NURS 5220 ADVANCED HEALTH
ASSESSMENT FINAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. A 65-year-old male presents with a chief complaint of sudden onset dyspnea. Upon
auscultation, you hear a high-pitched, musical sound during expiration. What is the most
likely pathophysiological mechanism?
A. Narrowing of the small airways due to bronchospasm
B. Inflammation of the pleura causing friction
C. Fluid in the alveoli causing collapsed air sacs to pop open
D. Upper airway obstruction involving the larynx
Answer: A
Conceptual Explanation: Wheezing is a high-pitched musical sound typically heard during
expiration, indicating air being forced through narrow small airways, common in asthma or
COPD.
2. While performing a cardiac assessment, the nurse practitioner notes a low-pitched late
diastolic sound heard best at the apex with the bell of the stethoscope. This finding is most
likely:
A. An S3 gallop, indicating fluid overload
,B. An opening snap of mitral stenosis
C. An S4 gallop, indicating decreased ventricular compliance
D. A physiological split S2
Answer: C
Conceptual Explanation: An S4 occurs in late diastole, just before S1, and is often
associated with stiff ventricles (hypertrophy or ischemia).
3. During a musculoskeletal exam, you perform the Lachman test on a patient who felt a ‘pop’
in their knee during soccer. A positive result indicates injury to which structure?
A. Anterior cruciate ligament (ACL)
B. Posterior cruciate ligament (PCL)
C. Medial collateral ligament (MCL)
D. Lateral meniscus
Answer: A
Conceptual Explanation: The Lachman test is the most sensitive clinical test for detecting
an ACL tear, indicated by increased laxity and lack of a firm endpoint when pulling the tibia
forward.
4. A patient presents with ‘the worst headache of my life.’ You note neck stiffness and
photophobia. What is the priority diagnostic suspicion?
A. Subarachnoid hemorrhage
, B. Cluster headache
C. Migraine with aura
D. Temporal arteritis
Answer: A
Conceptual Explanation: A ‘thunderclap’ headache or ‘worst headache of my life’ is a
classic presentation for a subarachnoid hemorrhage, a medical emergency.
5. Which cranial nerve is being assessed when you ask a patient to shrug their shoulders
against resistance?
A. Cranial Nerve X (Vagus)
B. Cranial Nerve XII (Hypoglossal)
C. Cranial Nerve XI (Spinal Accessory)
D. Cranial Nerve IX (Glossopharyngeal)
Answer: C
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; shoulder shrugging tests its motor function.
6. During an abdominal exam, you palpate deeply in the LLQ and the patient feels pain in the
RLQ. This is known as:
A. Murphy’s sign
B. Rovsing’s sign
ASSESSMENT FINAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. A 65-year-old male presents with a chief complaint of sudden onset dyspnea. Upon
auscultation, you hear a high-pitched, musical sound during expiration. What is the most
likely pathophysiological mechanism?
A. Narrowing of the small airways due to bronchospasm
B. Inflammation of the pleura causing friction
C. Fluid in the alveoli causing collapsed air sacs to pop open
D. Upper airway obstruction involving the larynx
Answer: A
Conceptual Explanation: Wheezing is a high-pitched musical sound typically heard during
expiration, indicating air being forced through narrow small airways, common in asthma or
COPD.
2. While performing a cardiac assessment, the nurse practitioner notes a low-pitched late
diastolic sound heard best at the apex with the bell of the stethoscope. This finding is most
likely:
A. An S3 gallop, indicating fluid overload
,B. An opening snap of mitral stenosis
C. An S4 gallop, indicating decreased ventricular compliance
D. A physiological split S2
Answer: C
Conceptual Explanation: An S4 occurs in late diastole, just before S1, and is often
associated with stiff ventricles (hypertrophy or ischemia).
3. During a musculoskeletal exam, you perform the Lachman test on a patient who felt a ‘pop’
in their knee during soccer. A positive result indicates injury to which structure?
A. Anterior cruciate ligament (ACL)
B. Posterior cruciate ligament (PCL)
C. Medial collateral ligament (MCL)
D. Lateral meniscus
Answer: A
Conceptual Explanation: The Lachman test is the most sensitive clinical test for detecting
an ACL tear, indicated by increased laxity and lack of a firm endpoint when pulling the tibia
forward.
4. A patient presents with ‘the worst headache of my life.’ You note neck stiffness and
photophobia. What is the priority diagnostic suspicion?
A. Subarachnoid hemorrhage
, B. Cluster headache
C. Migraine with aura
D. Temporal arteritis
Answer: A
Conceptual Explanation: A ‘thunderclap’ headache or ‘worst headache of my life’ is a
classic presentation for a subarachnoid hemorrhage, a medical emergency.
5. Which cranial nerve is being assessed when you ask a patient to shrug their shoulders
against resistance?
A. Cranial Nerve X (Vagus)
B. Cranial Nerve XII (Hypoglossal)
C. Cranial Nerve XI (Spinal Accessory)
D. Cranial Nerve IX (Glossopharyngeal)
Answer: C
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; shoulder shrugging tests its motor function.
6. During an abdominal exam, you palpate deeply in the LLQ and the patient feels pain in the
RLQ. This is known as:
A. Murphy’s sign
B. Rovsing’s sign
