NUR 6001 Advanced Health Assessment Exam 3 |
Questions and Answers + Rationales | 2026
Updates | 100% correct
1. Which maneuver is used to assess for a meniscal tear by rotating the tibia while the knee is
flexed and extended, eliciting a painful click?
A) Apley's compression test
B) McMurray's test
C) Lachman test
D) Thomas test
Correct Answer: McMurray's test
Rationale: McMurray's test is a specific orthopedic maneuver to detect meniscal tears. The
examiner flexes the patient's knee, rotates the tibia (externally for the medial meniscus,
internally for the lateral), and extends the knee. A painful click or pop indicates a positive test .
2. Which cranial nerve is evaluated by asking the patient to shrug their shoulders against
resistance?
A) CN IX (Glossopharyngeal)
B) CN X (Vagus)
C) CN XI (Accessory)
D) CN XII (Hypoglossal)
Correct Answer: CN XI (Accessory)
,Rationale: The spinal accessory nerve (CN XI) innervates the trapezius and sternocleidomastoid
muscles. Assessing the strength of a shoulder shrug directly tests the function of the trapezius
muscle, which is innervated by CN XI .
3. A patient reports a sudden, severe "thunderclap" headache described as the worst of their
life. Which condition must be immediately ruled out?
A) Migraine with aura
B) Subarachnoid hemorrhage
C) Tension-type headache
D) Cluster headache
Correct Answer: Subarachnoid hemorrhage
Rationale: A sudden, severe headache that reaches maximum intensity within minutes to an
hour, often described as a "thunderclap" or "worst headache of my life," is a classic presentation
of a subarachnoid hemorrhage. This is a life-threatening emergency requiring immediate
neuroimaging .
4. On lung auscultation, you hear high-pitched, musical sounds primarily during expiration. This
finding is most consistent with which condition?
A) Pulmonary fibrosis
B) Asthma
C) Pneumonia
D) Pleural effusion
Correct Answer: Asthma
,Rationale: Wheezes are continuous, high-pitched, musical sounds caused by airflow through
narrowed airways. They are commonly heard during expiration in obstructive airway diseases
like asthma and COPD. Fine crackles are associated with pulmonary fibrosis, and bronchial
breath sounds can indicate consolidation from pneumonia .
5. When inspecting the abdomen, which finding is most suggestive of ascites?
A) A visible pulsation in the epigastrium
B) Bulging flanks with a positive fluid wave test
C) Hyperpigmented striae
D) A well-healed surgical scar
Correct Answer: Bulging flanks with a positive fluid wave test
Rationale: Ascites is the accumulation of free fluid in the peritoneal cavity. A positive fluid wave
test, where a tap on one flank transmits a wave to the other side, along with bulging flanks and
shifting dullness, are classic physical exam findings that suggest significant ascites .
6. Which test is used to evaluate for carpal tunnel syndrome by having the patient hold their
wrists in flexion for 60 seconds?
A) Tinel's sign
B) Phalen's maneuver
C) Finkelstein's test
D) Allen's test
Correct Answer: Phalen's maneuver
Rationale: Phalen's maneuver is performed by asking the patient to flex their wrists to 90
degrees and hold that position for about 60 seconds. If this reproduces paresthesia
, (numbness/tingling) in the median nerve distribution (thumb, index, middle finger), it is
considered a positive test for carpal tunnel syndrome .
7. A patient presents with fever, nuchal rigidity (stiff neck), and confusion. What is the most
appropriate next step in management?
A) Order a head CT scan
B) Perform a lumbar puncture immediately
C) Administer empiric antibiotics and then CT before LP
D) Obtain blood cultures and wait for the results
Correct Answer: Administer empiric antibiotics and then CT before LP
Rationale: In suspected meningitis with signs of increased intracranial pressure (e.g.,
immunocompromised state, focal neurologic deficits, or seizures), the standard of care is to
administer empiric antibiotics promptly, then perform a head CT to rule out a mass lesion
before a lumbar puncture to prevent herniation .
8. A palpable, pulsatile, expansile mass in the midline of the upper abdomen is most concerning
for which condition?
