Wilkes University — NSG 500
3-1E · 005 GSN
WILKES
NSG 500 Advanced Health Assessment — Exams 1, 2 & 3
EXAM 1-3 CLINICAL EXCELLENCE · EVIDENCE-BASED PRACTICE
Wilkes University NSG 500 — Exam 3 (Comprehensive
Review)
Q U E ST I O N S W I T H 1 0 0 % CO R R E CT A N S W E RS | V E R I F I E D | L AT E ST U P DAT E 2 0 2 6
INSTITUTION Wilkes University — Passan School COURSE CODE NSG 500 — Advanced Health
of Nursing Assessment
PROGRAM Master of Science in Nursing ACADEMIC YEAR
EXAM TITLE Wilkes University NSG 500 — TOTAL QUESTIONS 258 Questions
Exams 1, 2 & 3 | Complete Study
Guide
COURSE TITLE Advanced Health Assessment & FORMAT Multiple Choice — Select the
Clinical Reasoning Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover prostate/rectal examination, musculoskeletal assessment, neurological examination,
sports physicals, geriatric assessment, and cranial nerve testing.
▸ Correct answers and detailed clinical rationales appear below each question.
▸ Content aligned with Wilkes University NSG 500 curriculum and evidence-based clinical guidelines.
, SECTION I — ADVANCED HEALTH ASSESSMENT
Questions 1 – 258
COMPREHENSIVE EXAMINATION (EXAMS 1, 2 & 3)
1. The best position for a prostate examination is ______.
A. Side lying with hips and knees flexed
B. Supine with legs extended
C. Standing and bending forward
D. Prone position
CORRECT ANSWER A — Side lying with hips and knees flexed
RATIONALE The left lateral decubitus (Sims) position — patient lying on the left side with
hips and knees flexed toward the chest — provides optimal access for digital
rectal examination and prostate palpation. This position relaxes the anal
sphincter, straightens the anorectal angle, and allows the examiner's finger to
reach the posterior prostate gland effectively. Alternative positions include
standing with the patient bent over the examination table, but the side-lying
position is preferred for comfort, relaxation, and thorough assessment.
2. A normal prostate feels ______.
A. Rubbery, smooth, and round
B. Hard and nodular
C. Soft and fluctuant
D. Irregular and tender
CORRECT ANSWER A — Rubbery, smooth, and round
RATIONALE The normal prostate gland on digital rectal examination feels rubbery (similar to
the consistency of the thenar eminence of the hand), smooth (no nodules or
irregularities), and round/heart-shaped with a palpable median sulcus (groove
dividing the two lateral lobes). It is approximately 2.5 cm in length and should
be non-tender to palpation. A hard, nodular, or irregular prostate raises concern
for prostate cancer; a boggy, tender prostate suggests prostatitis; an enlarged
but smooth prostate suggests benign prostatic hyperplasia (BPH).
,3. As a man ages, the prostate feels ______.
A. More rubbery
B. Softer and smaller
C. Unchanged from young adulthood
D. Hard and nodular
CORRECT ANSWER A — More rubbery
RATIONALE With aging, the prostate gland typically enlarges (benign prostatic hyperplasia
— BPH) and becomes more rubbery or firm in consistency due to glandular and
stromal hyperplasia. This is a normal age-related change driven by hormonal
shifts (increased estrogen-to-testosterone ratio, increased dihydrotestosterone
activity within the prostate). While the prostate becomes larger and firmer, it
should remain smooth and symmetric. The prevalence of BPH is approximately
50% by age 60 and 90% by age 85. Hardness, nodularity, or asymmetry are not
normal aging changes and warrant further investigation for malignancy.
4. During a prostate exam, do you feel the posterior prostate?
A. Yes
B. No
CORRECT ANSWER A — Yes
RATIONALE Digital rectal examination (DRE) palpates the posterior surface of the prostate
gland through the anterior rectal wall. The posterior lobe is the portion most
commonly affected by prostate cancer, making DRE an essential screening tool.
