NUR 504 EXAM 3 – Advanced Health Assessment
(2026)
St. Thomas University (STU) – Practice Examination
Questions 1–200
SECTION 1: HEAD, EYES, EARS, NOSE & THROAT
(HEENT) (Questions 1–40)
1. What is the correct order of the physical assessment
techniques?
A) Palpation, Inspection, Percussion, Auscultation
B) Inspection, Palpation, Percussion, Auscultation
C) Inspection, Auscultation, Palpation, Percussion
D) Auscultation, Inspection, Palpation, Percussion
Answer: B) Inspection, Palpation, Percussion,
Auscultation
Rationale: The correct order is Inspection, Palpation,
Percussion, Auscultation (IPPA). For abdominal assessment,
auscultation is performed before palpation to avoid
altering bowel sounds.
,2. When assessing a patient's pupillary response, which
cranial nerve is primarily responsible for pupillary
constriction?
A) CN II (Optic)
B) CN III (Oculomotor)
C) CN IV (Trochlear)
D) CN VI (Abducens)
Answer: B) CN III (Oculomotor)
Rationale: The oculomotor nerve (CN III) innervates the
pupillary sphincter muscle, which controls pupillary
constriction. The pupillary light reflex involves CN II
(afferent) and CN III (efferent).
3. A patient's pupils are unequal in size (5 mm left, 3
mm right) in normal room light. This finding is called:
A) Anisocoria
B) Miosis
C) Horner syndrome
D) Argyll Robertson pupil
Answer: A) Anisocoria
,Rationale: Anisocoria is defined as unequal pupil size.
While some degree of physiologic anisocoria is common
(difference <1 mm), a significant difference may indicate
neurological pathology.
4. The red reflex is a test of:
A) The abdomen
B) The spine
C) The eyes
D) The mouth
Answer: C) The eyes
Rationale: The red reflex test evaluates the eye for
abnormalities in the lens or retina. An absent or abnormal
red reflex may indicate cataracts, retinoblastoma, or other
ocular pathology.
5. What hearing test is specifically designed to
compare air conduction to bone conduction?
A) Rinne
B) Weber
, C) Whisper
D) Tympanic
Answer: A) Rinne
Rationale: The Rinne test compares air conduction (AC) to
bone conduction (BC). Normally, AC is louder than BC
(Rinne positive). In conductive hearing loss, BC is louder
than AC (Rinne negative).
6. The Weber test is used to:
A) Compare air conduction to bone conduction
B) Lateralize hearing to one ear
C) Assess tympanic membrane mobility
D) Test for nystagmus
Answer: B) Lateralize hearing to one ear
Rationale: The Weber test uses a tuning fork placed on
the midline of the skull. In a normal test, sound is heard
equally in both ears. In unilateral conductive loss, sound
lateralizes to the affected ear; in sensorineural loss, sound
lateralizes to the unaffected ear.
(2026)
St. Thomas University (STU) – Practice Examination
Questions 1–200
SECTION 1: HEAD, EYES, EARS, NOSE & THROAT
(HEENT) (Questions 1–40)
1. What is the correct order of the physical assessment
techniques?
A) Palpation, Inspection, Percussion, Auscultation
B) Inspection, Palpation, Percussion, Auscultation
C) Inspection, Auscultation, Palpation, Percussion
D) Auscultation, Inspection, Palpation, Percussion
Answer: B) Inspection, Palpation, Percussion,
Auscultation
Rationale: The correct order is Inspection, Palpation,
Percussion, Auscultation (IPPA). For abdominal assessment,
auscultation is performed before palpation to avoid
altering bowel sounds.
,2. When assessing a patient's pupillary response, which
cranial nerve is primarily responsible for pupillary
constriction?
A) CN II (Optic)
B) CN III (Oculomotor)
C) CN IV (Trochlear)
D) CN VI (Abducens)
Answer: B) CN III (Oculomotor)
Rationale: The oculomotor nerve (CN III) innervates the
pupillary sphincter muscle, which controls pupillary
constriction. The pupillary light reflex involves CN II
(afferent) and CN III (efferent).
3. A patient's pupils are unequal in size (5 mm left, 3
mm right) in normal room light. This finding is called:
A) Anisocoria
B) Miosis
C) Horner syndrome
D) Argyll Robertson pupil
Answer: A) Anisocoria
,Rationale: Anisocoria is defined as unequal pupil size.
While some degree of physiologic anisocoria is common
(difference <1 mm), a significant difference may indicate
neurological pathology.
4. The red reflex is a test of:
A) The abdomen
B) The spine
C) The eyes
D) The mouth
Answer: C) The eyes
Rationale: The red reflex test evaluates the eye for
abnormalities in the lens or retina. An absent or abnormal
red reflex may indicate cataracts, retinoblastoma, or other
ocular pathology.
5. What hearing test is specifically designed to
compare air conduction to bone conduction?
A) Rinne
B) Weber
, C) Whisper
D) Tympanic
Answer: A) Rinne
Rationale: The Rinne test compares air conduction (AC) to
bone conduction (BC). Normally, AC is louder than BC
(Rinne positive). In conductive hearing loss, BC is louder
than AC (Rinne negative).
6. The Weber test is used to:
A) Compare air conduction to bone conduction
B) Lateralize hearing to one ear
C) Assess tympanic membrane mobility
D) Test for nystagmus
Answer: B) Lateralize hearing to one ear
Rationale: The Weber test uses a tuning fork placed on
the midline of the skull. In a normal test, sound is heard
equally in both ears. In unilateral conductive loss, sound
lateralizes to the affected ear; in sensorineural loss, sound
lateralizes to the unaffected ear.
