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NR 304 EXAM 2 (CHAMBERLAIN) NEWEST 2026 ACTUAL EXAM
TEST BANK| NR304 HEALTH ASSESSMENT II EXAM 3 REVIEW
WITH 75 REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
Exam Format & Instructions
• Format: Multiple Choice, True/False, and Fill-in-the-Blank
• Answer Key: Correct answer immediately followed by a detailed, exam-focused rationale
• Primary References: Jarvis, C. (2024). Physical Examination & Health Assessment (9th ed.); Chamberlain
University course materials, eDAPT modules Weeks 4–6, and current 2025–2026 clinical practice
guidelines
• Exam Domains: Musculoskeletal Assessment (35%), Peripheral Vascular & Lymphatic Systems (25%),
Neurologic System (25%), Male/Female Genitourinary & Rectal Assessment (15%)
Competency Requirement: 75% or higher to pass the in-course exam.
SECTION 1: MUSCULOSKELETAL ASSESSMENT (Questions 1–27)
Question 1
A 65-year-old female with a 20-year history of osteoarthritis (OA) of both knees
presents with chronic bilateral knee pain, stiffness that improves after a few
minutes of movement, and crepitus upon flexion. On physical examination, the
nurse practitioner expects to find which of the following?
A) Symmetric swelling, warmth, and tenderness of the metacarpophalangeal
joints
B) Joint effusion with erythema and warmth, and a positive McMurray test
C) Bony enlargements (Heberden and Bouchard nodes), joint line tenderness, and
crepitus without significant swelling or erythema
D) Limited range of motion due to fibrous ankylosis and muscle atrophy in a
symmetric distribution
: Answer : C) Bony enlargements (Heberden and Bouchard nodes), joint line
tenderness, and crepitus without significant swelling or erythema
pg. 1
,2
Rationale: Osteoarthritis is a non-inflammatory, degenerative joint disease. It
affects weight-bearing joints (hips, knees) and the hands. On examination,
crepitus (grating sensation during movement) and bony enlargements (Heberden
nodes at the distal interphalangeal joints; Bouchard nodes at the proximal
interphalangeal joints) are classic. The joints are not warm or erythematous
unless there is an acute inflammatory flare. Symmetric small-joint swelling,
warmth, and tenderness (Option A) suggest rheumatoid arthritis. An effusion with
erythema and warmth is more typical of septic arthritis or a gout flare. Fibrous
ankylosis is more characteristic of long-standing rheumatoid arthritis, not OA.
Question 2
When performing the Phalen test on a patient with suspected carpal tunnel
syndrome, a positive test is indicated by:
A) Pain in the thumb, index, and middle fingers reproduced by direct percussion
over the median nerve at the wrist (Tinel sign)
B) Numbness and tingling in the median nerve distribution reproduced by holding
both wrists in full flexion for 60 seconds
C) Loss of sensation over the hypothenar eminence and the fifth digit
D) Decreased grip strength when the patient attempts to pinch the thumb and
index finger together
: Answer : B) Numbness and tingling in the median nerve distribution
reproduced by holding both wrists in full flexion for 60 seconds
Rationale: Phalen test (or Phalen maneuver) is performed by having the patient
hold both wrists in full, forced flexion (pushing the dorsal surfaces of both hands
together) for 60 seconds. A positive test reproduces paresthesias in the median
nerve distribution (thumb, index, middle finger, and radial half of the ring finger).
Option A describes the Tinel sign, which is a different physical exam maneuver.
Option C describes ulnar nerve pathology (e.g., cubital tunnel syndrome). Option
D (pinch grip weakness) may occur in carpal tunnel syndrome but is not the
definition of a positive Phalen test.
pg. 2
,3
Question 3
Which gait pattern is most characteristic of Parkinson disease?
A) Wide-based, unsteady, “drunken” gait
B) High-stepping gait with foot drop and slapping of the foot on the floor
C) Stooped posture, shortened stride, and shuffling gait with reduced arm swing
and difficulty initiating movement
D) Antalgic gait with a shortened stance phase on the painful limb
: Answer : C) Stooped posture, shortened stride, and shuffling gait with reduced
arm swing and difficulty initiating movement
Rationale: Parkinson disease produces a characteristic gait known as “festinating”
gait. The patient has a stooped, forward-leaning posture, decreased arm swing,
short, shuffling steps, and difficulty turning or initiating movement (sometimes
described as “freezing”). Option A (wide-based, ataxic gait) is typical of cerebellar
disorders. Option B (high-stepping, foot-slapping gait) is seen with foot drop (e.g.,
peroneal nerve injury). Option D (antalgic gait) is a pain-avoidance gait seen with
any painful lower-extremity condition.
Question 4
A 78-year-old man is brought to the clinic by his daughter because she has
noticed “a lot of falls.” He states, “My legs just give out when I try to walk.” Gait
examination shows a stooped posture, short stepped shuffling gait with reduced
arm swing, and difficulty turning, but he is able to maintain his balance. Which of
the following is the most appropriate next step?
