NSG3160 Health Assessment Final Exam Review
2025/2026 - 100% Correct Questions & A Grade
Answers for Galen College
A 68-year-old woman with a history of COPD and HTN presents with 3 days of
increasing dyspnea and ankle swelling. Her SpO₂ is 89 % on room air, respiratory rate 24,
and you note jugular venous distension to the angle of the jaw while she is positioned at
45°. Which focused assessment should you perform NEXT?
1. A) Auscultate for crackles over the posterior lung bases and assess for pitting
edema over the shins
B) Obtain peak-flow measurement to quantify airway obstruction
C) Palpate the radial pulse for rate and rhythm while obtaining orthostatic vital
signs
D) Percuss the anterior chest to document diaphragmatic descent
Answer: A
Rationale: JVD at 45° plus dyspnea and ankle swelling signals possible right-sided heart
failure; listening for basilar crackles and grading pitting edema directly evaluates
volume overload and left-sided failure as well. Peak-flow (B) addresses obstruction, not
fluid overload; orthostatics (C) are premature; diaphragmatic percussion (D) is not
priority here.
A 24-year-old man arrives after a skateboard accident with obvious external rotation
and shortening of the right lower extremity. He rates pain 9/10. Which assessment is
MOST urgent before moving him to radiology?
2. A) Palpate distal pulses, capillary refill, and assess motor/sensation of the right
foot
B) Perform passive range-of-motion to determine the hip’s full mobility
C) Auscultate bowel sounds in all four quadrants to rule intra-abdominal injury
D) Measure limb length discrepancy with a tape measure for documentation
,Answer: A
Rationale: Neurovascular compromise is the immediate threat in suspected fracture;
assessing dorsalis pedis/posterior tibial pulses, cap refill <3 s, and motor/sensation
identifies compartment syndrome or ischemia. Passive ROM (B) is contraindicated;
bowel sounds (D) are not priority in extremity trauma.
During a routine well-baby visit, you attempt to elicit the Moro reflex on a 2-week-old
infant. The infant extends and abducts arms, then brings them together and cries. Your
interpretation is:
3. A) Reflex is absent; refer for neurologic evaluation
B) Reflex is exaggerated; suggestive of hypoxic-ischemic injury
C) Reflex is normal and symmetric
D) Reflex is incomplete; repeat with sudden head extension
Answer: C
Rationale: The described sequence—extension/abduction, followed by adduction with
cry—is the normal Moro response, indicating intact brain-stem pathways. Absence or
persistent asymmetry would be abnormal.
A 55-year-old man with diabetes states, “I can’t feel my feet anymore.” Monofilament
testing reveals absent sensation at five of nine sites on the plantar surfaces. Which
finding would BEST confirm peripheral neuropathy rather than vascular insufficiency?
4. A) Bounding dorsalis pedis pulses bilaterally
B) Cool, shiny skin with hair loss on the toes
C) Capillary refill time of 5 seconds
D) Ankle-brachial index of 0.6
Answer: A
Rationale: Intact, even bounding, pulses suggest good arterial inflow, supporting
neuropathic rather than ischemic cause of numbness. Delayed cap refill (C) and ABI
<0.9 (D) point toward vascular disease.
,A 30-year-old pregnant woman at 28 weeks’ gestation reports constant heartburn. When
auscultating fetal heart tones with a Doppler, you should place the transducer:
5. A) At the fundus, midline, because the fetus is breech
B) Just above the symphysis pubis with the mother supine
C) In the lower quadrant between the umbilicus and anterior axillary line after
locating the fetal back with Leopold maneuvers
D) Over the right upper quadrant to avoid the placenta
Answer: C
Rationale: Leopold maneuvers identify fetal lie and position; the strongest heart tones
are heard through the fetal back, typically in the lower quadrant toward the mid-axillary
line at 28 weeks. Fundal placement (A) is premature unless breech is confirmed.
A 77-year-old woman is admitted with confusion. Her MMSE is 18/30. You note bilateral
eyelid drooping that WORSENS as the day progresses. Which cranial nerve should you
assess NEXT?
6. A) CN III (Oculomotor)
B) CN VII (Facial)
C) CN V (Trigeminal)
D) CN II (Optic)
Answer: A
Rationale: Fluctuating ptosis suggests neuromuscular junction disorder (myasthenia
gravis); CN III innervates levator palpebrae. Testing extra-ocular movements and looking
for fatigability confirms diagnosis.
