NUR 2180 / NUR2180: PHYSICAL ASSESSMENT MODULE 7 QUIZ
(LATEST ) RASMUSSEN UNIVERSITY
Comprehensive 50-Question Examination | NCLEX-RN Aligned | QSEN Competencies | Physical
Assessment Standards
Cognitive Distribution: 20% Recall — 50% Application — 30% Analysis | Format: 75% Scenario-based — 25% Direct
Knowledge
Section 1: Neurological & Mental Status Assessment
Q1: A 68-year-old male is admitted following a suspected stroke. The nurse observes that he opens his
eyes spontaneously, mutters inappropriate words, and withdraws his right arm when nailbed pressure
is applied. Using the Glasgow Coma Scale (eye opening, verbal response, motor response), what is his
total score?
A. 9 (E3 V3 M3)
B. 10 (E3 V3 M4)
C. 11 (E4 V3 M4) *[CORRECT]*
D. 12 (E4 V4 M4)
Correct Answer: C
Rationale: Spontaneous eye opening = 4, inappropriate words = 3, withdrawal to pain = 4, giving a total of 11. A
score of 9 misassigns eye opening as 'to sound' (3) and motor as 'flexion' (3). A score of 10 miscounts verbal as
'confused' (4) instead of 'inappropriate' (3). A score of 12 overestimates motor response as 'localizes pain' (5) when he
only withdrew. Per NUR 2180 standards, the GCS must be reported as three components (E_V_M_) in addition to the
total, since a total of 11 can reflect multiple combinations with different prognoses.
Q2: The nurse is assessing a 54-year-old postoperative patient who requires vigorous tactile
stimulation by the nurse shaking the patient's shoulder to arouse him. Once aroused, the patient
converses but stops responding and drifts back to sleep when the stimulation stops. How should the
nurse document this level of consciousness?
A. Lethargic
B. Comatose
C. Stuporous
D. Obtunded *[CORRECT]*
Correct Answer: D
Rationale: Obtunded describes a patient who requires vigorous (tactile) stimulation to arouse and exhibits limited
spontaneous interaction with the environment once aroused. Lethargic patients arouse with minimal verbal or tactile
stimulation and sustain attention briefly, which is less severe than this presentation. Stuporous patients require painful
stimulation to arouse and cannot communicate meaningfully when aroused. Comatose patients cannot be aroused even
with painful stimuli and do not respond purposefully. The NUR 2180 curriculum emphasizes distinguishing these terms
precisely, because they drive escalation of monitoring and intervention.
NUR 2180 Physical Assessment Module 7 Quiz (2026/2027) - Rasmussen Page 1
, Q3: A 72-year-old female is admitted for dehydration. When asked, she states her name correctly,
identifies that she is 'in the hospital,' and knows the year, but she cannot identify why she is receiving
intravenous fluids. Which documentation best captures her orientation status?
A. Oriented x3 (person, place, time)
B. Oriented to person, place, and time; disoriented to situation *[CORRECT]*
C. Oriented x2 (person, place); disoriented to time and situation
D. Disoriented to person, place, time, and situation
Correct Answer: B
Rationale: Orientation should be assessed across four spheres: person, place, time, and situation. Because she
correctly identifies self, location, and year but lacks awareness of the clinical reason for her care, she is oriented to
person, place, and time but disoriented to situation. Option A omits the situation domain entirely, which is a common
documentation error in NUR 2180. Option C mislabels time orientation because she knows the year. Option D
overstates the deficit. Documenting all four spheres supports clinical reasoning and continuity across shifts.
Q4: During a mental status examination, a 45-year-old patient with major depressive disorder
answers questions slowly with one- or two-word replies, shows minimal facial expression, and makes
no eye contact. The patient's mood is verbally endorsed as 'sad.' Which finding best describes the
observed affect?
A. Labile affect
B. Broad affect
C. Inappropriate affect
D. Blunted affect *[CORRECT]*
Correct Answer: D
Rationale: Blunted affect refers to a significant reduction in the intensity of emotional expression, including minimal
facial movement, monotone speech, and reduced eye contact, which matches this presentation. Labile affect describes
rapid, abrupt shifts in emotional expression, which is not described here. Inappropriate affect refers to emotional
expressions that are incongruent with the content of speech or situation. Broad affect describes a full, appropriate
range of emotional expression and is normal. The NUR 2180 curriculum distinguishes mood (subjective self-report)
from affect (objective observation) precisely.
