NSG3160 Health Assessment Exam 4 - NEW
2026/2027 Review & Verified Q&A | Grade A
Guaranteed | Galen College Nursing
Subtitle: Advanced Assessment Synthesis & Clinical Judgment | Exam 4 Focus |
2026/2027 Standards
Galen College of Nursing | NSG 3160 Health Assessment | Exam 4 Review
Part 1: Exam 4 Advanced Content Synthesis (High-Yield, Integrative Focus)
Comprehensive Head-to-Toe Sequence (≤8 min stable adult)
Inspection → Palpation → Percussion → Auscultation (IPPA) except abdomen (IPA)
Document: General survey (LOC, distress, nutrition, body habitus), then skin/hair/nails
→ HEENT → neck (thyroid, nodes) → posterior thorax/lungs → anterior thorax/lungs→
heart → breasts/axilla→ abdomen→ flanks→ inguinal→ lower extremities
neurovascular→ upper extremities→ neuro (mental status, CN, motor, sensory,
cerebellar, DTRs, gait)→ GU/rectal (if indicated).
Red-flag shortcuts: 3-point gait belt if unsteady, pulse ox before exertion, cap refill <3 s,
pain 0–10 scale every system.
Advanced Neurological Synthesis 2026/2027
, Cranial Nerve screen in 90 s:
I—odor ID each nostril; II—Snellen + fields + fundus; III, IV, VI—H-test, PERRLA; V—clench,
cotton light touch; VII—smile, eye squeeze; VIII—whisper 30 cm; IX, X—“ah” palate rise,
gag (if intubation risk); XI—shrug vs resistance; XII—stick tongue midline.
Central vs Peripheral Lesion Quick Rules:
UMN (brain/spine): hyperreflexia, Babinski +, spasticity, weakness pattern cortical (face
+ arm > leg).
LMN (nerve root/plexus/nerve): hyporeflexia, fasciculations, atrophy, weakness follows
nerve distribution.
Cerebellar: dysmetria (finger-to-nose), ataxic gait, nystagmus, intention tremor,
dysdiadochokinesia.
Document “CN II-XII intact” only if all tested; otherwise list deficits.
Musculoskeletal Integration
Look-Feel-Move-Measure-Function sequence.
Gait phases: heel-strike → loading → mid-stance → terminal stance → pre-swing →
initial/terminal swing.
Abnormal: antalgic (short stance), Trendelenburg (pelvis dips weak side), Parkinsonian
(festinating), spastic hemiplegic (circumduction), steppage (foot drop).
End-feel grades: Anatomical (hard—bone-on-bone), Pathological (empty—ligament tear,
spasm—muscle guard).
ROM 0–5 strength scale; 5/5 moves against gravity & full resistance.
2026/2027 Review & Verified Q&A | Grade A
Guaranteed | Galen College Nursing
Subtitle: Advanced Assessment Synthesis & Clinical Judgment | Exam 4 Focus |
2026/2027 Standards
Galen College of Nursing | NSG 3160 Health Assessment | Exam 4 Review
Part 1: Exam 4 Advanced Content Synthesis (High-Yield, Integrative Focus)
Comprehensive Head-to-Toe Sequence (≤8 min stable adult)
Inspection → Palpation → Percussion → Auscultation (IPPA) except abdomen (IPA)
Document: General survey (LOC, distress, nutrition, body habitus), then skin/hair/nails
→ HEENT → neck (thyroid, nodes) → posterior thorax/lungs → anterior thorax/lungs→
heart → breasts/axilla→ abdomen→ flanks→ inguinal→ lower extremities
neurovascular→ upper extremities→ neuro (mental status, CN, motor, sensory,
cerebellar, DTRs, gait)→ GU/rectal (if indicated).
Red-flag shortcuts: 3-point gait belt if unsteady, pulse ox before exertion, cap refill <3 s,
pain 0–10 scale every system.
Advanced Neurological Synthesis 2026/2027
, Cranial Nerve screen in 90 s:
I—odor ID each nostril; II—Snellen + fields + fundus; III, IV, VI—H-test, PERRLA; V—clench,
cotton light touch; VII—smile, eye squeeze; VIII—whisper 30 cm; IX, X—“ah” palate rise,
gag (if intubation risk); XI—shrug vs resistance; XII—stick tongue midline.
Central vs Peripheral Lesion Quick Rules:
UMN (brain/spine): hyperreflexia, Babinski +, spasticity, weakness pattern cortical (face
+ arm > leg).
LMN (nerve root/plexus/nerve): hyporeflexia, fasciculations, atrophy, weakness follows
nerve distribution.
Cerebellar: dysmetria (finger-to-nose), ataxic gait, nystagmus, intention tremor,
dysdiadochokinesia.
Document “CN II-XII intact” only if all tested; otherwise list deficits.
Musculoskeletal Integration
Look-Feel-Move-Measure-Function sequence.
Gait phases: heel-strike → loading → mid-stance → terminal stance → pre-swing →
initial/terminal swing.
Abnormal: antalgic (short stance), Trendelenburg (pelvis dips weak side), Parkinsonian
(festinating), spastic hemiplegic (circumduction), steppage (foot drop).
End-feel grades: Anatomical (hard—bone-on-bone), Pathological (empty—ligament tear,
spasm—muscle guard).
ROM 0–5 strength scale; 5/5 moves against gravity & full resistance.
