1
NR 304 EXAM 1 (CHAMBERLAIN) NEWEST 2026 ACTUAL EXAM
TEST BANK| NR304 HEALTH ASSESSMENT II EXAM 3 REVIEW
WITH 50 REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
SECTION 1: NEUROLOGIC SYSTEM (Q1–15)
1. The nurse is assessing a client’s coordination. The client is asked to touch the
nurse’s index finger, then touch their own nose repeatedly. This test assesses:
A) Romberg sign
B) Rapid alternating movements
C) Finger-to-nose test (cerebellar function)
D) Stereognosis
: Answer : C
Fullest Explanation:
The finger-to-nose test is a classic test of cerebellar function, specifically
evaluating coordination and accuracy of movement. The cerebellum is
responsible for smooth, coordinated voluntary movements. When the client
performs this test, the nurse observes for smooth, accurate movements; any
tremor that worsens as the finger approaches the target (intention tremor) or
past-pointing (missing the target) indicates cerebellar dysfunction.
• A (Romberg sign): This tests balance and proprioception. The client stands
with feet together, first with eyes open, then closed. A positive Romberg
(swaying or falling with eyes closed) indicates a loss of proprioception, not
cerebellar function.
• B (Rapid alternating movements): This is tested by asking the client to pat
their knees with both hands, alternating palm and back rapidly. It also
assesses cerebellar function but is a different test.
• D (Stereognosis): This is the ability to recognize an object by touch alone,
testing the sensory cortex and posterior column pathway. It does not assess
coordination.
pg. 1
,2
Key takeaway: Finger-to-nose = cerebellar coordination. Past-pointing or intention
tremor = cerebellar dysfunction.
2. A client’s patellar reflex is tested. A normal finding is:
A) No response after 3 attempts
B) Contraction of the quadriceps muscle with extension of the lower leg
C) Hyperextension of the knee with clonus
D) Dorsiflexion of the foot
: Answer : B
Fullest Explanation:
The patellar (deep tendon) reflex tests the integrity of the spinal cord at the L2–L4
level. When the patellar tendon is struck with a reflex hammer, the normal
response is contraction of the quadriceps muscle and extension of the lower leg.
This is a monosynaptic stretch reflex.
• A (No response): This is an absent reflex (areflexia), which is graded 0 and
indicates lower motor neuron disease, peripheral neuropathy, or spinal
cord injury at that level.
• C (Hyperextension with clonus): This indicates hyperreflexia, graded 4+,
which suggests an upper motor neuron lesion (e.g., stroke, spinal cord
injury above the level). Clonus is sustained rhythmic contractions.
• D (Dorsiflexion of the foot): That is not the patellar response; it might be a
crossed response or an abnormal reflex.
*Key takeaway: Patellar reflex = L2–L4; normal = contraction of quadriceps +
extension of lower leg.*
3. The nurse assesses a client’s cranial nerves. To test cranial nerve XII
(hypoglossal), the nurse should:
A) Ask the client to smile and frown
B) Test the gag reflex
pg. 2
,3
C) Ask the client to stick out the tongue and move it side to side
D) Assess visual acuity
: Answer : C
Fullest Explanation:
Cranial nerve XII (hypoglossal) is a motor nerve that innervates the muscles of the
tongue. The nurse asks the client to stick out the tongue and move it side to side,
observing for midline protrusion and symmetrical movement. Deviation to one
side indicates a lesion of the hypoglossal nerve on the same side (ipsilateral).
• A (Smile and frown): This tests cranial nerve VII (facial), both motor (smile,
frown, close eyes) and sensory (taste on anterior two-thirds of tongue).
• B (Gag reflex): This tests cranial nerves IX (glossopharyngeal – sensory) and
X (vagus – motor).
• D (Visual acuity): This tests cranial nerve II (optic).
Key takeaway: CN XII = tongue movement. Deviation points to the side of the
lesion.
4. The nurse is assessing a client with a suspected cerebrovascular accident
(CVA). The client is asked to follow a moving object with their eyes without
moving the head. Which cranial nerves are being tested?