The examiner inserts a lubricated, gloved finger approximately 7-10 cm into the
rectum and palpates the anterior wall, systematically assessing the prostate's
size, consistency, contour, symmetry, mobility, and tenderness. The anterior
and central portions of the prostate are not accessible by DRE.
, 5. What is a rectal prolapse and what does it look like?
A. A sliding sensation with a red donut appearance
B. A dark, necrotic mass protruding from the anus
C. A small skin tag at the anal verge
D. A fistula opening with purulent drainage
CORRECT ANSWER A — A sliding sensation with a red donut appearance
RATIONALE Rectal prolapse is the protrusion of the rectal mucosa or full-thickness rectal
wall through the anus. Patients often describe a "sliding" or "falling out"
sensation. On examination, the prolapse appears as a red, donut-shaped or
rosette-like mass of tissue protruding from the anus — the concentric circular
folds distinguish it from hemorrhoids (which have radial folds). It may occur
only with straining (defecation) and reduce spontaneously, or may be
persistent. Causes include chronic constipation, straining, weakened pelvic
floor muscles, and neurological conditions. Surgical repair is often required for
complete prolapse.
6. Internal hemorrhoids are located ______.
A. Above the dentate line
B. Below the dentate line
C. At the anal verge
D. Outside the anal canal
CORRECT ANSWER A — Above the dentate line
RATIONALE Internal hemorrhoids originate above the dentate (pectinate) line, which is the
anatomical boundary between the visceral columnar epithelium (above) and
somatic squamous epithelium (below). Because the mucosa above the dentate
line lacks somatic sensory innervation, internal hemorrhoids are typically
painless — presenting with bright red bleeding (blood on toilet paper or
dripping into the bowl), not mixed with stool, and a feeling of rectal fullness or
incomplete evacuation. They are classified by degree of prolapse (1st-4th).
External hemorrhoids, located below the dentate line, are somatically
innervated and therefore painful.
3-1E · 005 GSN
WILKES
NSG 500 Advanced Health Assessment — Exams 1, 2 & 3
EXAM 1-3 CLINICAL EXCELLENCE · EVIDENCE-BASED PRACTICE
Wilkes University NSG 500 — Exam 3 (Comprehensive
Review)
Q U E ST I O N S W I T H 1 0 0 % CO R R E CT A N S W E RS | V E R I F I E D | L AT E ST U P DAT E 2 0 2 6
INSTITUTION Wilkes University — Passan School COURSE CODE NSG 500 — Advanced Health
of Nursing Assessment
PROGRAM Master of Science in Nursing ACADEMIC YEAR
EXAM TITLE Wilkes University NSG 500 — TOTAL QUESTIONS 258 Questions
Exams 1, 2 & 3 | Complete Study
Guide
COURSE TITLE Advanced Health Assessment & FORMAT Multiple Choice — Select the
Clinical Reasoning Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover prostate/rectal examination, musculoskeletal assessment, neurological examination,
sports physicals, geriatric assessment, and cranial nerve testing.
▸ Correct answers and detailed clinical rationales appear below each question.
▸ Content aligned with Wilkes University NSG 500 curriculum and evidence-based clinical guidelines.
, SECTION I — ADVANCED HEALTH ASSESSMENT
Questions 1 – 258
COMPREHENSIVE EXAMINATION (EXAMS 1, 2 & 3)
1. The best position for a prostate examination is ______.
A. Side lying with hips and knees flexed
B. Supine with legs extended
C. Standing and bending forward
D. Prone position
CORRECT ANSWER A — Side lying with hips and knees flexed
RATIONALE The left lateral decubitus (Sims) position — patient lying on the left side with
hips and knees flexed toward the chest — provides optimal access for digital
rectal examination and prostate palpation. This position relaxes the anal
sphincter, straightens the anorectal angle, and allows the examiner's finger to
reach the posterior prostate gland effectively. Alternative positions include
standing with the patient bent over the examination table, but the side-lying
position is preferred for comfort, relaxation, and thorough assessment.
