NSG6020 WEEK 1 TO 3 EXAM PREP: 100 HIGH-YIELD
MCQS, VERIFIED ANSWERS & CLINICAL RATIONALES
(ADVANCED HEALTH & PHYSICAL ASSESSMENT)
Question 1
An advanced practice registered nurse (APRN) is constructing a Problem-
Oriented Medical Record (POMR) for a newly admitted patient with multiple
comorbidities. Which procedural step must be executed before writing
individual assessments for the patient's clinical conditions?
A. Formulating a nursing care plan for each secondary symptom.
B. Constructing a complete and comprehensive problem list.
C. Initiating a diagnostic review of systems (ROS).
D. Completing the family genogram.
Answer: B. Constructing a complete and comprehensive problem list.
Explanation: Within the Problem-Oriented Medical Record (POMR)
framework established by Lawrence Weed, an individual assessment can only
be properly documented after a comprehensive problem list has been
,completely constructed. This list serves as the index for the patient's chart,
ensuring that every identified issue is tracked systematically.
Question 2
During a well-child check exam of a 4-month-old infant, which physical
examination assessment is unique to this developmental stage and must be
explicitly documented in the chart?
A. Structural symmetry of the chest wall.
B. Presence of pupillary response to light.
C. Shape, size, and tenseness of the fontanels along with head circumference.
D. Deep tendon reflexes of the patellar tendon.
Answer: C. Shape, size, and tenseness of the fontanels along with head
circumference.
Explanation: Assessment of the anterior and posterior fontanels (checking for
flatness, bulging, or depression) paired with serial head circumference
tracking is a specific, crucial component of the pediatric physical exam used
to monitor intracranial pressure and neurodevelopmental growth.
Question 3
A 48-year-old patient presents with a complex array of symptoms including
progressive fatigue, intermittent epigastric pain, and a productive cough. How
should the APRN prioritize data collection during the clinical interview?
A. Conduct a head-to-toe Review of Systems (ROS) first to screen for systemic
,disease.
B. Investigate the family history to identify genetic predispositions to these
symptoms.
C. Focus initially on the Chief Complaint (CC) using the OLDCARTS
mnemonic to establish the History of Present Illness (HPI).
D. Order baseline laboratory diagnostics before starting the subjective
interview.
Answer: C. Focus initially on the Chief Complaint (CC) using the
OLDCARTS mnemonic to establish the History of Present Illness (HPI).
Explanation: The clinical interview must always prioritize the patient’s chief
complaint. Exploring the primary reason for the visit using a systematic
framework like OLDCARTS (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Radiation, Treatment, Severity) forms a
reliable History of Present Illness (HPI) before moving to broader systems.
Question 4
While performing a neurological assessment, the clinician lightly touches the
patient’s cornea with a sterile wisp of cotton. This action is designed to evaluate
which type of reflex?
A. Deep tendon reflex.
B. Pathological reflex.
C. Superficial reflex.
D. Visceral reflex.
Answer: C. Superficial reflex.
, Explanation: The corneal reflex is classified as a superficial (cutaneous)
reflex. This test evaluates the sensory integrity of Cranial Nerve V
(Trigeminal) and the motor response of Cranial Nerve VII (Facial), which
mediates the blinking response.
Question 5
The APRN asks a patient to shrug both shoulders against downward resistance
and turn their head from side to side against the clinician's hand. Which cranial
nerve is being isolated and evaluated during this maneuver?
A. Cranial Nerve CN X (Vagus).
B. Cranial Nerve CN XI (Spinal Accessory).
C. Cranial Nerve CN XII (Hypoglossal).
D. Cranial Nerve CN VII (Facial).
Answer: B. Cranial Nerve CN XI (Spinal Accessory).
Explanation: Cranial Nerve XI (Spinal Accessory) supplies motor innervation
to the trapezius and sternocleidomastoid muscles. Resisted shoulder
shrugging and head rotation directly test the motor function of this nerve.
Question 6
A patient presents with hyperactive deep tendon reflexes (DTRs) demonstrating
transient, rhythmic muscular contractions (clonus) upon rapid dorsiflexion of
the foot. How should the clinician grade this finding on the standard objective
DTR scale?