A) II, III
B) III, IV, VI
C) V, VII
D) IX, X, XII
: Answer : B
Fullest Explanation:
The test of extraocular movements (EOMs) assesses the function of cranial
nerves III (oculomotor), IV (trochlear), and VI (abducens). The nurse asks the
client to follow a finger or pen through the six cardinal fields of gaze. These three
nerves coordinate the six extraocular muscles that move the eye. Nystagmus,
paralysis, or inability to move in a specific direction indicates a lesion of the
corresponding nerve.
pg. 3
, 4
• A (II, III): CN II (optic) is for visual acuity and visual fields; CN III is only one
of the three motor nerves.
• C (V, VII): CN V (trigeminal) is for facial sensation and jaw movement; CN VII
(facial) is for facial expression.
• D (IX, X, XII): These are lower cranial nerves for gag, swallowing, and
tongue movement.
Key takeaway: EOMs = CN III, IV, VI.
5. A client presents with a drooping eyelid (ptosis), dilated pupil, and the eye is
deviated laterally and downward. Which cranial nerve is most likely affected?
A) Optic (II)
B) Oculomotor (III)
C) Trochlear (IV)
D) Abducens (VI)
: Answer : B
Fullest Explanation:
The oculomotor nerve (CN III) innervates most of the extraocular muscles
(superior, inferior, and medial rectus; inferior oblique), the levator palpebrae
superioris (elevates the eyelid), and the parasympathetic fibers that constrict the
pupil. A complete CN III palsy causes ptosis (drooping eyelid), mydriasis (dilated,
non-reactive pupil due to unopposed sympathetic activity), and the eye deviates
downward and outward (“down and out”) because the lateral rectus (CN VI) and
superior oblique (CN IV) are unopposed.
• A (CN II): Damage causes visual loss, not motor deficits.
• C (CN IV): Trochlear nerve innervates the superior oblique muscle, which
moves the eye down and inward (toward the nose). Palsy causes vertical
diplopia, especially when looking down and in.
• D (CN VI): Abducens nerve innervates the lateral rectus muscle, which
abducts the eye. Palsy causes inward deviation of the eye and horizontal
diplopia.
pg. 4
NR 304 EXAM 1 (CHAMBERLAIN) NEWEST 2026 ACTUAL EXAM
TEST BANK| NR304 HEALTH ASSESSMENT II EXAM 3 REVIEW
WITH 50 REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
SECTION 1: NEUROLOGIC SYSTEM (Q1–15)
1. The nurse is assessing a client’s coordination. The client is asked to touch the
nurse’s index finger, then touch their own nose repeatedly. This test assesses:
A) Romberg sign
B) Rapid alternating movements
C) Finger-to-nose test (cerebellar function)
D) Stereognosis
: Answer : C
Fullest Explanation:
The finger-to-nose test is a classic test of cerebellar function, specifically
evaluating coordination and accuracy of movement. The cerebellum is
responsible for smooth, coordinated voluntary movements. When the client
performs this test, the nurse observes for smooth, accurate movements; any
tremor that worsens as the finger approaches the target (intention tremor) or
past-pointing (missing the target) indicates cerebellar dysfunction.
• A (Romberg sign): This tests balance and proprioception. The client stands
with feet together, first with eyes open, then closed. A positive Romberg
(swaying or falling with eyes closed) indicates a loss of proprioception, not
cerebellar function.
• B (Rapid alternating movements): This is tested by asking the client to pat
their knees with both hands, alternating palm and back rapidly. It also
assesses cerebellar function but is a different test.
• D (Stereognosis): This is the ability to recognize an object by touch alone,
testing the sensory cortex and posterior column pathway. It does not assess
coordination.
pg. 1
,2
Key takeaway: Finger-to-nose = cerebellar coordination. Past-pointing or intention
tremor = cerebellar dysfunction.
2. A client’s patellar reflex is tested. A normal finding is:
A) No response after 3 attempts
B) Contraction of the quadriceps muscle with extension of the lower leg
C) Hyperextension of the knee with clonus
D) Dorsiflexion of the foot
: Answer : B
Fullest Explanation:
The patellar (deep tendon) reflex tests the integrity of the spinal cord at the L2–L4
level. When the patellar tendon is struck with a reflex hammer, the normal
response is contraction of the quadriceps muscle and extension of the lower leg.