2. A normal prostate feels ______.
A. Rubbery, smooth, and round
B. Hard and nodular
C. Soft and fluctuant
D. Irregular and tender
CORRECT ANSWER A — Rubbery, smooth, and round
RATIONALE The normal prostate gland on digital rectal examination feels rubbery (similar to
the consistency of the thenar eminence of the hand), smooth (no nodules or
irregularities), and round/heart-shaped with a palpable median sulcus (groove
dividing the two lateral lobes). It is approximately 2.5 cm in length and should
be non-tender to palpation. A hard, nodular, or irregular prostate raises concern
for prostate cancer; a boggy, tender prostate suggests prostatitis; an enlarged
but smooth prostate suggests benign prostatic hyperplasia (BPH).
,3. As a man ages, the prostate feels ______.
A. More rubbery
B. Softer and smaller
C. Unchanged from young adulthood
D. Hard and nodular
CORRECT ANSWER A — More rubbery
RATIONALE With aging, the prostate gland typically enlarges (benign prostatic hyperplasia
— BPH) and becomes more rubbery or firm in consistency due to glandular and
stromal hyperplasia. This is a normal age-related change driven by hormonal
shifts (increased estrogen-to-testosterone ratio, increased dihydrotestosterone
activity within the prostate). While the prostate becomes larger and firmer, it
should remain smooth and symmetric. The prevalence of BPH is approximately
50% by age 60 and 90% by age 85. Hardness, nodularity, or asymmetry are not
normal aging changes and warrant further investigation for malignancy.
4. During a prostate exam, do you feel the posterior prostate?
A. Yes
B. No
CORRECT ANSWER A — Yes
RATIONALE Digital rectal examination (DRE) palpates the posterior surface of the prostate
gland through the anterior rectal wall. The posterior lobe is the portion most
commonly affected by prostate cancer, making DRE an essential screening tool.
The examiner inserts a lubricated, gloved finger approximately 7-10 cm into the
rectum and palpates the anterior wall, systematically assessing the prostate's
size, consistency, contour, symmetry, mobility, and tenderness. The anterior
and central portions of the prostate are not accessible by DRE.
, 5. What is a rectal prolapse and what does it look like?
A. A sliding sensation with a red donut appearance
B. A dark, necrotic mass protruding from the anus
C. A small skin tag at the anal verge
D. A fistula opening with purulent drainage
CORRECT ANSWER A — A sliding sensation with a red donut appearance
RATIONALE Rectal prolapse is the protrusion of the rectal mucosa or full-thickness rectal
wall through the anus. Patients often describe a "sliding" or "falling out"
sensation. On examination, the prolapse appears as a red, donut-shaped or
rosette-like mass of tissue protruding from the anus — the concentric circular
folds distinguish it from hemorrhoids (which have radial folds). It may occur
only with straining (defecation) and reduce spontaneously, or may be
persistent. Causes include chronic constipation, straining, weakened pelvic
floor muscles, and neurological conditions. Surgical repair is often required for
complete prolapse.
6. Internal hemorrhoids are located ______.
A. Above the dentate line
B. Below the dentate line
C. At the anal verge
D. Outside the anal canal
CORRECT ANSWER A — Above the dentate line
RATIONALE Internal hemorrhoids originate above the dentate (pectinate) line, which is the
anatomical boundary between the visceral columnar epithelium (above) and
somatic squamous epithelium (below). Because the mucosa above the dentate
line lacks somatic sensory innervation, internal hemorrhoids are typically
painless — presenting with bright red bleeding (blood on toilet paper or
dripping into the bowl), not mixed with stool, and a feeling of rectal fullness or
incomplete evacuation. They are classified by degree of prolapse (1st-4th).
External hemorrhoids, located below the dentate line, are somatically
innervated and therefore painful.
