ADVANCED HEALTH ASSESSMENT
MIDTERM REVIEW 2026 PRACTICE
QUESTIONS AND CORRECT ANSWERS
COMPREHENSIVE STUDY GUIDE
You are examining an elderly man and notice the following: decreased
vibration sense in the feet and ankles, diminished gag reflex, right patellar
reflex less than the left, and diminished abdominal reflexes. Which of these
is abnormal?
Decreased vibration sense
Diminished gag reflex
Diminished right patellar reflex compared to the left
Diminished abdominal reflexes - CORRECT ANSWER-Diminished right
patellar reflex compared to the left
Asymmetry on any examination is usually reason for concern. The other
changes are commonly associated with aging. You may consider looking for
other neurologic signs on the right, although occasionally you may mistake
an abnormally brisk reflex to be normal when compared to the other side. It
is usually a good idea to question whether the opposite side is actually the
abnormal one when you find asymmetry on examination.
,Mr. White's son brings him in today because he notes that Mr. White has
not been himself lately. He seems forgetful and has not taken care of
himself as he normally does. He has reported falling twice at home to his
son and has telephoned late at night because of insomnia. His blood
pressure and diabetes have been difficult to control and his warfarin dosing
has become more difficult. Which of the following should you suspect?
Alzheimer's dementia
Alcohol use
Urinary tract infection
Stroke - CORRECT ANSWER-Alcohol use
All of these answers are common diseases of the elderly and many have
atypical presentations in this age group. The fact that his hypertension has
become more difficult to control and his warfarin dosing is challenging to
manage should lead you to consider that there is alcohol use. Further
questioning, quantifying his use of alcohol, and application of the CAGE
questionnaire may be useful.
Claire's daughter brings her in today after Claire fell at her home. Which
assessments are indicated at this time?
Orthostatic vital signs
Review of her medications
,Assessment of gait and balance
All of the above - CORRECT ANSWER-All of the above
Falls are common in the elderly and can often result in serious injuries.
When assessing the cause of falls, gait and balance should be checked first.
Medication, particularly use of more than three, is associated with falls.
Vision problems, lower-limb joint problems, and cardiovascular problems
such as arrhythmias may be reasonable to search for. Orthostatic vital sign
changes should be sought.
On routine screening you notice that the cup-to-disc ratio of the patient's
right eye is 1:2. What ocular condition should you suspect?
Macular degeneration
Diabetic retinopathy
Hypertensive retinopathy
Glaucoma - CORRECT ANSWER-Glaucoma
This cup-to-disc ratio means that the cup takes up 50% of the disc, which is
abnormally large. This is usually an indication of glaucoma, which is a
common cause of visual loss in the elderly. The cup-to-disc changes are not
, seen in diabetes, hypertension, or macular degeneration. Many elderly do
not have regular eye examinations and are not screened for glaucoma.
A patient with hearing loss by whisper test is further examined with a
tuning fork, using the Weber and Rinne maneuvers. The abnormal results
are as follows: bone conduction is greater than air on the left, and the
patient hears the sound of the tuning fork better on the left. Which of the
following is most likely?
Otitis media of the right ear
Exposure to chronic loud noise of the right ear
Perforation of the right eardrum
Otosclerosis of the left ear - CORRECT ANSWER-Otosclerosis of the left
ear
A patient complains of epistaxis. Which other cause should be considered?
Hematemesis
Hematoma of the nasal septum
Intracranial hemorrhage
MIDTERM REVIEW 2026 PRACTICE
QUESTIONS AND CORRECT ANSWERS
COMPREHENSIVE STUDY GUIDE
You are examining an elderly man and notice the following: decreased
vibration sense in the feet and ankles, diminished gag reflex, right patellar
reflex less than the left, and diminished abdominal reflexes. Which of these
is abnormal?
Decreased vibration sense
Diminished gag reflex
Diminished right patellar reflex compared to the left
Diminished abdominal reflexes - CORRECT ANSWER-Diminished right
patellar reflex compared to the left
Asymmetry on any examination is usually reason for concern. The other
changes are commonly associated with aging. You may consider looking for
other neurologic signs on the right, although occasionally you may mistake
an abnormally brisk reflex to be normal when compared to the other side. It
is usually a good idea to question whether the opposite side is actually the
abnormal one when you find asymmetry on examination.
,Mr. White's son brings him in today because he notes that Mr. White has
not been himself lately. He seems forgetful and has not taken care of
himself as he normally does. He has reported falling twice at home to his
son and has telephoned late at night because of insomnia. His blood
pressure and diabetes have been difficult to control and his warfarin dosing
has become more difficult. Which of the following should you suspect?
Alzheimer's dementia
Alcohol use
Urinary tract infection
Stroke - CORRECT ANSWER-Alcohol use
All of these answers are common diseases of the elderly and many have
atypical presentations in this age group. The fact that his hypertension has
become more difficult to control and his warfarin dosing is challenging to
manage should lead you to consider that there is alcohol use. Further
questioning, quantifying his use of alcohol, and application of the CAGE
questionnaire may be useful.
Claire's daughter brings her in today after Claire fell at her home. Which
assessments are indicated at this time?
Orthostatic vital signs
Review of her medications
,Assessment of gait and balance
All of the above - CORRECT ANSWER-All of the above
Falls are common in the elderly and can often result in serious injuries.
When assessing the cause of falls, gait and balance should be checked first.
Medication, particularly use of more than three, is associated with falls.
Vision problems, lower-limb joint problems, and cardiovascular problems
such as arrhythmias may be reasonable to search for. Orthostatic vital sign
changes should be sought.
On routine screening you notice that the cup-to-disc ratio of the patient's
right eye is 1:2. What ocular condition should you suspect?
Macular degeneration
Diabetic retinopathy
Hypertensive retinopathy
Glaucoma - CORRECT ANSWER-Glaucoma
This cup-to-disc ratio means that the cup takes up 50% of the disc, which is
abnormally large. This is usually an indication of glaucoma, which is a
common cause of visual loss in the elderly. The cup-to-disc changes are not
, seen in diabetes, hypertension, or macular degeneration. Many elderly do
not have regular eye examinations and are not screened for glaucoma.
A patient with hearing loss by whisper test is further examined with a
tuning fork, using the Weber and Rinne maneuvers. The abnormal results
are as follows: bone conduction is greater than air on the left, and the
patient hears the sound of the tuning fork better on the left. Which of the
following is most likely?
Otitis media of the right ear
Exposure to chronic loud noise of the right ear
Perforation of the right eardrum
Otosclerosis of the left ear - CORRECT ANSWER-Otosclerosis of the left
ear
A patient complains of epistaxis. Which other cause should be considered?
Hematemesis
Hematoma of the nasal septum
Intracranial hemorrhage