Q5: Which technique is correct for assessing cranial nerve I (olfactory)?
A. Test each nostril while the other is occluded, using a familiar, non-irritating substance such as
coffee or vanilla *[CORRECT]*
B. Use ammonia or peppermint to ensure a strong, easily detectable stimulus
C. Test both nostrils simultaneously with the patient's eyes closed
D. Assess only if the patient complains of headaches or vision changes
Correct Answer: A
Rationale: Cranial nerve I is tested one nostril at a time while occluding the contralateral nostril, using familiar,
non-irritating substances such as coffee, vanilla, or soap. Ammonia and other irritants are contraindicated because
they stimulate CN V (trigeminal) nociceptors, producing a false-positive result. Testing both nostrils simultaneously
prevents lateralization of deficits. Per NUR 2180 standards, olfaction is routinely tested when frontal lobe tumors,
head trauma, or viral illness are suspected, not only when headaches or vision changes are present.
NUR 2180 Physical Assessment Module 7 Quiz (2026/2027) - Rasmussen Page 2
, Q6: A 60-year-old patient reports gradually worsening vision. The nurse uses a Snellen chart and
finds the patient can read the 20/40 line with the right eye but misses half the letters on the 20/30 line.
Which cranial nerve and finding are correctly documented?
A. CN II (optic); visual acuity 20/40 OD *[CORRECT]*
B. CN III (oculomotor); visual acuity 20/40 OD
C. CN II (optic); visual acuity 20/30 OD
D. CN IV (trochlear); visual acuity 20/40 OD
Correct Answer: A
Rationale: Visual acuity using a Snellen chart is a function of cranial nerve II (optic). The recorded acuity is the
smallest line on which the patient can read at least half the letters correctly, so 20/40 OD is the appropriate
documentation. Option B confuses optic with oculomotor, which governs extraocular movement and pupillary
constriction, not acuity. Option C incorrectly records 20/30 because the patient missed more than half the letters on
that line. Option D misidentifies the nerve as trochlear, which innervates the superior oblique muscle.
Q7: A 35-year-old patient presents with new-onset diplopia and right eyelid ptosis. The nurse notes
the right eye is deviated downward and outward, and the pupil is fixed and dilated. Which cranial
nerve palsy is most likely?
A. CN IV (trochlear)
B. CN VI (abducens)
C. CN III (oculomotor) *[CORRECT]*
D. CN II (optic)
Correct Answer: C
Rationale: Down-and-out deviation of the eye, ptosis, diplopia, and a fixed dilated pupil together characterize a CN III
(oculomotor) palsy, since CN III innervates the medial, superior, and inferior recti, inferior oblique, levator palpebrae,
and parasympathetic pupillary constrictors. CN IV palsy produces vertical diplopia and downward-gaze difficulty but
not ptosis or pupillary dilation. CN VI palsy produces medial deviation (inability to abduct) but no ptosis or pupillary
change. CN II lesions cause vision loss, not ocular motility deficits. The NUR 2180 curriculum emphasizes the CN III
constellation as a neurosurgical red flag.
Q8: A 58-year-old patient has right-sided facial droop involving the forehead, eyelid, and corner of
the mouth, along with drooling from the right side of the mouth. Which finding and underlying lesion
type are most consistent?
A. Upper motor neuron lesion of the left cerebral hemisphere
B. Lower motor neuron lesion (Bell's palsy) of the right facial nerve *[CORRECT]*
C. Lower motor neuron lesion (Bell's palsy) of the left facial nerve
D. Upper motor neuron lesion of the right cerebral hemisphere
Correct Answer: B
Rationale: Involvement of the upper face (forehead) indicates a lower motor neuron lesion of the ipsilateral facial
nerve (CN VII), such as Bell's palsy, because the upper face receives bilateral UMN innervation and is therefore
spared in UMN lesions. The lesion is on the right, matching the facial droop. Option A misattributes the pattern to a
UMN lesion, which would spare the forehead. Option C mislabels the side. Option D misidentifies both the lesion type
and the forehead-sparing rule. Accurately distinguishing UMN from LMN facial palsy is a high-yield NUR 2180
clinical reasoning skill.