A 45-year-old woman with rheumatoid arthritis is on long-term corticosteroids. You note
a buffalo hump and central obesity. Which assessment finding is MOST consistent with
iatrogenic Cushing syndrome?
7. A) Hyperpigmented knuckles and hypotension
B) Proximal muscle weakness and wide (>2 cm) purple striae
C) Bradycardia and weight loss
D) Ptosis and diplopia
Answer: B
, Rationale: Proximal weakness and wide violaceous striae reflect protein catabolism and
skin thinning from excess glucocorticoids. Hyperpigmentation (A) occurs in Addison’s;
bradycardia/weight loss (C) are hypothyroid signs.
A 19-year-old college student presents with sore throat and fatigue. You observe
bilateral posterior cervical lymphadenopathy and palatal petechiae. Which technique
BEST increases specificity for infectious mononucleosis during the exam?
8. A) Gram stain of throat exudate
B) Monospot test after palpating spleen for enlargement
C) Rapid strep test before palpating cervical nodes
D) Visual inspection of tonsils for exudate
Answer: B
Rationale: Palpating for splenomegaly (light percussion or gentle subcostal palpation)
supports mono diagnosis because strep rarely causes splenic enlargement. Monospot
then confirms. Rapid strep (C) does not distinguish etiology.
A 60-year-old man post-MI 3 days ago reports sudden sharp chest pain that radiates to
his left shoulder and improves when he sits up. On auscultation you hear a scratchy,
high-pitched sound that is loudest at the left lower sternal border and persists when you
briefly stop breathing. You document this as:
9. A) Pleural friction rub—pleuritic chest pain
B) Pericardial friction rub—suggestive of pericarditis
C) Systolic ejection murmur—papillary-muscle rupture
D) Fine crackles—pulmonary edema
Answer: B
Rationale: Sound unchanged by respiration and improved by sitting up is classic
pericardial friction rub, a post-MI complication. Pleural rub (A) would vary with breath;
murmur (C) is cardiac cycle–dependent.
A 6-year-old boy is brought in for a school physical. You note he is Tanner stage I. His
mother asks when puberty will start. The FIRST physical sign of male puberty you
should tell her to expect is:
2025/2026 - 100% Correct Questions & A Grade
Answers for Galen College
A 68-year-old woman with a history of COPD and HTN presents with 3 days of
increasing dyspnea and ankle swelling. Her SpO₂ is 89 % on room air, respiratory rate 24,
and you note jugular venous distension to the angle of the jaw while she is positioned at
45°. Which focused assessment should you perform NEXT?
1. A) Auscultate for crackles over the posterior lung bases and assess for pitting
edema over the shins
B) Obtain peak-flow measurement to quantify airway obstruction
C) Palpate the radial pulse for rate and rhythm while obtaining orthostatic vital
signs
D) Percuss the anterior chest to document diaphragmatic descent
Answer: A
Rationale: JVD at 45° plus dyspnea and ankle swelling signals possible right-sided heart
failure; listening for basilar crackles and grading pitting edema directly evaluates
volume overload and left-sided failure as well. Peak-flow (B) addresses obstruction, not
fluid overload; orthostatics (C) are premature; diaphragmatic percussion (D) is not
priority here.
A 24-year-old man arrives after a skateboard accident with obvious external rotation
and shortening of the right lower extremity. He rates pain 9/10. Which assessment is
MOST urgent before moving him to radiology?
2. A) Palpate distal pulses, capillary refill, and assess motor/sensation of the right
foot
B) Perform passive range-of-motion to determine the hip’s full mobility
C) Auscultate bowel sounds in all four quadrants to rule intra-abdominal injury
D) Measure limb length discrepancy with a tape measure for documentation
,Answer: A
Rationale: Neurovascular compromise is the immediate threat in suspected fracture;
assessing dorsalis pedis/posterior tibial pulses, cap refill <3 s, and motor/sensation
identifies compartment syndrome or ischemia. Passive ROM (B) is contraindicated;
bowel sounds (D) are not priority in extremity trauma.
During a routine well-baby visit, you attempt to elicit the Moro reflex on a 2-week-old
infant. The infant extends and abducts arms, then brings them together and cries. Your
interpretation is:
3. A) Reflex is absent; refer for neurologic evaluation
B) Reflex is exaggerated; suggestive of hypoxic-ischemic injury
C) Reflex is normal and symmetric
D) Reflex is incomplete; repeat with sudden head extension
Answer: C
Rationale: The described sequence—extension/abduction, followed by adduction with
cry—is the normal Moro response, indicating intact brain-stem pathways. Absence or
persistent asymmetry would be abnormal.
