WILKES UNIVERSITY NSG 500 EXAM 3
MASTER QUESTION BANK | ADVANCED
HEALTH ASSESSMENT ACTUAL EXAM PREP
Q&As (UPDATED VERIFIED VERSION)
This comprehensive study resource features 300 highly specialized multiple-choice questions designed
to perfectly mirror the formatting and system-focused content of Wilkes University's advanced health
assessment curriculum. Every single item includes the updated verified correct answer in bold italic
alongside an in-depth, high-utility rationale to reinforce critical clinical reasoning and diagnostic criteria.
Perfect for nursing students seeking an elite preparation tool, this verified test bank guarantees absolute
mastery of complex physical examination techniques, specialized grading scales, and pathological
variations across all major body systems.
Question 1
During an physical examination of a 45-year-old female patient, the nurse practitioner
notes localized tenderness when applying direct pressure to the distal interphalangeal
(DIP) joints of the fingers. Bony overgrowths are visible at these sites. How should
these nodules be documented?
A. Bouchard’s nodes
B. Heberden’s nodes
C. Tophi
D. Rheumatoid nodules
Correct Answer: B. Heberden’s nodes
Rationale: Heberden's nodes are characteristic hard bony overgrowths or
osteophytes that develop at the distal interphalangeal (DIP) joints in patients with
osteoarthritis. Bouchard's nodes occur at the proximal interphalangeal (PIP)
joints.
Question 2
A 22-year-old male presents with sharp knee pain after a sports injury. The nurse
practitioner suspects a ligamentous tear. To perform the Lachman test accurately, how
should the patient's knee be positioned?
A. Extended fully to 0 degrees
B. Flexed at a 20 to 30-degree angle
, C. Flexed at a 90-degree angle
D. Flexed beyond 120 degrees
Correct Answer: B. Flexed at a 20 to 30-degree angle
Rationale: The Lachman test is the most sensitive physical examination
maneuver for confirming an anterior cruciate ligament (ACL) tear. It is performed
with the patient supine and the knee flexed slightly at 20 to 30 degrees while
stabilizing the distal femur and pulling the proximal tibia forward.
Question 3
The nurse practitioner performs a neurological evaluation on a patient brought to the
clinic with suspected meningitis. When the patient's neck is passively flexed forward, the
patient involuntarily flexes their hips and knees. This is a positive:
A. Kernig's sign
B. Brudzinski's sign
C. Babinski's sign
D. Romberg sign
Correct Answer: B. Brudzinski's sign
Rationale: Brudzinski's sign is an involuntary flexion of the hips and knees in
response to passive flexion of the neck. It occurs due to severe meningeal
irritation and inflammation, often seen in acute meningitis.
Question 4
While performing a digital rectal examination (DRE) on a 65-year-old male patient, the
nurse practitioner palpatory findings reveal a prostate gland that feels hot, boggy,
exquisitely tender, and uniformly enlarged. What condition do these findings indicate?
A. Benign Prostatic Hyperplasia (BPH)
B. Prostate Adenocarcinoma
C. Acute Prostatitis
D. Chronic Urinary Retention
Correct Answer: C. Acute Prostatitis
Rationale: An exquisitely tender, soft, hot, and boggy prostate gland on digital
rectal examination is a classic indicator of acute bacterial prostatitis. Vigorous
palpation should be avoided to minimize the risk of inducing bacteremia.
, Question 5
During a routine physical exam of a 55-year-old male, the nurse practitioner notes
structural changes in the rectum. The patient states that when he strains during bowel
movements, tissue protrudes outside the anus but returns inside spontaneously once he
stops straining. This corresponds to:
A. First-degree internal hemorrhoids
B. Second-degree internal hemorrhoids
C. Third-degree internal hemorrhoids
D. Fourth-degree internal hemorrhoids
Correct Answer: B. Second-degree internal hemorrhoids
Rationale: Second-degree internal hemorrhoids are defined as lesions that
prolapse through the anal canal during straining or defecation but reduce
spontaneously back into the rectum. Third-degree hemorrhoids require manual
reduction.