NUR 2180 Physical Assessment Module 7 Quiz (2026/2027) - Rasmussen Page 3
(LATEST ) RASMUSSEN UNIVERSITY
Comprehensive 50-Question Examination | NCLEX-RN Aligned | QSEN Competencies | Physical
Assessment Standards
Cognitive Distribution: 20% Recall — 50% Application — 30% Analysis | Format: 75% Scenario-based — 25% Direct
Knowledge
Section 1: Neurological & Mental Status Assessment
Q1: A 68-year-old male is admitted following a suspected stroke. The nurse observes that he opens his
eyes spontaneously, mutters inappropriate words, and withdraws his right arm when nailbed pressure
is applied. Using the Glasgow Coma Scale (eye opening, verbal response, motor response), what is his
total score?
A. 9 (E3 V3 M3)
B. 10 (E3 V3 M4)
C. 11 (E4 V3 M4) *[CORRECT]*
D. 12 (E4 V4 M4)
Correct Answer: C
Rationale: Spontaneous eye opening = 4, inappropriate words = 3, withdrawal to pain = 4, giving a total of 11. A
score of 9 misassigns eye opening as 'to sound' (3) and motor as 'flexion' (3). A score of 10 miscounts verbal as
'confused' (4) instead of 'inappropriate' (3). A score of 12 overestimates motor response as 'localizes pain' (5) when he
only withdrew. Per NUR 2180 standards, the GCS must be reported as three components (E_V_M_) in addition to the
total, since a total of 11 can reflect multiple combinations with different prognoses.
Q2: The nurse is assessing a 54-year-old postoperative patient who requires vigorous tactile
stimulation by the nurse shaking the patient's shoulder to arouse him. Once aroused, the patient
converses but stops responding and drifts back to sleep when the stimulation stops. How should the
nurse document this level of consciousness?
A. Lethargic
B. Comatose
C. Stuporous
D. Obtunded *[CORRECT]*
Correct Answer: D
Rationale: Obtunded describes a patient who requires vigorous (tactile) stimulation to arouse and exhibits limited
spontaneous interaction with the environment once aroused. Lethargic patients arouse with minimal verbal or tactile
stimulation and sustain attention briefly, which is less severe than this presentation. Stuporous patients require painful
stimulation to arouse and cannot communicate meaningfully when aroused. Comatose patients cannot be aroused even
with painful stimuli and do not respond purposefully. The NUR 2180 curriculum emphasizes distinguishing these terms
precisely, because they drive escalation of monitoring and intervention.
NUR 2180 Physical Assessment Module 7 Quiz (2026/2027) - Rasmussen Page 1
, Q3: A 72-year-old female is admitted for dehydration. When asked, she states her name correctly,
identifies that she is 'in the hospital,' and knows the year, but she cannot identify why she is receiving
intravenous fluids. Which documentation best captures her orientation status?
A. Oriented x3 (person, place, time)
B. Oriented to person, place, and time; disoriented to situation *[CORRECT]*
C. Oriented x2 (person, place); disoriented to time and situation
D. Disoriented to person, place, time, and situation
Correct Answer: B
Rationale: Orientation should be assessed across four spheres: person, place, time, and situation. Because she
correctly identifies self, location, and year but lacks awareness of the clinical reason for her care, she is oriented to
person, place, and time but disoriented to situation. Option A omits the situation domain entirely, which is a common
documentation error in NUR 2180. Option C mislabels time orientation because she knows the year. Option D
overstates the deficit. Documenting all four spheres supports clinical reasoning and continuity across shifts.
Q4: During a mental status examination, a 45-year-old patient with major depressive disorder
answers questions slowly with one- or two-word replies, shows minimal facial expression, and makes
no eye contact. The patient's mood is verbally endorsed as 'sad.' Which finding best describes the
observed affect?
A. Labile affect
B. Broad affect
C. Inappropriate affect
D. Blunted affect *[CORRECT]*
Correct Answer: D
Rationale: Blunted affect refers to a significant reduction in the intensity of emotional expression, including minimal
facial movement, monotone speech, and reduced eye contact, which matches this presentation. Labile affect describes
rapid, abrupt shifts in emotional expression, which is not described here. Inappropriate affect refers to emotional
expressions that are incongruent with the content of speech or situation. Broad affect describes a full, appropriate
range of emotional expression and is normal. The NUR 2180 curriculum distinguishes mood (subjective self-report)
from affect (objective observation) precisely.
