NURS 5220 Exam 3 V1 | NURS 5220
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 3) |
The University of Texas at Arlington
1. When assessing the knee of a 24-year-old athlete who reports a ‘locking’ sensation, the
nurse practitioner performs the McMurray test. A positive result is indicated by a click or pop
and suggests which of the following?
A. Prepatellar bursitis
B. An anterior cruciate ligament rupture
C. Patellofemoral syndrome
D. A meniscal tear
Answer: D
Rationale: The McMurray test is a clinical maneuver used specifically to evaluate for tears
in the meniscus of the knee. During the test, the examiner rotates the patient’s lower leg
while applying stress to the joint line to elicit a mechanical response. A positive finding
consists of an audible or palpable click, which represents the torn meniscus being caught
between the femoral and tibial surfaces.
,2. A 45-year-old office worker presents with numbness and tingling in the first three digits of
the right hand. Which provocative maneuver should the clinician use to assess for carpal
tunnel syndrome?
A. Allen test
B. Mcmurray’s test
C. Finkelstein’s test
D. Phalen’s maneuver
Answer: D
Rationale: Phalen’s maneuver involves asking the patient to hold the backs of their hands
together with wrists flexed at 90 degrees for 60 seconds. A positive test occurs if the
patient experiences numbness or tingling in the distribution of the median nerve. This test
is highly sensitive for identifying carpal tunnel syndrome caused by median nerve
compression.
3. During a neurological examination, the nurse practitioner asks the patient to puff out their
cheeks and smile. Which cranial nerve is being primarily assessed?
A. Cranial Nerve VII
B. Cranial Nerve VI
C. Cranial Nerve V
D. Cranial Nerve IX
,Answer: A
Rationale: Cranial Nerve VII, also known as the Facial Nerve, controls the muscles of facial
expression and carries taste from the anterior two-thirds of the tongue. By asking the
patient to puff out their cheeks, smile, or frown, the clinician is evaluating the motor
strength and symmetry of this nerve. Weakness or asymmetry may indicate a peripheral
lesion like Bell’s palsy or a central lesion such as a stroke.
4. Upon digital rectal examination (DRE) of a 68-year-old male, the clinician notes a hard,
fixed, irregular nodule on the posterior surface of the prostate gland. This finding is most
consistent with:
A. Benign Prostatic Hyperplasia (BPH)
B. Prostate cancer
C. Prostatic abscess
D. Prostatitis
Answer: B
Rationale: A hard, fixed, or irregular nodule found during a digital rectal exam is a classic
clinical indicator of prostatic malignancy. While BPH typically presents as a rubbery,
symmetrically enlarged gland, cancer is often localized and feels firm or stony. The clinician
must follow up such findings with a PSA level and potentially a transrectal ultrasound-
guided biopsy.
, 5. To assess for cerebellar function and proprioception, the clinician asks the patient to stand
with feet together and eyes closed. What is this test called?
A. Romberg test
B. Babinski test
C. Lachman test
D. Gower sign
Answer: A
Rationale: The Romberg test is used to evaluate the patient’s balance and proprioceptive
function by removing visual input. A positive Romberg occurs if the patient loses balance or
steps out of position after closing their eyes, suggesting an issue with the vestibular system
or dorsal columns. This assessment is a standard component of the neurological physical
examination in advanced health assessment.
6. A patient exhibits dorsiflexion of the great toe and fanning of the other toes when the
clinician strokes the lateral aspect of the sole of the foot. In an adult, this is known as:
A. A normal plantar reflex
B. A normal cremasteric reflex
C. A positive Babinski sign
D. An indicative sign of cerebellar ataxia
Answer: C
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 3) |
The University of Texas at Arlington
1. When assessing the knee of a 24-year-old athlete who reports a ‘locking’ sensation, the
nurse practitioner performs the McMurray test. A positive result is indicated by a click or pop
and suggests which of the following?
A. Prepatellar bursitis
B. An anterior cruciate ligament rupture
C. Patellofemoral syndrome
D. A meniscal tear
Answer: D
Rationale: The McMurray test is a clinical maneuver used specifically to evaluate for tears
in the meniscus of the knee. During the test, the examiner rotates the patient’s lower leg
while applying stress to the joint line to elicit a mechanical response. A positive finding
consists of an audible or palpable click, which represents the torn meniscus being caught
between the femoral and tibial surfaces.
,2. A 45-year-old office worker presents with numbness and tingling in the first three digits of
the right hand. Which provocative maneuver should the clinician use to assess for carpal
tunnel syndrome?
A. Allen test
B. Mcmurray’s test
C. Finkelstein’s test
D. Phalen’s maneuver
Answer: D
Rationale: Phalen’s maneuver involves asking the patient to hold the backs of their hands
together with wrists flexed at 90 degrees for 60 seconds. A positive test occurs if the
patient experiences numbness or tingling in the distribution of the median nerve. This test
is highly sensitive for identifying carpal tunnel syndrome caused by median nerve
compression.
3. During a neurological examination, the nurse practitioner asks the patient to puff out their
cheeks and smile. Which cranial nerve is being primarily assessed?
A. Cranial Nerve VII
B. Cranial Nerve VI
C. Cranial Nerve V
D. Cranial Nerve IX
,Answer: A
Rationale: Cranial Nerve VII, also known as the Facial Nerve, controls the muscles of facial
expression and carries taste from the anterior two-thirds of the tongue. By asking the
patient to puff out their cheeks, smile, or frown, the clinician is evaluating the motor
strength and symmetry of this nerve. Weakness or asymmetry may indicate a peripheral
lesion like Bell’s palsy or a central lesion such as a stroke.
4. Upon digital rectal examination (DRE) of a 68-year-old male, the clinician notes a hard,
fixed, irregular nodule on the posterior surface of the prostate gland. This finding is most
consistent with:
A. Benign Prostatic Hyperplasia (BPH)
B. Prostate cancer
C. Prostatic abscess
D. Prostatitis
Answer: B
Rationale: A hard, fixed, or irregular nodule found during a digital rectal exam is a classic
clinical indicator of prostatic malignancy. While BPH typically presents as a rubbery,
symmetrically enlarged gland, cancer is often localized and feels firm or stony. The clinician
must follow up such findings with a PSA level and potentially a transrectal ultrasound-
guided biopsy.
, 5. To assess for cerebellar function and proprioception, the clinician asks the patient to stand
with feet together and eyes closed. What is this test called?
A. Romberg test
B. Babinski test
C. Lachman test
D. Gower sign
Answer: A
Rationale: The Romberg test is used to evaluate the patient’s balance and proprioceptive
function by removing visual input. A positive Romberg occurs if the patient loses balance or
steps out of position after closing their eyes, suggesting an issue with the vestibular system
or dorsal columns. This assessment is a standard component of the neurological physical
examination in advanced health assessment.
6. A patient exhibits dorsiflexion of the great toe and fanning of the other toes when the
clinician strokes the lateral aspect of the sole of the foot. In an adult, this is known as:
A. A normal plantar reflex
B. A normal cremasteric reflex
C. A positive Babinski sign
D. An indicative sign of cerebellar ataxia
Answer: C