A) Gastric outlet obstruction
B) Pancreatic pseudocyst
C) Abdominal aortic aneurysm
D) Enlarged liver
Correct Answer: Abdominal aortic aneurysm
Questions and Answers + Rationales | 2026
Updates | 100% correct
1. Which maneuver is used to assess for a meniscal tear by rotating the tibia while the knee is
flexed and extended, eliciting a painful click?
A) Apley's compression test
B) McMurray's test
C) Lachman test
D) Thomas test
Correct Answer: McMurray's test
Rationale: McMurray's test is a specific orthopedic maneuver to detect meniscal tears. The
examiner flexes the patient's knee, rotates the tibia (externally for the medial meniscus,
internally for the lateral), and extends the knee. A painful click or pop indicates a positive test .
2. Which cranial nerve is evaluated by asking the patient to shrug their shoulders against
resistance?
A) CN IX (Glossopharyngeal)
B) CN X (Vagus)
C) CN XI (Accessory)
D) CN XII (Hypoglossal)
Correct Answer: CN XI (Accessory)
,Rationale: The spinal accessory nerve (CN XI) innervates the trapezius and sternocleidomastoid
muscles. Assessing the strength of a shoulder shrug directly tests the function of the trapezius
muscle, which is innervated by CN XI .
3. A patient reports a sudden, severe "thunderclap" headache described as the worst of their
life. Which condition must be immediately ruled out?
A) Migraine with aura
B) Subarachnoid hemorrhage
C) Tension-type headache
D) Cluster headache
Correct Answer: Subarachnoid hemorrhage
Rationale: A sudden, severe headache that reaches maximum intensity within minutes to an
hour, often described as a "thunderclap" or "worst headache of my life," is a classic presentation
of a subarachnoid hemorrhage. This is a life-threatening emergency requiring immediate
neuroimaging .
4. On lung auscultation, you hear high-pitched, musical sounds primarily during expiration. This
finding is most consistent with which condition?
A) Pulmonary fibrosis
B) Asthma
C) Pneumonia
D) Pleural effusion
Correct Answer: Asthma
,Rationale: Wheezes are continuous, high-pitched, musical sounds caused by airflow through
narrowed airways. They are commonly heard during expiration in obstructive airway diseases
like asthma and COPD. Fine crackles are associated with pulmonary fibrosis, and bronchial
breath sounds can indicate consolidation from pneumonia .
5. When inspecting the abdomen, which finding is most suggestive of ascites?
A) A visible pulsation in the epigastrium
B) Bulging flanks with a positive fluid wave test
C) Hyperpigmented striae
D) A well-healed surgical scar
Correct Answer: Bulging flanks with a positive fluid wave test
Rationale: Ascites is the accumulation of free fluid in the peritoneal cavity. A positive fluid wave
test, where a tap on one flank transmits a wave to the other side, along with bulging flanks and
shifting dullness, are classic physical exam findings that suggest significant ascites .
6. Which test is used to evaluate for carpal tunnel syndrome by having the patient hold their
wrists in flexion for 60 seconds?
A) Tinel's sign
B) Phalen's maneuver
C) Finkelstein's test
D) Allen's test
Correct Answer: Phalen's maneuver
Rationale: Phalen's maneuver is performed by asking the patient to flex their wrists to 90
degrees and hold that position for about 60 seconds. If this reproduces paresthesia
, (numbness/tingling) in the median nerve distribution (thumb, index, middle finger), it is
considered a positive test for carpal tunnel syndrome .
7. A patient presents with fever, nuchal rigidity (stiff neck), and confusion. What is the most
appropriate next step in management?
A) Order a head CT scan
B) Perform a lumbar puncture immediately
C) Administer empiric antibiotics and then CT before LP
D) Obtain blood cultures and wait for the results
Correct Answer: Administer empiric antibiotics and then CT before LP
Rationale: In suspected meningitis with signs of increased intracranial pressure (e.g.,
immunocompromised state, focal neurologic deficits, or seizures), the standard of care is to
administer empiric antibiotics promptly, then perform a head CT to rule out a mass lesion
before a lumbar puncture to prevent herniation .
8. A palpable, pulsatile, expansile mass in the midline of the upper abdomen is most concerning
for which condition?
A) Gastric outlet obstruction
B) Pancreatic pseudocyst
C) Abdominal aortic aneurysm
D) Enlarged liver
Correct Answer: Abdominal aortic aneurysm
