NUR 6001 Exam 3
Advanced Health Assessment
William Paterson University (WPU)
2026/2027 | Newly Released
Verified Q & A with Rationales |100% Guaranteed Pass | Graded A+
Q1: A 58-year-old male presents with sudden onset right-sided facial droop. On examination,
the entire right side of his face is affected — he cannot wrinkle his right forehead, close his right
eye, or smile symmetrically. He also reports ear pain and decreased taste on the right side of his
tongue. Which diagnosis is most consistent with these findings?
A. Central cerebrovascular accident (CVA)
B. Bell's palsy (peripheral CN VII lesion)
C. Myasthenia gravis
D. Trigeminal neuralgia
Correct Answer: B
Rationale: Correct because Bell's palsy is a peripheral CN VII (facial nerve) lesion that affects
the entire ipsilateral face including the forehead, because the facial nerve innervates all facial
muscles on that side unilaterally. The presence of ear pain, hyperacusis, and decreased taste on
the anterior two-thirds of the tongue further supports a peripheral CN VII lesion. Central CVA
spares the forehead due to bilateral cortical innervation of the upper facial muscles, so the
ability to wrinkle the forehead distinguishes peripheral from central causes.
Q2: A nurse performs the patellar deep tendon reflex on a patient and notes a brisk response
with clonus (rhythmic, oscillating contractions) when the foot is rapidly dorsiflexed. How should
this reflex be graded?
A. 0 (areflexia)
B. 2+ (normal)
C. 3+ (hyperactive)
D. 4+ (hyperactive with clonus)
Correct Answer: D
,Rationale: Correct because a DTR grade of 4+ indicates a hyperactive reflex with sustained
clonus present, which is a hallmark finding of upper motor neuron lesions such as CVA, spinal
cord injury, or ALS. The DTR scale is defined as 0 = no response, 1+ = hypoactive, 2+ = normal,
3+ = hyperactive (brisker than average but no clonus), and 4+ = hyperactive with clonus.
Sustained clonus at the ankle is a pathologic finding requiring further neurologic evaluation.
Q3: During a neurological examination, the nurse strokes the sole of the patient's foot from heel
to toe. The great toe extends upward with fanning of the other toes. How should this finding be
documented?
A. Normal plantar reflex
B. Positive Babinski sign indicating upper motor neuron lesion
C. Negative Babinski sign indicating intact corticospinal tract
D. Withdrawal reflex indicating spinal cord injury
Correct Answer: B
Rationale: Correct because a positive Babinski sign is characterized by dorsiflexion of the great
toe with fanning of the other toes, which is abnormal in adults and indicates an upper motor
neuron lesion (damage to the corticospinal tract). A normal plantar reflex in adults produces
flexion of all toes downward. The Babinski sign is one of the most important findings in
neurological assessment because it helps localize lesions to the central nervous system.
Q4: A 45-year-old female presents with numbness and tingling in her thumb, index, and middle
fingers that worsens at night. On examination, the nurse performs Phalen's test by having the
patient flex both wrists maximally for 60 seconds, which reproduces the paresthesia. Which
condition does this most likely indicate?
A. Cervical radiculopathy
B. Carpal tunnel syndrome (median nerve entrapment)
C. De Quervain's tenosynovitis
D. Cubital tunnel syndrome
Correct Answer: B
Rationale: Correct because Phalen's test is a provocative maneuver for carpal tunnel
syndrome, in which sustained wrist flexion compresses the median nerve within the carpal
tunnel, reproducing paresthesia in the thumb, index, middle, and radial half of the ring finger.
Tinel's sign (tapping over the median nerve at the wrist) is another test for the same condition.
Cervical radiculopathy would present with neck pain and dermatomal distribution, De
Quervain's affects the radial side of the wrist, and cubital tunnel syndrome involves the ulnar
nerve distribution.
, Q5: A nurse assesses cranial nerve II (optic) in a patient. The patient reads the 20/40 line on the
Snellen chart. How should this visual acuity be documented?
A. The patient has normal vision
B. The patient can see at 20 feet what a person with normal vision can see at 40 feet
C. The patient is blind in one eye
D. The patient has 20/20 vision
Correct Answer: B
Rationale: Correct because a Snellen acuity of 20/40 means the patient must stand at 20 feet
to read what a person with normal (20/20) vision can read at 40 feet, indicating reduced visual
acuity. The numerator is always the testing distance (20 feet), and the denominator is the
distance at which a normal eye can read the same line. Visual acuity assessment is a core
component of the CN II examination and is essential for detecting optic nerve pathology,
cataracts, and other visual disturbances.
Q6: A 62-year-old male presents with right knee pain after a twisting injury during a basketball
game. The nurse performs Lachman's test with the knee flexed 20–30 degrees and notes
excessive anterior translation of the tibia relative to the femur with a soft, mushy endpoint.
Which ligament is most likely injured?
A. Posterior cruciate ligament (PCL)
B. Medial collateral ligament (MCL)
C. Anterior cruciate ligament (ACL)
D. Lateral collateral ligament (LCL)
Correct Answer: C
Rationale: Correct because Lachman's test is the most sensitive and specific clinical test for
ACL tear, performed with the knee flexed 20–30 degrees. Excessive anterior translation of the
tibia with a soft or mushy endpoint (lack of firm endpoint) indicates ACL rupture. The ACL
prevents anterior displacement of the tibia on the femur and is commonly injured in non-
contact deceleration, pivoting, or hyperextension mechanisms. The anterior drawer test (knee at
90 degrees) is less sensitive in acute settings due to effusion and guarding.
