NIGHTINGALE ANATOMY FINAL EXAM
QUESTIONS AND ANSWERS GRADED A+
Introduction
This 100-item examination mirrors the length and breadth of the Nightingale College
Anatomy Final. Content spans gross anatomy with correct regional terminology, micro-
anatomy (histology), embryological foundations, and integrated systemic anatomy of all
major body systems. Each question is original, board-style, and aligned with 2024–2025
nursing-program standards to support mastery-level performance.
Question 1
Which surface-region corresponds to the depression located immediately lateral to the
olecranon process?
A. Olecranal fossa
B. Trochlear notch
C. Olecranon fossa
D. Coronoid fossa
Answer: C. Olecranon fossa
Solution: The olecranon fossa is the posterior depression on the distal humerus that
receives the olecranon process during extension. The olecranal fossa (A) is a non-
standard term; trochlear notch (B) is on the ulna; coronoid fossa (D) is anterior.
Question 2
A 3-year-old patient presents with recurrent otitis-media. The most immature &
horizontal of the adult auditory ossicles—creating poor drainage—is the:
A. Malleus
B. Incus
C. Stapes
D. Tympanic membrane
Answer: A. Malleus
Solution: In infants the handle (manubrium) of the malleus lies more horizontally,
contributing to poor Eustachian-tube angle and drainage. Incus (B) and stapes (C) are
not horizontal determinants; tympanic membrane (D) is a membrane, not an ossicle.
pg. 1
,Question 3
The ligament resisting posterior translation of the femur on the tibia during knee
extension is the:
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Medial collateral ligament
D. Lateral meniscus
Answer: A. Anterior cruciate ligament
Solution: ACL becomes taut in extension, preventing posterior femoral roll. PCL (B)
resists anterior femoral translation in flexion; MCL (C) stabilizes medially; meniscus (D)
is cartilage, not a check-rein ligament.
Question 4
Which histological feature BEST distinguishes cardiac from skeletal-muscle tissue?
A. Multinucleated fibers
B. Striations
C. Intercalated discs
D. Peripheral nuclei
Answer: C. Intercalated discs
Solution: Intercalated discs are unique electrochemical junctions in cardiac muscle.
Both tissues are striated (B) and can be multinucleated (A) (skeletal always, cardiac
sometimes); peripheral nuclei (D) are typical of skeletal, not unique.
Question 5
A nurse palpates the thyroid and feels a firm nodule located immediately inferior to the
superior thyroid notch. The nodule lies in which lobe?
A. Right anterior
B. Left posterior
C. Isthmus
D. Pyramidal lobe
Answer: C. Isthmus
Solution: The isthmus overlies the 2nd–4th tracheal rings and is inferior to the thyroid
notch. Palpation below the notch accesses isthmus, not a lateral lobe (A, B) or pyramidal
lobe (D), which ascends from isthmus.
Question 6
Which layer of the digestive-tract wall contains the myenteric (Auerbach) plexus?
pg. 2
,A. Mucosa
B. Submucosa
C. Muscularis externa
D. Serosa
Answer: C. Muscularis externa
Solution: Myenteric plexus lies between circular & longitudinal layers of muscularis
externa, regulating peristalsis. Submucosa (B) houses Meissner’s plexus; mucosa (A)
absorbs; serosa (D) protects.
Question 7
During quiet-breathing, the first muscle to be voluntarily recruited for deeper
inspiration is the:
A. External intercostal
B. Diaphragm
C. Sternocleidomastoid
D. Scalene
Answer: B. Diaphragm
Solution: Diaphragm is the primary inspiratory muscle; its contraction flattens to
increase thoracic volume. External intercostals (A) elevate ribs more during forced
inspiration; SCM (C) and scalenes (D) are accessory muscles recruited only during
labored breathing.
Question 8
The sinoatrial node is supplied primarily by which coronary artery branch?
