NSG 500 Exam 4 V3 | NSG 500 Advanced
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 4 2026)
1. An advanced practice nurse is assessing the motor function of Cranial Nerve V (Trigeminal).
Which maneuver is most appropriate to evaluate this nerve?
A. Palpating the temporal and masseter muscles while the patient clenches their teeth
B. Asking the patient to smile and puff out their cheeks
C. Applying a cotton wisp to the cornea to elicit a blink
D. Testing the patient’s ability to resist shoulder shrugging
Answer: A
Rationale: The trigeminal nerve is responsible for the motor innervation of the muscles of
mastication. By palpating the masseter and temporal muscles during jaw clenching, the
clinician assesses the strength and symmetry of the motor division. Deficits in this area
may indicate a lesion in the trigeminal nerve pathway or the brainstem.
2. When evaluating a patient for carpal tunnel syndrome, the clinician performs the Phalen
test. What finding constitutes a positive result for this test?
A. Pain upon percussion over the median nerve at the wrist
B. Visible atrophy of the thenar eminence
,C. Weakness in the abduction of the thumb against resistance
D. Numbness and paresthesia in the median nerve distribution within 60 seconds
Answer: D
Rationale: The Phalen test involves asking the patient to hold the backs of their hands
together with wrists flexed at 90 degrees for one minute. This position increases pressure
within the carpal tunnel, compressing the median nerve. A positive result is the
reproduction of tingling or numbness, which is a hallmark sign of nerve entrapment.
3. During a musculoskeletal examination of the knee, the clinician performs the McMurray
test. This specialized maneuver is specifically designed to detect which of the following?
A. Tear of the anterior cruciate ligament (ACL)
B. Joint effusion using the bulge sign
C. Presence of a Baker cyst in the popliteal fossa
D. Tear of the medial or lateral meniscus
Answer: D
Rationale: The McMurray test is a clinical maneuver used to identify meniscal tears by
rotating the lower leg while extending the knee. A palpable or audible ‘click’ along the joint
line during this movement suggests a tear in the fibrocartilage. It is a critical component of
a comprehensive orthopedic assessment for patients reporting knee locking or giving way.
, 4. A 28-year-old male presents with acute scrotal pain. The clinician notes that the pain is
relieved when the scrotum is elevated. This finding, known as Prehn’s sign, is most consistent
with:
A. Testicular torsion
B. Epididymitis
C. Hydrocele
D. Inguinal hernia
Answer: B
Rationale: Prehn’s sign is traditionally used to differentiate between epididymitis and
testicular torsion, although its reliability is limited. A positive sign occurs when elevation of
the scrotum relieves the pain, which typically points toward epididymitis. Conversely, pain
that is not relieved by elevation is highly suspicious for testicular torsion, which is a
surgical emergency.
5. In the pediatric population, the Gower’s sign is an important physical finding. What does a
positive Gower’s sign typically indicate?
A. Early signs of meningeal irritation
B. Weakness of the proximal hip girdle muscles, often seen in Duchenne muscular
dystrophy
C. Developmental dysplasia of the hip
D. Cerebellar ataxia and lack of coordination
Health Assessment | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG500
Exam 4 2026)
1. An advanced practice nurse is assessing the motor function of Cranial Nerve V (Trigeminal).
Which maneuver is most appropriate to evaluate this nerve?
A. Palpating the temporal and masseter muscles while the patient clenches their teeth
B. Asking the patient to smile and puff out their cheeks
C. Applying a cotton wisp to the cornea to elicit a blink
D. Testing the patient’s ability to resist shoulder shrugging
Answer: A
Rationale: The trigeminal nerve is responsible for the motor innervation of the muscles of
mastication. By palpating the masseter and temporal muscles during jaw clenching, the
clinician assesses the strength and symmetry of the motor division. Deficits in this area
may indicate a lesion in the trigeminal nerve pathway or the brainstem.
2. When evaluating a patient for carpal tunnel syndrome, the clinician performs the Phalen
test. What finding constitutes a positive result for this test?
A. Pain upon percussion over the median nerve at the wrist
B. Visible atrophy of the thenar eminence
,C. Weakness in the abduction of the thumb against resistance
D. Numbness and paresthesia in the median nerve distribution within 60 seconds
Answer: D
Rationale: The Phalen test involves asking the patient to hold the backs of their hands
together with wrists flexed at 90 degrees for one minute. This position increases pressure
within the carpal tunnel, compressing the median nerve. A positive result is the
reproduction of tingling or numbness, which is a hallmark sign of nerve entrapment.
3. During a musculoskeletal examination of the knee, the clinician performs the McMurray
test. This specialized maneuver is specifically designed to detect which of the following?
A. Tear of the anterior cruciate ligament (ACL)
B. Joint effusion using the bulge sign
C. Presence of a Baker cyst in the popliteal fossa
D. Tear of the medial or lateral meniscus
Answer: D
Rationale: The McMurray test is a clinical maneuver used to identify meniscal tears by
rotating the lower leg while extending the knee. A palpable or audible ‘click’ along the joint
line during this movement suggests a tear in the fibrocartilage. It is a critical component of
a comprehensive orthopedic assessment for patients reporting knee locking or giving way.
, 4. A 28-year-old male presents with acute scrotal pain. The clinician notes that the pain is
relieved when the scrotum is elevated. This finding, known as Prehn’s sign, is most consistent
with:
A. Testicular torsion
B. Epididymitis
C. Hydrocele
D. Inguinal hernia
Answer: B
Rationale: Prehn’s sign is traditionally used to differentiate between epididymitis and
testicular torsion, although its reliability is limited. A positive sign occurs when elevation of
the scrotum relieves the pain, which typically points toward epididymitis. Conversely, pain
that is not relieved by elevation is highly suspicious for testicular torsion, which is a
surgical emergency.
5. In the pediatric population, the Gower’s sign is an important physical finding. What does a
positive Gower’s sign typically indicate?
A. Early signs of meningeal irritation
B. Weakness of the proximal hip girdle muscles, often seen in Duchenne muscular
dystrophy
C. Developmental dysplasia of the hip
D. Cerebellar ataxia and lack of coordination
