NSG 500 Exam 4 V2 | NSG 500 Advanced
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 4 2026)
1. A 45-year-old patient presents with complaints of numbness and tingling in the thumb,
index, and middle fingers. The clinician performs Phalen’s test, which reproduces the
symptoms. Which condition is most likely?
A. De Quervain’s tenosynovitis
B. Ulnar nerve entrapment
C. Carpal tunnel syndrome
D. Dupuytren’s contracture
Answer: C
Rationale: Phalen’s test is specifically used to assess for median nerve compression within
the carpal tunnel. The symptoms described involve the specific distribution of the median
nerve in the hand. A positive test result, where symptoms are reproduced within 60
seconds of wrist flexion, is highly suggestive of carpal tunnel syndrome.
,2. During a neurological examination, the clinician asks the patient to identify a common
object (like a key or coin) placed in their hand while their eyes are closed. What is this
sensory test called?
A. Graphesthesia
B. Extinction
C. Proprioception
D. Stereognosis
Answer: D
Rationale: Stereognosis is the ability to perceive and recognize the form of an object in the
absence of visual and auditory information. This test evaluates the higher-level functions of
the sensory cortex and posterior columns. Failure to identify the object correctly is known
as astereognosis, which may indicate a lesion in the sensory cortex.
3. Which cranial nerve is being evaluated when the clinician asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
Answer: C
, Rationale: Cranial Nerve XI, the spinal accessory nerve, supplies the trapezius and
sternocleidomastoid muscles. Asking the patient to shrug their shoulders tests the
trapezius muscle strength. Weakness or asymmetry during this maneuver suggests
dysfunction of the accessory nerve on the affected side.
4. A patient exhibits a ‘positive drawer sign’ during an evaluation of the knee. This finding is
most indicative of injury to which structure?
A. Medial collateral ligament (MCL)
B. Anterior cruciate ligament (ACL)
C. Lateral meniscus
D. Posterior cruciate ligament (PCL)
Answer: B
Rationale: The anterior drawer test is performed to assess the integrity of the anterior
cruciate ligament. A positive sign occurs when the tibia slides forward excessively from
under the femur. This indicates laxity or a tear in the ACL, which is critical for knee
stability.
5. When grading deep tendon reflexes (DTRs), which score is considered ‘normal’ or
‘average’?
A. 1+
B. 3+
C. 2+
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 4 2026)
1. A 45-year-old patient presents with complaints of numbness and tingling in the thumb,
index, and middle fingers. The clinician performs Phalen’s test, which reproduces the
symptoms. Which condition is most likely?
A. De Quervain’s tenosynovitis
B. Ulnar nerve entrapment
C. Carpal tunnel syndrome
D. Dupuytren’s contracture
Answer: C
Rationale: Phalen’s test is specifically used to assess for median nerve compression within
the carpal tunnel. The symptoms described involve the specific distribution of the median
nerve in the hand. A positive test result, where symptoms are reproduced within 60
seconds of wrist flexion, is highly suggestive of carpal tunnel syndrome.
,2. During a neurological examination, the clinician asks the patient to identify a common
object (like a key or coin) placed in their hand while their eyes are closed. What is this
sensory test called?
A. Graphesthesia
B. Extinction
C. Proprioception
D. Stereognosis
Answer: D
Rationale: Stereognosis is the ability to perceive and recognize the form of an object in the
absence of visual and auditory information. This test evaluates the higher-level functions of
the sensory cortex and posterior columns. Failure to identify the object correctly is known
as astereognosis, which may indicate a lesion in the sensory cortex.
3. Which cranial nerve is being evaluated when the clinician asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
Answer: C
, Rationale: Cranial Nerve XI, the spinal accessory nerve, supplies the trapezius and
sternocleidomastoid muscles. Asking the patient to shrug their shoulders tests the
trapezius muscle strength. Weakness or asymmetry during this maneuver suggests
dysfunction of the accessory nerve on the affected side.
4. A patient exhibits a ‘positive drawer sign’ during an evaluation of the knee. This finding is
most indicative of injury to which structure?
A. Medial collateral ligament (MCL)
B. Anterior cruciate ligament (ACL)
C. Lateral meniscus
D. Posterior cruciate ligament (PCL)
Answer: B
Rationale: The anterior drawer test is performed to assess the integrity of the anterior
cruciate ligament. A positive sign occurs when the tibia slides forward excessively from
under the femur. This indicates laxity or a tear in the ACL, which is critical for knee
stability.
5. When grading deep tendon reflexes (DTRs), which score is considered ‘normal’ or
‘average’?
A. 1+
B. 3+
C. 2+