A. Left anterior descending
B. Circumflex
C. Right coronary (RCA) in 60–70 % of hearts
D. Posterior interventricular (PDA)
Answer: C. Right coronary (RCA) in 60–70 % of hearts
Solution: SA nodal artery usually arises from RCA (right-dominant pattern). LAD (A)
supplies anterior ventricular wall; circumflex (B) may supply in left-dominant hearts
but is less common; PDA (D) supplies posterior interventricular septum, not node.
Question 9
Which embryological structure gives rise to the definitive atrial septum secundum?
A. Endocardial cushions
B. Septum primum
pg. 3
, C. Sinus venosus
D. Septum transversum
Answer: B. Septum primum
Solution: Septum primum grows from dorsal atrial wall; its flap forms the foramen
ovale (septum secundum). Endocardial cushions (A) form AV valves; sinus venosus (C)
incorporates into right atrium; septum transversum (D) forms central tendon of
diaphragm.
Question 10
A blood sample shows markedly elevated serum gastrin. Which gastric-cell type is being
hyper-stimulated?
A. Parietal (oxyntic) cells
B. Chief (zymogenic) cells
C. Mucous neck cells
D. Enteroendocrine G-cells
Answer: D. Enteroendocrine G-cells
Solution: G-cells secrete gastrin; hyper-gastrinemia reflects either G-cell hyperplasia or
feedback failure (e.g., Zollinger-Ellison). Parietal (A) is the target of gastrin; chief (B)
secretes pepsinogen; mucous neck (C) secretes mucus.
Question 11
The adrenal cortex zona glomerulosa is distinguished from fasciculata by its capacity to
produce:
A. Cortisol
B. Aldosterone
C. Androgens
D. Epinephrine
Answer: B. Aldosterone
Solution: Zona glomerulosa uniquely expresses aldosterone synthase (CYP11B2).
Fasciculata produces cortisol (A); reticularis makes androgens (C); adrenal medulla
secretes epinephrine (D).
Question 12
Which cranial nerve exits the brain-stem between the pyramid and olive?
A. Abducens (VI)
B. Facial (VII)
pg. 4
QUESTIONS AND ANSWERS GRADED A+
Introduction
This 100-item examination mirrors the length and breadth of the Nightingale College
Anatomy Final. Content spans gross anatomy with correct regional terminology, micro-
anatomy (histology), embryological foundations, and integrated systemic anatomy of all
major body systems. Each question is original, board-style, and aligned with 2024–2025
nursing-program standards to support mastery-level performance.
Question 1
Which surface-region corresponds to the depression located immediately lateral to the
olecranon process?
A. Olecranal fossa
B. Trochlear notch
C. Olecranon fossa
D. Coronoid fossa
Answer: C. Olecranon fossa
Solution: The olecranon fossa is the posterior depression on the distal humerus that
receives the olecranon process during extension. The olecranal fossa (A) is a non-
standard term; trochlear notch (B) is on the ulna; coronoid fossa (D) is anterior.
Question 2
A 3-year-old patient presents with recurrent otitis-media. The most immature &
horizontal of the adult auditory ossicles—creating poor drainage—is the:
A. Malleus
B. Incus
C. Stapes
D. Tympanic membrane
Answer: A. Malleus
Solution: In infants the handle (manubrium) of the malleus lies more horizontally,
contributing to poor Eustachian-tube angle and drainage. Incus (B) and stapes (C) are
not horizontal determinants; tympanic membrane (D) is a membrane, not an ossicle.
pg. 1
,Question 3
The ligament resisting posterior translation of the femur on the tibia during knee
extension is the:
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Medial collateral ligament
D. Lateral meniscus
Answer: A. Anterior cruciate ligament
Solution: ACL becomes taut in extension, preventing posterior femoral roll. PCL (B)
resists anterior femoral translation in flexion; MCL (C) stabilizes medially; meniscus (D)
is cartilage, not a check-rein ligament.
Question 4
Which histological feature BEST distinguishes cardiac from skeletal-muscle tissue?
