meniscus.
4. A patient exhibits a positive Romberg test. Which system is primarily responsible for this
finding?
A. Proprioception and vestibular function
B. Cerebellar function
C. Oculomotor nerve integrity
D. Upper motor neuron strength
Answer: A
Conceptual Explanation: The Romberg test assesses proprioception and vestibular
function. Losing balance when eyes are closed suggests a sensory ataxia rather than a
cerebellar issue.
5. Which of the following is considered a ‘red flag’ finding during a pediatric headache
assessment?
A. Pain relieved by ibuprofen
B. Headache that worsens when lying down or awakens the child at night
C. Family history of migraines
D. Association with photophobia
Answer: B
ASSESSMENT FINAL EXAM STUDY
GUIDE
1. When assessing a patient for tactile fremitus, the nurse practitioner notes increased
vibrations over the right lower lobe. Which condition is most likely associated with this
finding?
A. Pleural effusion
B. Chronic obstructive pulmonary disease
C. Pneumothorax
D. Lobar pneumonia
Answer: D
Conceptual Explanation: Increased tactile fremitus occurs with lung consolidation, such
as in lobar pneumonia, where fluid-filled tissue transmits sound better than air. Pleural
effusion and pneumothorax decrease fremitus by blocking sound transmission.
,2. A 68-year-old male presents with a harsh, mid-systolic crescendo-decrescendo murmur
heard best at the second right intercostal space, radiating to the neck. What is the most likely
diagnosis?
A. Mitral regurgitation
B. Aortic stenosis
C. Aortic regurgitation
D. Mitral stenosis
Answer: B
Conceptual Explanation: Aortic stenosis presents as a systolic ejection murmur at the
right upper sternal border that radiates to the carotids. Mitral regurgitation is holosystolic
at the apex.
3. During a musculoskeletal exam, you perform the McMurray test. A click and palpable pop
are felt. This indicates an injury to which structure?
A. Anterior cruciate ligament
B. Medial meniscus
C. Posterior cruciate ligament
D. Medial collateral ligament
Answer: B
, Conceptual Explanation: The McMurray test is used to evaluate the meniscus. A click or
pop during the maneuver suggests a meniscal tear, most commonly the medial meniscus.
4. A patient exhibits a positive Romberg test. Which system is primarily responsible for this
finding?
A. Proprioception and vestibular function
B. Cerebellar function
C. Oculomotor nerve integrity
D. Upper motor neuron strength
Answer: A
Conceptual Explanation: The Romberg test assesses proprioception and vestibular
function. Losing balance when eyes are closed suggests a sensory ataxia rather than a
cerebellar issue.
5. Which of the following is considered a ‘red flag’ finding during a pediatric headache
assessment?
A. Pain relieved by ibuprofen
B. Headache that worsens when lying down or awakens the child at night
C. Family history of migraines
D. Association with photophobia
Answer: B
