NURS 6512 Exam 4 V3 | NURS 6512
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 4) |
Walden University
1. When assessing for carpal tunnel syndrome, the clinician asks the patient to hold both
wrists in a fully palmar-flexed position with the dorsal surfaces pressed together for one
minute. What is the name of this test?
A. Phalen test
B. Tinel sign
C. McMurray test
D. Lachman test
Answer: A
Rationale: The Phalen test is used to identify carpal tunnel syndrome by compressing the
median nerve. A positive result is the reproduction of numbness or tingling in the
distribution of the median nerve within 60 seconds. This maneuver increases pressure in
the carpal tunnel, which is why it is diagnostic for this condition.
,2. A patient presents with a history of joint pain that is worse in the morning and improves
with activity. On physical exam, the nurse practitioner notes symmetrical joint swelling and
ulnar deviation. These findings are most consistent with:
A. Rheumatoid arthritis
B. Septic arthritis
C. Osteoarthritis
D. Gouty arthritis
Answer: A
Rationale: Rheumatoid arthritis is a systemic inflammatory disease characterized by
symmetrical joint involvement and morning stiffness lasting more than an hour. The ulnar
deviation of the fingers is a classic late-stage deformity caused by chronic inflammation of
the metacarpophalangeal joints. Unlike osteoarthritis, the pain usually improves as the
patient moves and uses the joints throughout the day.
3. The clinician is assessing a 4-year-old child and notices that when the child rises from a
seated position on the floor, he uses his hands to ‘walk up’ his legs. This finding is known as:
A. Ortolani sign
B. Gower sign
C. Trendelenburg sign
D. Babinski sign
, Answer: B
Rationale: The Gower sign is indicative of proximal muscle weakness, most commonly
associated with Duchenne muscular dystrophy. The patient must use their arms and hands
to support their body as they stand because their pelvic girdle muscles are too weak. This
clinical observation is a critical part of the pediatric musculoskeletal and neurological
assessment.
4. To evaluate the function of Cranial Nerve VII (Facial), the clinician should ask the patient to:
A. Shrug the shoulders against resistance
B. Protrude the tongue and move it side to side
C. Identify common smells with eyes closed
D. Smile, frown, and puff out the cheeks
Answer: D
Rationale: Cranial Nerve VII (Facial) controls the muscles of facial expression and taste on
the anterior two-thirds of the tongue. Assessing for symmetry while the patient smiles,
frowns, or puffs out their cheeks helps identify facial nerve palsy or weakness. This nerve is
also responsible for eyelid closure and some sensory functions.
5. Which maneuver is used to assess for a torn meniscus in the knee?
A. Lachman test
B. McMurray test
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 4) |
Walden University
1. When assessing for carpal tunnel syndrome, the clinician asks the patient to hold both
wrists in a fully palmar-flexed position with the dorsal surfaces pressed together for one
minute. What is the name of this test?
A. Phalen test
B. Tinel sign
C. McMurray test
D. Lachman test
Answer: A
Rationale: The Phalen test is used to identify carpal tunnel syndrome by compressing the
median nerve. A positive result is the reproduction of numbness or tingling in the
distribution of the median nerve within 60 seconds. This maneuver increases pressure in
the carpal tunnel, which is why it is diagnostic for this condition.
,2. A patient presents with a history of joint pain that is worse in the morning and improves
with activity. On physical exam, the nurse practitioner notes symmetrical joint swelling and
ulnar deviation. These findings are most consistent with:
A. Rheumatoid arthritis
B. Septic arthritis
C. Osteoarthritis
D. Gouty arthritis
Answer: A
Rationale: Rheumatoid arthritis is a systemic inflammatory disease characterized by
symmetrical joint involvement and morning stiffness lasting more than an hour. The ulnar
deviation of the fingers is a classic late-stage deformity caused by chronic inflammation of
the metacarpophalangeal joints. Unlike osteoarthritis, the pain usually improves as the
patient moves and uses the joints throughout the day.
3. The clinician is assessing a 4-year-old child and notices that when the child rises from a
seated position on the floor, he uses his hands to ‘walk up’ his legs. This finding is known as:
A. Ortolani sign
B. Gower sign
C. Trendelenburg sign
D. Babinski sign
, Answer: B
Rationale: The Gower sign is indicative of proximal muscle weakness, most commonly
associated with Duchenne muscular dystrophy. The patient must use their arms and hands
to support their body as they stand because their pelvic girdle muscles are too weak. This
clinical observation is a critical part of the pediatric musculoskeletal and neurological
assessment.
4. To evaluate the function of Cranial Nerve VII (Facial), the clinician should ask the patient to:
A. Shrug the shoulders against resistance
B. Protrude the tongue and move it side to side
C. Identify common smells with eyes closed
D. Smile, frown, and puff out the cheeks
Answer: D
Rationale: Cranial Nerve VII (Facial) controls the muscles of facial expression and taste on
the anterior two-thirds of the tongue. Assessing for symmetry while the patient smiles,
frowns, or puffs out their cheeks helps identify facial nerve palsy or weakness. This nerve is
also responsible for eyelid closure and some sensory functions.
5. Which maneuver is used to assess for a torn meniscus in the knee?
A. Lachman test
B. McMurray test