This is a monosynaptic stretch reflex.
• A (No response): This is an absent reflex (areflexia), which is graded 0 and
indicates lower motor neuron disease, peripheral neuropathy, or spinal
cord injury at that level.
• C (Hyperextension with clonus): This indicates hyperreflexia, graded 4+,
which suggests an upper motor neuron lesion (e.g., stroke, spinal cord
injury above the level). Clonus is sustained rhythmic contractions.
• D (Dorsiflexion of the foot): That is not the patellar response; it might be a
crossed response or an abnormal reflex.
*Key takeaway: Patellar reflex = L2–L4; normal = contraction of quadriceps +
extension of lower leg.*
3. The nurse assesses a client’s cranial nerves. To test cranial nerve XII
(hypoglossal), the nurse should:
A) Ask the client to smile and frown
B) Test the gag reflex
pg. 2
,3
C) Ask the client to stick out the tongue and move it side to side
D) Assess visual acuity
: Answer : C
Fullest Explanation:
Cranial nerve XII (hypoglossal) is a motor nerve that innervates the muscles of the
tongue. The nurse asks the client to stick out the tongue and move it side to side,
observing for midline protrusion and symmetrical movement. Deviation to one
side indicates a lesion of the hypoglossal nerve on the same side (ipsilateral).
• A (Smile and frown): This tests cranial nerve VII (facial), both motor (smile,
frown, close eyes) and sensory (taste on anterior two-thirds of tongue).
• B (Gag reflex): This tests cranial nerves IX (glossopharyngeal – sensory) and
X (vagus – motor).
• D (Visual acuity): This tests cranial nerve II (optic).
Key takeaway: CN XII = tongue movement. Deviation points to the side of the
lesion.
4. The nurse is assessing a client with a suspected cerebrovascular accident
(CVA). The client is asked to follow a moving object with their eyes without
moving the head. Which cranial nerves are being tested?
A) II, III
B) III, IV, VI
C) V, VII
D) IX, X, XII
: Answer : B
Fullest Explanation:
The test of extraocular movements (EOMs) assesses the function of cranial
nerves III (oculomotor), IV (trochlear), and VI (abducens). The nurse asks the
client to follow a finger or pen through the six cardinal fields of gaze. These three
nerves coordinate the six extraocular muscles that move the eye. Nystagmus,
paralysis, or inability to move in a specific direction indicates a lesion of the
corresponding nerve.
pg. 3
, 4
• A (II, III): CN II (optic) is for visual acuity and visual fields; CN III is only one
of the three motor nerves.
• C (V, VII): CN V (trigeminal) is for facial sensation and jaw movement; CN VII
(facial) is for facial expression.
• D (IX, X, XII): These are lower cranial nerves for gag, swallowing, and
tongue movement.
Key takeaway: EOMs = CN III, IV, VI.
5. A client presents with a drooping eyelid (ptosis), dilated pupil, and the eye is
deviated laterally and downward. Which cranial nerve is most likely affected?
A) Optic (II)
B) Oculomotor (III)
C) Trochlear (IV)
D) Abducens (VI)
: Answer : B
Fullest Explanation:
The oculomotor nerve (CN III) innervates most of the extraocular muscles
(superior, inferior, and medial rectus; inferior oblique), the levator palpebrae
superioris (elevates the eyelid), and the parasympathetic fibers that constrict the
pupil. A complete CN III palsy causes ptosis (drooping eyelid), mydriasis (dilated,
non-reactive pupil due to unopposed sympathetic activity), and the eye deviates
downward and outward (“down and out”) because the lateral rectus (CN VI) and
superior oblique (CN IV) are unopposed.
• A (CN II): Damage causes visual loss, not motor deficits.
• C (CN IV): Trochlear nerve innervates the superior oblique muscle, which
moves the eye down and inward (toward the nose). Palsy causes vertical
diplopia, especially when looking down and in.
• D (CN VI): Abducens nerve innervates the lateral rectus muscle, which
abducts the eye. Palsy causes inward deviation of the eye and horizontal
diplopia.
pg. 4
