NSG 500 Exam 1 V1 | NSG 500 Advanced
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 1 2026)
1. During a comprehensive health history, a patient describes their chest pain using the
PQRST mnemonic. Which component of the mnemonic is being addressed when the patient
states, ‘The pain feels like an elephant is sitting on my chest’?
A. Provocation/Palliative
B. Severity
C. Region/Radiation
D. Quality
Answer: D
Rationale: The ‘Quality’ component of the PQRST mnemonic focuses on the description of
the sensation. Describing the pain as a heavy weight or ‘elephant sitting on the chest’
provides qualitative data about the nature of the discomfort. This helps clinicians
differentiate between various types of pain, such as muscular, cardiac, or pleuritic.
2. When assessing an older adult patient, the nurse practitioner notes a slow, persistent skin
tenting after pinching the skin over the sternum. How should this finding be documented?
A. Decreased skin turgor
,B. Increased skin turgor
C. Normal age-related elasticity
D. Presence of anasarca
Answer: A
Rationale: Skin turgor is a measure of skin elasticity and hydration status. Tenting, or a
delay in the skin returning to its original position, indicates decreased turgor and is a
common sign of dehydration. While skin elasticity decreases with age, persistent tenting is
still considered an abnormal finding requiring further investigation.
3. Which physical examination technique is most appropriate for assessing the density of
underlying tissues in the lungs?
A. Percussion
B. Palpation
C. Inspection
D. Auscultation
Answer: A
Rationale: Percussion involves striking the body surface to elicit sounds that reflect the
density of the underlying structures. In the lungs, resonance is the normal sound, while
dullness indicates consolidation or fluid. This technique is vital for mapping out the
borders of organs and identifying abnormalities in tissue density.
, 4. A patient presents with a suspicious mole on their back. The clinician uses the ABCDE
criteria for melanoma. What does the ‘E’ in this mnemonic represent?
A. Erythema
B. Elevation
C. Exudate
D. Evolution
Answer: D
Rationale: Evolution refers to any change in the size, shape, color, or symptoms of a lesion
over time. Rapid changes are a significant warning sign for malignant melanoma and
necessitate a biopsy. Modern assessment standards emphasize that any evolving lesion
should be treated with high clinical suspicion.
5. When performing an otoscopic examination on an adult, the clinician should pull the pinna
in which direction to straighten the ear canal?
A. Up and back
B. Down and back
C. Straight back
D. Down and forward
Answer: A
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 1 2026)
1. During a comprehensive health history, a patient describes their chest pain using the
PQRST mnemonic. Which component of the mnemonic is being addressed when the patient
states, ‘The pain feels like an elephant is sitting on my chest’?
A. Provocation/Palliative
B. Severity
C. Region/Radiation
D. Quality
Answer: D
Rationale: The ‘Quality’ component of the PQRST mnemonic focuses on the description of
the sensation. Describing the pain as a heavy weight or ‘elephant sitting on the chest’
provides qualitative data about the nature of the discomfort. This helps clinicians
differentiate between various types of pain, such as muscular, cardiac, or pleuritic.
2. When assessing an older adult patient, the nurse practitioner notes a slow, persistent skin
tenting after pinching the skin over the sternum. How should this finding be documented?
A. Decreased skin turgor
,B. Increased skin turgor
C. Normal age-related elasticity
D. Presence of anasarca
Answer: A
Rationale: Skin turgor is a measure of skin elasticity and hydration status. Tenting, or a
delay in the skin returning to its original position, indicates decreased turgor and is a
common sign of dehydration. While skin elasticity decreases with age, persistent tenting is
still considered an abnormal finding requiring further investigation.
3. Which physical examination technique is most appropriate for assessing the density of
underlying tissues in the lungs?
A. Percussion
B. Palpation
C. Inspection
D. Auscultation
Answer: A
Rationale: Percussion involves striking the body surface to elicit sounds that reflect the
density of the underlying structures. In the lungs, resonance is the normal sound, while
dullness indicates consolidation or fluid. This technique is vital for mapping out the
borders of organs and identifying abnormalities in tissue density.
, 4. A patient presents with a suspicious mole on their back. The clinician uses the ABCDE
criteria for melanoma. What does the ‘E’ in this mnemonic represent?
A. Erythema
B. Elevation
C. Exudate
D. Evolution
Answer: D
Rationale: Evolution refers to any change in the size, shape, color, or symptoms of a lesion
over time. Rapid changes are a significant warning sign for malignant melanoma and
necessitate a biopsy. Modern assessment standards emphasize that any evolving lesion
should be treated with high clinical suspicion.
5. When performing an otoscopic examination on an adult, the clinician should pull the pinna
in which direction to straighten the ear canal?
A. Up and back
B. Down and back
C. Straight back
D. Down and forward
Answer: A