A) Order an MRI of the lumbar spine
B) Refer the patient to physical therapy for gait training
C) Begin a trial of carbidopa-levodopa
D) Perform a “pull test” to assess postural stability
: Answer : D) Perform a “pull test” to assess postural stability
Rationale: The gait features described are highly suggestive of Parkinson disease.
Before initiating pharmacotherapy or physical therapy, the examiner should
confirm the presence of rigidity, bradykinesia, tremor, or postural instability. The
pg. 3
, 4
“pull test” (also known as the retropulsion test) assesses postural stability: the
examiner stands behind the patient and gives a sudden pull on the shoulders. A
normal response is a quick correction (1–2 steps). A positive test (loss of balance
or inability to recover) indicates impaired postural reflexes and is part of the
Unified Parkinson Disease Rating Scale (UPDRS). MRI is not required unless
atypical features are present. Physical therapy is important but not the next
immediate diagnostic step. Carbidopa-levodopa should be started only after a
confirmed diagnosis.
Question 5
A 16-year-old male is seen for a sports physical. He has no symptoms, but the
nurse practitioner notes that when he bends forward with the feet together and
knees straight, the right thoracic spine is visibly higher than the left and the right
scapula appears prominent. What is the most likely diagnosis, and what is the
appropriate next step?
A) Adolescent kyphosis; order a standing lateral spine X-ray
B) Idiopathic scoliosis; measure the curve with a scoliometer and consider X-ray if
the curve is >7 degrees
C) Normal variant; reassurance only
D) Lumbar radiculopathy; order an MRI of the lumbar spine
: Answer : B) Idiopathic scoliosis; measure the curve with a scoliometer and
consider X-ray if the curve is >7 degrees
Rationale: The forward-bend test (Adams test) is used to screen for scoliosis. A
visible asymmetry of the thoracic spine with scapular prominence is suggestive of
idiopathic scoliosis, the most common type in adolescence. The next step is to
measure the angle of trunk rotation using a scoliometer. An angle of trunk
rotation >7 degrees is associated with a Cobb angle >20 degrees and typically
warrants standing posteroanterior and lateral X-rays. Kyphosis (Option A)
presents as a rounded upper back (“hunchback”) and is best seen from the side.
Normal variant (Option C) would not produce a visible asymmetry. Radiculopathy
(Option D) is unlikely in an asymptomatic adolescent.
pg. 4
NR 304 EXAM 2 (CHAMBERLAIN) NEWEST 2026 ACTUAL EXAM
TEST BANK| NR304 HEALTH ASSESSMENT II EXAM 3 REVIEW
WITH 75 REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
Exam Format & Instructions
• Format: Multiple Choice, True/False, and Fill-in-the-Blank
• Answer Key: Correct answer immediately followed by a detailed, exam-focused rationale
• Primary References: Jarvis, C. (2024). Physical Examination & Health Assessment (9th ed.); Chamberlain
University course materials, eDAPT modules Weeks 4–6, and current 2025–2026 clinical practice
guidelines
• Exam Domains: Musculoskeletal Assessment (35%), Peripheral Vascular & Lymphatic Systems (25%),
Neurologic System (25%), Male/Female Genitourinary & Rectal Assessment (15%)
Competency Requirement: 75% or higher to pass the in-course exam.
SECTION 1: MUSCULOSKELETAL ASSESSMENT (Questions 1–27)
Question 1
A 65-year-old female with a 20-year history of osteoarthritis (OA) of both knees
presents with chronic bilateral knee pain, stiffness that improves after a few
minutes of movement, and crepitus upon flexion. On physical examination, the
nurse practitioner expects to find which of the following?
A) Symmetric swelling, warmth, and tenderness of the metacarpophalangeal
joints
B) Joint effusion with erythema and warmth, and a positive McMurray test
C) Bony enlargements (Heberden and Bouchard nodes), joint line tenderness, and
crepitus without significant swelling or erythema
D) Limited range of motion due to fibrous ankylosis and muscle atrophy in a
symmetric distribution
: Answer : C) Bony enlargements (Heberden and Bouchard nodes), joint line
tenderness, and crepitus without significant swelling or erythema
pg. 1
,2
Rationale: Osteoarthritis is a non-inflammatory, degenerative joint disease. It
affects weight-bearing joints (hips, knees) and the hands. On examination,
crepitus (grating sensation during movement) and bony enlargements (Heberden
nodes at the distal interphalangeal joints; Bouchard nodes at the proximal
interphalangeal joints) are classic. The joints are not warm or erythematous
unless there is an acute inflammatory flare. Symmetric small-joint swelling,
warmth, and tenderness (Option A) suggest rheumatoid arthritis. An effusion with
erythema and warmth is more typical of septic arthritis or a gout flare. Fibrous
ankylosis is more characteristic of long-standing rheumatoid arthritis, not OA.