MCQS, VERIFIED ANSWERS & CLINICAL RATIONALES
(ADVANCED HEALTH & PHYSICAL ASSESSMENT)
Question 1
An advanced practice registered nurse (APRN) is constructing a Problem-
Oriented Medical Record (POMR) for a newly admitted patient with multiple
comorbidities. Which procedural step must be executed before writing
individual assessments for the patient's clinical conditions?
A. Formulating a nursing care plan for each secondary symptom.
B. Constructing a complete and comprehensive problem list.
C. Initiating a diagnostic review of systems (ROS).
D. Completing the family genogram.
Answer: B. Constructing a complete and comprehensive problem list.
Explanation: Within the Problem-Oriented Medical Record (POMR)
framework established by Lawrence Weed, an individual assessment can only
be properly documented after a comprehensive problem list has been
,completely constructed. This list serves as the index for the patient's chart,
ensuring that every identified issue is tracked systematically.
Question 2
During a well-child check exam of a 4-month-old infant, which physical
examination assessment is unique to this developmental stage and must be
explicitly documented in the chart?
A. Structural symmetry of the chest wall.
B. Presence of pupillary response to light.
C. Shape, size, and tenseness of the fontanels along with head circumference.
D. Deep tendon reflexes of the patellar tendon.
Answer: C. Shape, size, and tenseness of the fontanels along with head
circumference.
Explanation: Assessment of the anterior and posterior fontanels (checking for
flatness, bulging, or depression) paired with serial head circumference
tracking is a specific, crucial component of the pediatric physical exam used
to monitor intracranial pressure and neurodevelopmental growth.
Question 3
A 48-year-old patient presents with a complex array of symptoms including
progressive fatigue, intermittent epigastric pain, and a productive cough. How
should the APRN prioritize data collection during the clinical interview?
A. Conduct a head-to-toe Review of Systems (ROS) first to screen for systemic
,disease.
B. Investigate the family history to identify genetic predispositions to these
symptoms.
C. Focus initially on the Chief Complaint (CC) using the OLDCARTS
mnemonic to establish the History of Present Illness (HPI).
D. Order baseline laboratory diagnostics before starting the subjective
interview.
Answer: C. Focus initially on the Chief Complaint (CC) using the
OLDCARTS mnemonic to establish the History of Present Illness (HPI).
Explanation: The clinical interview must always prioritize the patient’s chief
complaint. Exploring the primary reason for the visit using a systematic
framework like OLDCARTS (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Radiation, Treatment, Severity) forms a
reliable History of Present Illness (HPI) before moving to broader systems.
Question 4
While performing a neurological assessment, the clinician lightly touches the
patient’s cornea with a sterile wisp of cotton. This action is designed to evaluate
which type of reflex?
A. Deep tendon reflex.
B. Pathological reflex.
C. Superficial reflex.
D. Visceral reflex.
Answer: C. Superficial reflex.
, Explanation: The corneal reflex is classified as a superficial (cutaneous)
reflex. This test evaluates the sensory integrity of Cranial Nerve V
(Trigeminal) and the motor response of Cranial Nerve VII (Facial), which
mediates the blinking response.
Question 5
The APRN asks a patient to shrug both shoulders against downward resistance
and turn their head from side to side against the clinician's hand. Which cranial
nerve is being isolated and evaluated during this maneuver?
A. Cranial Nerve CN X (Vagus).
B. Cranial Nerve CN XI (Spinal Accessory).
C. Cranial Nerve CN XII (Hypoglossal).
D. Cranial Nerve CN VII (Facial).
Answer: B. Cranial Nerve CN XI (Spinal Accessory).
Explanation: Cranial Nerve XI (Spinal Accessory) supplies motor innervation
to the trapezius and sternocleidomastoid muscles. Resisted shoulder
shrugging and head rotation directly test the motor function of this nerve.
Question 6
A patient presents with hyperactive deep tendon reflexes (DTRs) demonstrating
transient, rhythmic muscular contractions (clonus) upon rapid dorsiflexion of
the foot. How should the clinician grade this finding on the standard objective
DTR scale?
