,NUR 6001 Exam 2 | Advanced Health Assessment |
William Paterson University
1. A clinician is assessing a patient who reports a "scratchy" sensation in the
throat and difficulty swallowing. Which cranial nerve is primarily responsible for
the motor function of the pharynx?
A) Cranial nerve VII
B) Cranial nerve IX
C) Cranial nerve X
D) Cranial nerve XII
Correct Answer: Cranial nerve X
Rationale: The vagus nerve (CN X) provides motor innervation to the pharynx
and larynx, which is essential for swallowing. The glossopharyngeal nerve (CN IX)
provides sensory and some motor function, but the vagus nerve is the primary
motor nerve for pharyngeal movement. CN VII controls facial expressions, and CN
XII controls tongue movement.
2. During an otoscopic examination, the clinician notes a pearly gray, translucent
tympanic membrane with a visible cone of light. What does this finding indicate?
A) Acute otitis media
B) Serous otitis media
C) Normal tympanic membrane
D) Perforated tympanic membrane
Correct Answer: Normal tympanic membrane
,Rationale: A pearly gray, translucent tympanic membrane with a visible cone of
light in the anterior-inferior quadrant is a normal finding. Acute otitis media
presents with a bulging, erythematous membrane. Serous otitis media may show
an air-fluid level, and a perforation would appear as a hole or tear.
3. A patient presents with a unilateral, severe, throbbing headache accompanied
by nausea and photophobia. Which type of headache is most likely?
A) Tension headache
B) Cluster headache
C) Migraine headache
D) Sinus headache
Correct Answer: Migraine headache
Rationale: Migraine headaches are typically unilateral, throbbing, and
accompanied by nausea, photophobia, and phonophobia. Tension headaches are
bilateral and pressing. Cluster headaches are severe, unilateral, and periorbital
with autonomic symptoms. Sinus headaches are associated with facial pressure
and purulent discharge.
4. Which test is used to assess for tactile fremitus during a respiratory
examination?
A) Asking the patient to say "ninety-nine" while palpating the chest
B) Percussing the chest wall
C) Auscultating breath sounds
D) Measuring chest expansion
, Correct Answer: Asking the patient to say "ninety-nine" while palpating the
chest
Rationale: Tactile fremitus is assessed by having the patient repeat "ninety-
nine" or "blue moon" while the clinician palpates the chest wall. Increased
fremitus suggests consolidation, while decreased fremitus suggests pleural
effusion or pneumothorax. Percussion assesses density, and auscultation assesses
breath sounds.
5. A patient with a history of heart failure presents with jugular venous distention,
bilateral crackles, and an S3 gallop. What do these findings indicate?
A) Fluid overload
B) Pneumonia
C) Pulmonary embolism
D) Myocardial infarction
Correct Answer: Fluid overload
Rationale: Jugular venous distention, crackles, and an S3 gallop are classic signs
of fluid overload in heart failure. Pneumonia would present with fever and focal
crackles. Pulmonary embolism typically presents with sudden dyspnea and
pleuritic chest pain. Myocardial infarction causes chest pain and elevated
troponin.
6. A clinician is performing a cardiovascular assessment and auscultates a
blowing, high-pitched systolic murmur at the right second intercostal space.
Which valvular disorder does this finding suggest?
A) Mitral regurgitation
B) Aortic stenosis
William Paterson University
1. A clinician is assessing a patient who reports a "scratchy" sensation in the
throat and difficulty swallowing. Which cranial nerve is primarily responsible for
the motor function of the pharynx?
A) Cranial nerve VII
B) Cranial nerve IX
C) Cranial nerve X
D) Cranial nerve XII
Correct Answer: Cranial nerve X
Rationale: The vagus nerve (CN X) provides motor innervation to the pharynx
and larynx, which is essential for swallowing. The glossopharyngeal nerve (CN IX)
provides sensory and some motor function, but the vagus nerve is the primary
motor nerve for pharyngeal movement. CN VII controls facial expressions, and CN
XII controls tongue movement.
2. During an otoscopic examination, the clinician notes a pearly gray, translucent
tympanic membrane with a visible cone of light. What does this finding indicate?
A) Acute otitis media
B) Serous otitis media
C) Normal tympanic membrane
D) Perforated tympanic membrane
Correct Answer: Normal tympanic membrane
,Rationale: A pearly gray, translucent tympanic membrane with a visible cone of
light in the anterior-inferior quadrant is a normal finding. Acute otitis media
presents with a bulging, erythematous membrane. Serous otitis media may show
an air-fluid level, and a perforation would appear as a hole or tear.
3. A patient presents with a unilateral, severe, throbbing headache accompanied
by nausea and photophobia. Which type of headache is most likely?
A) Tension headache
B) Cluster headache
C) Migraine headache
D) Sinus headache
Correct Answer: Migraine headache
Rationale: Migraine headaches are typically unilateral, throbbing, and
accompanied by nausea, photophobia, and phonophobia. Tension headaches are
bilateral and pressing. Cluster headaches are severe, unilateral, and periorbital
with autonomic symptoms. Sinus headaches are associated with facial pressure
and purulent discharge.
4. Which test is used to assess for tactile fremitus during a respiratory
examination?
A) Asking the patient to say "ninety-nine" while palpating the chest
B) Percussing the chest wall
C) Auscultating breath sounds
D) Measuring chest expansion
, Correct Answer: Asking the patient to say "ninety-nine" while palpating the
chest
Rationale: Tactile fremitus is assessed by having the patient repeat "ninety-
nine" or "blue moon" while the clinician palpates the chest wall. Increased
fremitus suggests consolidation, while decreased fremitus suggests pleural
effusion or pneumothorax. Percussion assesses density, and auscultation assesses
breath sounds.
5. A patient with a history of heart failure presents with jugular venous distention,
bilateral crackles, and an S3 gallop. What do these findings indicate?
A) Fluid overload
B) Pneumonia
C) Pulmonary embolism
D) Myocardial infarction
Correct Answer: Fluid overload
Rationale: Jugular venous distention, crackles, and an S3 gallop are classic signs
of fluid overload in heart failure. Pneumonia would present with fever and focal
crackles. Pulmonary embolism typically presents with sudden dyspnea and
pleuritic chest pain. Myocardial infarction causes chest pain and elevated
troponin.
6. A clinician is performing a cardiovascular assessment and auscultates a
blowing, high-pitched systolic murmur at the right second intercostal space.
Which valvular disorder does this finding suggest?
A) Mitral regurgitation
B) Aortic stenosis