A 55-year-old man with diabetes states, “I can’t feel my feet anymore.” Monofilament
testing reveals absent sensation at five of nine sites on the plantar surfaces. Which
finding would BEST confirm peripheral neuropathy rather than vascular insufficiency?
4. A) Bounding dorsalis pedis pulses bilaterally
B) Cool, shiny skin with hair loss on the toes
C) Capillary refill time of 5 seconds
D) Ankle-brachial index of 0.6
Answer: A
Rationale: Intact, even bounding, pulses suggest good arterial inflow, supporting
neuropathic rather than ischemic cause of numbness. Delayed cap refill (C) and ABI
<0.9 (D) point toward vascular disease.
,A 30-year-old pregnant woman at 28 weeks’ gestation reports constant heartburn. When
auscultating fetal heart tones with a Doppler, you should place the transducer:
5. A) At the fundus, midline, because the fetus is breech
B) Just above the symphysis pubis with the mother supine
C) In the lower quadrant between the umbilicus and anterior axillary line after
locating the fetal back with Leopold maneuvers
D) Over the right upper quadrant to avoid the placenta
Answer: C
Rationale: Leopold maneuvers identify fetal lie and position; the strongest heart tones
are heard through the fetal back, typically in the lower quadrant toward the mid-axillary
line at 28 weeks. Fundal placement (A) is premature unless breech is confirmed.
A 77-year-old woman is admitted with confusion. Her MMSE is 18/30. You note bilateral
eyelid drooping that WORSENS as the day progresses. Which cranial nerve should you
assess NEXT?
6. A) CN III (Oculomotor)
B) CN VII (Facial)
C) CN V (Trigeminal)
D) CN II (Optic)
Answer: A
Rationale: Fluctuating ptosis suggests neuromuscular junction disorder (myasthenia
gravis); CN III innervates levator palpebrae. Testing extra-ocular movements and looking
for fatigability confirms diagnosis.
A 45-year-old woman with rheumatoid arthritis is on long-term corticosteroids. You note
a buffalo hump and central obesity. Which assessment finding is MOST consistent with
iatrogenic Cushing syndrome?
7. A) Hyperpigmented knuckles and hypotension
B) Proximal muscle weakness and wide (>2 cm) purple striae
C) Bradycardia and weight loss
D) Ptosis and diplopia
Answer: B
, Rationale: Proximal weakness and wide violaceous striae reflect protein catabolism and
skin thinning from excess glucocorticoids. Hyperpigmentation (A) occurs in Addison’s;
bradycardia/weight loss (C) are hypothyroid signs.
A 19-year-old college student presents with sore throat and fatigue. You observe
bilateral posterior cervical lymphadenopathy and palatal petechiae. Which technique
BEST increases specificity for infectious mononucleosis during the exam?
8. A) Gram stain of throat exudate
B) Monospot test after palpating spleen for enlargement
C) Rapid strep test before palpating cervical nodes
D) Visual inspection of tonsils for exudate
Answer: B
Rationale: Palpating for splenomegaly (light percussion or gentle subcostal palpation)
supports mono diagnosis because strep rarely causes splenic enlargement. Monospot
then confirms. Rapid strep (C) does not distinguish etiology.
A 60-year-old man post-MI 3 days ago reports sudden sharp chest pain that radiates to
his left shoulder and improves when he sits up. On auscultation you hear a scratchy,
high-pitched sound that is loudest at the left lower sternal border and persists when you
briefly stop breathing. You document this as:
9. A) Pleural friction rub—pleuritic chest pain
B) Pericardial friction rub—suggestive of pericarditis
C) Systolic ejection murmur—papillary-muscle rupture
D) Fine crackles—pulmonary edema
Answer: B
Rationale: Sound unchanged by respiration and improved by sitting up is classic
pericardial friction rub, a post-MI complication. Pleural rub (A) would vary with breath;
murmur (C) is cardiac cycle–dependent.
A 6-year-old boy is brought in for a school physical. You note he is Tanner stage I. His
mother asks when puberty will start. The FIRST physical sign of male puberty you
should tell her to expect is:
