NSG 500 Exam 1 V3 | NSG 500 Advanced
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 1 2026)
1. When conducting a comprehensive health history, the practitioner knows that the ‘Review
of Systems’ (ROS) serves which primary purpose?
A. To document the physical examination findings discovered by the clinician.
B. To verify the laboratory results and diagnostic imaging findings.
C. To provide a definitive medical diagnosis for the patient’s chief complaint.
D. To evaluate the past and present health state of each body system through patient-
reported data.
Answer: D
Rationale: The Review of Systems is a subjective assessment where the clinician asks the
patient about symptoms related to each body system. This process helps identify issues the
patient might have overlooked and establishes a baseline for the current health status. It is
distinct from the physical exam, which focuses on objective data gathered by the
practitioner.
2. While assessing a patient’s lungs, the advanced practice nurse notes a high-pitched,
musical sound heard primarily during expiration. How should this be documented?
A. Wheezes
,B. Pleural friction rub
C. Coarse crackles
D. Stridor
Answer: A
Rationale: Wheezes are continuous, musical sounds caused by air flowing through
narrowed or obstructed airways. They are most commonly heard during expiration but can
occur during inspiration in severe cases. Accurate documentation of adventitious sounds is
crucial for diagnosing obstructive lung diseases like asthma or COPD.
3. During the abdominal examination, what is the correct sequence of physical assessment
techniques used by the clinician?
A. Inspection, Palpation, Percussion, Auscultation
B. Percussion, Palpation, Auscultation, Inspection
C. Auscultation, Inspection, Palpation, Percussion
D. Inspection, Auscultation, Percussion, Palpation
Answer: D
Rationale: In abdominal assessment, auscultation must follow inspection but precede
percussion and palpation. This sequence is necessary because vigorous percussion or
palpation can alter bowel sounds and lead to inaccurate clinical findings. Maintaining this
, order ensures that the recorded bowel motility is a true representation of the patient’s
physiological state.
4. A patient presents with a ‘shifting dullness’ during abdominal percussion. This finding is
most suggestive of which condition?
A. Gastrointestinal obstruction
B. Ascites
C. Appendicitis
D. Splenomegaly
Answer: B
Rationale: Shifting dullness is a classic sign of ascites, indicating the presence of free fluid
within the peritoneal cavity. As the patient changes position, the fluid shifts, causing the
area of percussion dullness to move accordingly. This physical exam maneuver helps
differentiate between fluid and gaseous distension.
5. When assessing the thyroid gland, the practitioner asks the patient to swallow while
palpating. What is the rationale for this action?
A. To facilitate the movement of the thyroid gland upward for easier palpation.
B. To check for the presence of a carotid bruit.
C. To test the function of the glossopharyngeal nerve (CN IX).
D. To assess the patient’s ability to protect the airway.
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 1 2026)
1. When conducting a comprehensive health history, the practitioner knows that the ‘Review
of Systems’ (ROS) serves which primary purpose?
A. To document the physical examination findings discovered by the clinician.
B. To verify the laboratory results and diagnostic imaging findings.
C. To provide a definitive medical diagnosis for the patient’s chief complaint.
D. To evaluate the past and present health state of each body system through patient-
reported data.
Answer: D
Rationale: The Review of Systems is a subjective assessment where the clinician asks the
patient about symptoms related to each body system. This process helps identify issues the
patient might have overlooked and establishes a baseline for the current health status. It is
distinct from the physical exam, which focuses on objective data gathered by the
practitioner.
2. While assessing a patient’s lungs, the advanced practice nurse notes a high-pitched,
musical sound heard primarily during expiration. How should this be documented?
A. Wheezes
,B. Pleural friction rub
C. Coarse crackles
D. Stridor
Answer: A
Rationale: Wheezes are continuous, musical sounds caused by air flowing through
narrowed or obstructed airways. They are most commonly heard during expiration but can
occur during inspiration in severe cases. Accurate documentation of adventitious sounds is
crucial for diagnosing obstructive lung diseases like asthma or COPD.
3. During the abdominal examination, what is the correct sequence of physical assessment
techniques used by the clinician?
A. Inspection, Palpation, Percussion, Auscultation
B. Percussion, Palpation, Auscultation, Inspection
C. Auscultation, Inspection, Palpation, Percussion
D. Inspection, Auscultation, Percussion, Palpation
Answer: D
Rationale: In abdominal assessment, auscultation must follow inspection but precede
percussion and palpation. This sequence is necessary because vigorous percussion or
palpation can alter bowel sounds and lead to inaccurate clinical findings. Maintaining this
, order ensures that the recorded bowel motility is a true representation of the patient’s
physiological state.
4. A patient presents with a ‘shifting dullness’ during abdominal percussion. This finding is
most suggestive of which condition?
A. Gastrointestinal obstruction
B. Ascites
C. Appendicitis
D. Splenomegaly
Answer: B
Rationale: Shifting dullness is a classic sign of ascites, indicating the presence of free fluid
within the peritoneal cavity. As the patient changes position, the fluid shifts, causing the
area of percussion dullness to move accordingly. This physical exam maneuver helps
differentiate between fluid and gaseous distension.
5. When assessing the thyroid gland, the practitioner asks the patient to swallow while
palpating. What is the rationale for this action?
A. To facilitate the movement of the thyroid gland upward for easier palpation.
B. To check for the presence of a carotid bruit.
C. To test the function of the glossopharyngeal nerve (CN IX).
D. To assess the patient’s ability to protect the airway.