Question 6
A patient presents with symptoms of numbness and tingling in the thumb, index finger,
and middle finger of the right hand. The nurse practitioner taps over the median nerve at
the wrist crease, reproducing these paresthesias. This finding is a positive:
A. Phalen's test
B. Tinel's sign
C. Finkelstein's test
D. Allen's test
Correct Answer: B. Tinel's sign
Rationale: Tinel's sign is elicited by lightly tapping the volar aspect of the wrist
over the median nerve. A positive sign is defined as a tingling sensation radiating
into the median nerve distribution, indicating carpal tunnel syndrome.
Question 7
During an abdominal assessment, the nurse practitioner follows a strict sequence of
techniques. Immediately after inspecting the abdominal wall profile, what is the next
step to prevent altering clinical findings?
A. Light palpation
B. Percussion
C. Auscultation
D. Deep palpation
Correct Answer: C. Auscultation
, Rationale: Auscultation must always be performed immediately after inspection
during an abdominal examination because manual palpation or percussion can
mechanically stimulate the intestines, altering the frequency and character of
bowel sounds.
Question 8
The nurse practitioner is checking a patient's deep tendon reflexes (DTRs). Tapping the
patellar tendon elicits a response that is clearly hyperactive, very brisk, and
accompanied by transient, rhythmic muscle contractions (clonus). How should this be
graded?
A. 1+
B. 2+
C. 3+
D. 4+
Correct Answer: D. 4+
Rationale: On the standard deep tendon reflex scale, a grade of 4+ is assigned to
hyperactive, extremely brisk responses that present with clonus. This clinical
pattern is indicative of an upper motor neuron pathology. [1]
Question 9
While performing a physical examination on a patient presenting with an altered gait,
the nurse practitioner evaluates muscle strength. The patient is able to move their lower
leg horizontally across the examination table when gravity is eliminated, but cannot lift it
against gravity. How should this muscle strength be graded?
A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4
Correct Answer: B. Grade 2
Rationale: Muscle strength is graded from 0 to 5. Grade 2 signifies active
movement of the body part only when gravity is entirely eliminated (such as
moving a limb across a flat surface without lifting it).
Question 10
A 50-year-old male complains of a painful right shoulder. The nurse practitioner
MASTER QUESTION BANK | ADVANCED
HEALTH ASSESSMENT ACTUAL EXAM PREP
Q&As (UPDATED VERIFIED VERSION)
This comprehensive study resource features 300 highly specialized multiple-choice questions designed
to perfectly mirror the formatting and system-focused content of Wilkes University's advanced health
assessment curriculum. Every single item includes the updated verified correct answer in bold italic
alongside an in-depth, high-utility rationale to reinforce critical clinical reasoning and diagnostic criteria.
Perfect for nursing students seeking an elite preparation tool, this verified test bank guarantees absolute
mastery of complex physical examination techniques, specialized grading scales, and pathological
variations across all major body systems.
Question 1
During an physical examination of a 45-year-old female patient, the nurse practitioner
notes localized tenderness when applying direct pressure to the distal interphalangeal
(DIP) joints of the fingers. Bony overgrowths are visible at these sites. How should
these nodules be documented?
A. Bouchard’s nodes
B. Heberden’s nodes
C. Tophi
D. Rheumatoid nodules
Correct Answer: B. Heberden’s nodes
Rationale: Heberden's nodes are characteristic hard bony overgrowths or
osteophytes that develop at the distal interphalangeal (DIP) joints in patients with
osteoarthritis. Bouchard's nodes occur at the proximal interphalangeal (PIP)
joints.
Question 2
A 22-year-old male presents with sharp knee pain after a sports injury. The nurse
practitioner suspects a ligamentous tear. To perform the Lachman test accurately, how
should the patient's knee be positioned?
A. Extended fully to 0 degrees
B. Flexed at a 20 to 30-degree angle
, C. Flexed at a 90-degree angle
D. Flexed beyond 120 degrees
Correct Answer: B. Flexed at a 20 to 30-degree angle
Rationale: The Lachman test is the most sensitive physical examination
maneuver for confirming an anterior cruciate ligament (ACL) tear. It is performed
with the patient supine and the knee flexed slightly at 20 to 30 degrees while
stabilizing the distal femur and pulling the proximal tibia forward.