Question 2
When performing the Phalen test on a patient with suspected carpal tunnel
syndrome, a positive test is indicated by:
A) Pain in the thumb, index, and middle fingers reproduced by direct percussion
over the median nerve at the wrist (Tinel sign)
B) Numbness and tingling in the median nerve distribution reproduced by holding
both wrists in full flexion for 60 seconds
C) Loss of sensation over the hypothenar eminence and the fifth digit
D) Decreased grip strength when the patient attempts to pinch the thumb and
index finger together
: Answer : B) Numbness and tingling in the median nerve distribution
reproduced by holding both wrists in full flexion for 60 seconds
Rationale: Phalen test (or Phalen maneuver) is performed by having the patient
hold both wrists in full, forced flexion (pushing the dorsal surfaces of both hands
together) for 60 seconds. A positive test reproduces paresthesias in the median
nerve distribution (thumb, index, middle finger, and radial half of the ring finger).
Option A describes the Tinel sign, which is a different physical exam maneuver.
Option C describes ulnar nerve pathology (e.g., cubital tunnel syndrome). Option
D (pinch grip weakness) may occur in carpal tunnel syndrome but is not the
definition of a positive Phalen test.
pg. 2
,3
Question 3
Which gait pattern is most characteristic of Parkinson disease?
A) Wide-based, unsteady, “drunken” gait
B) High-stepping gait with foot drop and slapping of the foot on the floor
C) Stooped posture, shortened stride, and shuffling gait with reduced arm swing
and difficulty initiating movement
D) Antalgic gait with a shortened stance phase on the painful limb
: Answer : C) Stooped posture, shortened stride, and shuffling gait with reduced
arm swing and difficulty initiating movement
Rationale: Parkinson disease produces a characteristic gait known as “festinating”
gait. The patient has a stooped, forward-leaning posture, decreased arm swing,
short, shuffling steps, and difficulty turning or initiating movement (sometimes
described as “freezing”). Option A (wide-based, ataxic gait) is typical of cerebellar
disorders. Option B (high-stepping, foot-slapping gait) is seen with foot drop (e.g.,
peroneal nerve injury). Option D (antalgic gait) is a pain-avoidance gait seen with
any painful lower-extremity condition.
Question 4
A 78-year-old man is brought to the clinic by his daughter because she has
noticed “a lot of falls.” He states, “My legs just give out when I try to walk.” Gait
examination shows a stooped posture, short stepped shuffling gait with reduced
arm swing, and difficulty turning, but he is able to maintain his balance. Which of
the following is the most appropriate next step?
A) Order an MRI of the lumbar spine
B) Refer the patient to physical therapy for gait training
C) Begin a trial of carbidopa-levodopa
D) Perform a “pull test” to assess postural stability
: Answer : D) Perform a “pull test” to assess postural stability
Rationale: The gait features described are highly suggestive of Parkinson disease.
Before initiating pharmacotherapy or physical therapy, the examiner should
confirm the presence of rigidity, bradykinesia, tremor, or postural instability. The
pg. 3
, 4
“pull test” (also known as the retropulsion test) assesses postural stability: the
examiner stands behind the patient and gives a sudden pull on the shoulders. A
normal response is a quick correction (1–2 steps). A positive test (loss of balance
or inability to recover) indicates impaired postural reflexes and is part of the
Unified Parkinson Disease Rating Scale (UPDRS). MRI is not required unless
atypical features are present. Physical therapy is important but not the next
immediate diagnostic step. Carbidopa-levodopa should be started only after a
confirmed diagnosis.
Question 5
A 16-year-old male is seen for a sports physical. He has no symptoms, but the
nurse practitioner notes that when he bends forward with the feet together and
knees straight, the right thoracic spine is visibly higher than the left and the right
scapula appears prominent. What is the most likely diagnosis, and what is the
appropriate next step?
A) Adolescent kyphosis; order a standing lateral spine X-ray
B) Idiopathic scoliosis; measure the curve with a scoliometer and consider X-ray if
the curve is >7 degrees
C) Normal variant; reassurance only
D) Lumbar radiculopathy; order an MRI of the lumbar spine
: Answer : B) Idiopathic scoliosis; measure the curve with a scoliometer and
consider X-ray if the curve is >7 degrees
Rationale: The forward-bend test (Adams test) is used to screen for scoliosis. A
visible asymmetry of the thoracic spine with scapular prominence is suggestive of
idiopathic scoliosis, the most common type in adolescence. The next step is to
measure the angle of trunk rotation using a scoliometer. An angle of trunk
rotation >7 degrees is associated with a Cobb angle >20 degrees and typically
warrants standing posteroanterior and lateral X-rays. Kyphosis (Option A)
presents as a rounded upper back (“hunchback”) and is best seen from the side.
Normal variant (Option C) would not produce a visible asymmetry. Radiculopathy
(Option D) is unlikely in an asymptomatic adolescent.
pg. 4