A. Multinucleated fibers
B. Striations
C. Intercalated discs
D. Peripheral nuclei
Answer: C. Intercalated discs
Solution: Intercalated discs are unique electrochemical junctions in cardiac muscle.
Both tissues are striated (B) and can be multinucleated (A) (skeletal always, cardiac
sometimes); peripheral nuclei (D) are typical of skeletal, not unique.
Question 5
A nurse palpates the thyroid and feels a firm nodule located immediately inferior to the
superior thyroid notch. The nodule lies in which lobe?
A. Right anterior
B. Left posterior
C. Isthmus
D. Pyramidal lobe
Answer: C. Isthmus
Solution: The isthmus overlies the 2nd–4th tracheal rings and is inferior to the thyroid
notch. Palpation below the notch accesses isthmus, not a lateral lobe (A, B) or pyramidal
lobe (D), which ascends from isthmus.
Question 6
Which layer of the digestive-tract wall contains the myenteric (Auerbach) plexus?
pg. 2
,A. Mucosa
B. Submucosa
C. Muscularis externa
D. Serosa
Answer: C. Muscularis externa
Solution: Myenteric plexus lies between circular & longitudinal layers of muscularis
externa, regulating peristalsis. Submucosa (B) houses Meissner’s plexus; mucosa (A)
absorbs; serosa (D) protects.
Question 7
During quiet-breathing, the first muscle to be voluntarily recruited for deeper
inspiration is the:
A. External intercostal
B. Diaphragm
C. Sternocleidomastoid
D. Scalene
Answer: B. Diaphragm
Solution: Diaphragm is the primary inspiratory muscle; its contraction flattens to
increase thoracic volume. External intercostals (A) elevate ribs more during forced
inspiration; SCM (C) and scalenes (D) are accessory muscles recruited only during
labored breathing.
Question 8
The sinoatrial node is supplied primarily by which coronary artery branch?
A. Left anterior descending
B. Circumflex
C. Right coronary (RCA) in 60–70 % of hearts
D. Posterior interventricular (PDA)
Answer: C. Right coronary (RCA) in 60–70 % of hearts
Solution: SA nodal artery usually arises from RCA (right-dominant pattern). LAD (A)
supplies anterior ventricular wall; circumflex (B) may supply in left-dominant hearts
but is less common; PDA (D) supplies posterior interventricular septum, not node.
Question 9
Which embryological structure gives rise to the definitive atrial septum secundum?
A. Endocardial cushions
B. Septum primum
pg. 3
, C. Sinus venosus
D. Septum transversum
Answer: B. Septum primum
Solution: Septum primum grows from dorsal atrial wall; its flap forms the foramen
ovale (septum secundum). Endocardial cushions (A) form AV valves; sinus venosus (C)
incorporates into right atrium; septum transversum (D) forms central tendon of
diaphragm.
Question 10
A blood sample shows markedly elevated serum gastrin. Which gastric-cell type is being
hyper-stimulated?
A. Parietal (oxyntic) cells
B. Chief (zymogenic) cells
C. Mucous neck cells
D. Enteroendocrine G-cells
Answer: D. Enteroendocrine G-cells
Solution: G-cells secrete gastrin; hyper-gastrinemia reflects either G-cell hyperplasia or
feedback failure (e.g., Zollinger-Ellison). Parietal (A) is the target of gastrin; chief (B)
secretes pepsinogen; mucous neck (C) secretes mucus.
Question 11
The adrenal cortex zona glomerulosa is distinguished from fasciculata by its capacity to
produce:
A. Cortisol
B. Aldosterone
C. Androgens
D. Epinephrine
Answer: B. Aldosterone
Solution: Zona glomerulosa uniquely expresses aldosterone synthase (CYP11B2).
Fasciculata produces cortisol (A); reticularis makes androgens (C); adrenal medulla
secretes epinephrine (D).
Question 12
Which cranial nerve exits the brain-stem between the pyramid and olive?
A. Abducens (VI)
B. Facial (VII)
pg. 4