Advanced Health Assessment
William Paterson University (WPU)
2026/2027 | Newly Released
Verified Q & A with Rationales |100% Guaranteed Pass | Graded A+
Q1: A 58-year-old male presents with sudden onset right-sided facial droop. On examination,
the entire right side of his face is affected — he cannot wrinkle his right forehead, close his right
eye, or smile symmetrically. He also reports ear pain and decreased taste on the right side of his
tongue. Which diagnosis is most consistent with these findings?
A. Central cerebrovascular accident (CVA)
B. Bell's palsy (peripheral CN VII lesion)
C. Myasthenia gravis
D. Trigeminal neuralgia
Correct Answer: B
Rationale: Correct because Bell's palsy is a peripheral CN VII (facial nerve) lesion that affects
the entire ipsilateral face including the forehead, because the facial nerve innervates all facial
muscles on that side unilaterally. The presence of ear pain, hyperacusis, and decreased taste on
the anterior two-thirds of the tongue further supports a peripheral CN VII lesion. Central CVA
spares the forehead due to bilateral cortical innervation of the upper facial muscles, so the
ability to wrinkle the forehead distinguishes peripheral from central causes.
Q2: A nurse performs the patellar deep tendon reflex on a patient and notes a brisk response
with clonus (rhythmic, oscillating contractions) when the foot is rapidly dorsiflexed. How should
this reflex be graded?
A. 0 (areflexia)
B. 2+ (normal)
C. 3+ (hyperactive)
D. 4+ (hyperactive with clonus)
Correct Answer: D
,Rationale: Correct because a DTR grade of 4+ indicates a hyperactive reflex with sustained
clonus present, which is a hallmark finding of upper motor neuron lesions such as CVA, spinal
cord injury, or ALS. The DTR scale is defined as 0 = no response, 1+ = hypoactive, 2+ = normal,
3+ = hyperactive (brisker than average but no clonus), and 4+ = hyperactive with clonus.
Sustained clonus at the ankle is a pathologic finding requiring further neurologic evaluation.
Q3: During a neurological examination, the nurse strokes the sole of the patient's foot from heel
to toe. The great toe extends upward with fanning of the other toes. How should this finding be
documented?
A. Normal plantar reflex
B. Positive Babinski sign indicating upper motor neuron lesion
C. Negative Babinski sign indicating intact corticospinal tract
D. Withdrawal reflex indicating spinal cord injury
Correct Answer: B
Rationale: Correct because a positive Babinski sign is characterized by dorsiflexion of the great
toe with fanning of the other toes, which is abnormal in adults and indicates an upper motor
neuron lesion (damage to the corticospinal tract). A normal plantar reflex in adults produces
flexion of all toes downward. The Babinski sign is one of the most important findings in
neurological assessment because it helps localize lesions to the central nervous system.
Q4: A 45-year-old female presents with numbness and tingling in her thumb, index, and middle
fingers that worsens at night. On examination, the nurse performs Phalen's test by having the
patient flex both wrists maximally for 60 seconds, which reproduces the paresthesia. Which
condition does this most likely indicate?
A. Cervical radiculopathy
B. Carpal tunnel syndrome (median nerve entrapment)
C. De Quervain's tenosynovitis
D. Cubital tunnel syndrome
Correct Answer: B
Rationale: Correct because Phalen's test is a provocative maneuver for carpal tunnel
syndrome, in which sustained wrist flexion compresses the median nerve within the carpal
tunnel, reproducing paresthesia in the thumb, index, middle, and radial half of the ring finger.
Tinel's sign (tapping over the median nerve at the wrist) is another test for the same condition.
Cervical radiculopathy would present with neck pain and dermatomal distribution, De
Quervain's affects the radial side of the wrist, and cubital tunnel syndrome involves the ulnar
nerve distribution.
, Q5: A nurse assesses cranial nerve II (optic) in a patient. The patient reads the 20/40 line on the
Snellen chart. How should this visual acuity be documented?
A. The patient has normal vision
B. The patient can see at 20 feet what a person with normal vision can see at 40 feet
C. The patient is blind in one eye
D. The patient has 20/20 vision
Correct Answer: B
Rationale: Correct because a Snellen acuity of 20/40 means the patient must stand at 20 feet
to read what a person with normal (20/20) vision can read at 40 feet, indicating reduced visual
acuity. The numerator is always the testing distance (20 feet), and the denominator is the
distance at which a normal eye can read the same line. Visual acuity assessment is a core
component of the CN II examination and is essential for detecting optic nerve pathology,
cataracts, and other visual disturbances.
Q6: A 62-year-old male presents with right knee pain after a twisting injury during a basketball
game. The nurse performs Lachman's test with the knee flexed 20–30 degrees and notes
excessive anterior translation of the tibia relative to the femur with a soft, mushy endpoint.
Which ligament is most likely injured?
A. Posterior cruciate ligament (PCL)
B. Medial collateral ligament (MCL)
C. Anterior cruciate ligament (ACL)
D. Lateral collateral ligament (LCL)
Correct Answer: C
Rationale: Correct because Lachman's test is the most sensitive and specific clinical test for
ACL tear, performed with the knee flexed 20–30 degrees. Excessive anterior translation of the
tibia with a soft or mushy endpoint (lack of firm endpoint) indicates ACL rupture. The ACL
prevents anterior displacement of the tibia on the femur and is commonly injured in non-
contact deceleration, pivoting, or hyperextension mechanisms. The anterior drawer test (knee at
90 degrees) is less sensitive in acute settings due to effusion and guarding.
