NR304 Health Assessment II Exam 2
Comprehensive Review | Advanced Assessment
Techniques | 2026/2027 New Edition
NCLEX-Style | 35 Items | Systems-Based Application & Analysis
SECTION 1 – Neurological & Sensory Assessment
Q1 When assessing cranial nerve V (trigeminal), which technique correctly tests the
sensory component?
A. Ask the client to identify a familiar scent with eyes closed
B. Have the client clench the teeth while palpating the masseter muscles
C. Lightly touch the cornea with cotton to observe blink reflex
D. Use a cotton wisp to touch forehead, cheeks, and jaw; ask client to say “now” when
felt
Correct Answer: D
Rationale: CN V has three sensory divisions (ophthalmic, maxillary, mandibular).
Light-touch testing in all three distributions tests sensory integrity. A = CN I, B = motor
branch of CN V, C = corneal reflex (V + VII).
Q2 Which finding indicates normal cerebellar function?
A. Slight drift of one arm when eyes closed & arms extended
,B. Rhythmic, rapid alternating movements (RAM) with equal speed/distance
C. Positive Romberg (loss of balance when eyes closed)
D. Heel-to-shin test shows downward drift of foot
Correct Answer: B
Rationale: Smooth, coordinated RAM (pronation/supination) indicates intact cerebellar
timing. A = possible proprioceptive loss, C/D = abnormal.
Q3 Order the correct sequence for an adult neurological screening exam:
1. Mental status / cognition
2. Cranial nerves
3. Motor & cerebellar
4. Sensory & reflexes
Correct Order: 1 → 2 → 3 → 4
Rationale: Begin with higher cortical functions; proceed anatomically downward.
Q4 A 24-yr-old’s Glasgow Coma Scale = E2 V3 M5. Total score and interpretation?
A. 10 = moderate brain injury
B. 8 = severe brain injury
C. 10 = mild brain injury
D. 8 = moderate brain injury
Correct Answer: A
Rationale: 2 + 3 + 5 = 10 (moderate TBI; severe = ≤8).
, Q5 You note absent Doll’s-eye reflex (oculocephalic). This indicates:
A. Bilateral CN III palsy
B. Brain-stem dysfunction; test contraindicated if cervical injury possible
C. Vestibular end-organ disease
D. Normal finding in awake patient
Correct Answer: B
Rationale: Absent reflex = brain-stem injury; test only in comatose, stable-neck patients.
SECTION 2 – Cardiovascular & Peripheral Vascular
Q6 You auscopate a crescendo-decrescendo systolic murmur at the right 2nd ICS
radiating to carotids. Likely cause and expected finding:
A. Mitral regurgitation; S1 diminished
B. Aortic stenosis; delayed carotid upstroke (pulsus parvus et tardus)
C. Aortic regurgitation; wide pulse pressure
D. Mitral stenosis; opening snap after S2
Correct Answer: B
Rationale: R 2nd ICS = aortic area; cresc-decresc systolic murmur + delayed upstroke =
aortic stenosis.
Q7 Which technique best palpates the apex impulse in an adult?
Comprehensive Review | Advanced Assessment
Techniques | 2026/2027 New Edition
NCLEX-Style | 35 Items | Systems-Based Application & Analysis
SECTION 1 – Neurological & Sensory Assessment
Q1 When assessing cranial nerve V (trigeminal), which technique correctly tests the
sensory component?
A. Ask the client to identify a familiar scent with eyes closed
B. Have the client clench the teeth while palpating the masseter muscles
C. Lightly touch the cornea with cotton to observe blink reflex
D. Use a cotton wisp to touch forehead, cheeks, and jaw; ask client to say “now” when
felt
Correct Answer: D
Rationale: CN V has three sensory divisions (ophthalmic, maxillary, mandibular).
Light-touch testing in all three distributions tests sensory integrity. A = CN I, B = motor
branch of CN V, C = corneal reflex (V + VII).
Q2 Which finding indicates normal cerebellar function?
A. Slight drift of one arm when eyes closed & arms extended
,B. Rhythmic, rapid alternating movements (RAM) with equal speed/distance
C. Positive Romberg (loss of balance when eyes closed)
D. Heel-to-shin test shows downward drift of foot
Correct Answer: B
Rationale: Smooth, coordinated RAM (pronation/supination) indicates intact cerebellar
timing. A = possible proprioceptive loss, C/D = abnormal.
Q3 Order the correct sequence for an adult neurological screening exam:
1. Mental status / cognition
2. Cranial nerves
3. Motor & cerebellar
4. Sensory & reflexes
Correct Order: 1 → 2 → 3 → 4
Rationale: Begin with higher cortical functions; proceed anatomically downward.
Q4 A 24-yr-old’s Glasgow Coma Scale = E2 V3 M5. Total score and interpretation?
A. 10 = moderate brain injury
B. 8 = severe brain injury
C. 10 = mild brain injury
D. 8 = moderate brain injury
Correct Answer: A
Rationale: 2 + 3 + 5 = 10 (moderate TBI; severe = ≤8).
, Q5 You note absent Doll’s-eye reflex (oculocephalic). This indicates:
A. Bilateral CN III palsy
B. Brain-stem dysfunction; test contraindicated if cervical injury possible
C. Vestibular end-organ disease
D. Normal finding in awake patient
Correct Answer: B
Rationale: Absent reflex = brain-stem injury; test only in comatose, stable-neck patients.
SECTION 2 – Cardiovascular & Peripheral Vascular
Q6 You auscopate a crescendo-decrescendo systolic murmur at the right 2nd ICS
radiating to carotids. Likely cause and expected finding:
A. Mitral regurgitation; S1 diminished
B. Aortic stenosis; delayed carotid upstroke (pulsus parvus et tardus)
C. Aortic regurgitation; wide pulse pressure
D. Mitral stenosis; opening snap after S2
Correct Answer: B
Rationale: R 2nd ICS = aortic area; cresc-decresc systolic murmur + delayed upstroke =
aortic stenosis.
Q7 Which technique best palpates the apex impulse in an adult?