Q5: Which technique is correct for assessing cranial nerve I (olfactory)?
A. Test each nostril while the other is occluded, using a familiar, non-irritating substance such as
coffee or vanilla *[CORRECT]*
B. Use ammonia or peppermint to ensure a strong, easily detectable stimulus
C. Test both nostrils simultaneously with the patient's eyes closed
D. Assess only if the patient complains of headaches or vision changes
Correct Answer: A
Rationale: Cranial nerve I is tested one nostril at a time while occluding the contralateral nostril, using familiar,
non-irritating substances such as coffee, vanilla, or soap. Ammonia and other irritants are contraindicated because
they stimulate CN V (trigeminal) nociceptors, producing a false-positive result. Testing both nostrils simultaneously
prevents lateralization of deficits. Per NUR 2180 standards, olfaction is routinely tested when frontal lobe tumors,
head trauma, or viral illness are suspected, not only when headaches or vision changes are present.
NUR 2180 Physical Assessment Module 7 Quiz (2026/2027) - Rasmussen Page 2
, Q6: A 60-year-old patient reports gradually worsening vision. The nurse uses a Snellen chart and
finds the patient can read the 20/40 line with the right eye but misses half the letters on the 20/30 line.
Which cranial nerve and finding are correctly documented?
A. CN II (optic); visual acuity 20/40 OD *[CORRECT]*
B. CN III (oculomotor); visual acuity 20/40 OD
C. CN II (optic); visual acuity 20/30 OD
D. CN IV (trochlear); visual acuity 20/40 OD
Correct Answer: A
Rationale: Visual acuity using a Snellen chart is a function of cranial nerve II (optic). The recorded acuity is the
smallest line on which the patient can read at least half the letters correctly, so 20/40 OD is the appropriate
documentation. Option B confuses optic with oculomotor, which governs extraocular movement and pupillary
constriction, not acuity. Option C incorrectly records 20/30 because the patient missed more than half the letters on
that line. Option D misidentifies the nerve as trochlear, which innervates the superior oblique muscle.
Q7: A 35-year-old patient presents with new-onset diplopia and right eyelid ptosis. The nurse notes
the right eye is deviated downward and outward, and the pupil is fixed and dilated. Which cranial
nerve palsy is most likely?
A. CN IV (trochlear)
B. CN VI (abducens)
C. CN III (oculomotor) *[CORRECT]*
D. CN II (optic)
Correct Answer: C
Rationale: Down-and-out deviation of the eye, ptosis, diplopia, and a fixed dilated pupil together characterize a CN III
(oculomotor) palsy, since CN III innervates the medial, superior, and inferior recti, inferior oblique, levator palpebrae,
and parasympathetic pupillary constrictors. CN IV palsy produces vertical diplopia and downward-gaze difficulty but
not ptosis or pupillary dilation. CN VI palsy produces medial deviation (inability to abduct) but no ptosis or pupillary
change. CN II lesions cause vision loss, not ocular motility deficits. The NUR 2180 curriculum emphasizes the CN III
constellation as a neurosurgical red flag.
Q8: A 58-year-old patient has right-sided facial droop involving the forehead, eyelid, and corner of
the mouth, along with drooling from the right side of the mouth. Which finding and underlying lesion
type are most consistent?
A. Upper motor neuron lesion of the left cerebral hemisphere
B. Lower motor neuron lesion (Bell's palsy) of the right facial nerve *[CORRECT]*
C. Lower motor neuron lesion (Bell's palsy) of the left facial nerve
D. Upper motor neuron lesion of the right cerebral hemisphere
Correct Answer: B
Rationale: Involvement of the upper face (forehead) indicates a lower motor neuron lesion of the ipsilateral facial
nerve (CN VII), such as Bell's palsy, because the upper face receives bilateral UMN innervation and is therefore
spared in UMN lesions. The lesion is on the right, matching the facial droop. Option A misattributes the pattern to a
UMN lesion, which would spare the forehead. Option C mislabels the side. Option D misidentifies both the lesion type
and the forehead-sparing rule. Accurately distinguishing UMN from LMN facial palsy is a high-yield NUR 2180
clinical reasoning skill.
NUR 2180 Physical Assessment Module 7 Quiz (2026/2027) - Rasmussen Page 3
