NURS 5220: ADVANCED HEALTH
ASSESSMENT - COMPREHENSIVE
EXAM (EENT, RESPIRATORY,
CARDIAC, AND VASCULAR)
1. During a fundoscopic examination, you observe silver-wiring and arteriovenous (AV)
nicking. These findings are most characteristic of which condition?
A. Diabetic retinopathy
B. Chronic hypertension
C. Increased intracranial pressure
D. Acute macular degeneration
Answer: B
Conceptual Explanation: Chronic hypertension causes narrowing of the retinal arteries
(silver/copper wiring) and compression of venules where arteries cross them (AV nicking).
2. A patient presents with sudden, painless unilateral vision loss and a ‘cherry-red spot’ on
the macula during examination. What is the most likely diagnosis?
A. Central Retinal Vein Occlusion
,B. Retinal Detachment
C. Central Retinal Artery Occlusion
D. Acute Angle-Closure Glaucoma
Answer: C
Conceptual Explanation: Central retinal artery occlusion is an ocular emergency
characterized by sudden painless vision loss and a cherry-red spot on the macula due to
retinal edema.
3. When performing the Weber test, the sound lateralizes to the patient’s right ear. The Rinne
test shows AC > BC bilaterally. What is the correct interpretation?
A. Conductive hearing loss in the right ear
B. Conductive hearing loss in the left ear
C. Sensorineural hearing loss in the left ear
D. Normal hearing in both ears
Answer: C
Conceptual Explanation: If sound lateralizes to the right ear and Rinne is normal (AC >
BC) bilaterally, the patient has sensorineural loss in the opposite (left) ear.
4. Upon inspection of the tympanic membrane, you note a dense white patch. The patient
has a history of multiple childhood ear infections. This finding is likely:
A. Cholesteatoma
, B. Tympanosclerosis
C. Otitis media with effusion
D. Acute otitis media
Answer: B
Conceptual Explanation: Tympanosclerosis is a scarring of the tympanic membrane, often
appearing as chalky white patches after repeated infections or surgery.
5. A 45-year-old patient reports severe paroxysmal pain in the right cheek triggered by
brushing their teeth. Which cranial nerve is likely involved?
A. CN VII (Facial)
B. CN V (Trigeminal)
C. CN IX (Glossopharyngeal)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: Trigeminal neuralgia involves CN V and is characterized by brief,
intense, shock-like pain in the distribution of the nerve branches.
6. Which of the following physical exam findings is most indicative of a peritonsillar abscess
rather than simple pharyngitis?
A. Erythematous tonsils with exudate
B. Uvular deviation to the unaffected side
ASSESSMENT - COMPREHENSIVE
EXAM (EENT, RESPIRATORY,
CARDIAC, AND VASCULAR)
1. During a fundoscopic examination, you observe silver-wiring and arteriovenous (AV)
nicking. These findings are most characteristic of which condition?
A. Diabetic retinopathy
B. Chronic hypertension
C. Increased intracranial pressure
D. Acute macular degeneration
Answer: B
Conceptual Explanation: Chronic hypertension causes narrowing of the retinal arteries
(silver/copper wiring) and compression of venules where arteries cross them (AV nicking).
2. A patient presents with sudden, painless unilateral vision loss and a ‘cherry-red spot’ on
the macula during examination. What is the most likely diagnosis?
A. Central Retinal Vein Occlusion
,B. Retinal Detachment
C. Central Retinal Artery Occlusion
D. Acute Angle-Closure Glaucoma
Answer: C
Conceptual Explanation: Central retinal artery occlusion is an ocular emergency
characterized by sudden painless vision loss and a cherry-red spot on the macula due to
retinal edema.
3. When performing the Weber test, the sound lateralizes to the patient’s right ear. The Rinne
test shows AC > BC bilaterally. What is the correct interpretation?
A. Conductive hearing loss in the right ear
B. Conductive hearing loss in the left ear
C. Sensorineural hearing loss in the left ear
D. Normal hearing in both ears
Answer: C
Conceptual Explanation: If sound lateralizes to the right ear and Rinne is normal (AC >
BC) bilaterally, the patient has sensorineural loss in the opposite (left) ear.
4. Upon inspection of the tympanic membrane, you note a dense white patch. The patient
has a history of multiple childhood ear infections. This finding is likely:
A. Cholesteatoma
, B. Tympanosclerosis
C. Otitis media with effusion
D. Acute otitis media
Answer: B
Conceptual Explanation: Tympanosclerosis is a scarring of the tympanic membrane, often
appearing as chalky white patches after repeated infections or surgery.
5. A 45-year-old patient reports severe paroxysmal pain in the right cheek triggered by
brushing their teeth. Which cranial nerve is likely involved?
A. CN VII (Facial)
B. CN V (Trigeminal)
C. CN IX (Glossopharyngeal)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: Trigeminal neuralgia involves CN V and is characterized by brief,
intense, shock-like pain in the distribution of the nerve branches.
6. Which of the following physical exam findings is most indicative of a peritonsillar abscess
rather than simple pharyngitis?
A. Erythematous tonsils with exudate
B. Uvular deviation to the unaffected side