Question 3
The nurse practitioner performs a neurological evaluation on a patient brought to the
clinic with suspected meningitis. When the patient's neck is passively flexed forward, the
patient involuntarily flexes their hips and knees. This is a positive:
A. Kernig's sign
B. Brudzinski's sign
C. Babinski's sign
D. Romberg sign
Correct Answer: B. Brudzinski's sign
Rationale: Brudzinski's sign is an involuntary flexion of the hips and knees in
response to passive flexion of the neck. It occurs due to severe meningeal
irritation and inflammation, often seen in acute meningitis.
Question 4
While performing a digital rectal examination (DRE) on a 65-year-old male patient, the
nurse practitioner palpatory findings reveal a prostate gland that feels hot, boggy,
exquisitely tender, and uniformly enlarged. What condition do these findings indicate?
A. Benign Prostatic Hyperplasia (BPH)
B. Prostate Adenocarcinoma
C. Acute Prostatitis
D. Chronic Urinary Retention
Correct Answer: C. Acute Prostatitis
Rationale: An exquisitely tender, soft, hot, and boggy prostate gland on digital
rectal examination is a classic indicator of acute bacterial prostatitis. Vigorous
palpation should be avoided to minimize the risk of inducing bacteremia.
, Question 5
During a routine physical exam of a 55-year-old male, the nurse practitioner notes
structural changes in the rectum. The patient states that when he strains during bowel
movements, tissue protrudes outside the anus but returns inside spontaneously once he
stops straining. This corresponds to:
A. First-degree internal hemorrhoids
B. Second-degree internal hemorrhoids
C. Third-degree internal hemorrhoids
D. Fourth-degree internal hemorrhoids
Correct Answer: B. Second-degree internal hemorrhoids
Rationale: Second-degree internal hemorrhoids are defined as lesions that
prolapse through the anal canal during straining or defecation but reduce
spontaneously back into the rectum. Third-degree hemorrhoids require manual
reduction.
Question 6
A patient presents with symptoms of numbness and tingling in the thumb, index finger,
and middle finger of the right hand. The nurse practitioner taps over the median nerve at
the wrist crease, reproducing these paresthesias. This finding is a positive:
A. Phalen's test
B. Tinel's sign
C. Finkelstein's test
D. Allen's test
Correct Answer: B. Tinel's sign
Rationale: Tinel's sign is elicited by lightly tapping the volar aspect of the wrist
over the median nerve. A positive sign is defined as a tingling sensation radiating
into the median nerve distribution, indicating carpal tunnel syndrome.
Question 7
During an abdominal assessment, the nurse practitioner follows a strict sequence of
techniques. Immediately after inspecting the abdominal wall profile, what is the next
step to prevent altering clinical findings?
A. Light palpation
B. Percussion
C. Auscultation
D. Deep palpation
Correct Answer: C. Auscultation
, Rationale: Auscultation must always be performed immediately after inspection
during an abdominal examination because manual palpation or percussion can
mechanically stimulate the intestines, altering the frequency and character of
bowel sounds.
Question 8
The nurse practitioner is checking a patient's deep tendon reflexes (DTRs). Tapping the
patellar tendon elicits a response that is clearly hyperactive, very brisk, and
accompanied by transient, rhythmic muscle contractions (clonus). How should this be
graded?
A. 1+
B. 2+
C. 3+
D. 4+
Correct Answer: D. 4+
Rationale: On the standard deep tendon reflex scale, a grade of 4+ is assigned to
hyperactive, extremely brisk responses that present with clonus. This clinical
pattern is indicative of an upper motor neuron pathology. [1]
Question 9
While performing a physical examination on a patient presenting with an altered gait,
the nurse practitioner evaluates muscle strength. The patient is able to move their lower
leg horizontally across the examination table when gravity is eliminated, but cannot lift it
against gravity. How should this muscle strength be graded?
A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4
Correct Answer: B. Grade 2
Rationale: Muscle strength is graded from 0 to 5. Grade 2 signifies active
movement of the body part only when gravity is entirely eliminated (such as
moving a limb across a flat surface without lifting it).
Question 10
A 50-year-old male complains of a painful right shoulder. The nurse practitioner
