NSG 500
EXAM 3
Advanced Health Assessment
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
➢150 Exam Questions w/ Answers
➢Expert Rationales included
➢Exam 3 Comprehensive Study Guide
,Table of Contents
NSG 500 Exam 3 ............................................................................. 2
NSG 500 Exam 3 ........................................................................... 35
NSG 500 Exam 3 Study Guide .................................................... 67
NSG 500 Exam 3
1. A 68-year-old male presents for his annual physical examination. The nurse
practitioner is preparing to perform a digital rectal exam (DRE) and prostate
assessment. Which positioning is most appropriate for this examination?
A. Lithotomy position with hips abducted
B. Supine with knees extended
C. Side-lying with hips and knees flexed
D. Prone with a pillow under the abdomen
Correct Answer: C
Rationale: The side-lying position with hips and knees flexed (Sims' position) is the
preferred positioning for rectal and prostate examination. This position allows for optimal
visualization and palpation of the rectum and prostate gland while maintaining patient
comfort and dignity. The lithotomy position (A) is used for pelvic examinations in females.
Supine (B) and prone (D) positions do not provide adequate access for DRE.
2. During a digital rectal examination of a 55-year-old male, the nurse practitioner
palpates the posterior prostate. Which finding would be considered NORMAL?
A. Hard, irregular, and nodular
B. Smooth, rubbery, and round
C. Tender, boggy, and enlarged
D. Fixed and asymmetrical
Correct Answer: B
,Rationale: Normal prostate examination findings include a smooth, rubbery, and round
consistency. As males age, the prostate typically becomes more rubbery due to benign
prostatic hyperplasia. A hard, irregular, nodular prostate (A) is suggestive of prostate
malignancy. A tender, boggy prostate (C) indicates prostatitis. A fixed, asymmetrical
prostate (D) is abnormal and warrants further investigation.
3. A 72-year-old female reports that during bowel movements, she notices a red,
fleshy mass protruding from her rectum that slides back inside when she stands up.
Which condition does this describe?
A. Internal hemorrhoids
B. External hemorrhoids
C. Rectal prolapse
D. Anal fissure
Correct Answer: C
Rationale: Rectal prolapse is characterized by the sliding of rectal tissue through the anus,
often appearing as a red mass during defecation that may reduce spontaneously when
standing. Internal hemorrhoids (A) are smooth, round masses palpated digitally and
typically do not protrude unless severely prolapsed. External hemorrhoids (B) appear as
purple/dark lesions around the anal verge. Anal fissures (D) present as linear tears with
sharp pain during defecation.
4. During a digital rectal examination, the nurse practitioner palpates smooth, round
masses within the anal canal. These findings are most consistent with:
A. External thrombosed hemorrhoids
B. Internal hemorrhoids
C. Rectal polyps
D. Anal carcinoma
Correct Answer: B
Rationale: Internal hemorrhoids are palpated as smooth, round masses during digital
rectal examination. They originate above the dentate line and are covered by mucosa.
External thrombosed hemorrhoids (A) appear as purple/dark, painful nodules at the anal
verge. Rectal polyps (C) may be palpable but are less common and require colonoscopic
evaluation. Anal carcinoma (D) presents as irregular, ulcerated, or firm masses.
,5. A patient presents with dark purple, painful nodules at the anal verge. The nurse
practitioner recognizes these as external hemorrhoids. Which finding would be most
concerning and indicate the need for surgical intervention?
A. Mild itching with no discoloration
B. Bleeding during defecation
C. Purple/dark color indicating thrombus with compromised blood supply
D. Soft, reducible mass
Correct Answer: C
Rationale: External hemorrhoids that appear purple or dark indicate thrombosis with
compromised blood supply, which can lead to tissue necrosis. This is a surgical emergency
requiring intervention. Mild itching (A) and bleeding (B) are common symptoms of
hemorrhoids but do not indicate necrosis. A soft, reducible mass (D) is consistent with
uncomplicated hemorrhoids.
6. Select All That Apply: A 45-year-old patient presents with complaints of rectal
discomfort. Which symptoms are commonly associated with hemorrhoids? (Select all
that apply.)
A. Bleeding
B. Pain
C. Itching
D. Fever
E. Weight loss
Correct Answers: A, B, C
Rationale: The common signs and symptoms of hemorrhoids include bleeding (typically
bright red blood on toilet paper or in the stool), pain (especially with thrombosed external
hemorrhoids), and itching (due to mucus secretion and perianal moisture). Fever (D) and
weight loss (E) are not associated with uncomplicated hemorrhoids and would suggest
infection, malignancy, or inflammatory bowel disease requiring further evaluation.
7. A 50-year-old patient reports bright red blood in the stool. The nurse practitioner
notes no evidence of hemorrhoids on examination and learns the patient has a family
history of colon cancer. What is the most appropriate clinical action?
A. Reassure the patient and recommend increased fiber intake
B. Order a colonoscopy for further evaluation
,C. Prescribe hemorrhoid cream and schedule follow-up in 6 months
D. Recommend a fecal occult blood test only
Correct Answer: B
Rationale: Rectal bleeding in the absence of hemorrhoids, particularly with a family history
of colon cancer, warrants immediate further evaluation with colonoscopy. This is a red flag
symptom that requires ruling out malignancy, inflammatory bowel disease, or polyps.
Reassurance (A) or topical treatment (C) would be inappropriate without identifying the
source of bleeding. While fecal occult blood testing (D) has screening value, direct
visualization via colonoscopy is indicated given the clinical presentation.
8. Select All That Apply: Which of the following are potential causes of rectal
bleeding? (Select all that apply.)
