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Maryville University NURS 612 Actual Exam
Questions and Answers with Rationales
2026/2027 | Advanced Health Assessment Exam 2
| Pass Guarantee
Q001: A 58-year-old male presents with sudden-onset right facial droop, slurred
speech, and right arm drift lasting 20 minutes. On exam you note right upper face
involvement, left gaze preference, and no limb ataxia. Carotid auscultation reveals
a faint systolic bruit. Which cranial nerve dysfunction best localizes this transient
episode?
Options:
A. Right CN VII nuclear lesion
B. Left CN VI peripheral palsy
C. Left cortical CN VII upper motor neuron involvement - CORRECT
D. Right CN XII lower motor neuron lesion
(Correct Answer: C)
Q002: A 34-year-old violinist reports painless clicking when opening her jaw. On
palpation during opening you feel a subtle reciprocal click with lateral pole
tenderness; no locking occurs. The mandible deviates slightly left on opening >30
mm. Which temporomandibular assessment finding is most predictive of intra-
articular disc displacement?
Options:
A. Deviation to contralateral side on opening - CORRECT
B. Ipsilateral masseter spasm
C. Reduced vertical range <25 mm
D. Audible crepitus on closing
(Correct Answer: A)
, 2
Q003: A 71-year-old female with atrial fibrillation on rivaroxaban presents with
acute left calf pain and swelling. Homan sign is negative but Wells score is 3.
Which component of the Wells criteria carries the highest individual positive
weight and should prompt urgent duplex imaging?
Options:
A. Previously documented DVT - CORRECT
B. Active cancer treatment
C. Recent plaster immobilization
D. Alternative diagnosis less likely
(Correct Answer: A)
Q004: A 46-year-old male reports burning retrosternal pain when lying flat. On
auscultation you hear a soft holosystolic murmur at the apex radiating to axilla
increasing with handgrip. Which valvular pathology is most consistent with these
findings?
Options:
A. Mitral regurgitation - CORRECT
B. Tricuspid stenosis
C. Aortic stenosis
D. Pulmonic regurgitation
(Correct Answer: A)
Q005: A 29-year-old woman with MS reports transient bilateral blurred vision
when looking left. On exam you note bilateral horizontal nystagmus on left gaze
that fatigues after 10 seconds. Which type of nystagmus is most characteristic of
demyelinating brainstem disease?
Options:
A. Gaze-evoked nystagmus - CORRECT
B. Down-beat nystagmus
, 3
C. Periodic alternating nystagmus
D. Ocular bobbing
(Correct Answer: A)
Q006: A 62-year-old smoker presents with clubbing and right supraclavicular
lymphadenopathy. On chest auscultation you note a faint right apical crackle that
persists after cough. Which advanced percussion technique best assesses
underlying apical consolidation?
Options:
A. Kronig isthmus comparison - CORRECT
B. Traube space tympany
C. Grocco triangle dullness
D. Whispered pectoriloquy at T4
(Correct Answer: A)
Q007: A 50-year-old male with diabetes complains of numbness in both feet
ascending to mid-shins. Monofilament testing reveals absent protective sensation
at 5 of 10 plantar sites; ankle reflexes are absent. Which component of the
peripheral neuro exam provides the most reliable early indicator of diabetic
sensorimotor polyneuropathy?
Options:
A. 10-g monofilament loss - CORRECT
B. Ipsilateral Romberg sign
C. Decreased patellar DTR
D. Loss of vibration at hip
(Correct Answer: A)
Q008: A 19-year-old basketball player hears a pop when landing from a jump; his
knee flexes to 90° but he cannot extend it fully. On exam you palpate a soft tissue
Maryville University NURS 612 Actual Exam
Questions and Answers with Rationales
2026/2027 | Advanced Health Assessment Exam 2
| Pass Guarantee
Q001: A 58-year-old male presents with sudden-onset right facial droop, slurred
speech, and right arm drift lasting 20 minutes. On exam you note right upper face
involvement, left gaze preference, and no limb ataxia. Carotid auscultation reveals
a faint systolic bruit. Which cranial nerve dysfunction best localizes this transient
episode?
Options:
A. Right CN VII nuclear lesion
B. Left CN VI peripheral palsy
C. Left cortical CN VII upper motor neuron involvement - CORRECT
D. Right CN XII lower motor neuron lesion
(Correct Answer: C)
Q002: A 34-year-old violinist reports painless clicking when opening her jaw. On
palpation during opening you feel a subtle reciprocal click with lateral pole
tenderness; no locking occurs. The mandible deviates slightly left on opening >30
mm. Which temporomandibular assessment finding is most predictive of intra-
articular disc displacement?
Options:
A. Deviation to contralateral side on opening - CORRECT
B. Ipsilateral masseter spasm
C. Reduced vertical range <25 mm
D. Audible crepitus on closing
(Correct Answer: A)
, 2
Q003: A 71-year-old female with atrial fibrillation on rivaroxaban presents with
acute left calf pain and swelling. Homan sign is negative but Wells score is 3.
Which component of the Wells criteria carries the highest individual positive
weight and should prompt urgent duplex imaging?
Options:
A. Previously documented DVT - CORRECT
B. Active cancer treatment
C. Recent plaster immobilization
D. Alternative diagnosis less likely
(Correct Answer: A)
Q004: A 46-year-old male reports burning retrosternal pain when lying flat. On
auscultation you hear a soft holosystolic murmur at the apex radiating to axilla
increasing with handgrip. Which valvular pathology is most consistent with these
findings?
Options:
A. Mitral regurgitation - CORRECT
B. Tricuspid stenosis
C. Aortic stenosis
D. Pulmonic regurgitation
(Correct Answer: A)
Q005: A 29-year-old woman with MS reports transient bilateral blurred vision
when looking left. On exam you note bilateral horizontal nystagmus on left gaze
that fatigues after 10 seconds. Which type of nystagmus is most characteristic of
demyelinating brainstem disease?
Options:
A. Gaze-evoked nystagmus - CORRECT
B. Down-beat nystagmus
, 3
C. Periodic alternating nystagmus
D. Ocular bobbing
(Correct Answer: A)
Q006: A 62-year-old smoker presents with clubbing and right supraclavicular
lymphadenopathy. On chest auscultation you note a faint right apical crackle that
persists after cough. Which advanced percussion technique best assesses
underlying apical consolidation?
Options:
A. Kronig isthmus comparison - CORRECT
B. Traube space tympany
C. Grocco triangle dullness
D. Whispered pectoriloquy at T4
(Correct Answer: A)
Q007: A 50-year-old male with diabetes complains of numbness in both feet
ascending to mid-shins. Monofilament testing reveals absent protective sensation
at 5 of 10 plantar sites; ankle reflexes are absent. Which component of the
peripheral neuro exam provides the most reliable early indicator of diabetic
sensorimotor polyneuropathy?
Options:
A. 10-g monofilament loss - CORRECT
B. Ipsilateral Romberg sign
C. Decreased patellar DTR
D. Loss of vibration at hip
(Correct Answer: A)
Q008: A 19-year-old basketball player hears a pop when landing from a jump; his
knee flexes to 90° but he cannot extend it fully. On exam you palpate a soft tissue