A. Hemorrhoids
B. NSAID use
C. Inflammatory bowel disease
D. Crohn's disease
E. Ulcerative colitis
F. Anal fissures
G. Anticoagulant therapy
H. Upper and lower GI bleeding
I. Constipation with straining
J. Excessive alcohol consumption
Correct Answers: A, B, C, D, E, F, G, H, I, J
Rationale: Rectal bleeding has multiple etiologies. Hemorrhoids (A) and anal fissures (F)
are common anorectal causes. NSAIDs (B) and anticoagulants (G) can cause or exacerbate
bleeding by impairing clotting or causing mucosal injury. Inflammatory bowel diseases
including Crohn's disease (D) and ulcerative colitis (E) cause mucosal inflammation and
bleeding. Both upper and lower GI bleeding (H) can present as rectal bleeding. Constipation
with straining (I) can precipitate hemorrhoidal bleeding or fissures. Excessive alcohol
consumption (J) is associated with GI bleeding through multiple mechanisms including
gastritis, liver disease, and coagulopathy.
9. A nurse practitioner is conducting a musculoskeletal examination on a 35-year-old
athlete. What is the correct sequence for this assessment?
,A. Inspect → Palpate → ROM (active and passive) → Joint stability
B. Palpate → Inspect → Joint stability → ROM
C. ROM → Inspect → Palpate → Joint stability
D. Joint stability → Inspect → Palpate → ROM
Correct Answer: A
Rationale: The standard sequence for musculoskeletal examination is: Inspection (observe
for deformity, swelling, asymmetry, skin changes), Palpation (assess for tenderness,
warmth, crepitus, effusions), Range of Motion (active first, then passive if limited), and Joint
Stability (special tests). This sequence follows the general physical examination principle of
least invasive to most invasive, beginning with visual observation before touching or
manipulating the joint.
10. A 65-year-old postmenopausal female is concerned about bone health. The nurse
practitioner explains that weakening bones in aging females are primarily due to:
A. Decreased physical activity
B. Increased bone resorption due to decreased estrogen and calcium demands
C. Excessive calcium supplementation
D. Increased osteoblastic activity
Correct Answer: B
Rationale: Postmenopausal females experience increased bone resorption due to
decreased estrogen levels, which normally suppresses osteoclast activity. The body also has
ongoing calcium demands for metabolic processes. A DEXA scan is the gold standard for
assessing bone mineral density and diagnosing osteoporosis. While decreased activity (A)
contributes to bone loss, the primary mechanism is hormonal. Excessive calcium (C) does
not cause weakening bones, and decreased—not increased—osteoblastic activity (D)
occurs with aging.
11. During a musculoskeletal examination, the nurse practitioner is assessing joint
symmetry. Which technique is most appropriate?
A. Palpation of bilateral joints simultaneously
B. Inspection of bilateral joints for comparison
C. Active ROM testing of one joint at a time
D. Percussion over joint spaces
Correct Answer: B
,Rationale: Joint symmetry is assessed through inspection by visually comparing bilateral
joints for alignment, size, contour, and skin changes. Simultaneous palpation (A) is used for
temperature comparison. Active ROM (C) assesses function rather than symmetry.
Percussion (D) is not a standard musculoskeletal assessment technique.
12. The nurse practitioner palpates a patient's knee and notes a soft, spongy sensation
around the joint line. This finding is described as:
A. Crepitus
B. Boggy
C. Indurated
D. Fluctuant
Correct Answer: B
Rationale: A boggy sensation on palpation indicates joint effusion—soft and spongy due to
accumulated synovial fluid within the joint capsule. Crepitus (A) is a grating sensation or
sound. Indurated (C) describes hardened tissue. Fluctuant (D) describes a wave-like
sensation suggestive of fluid but is not the specific term used for joint effusion palpation.
13. Select All That Apply: Which factors increase the risk for developing
osteoarthritis? (Select all that apply.)
A. Advanced age
B. Obesity
C. Smoking
D. Excessive alcohol consumption
E. Family history
F. Female gender
G. Overuse injuries
H. Chronic pain conditions
Correct Answers: A, B, C, D, E, F, G
Rationale: Risk factors for osteoarthritis include advanced age (A), obesity (B) (increases
mechanical stress on weight-bearing joints), smoking (C), excessive alcohol consumption
(D), family history (E), female gender (F), and overuse injuries (G). Chronic pain conditions
(H) are not a recognized risk factor for OA development, though pain is a symptom of
established OA.
,14. A 70-year-old patient presents with bony enlargements at the distal
interphalangeal joints of the fingers. The nurse practitioner identifies these as
Heberden's nodes. What is the recommended treatment?
A. Joint replacement surgery
B. Immobilization and rest
C. Exercise
D. High-dose corticosteroids
Correct Answer: C
Rationale: Heberden's nodes are bony enlargements at the distal interphalangeal joints
characteristic of osteoarthritis. The recommended treatment is exercise to maintain joint
mobility, strengthen surrounding muscles, and improve function. Joint replacement (A) is
reserved for severe, debilitating cases. Immobilization (B) leads to further stiffness and
functional decline. Corticosteroids (D) may provide symptomatic relief but are not first-line
treatment and do not alter disease progression.
15. A 22-year-old soccer player reports a twisting injury to the knee with a popping
sensation. During the examination, the nurse practitioner performs a test that elicits
a clicking sound. Which test is being performed?
A. Lachman test
B. McMurray test
C. Anterior drawer test
D. Apley's compression test
Correct Answer: B
Rationale: The McMurray test is performed to assess for meniscus injury. A positive test is
indicated by a clicking or popping sensation when the knee is flexed, rotated, and then
extended. The Lachman test (A) assesses ACL integrity. The anterior drawer test (C) also
evaluates the ACL. Apley's compression test (D) is another meniscal test but involves
compression rather than the characteristic clicking of McMurray.
16. During a newborn examination, the nurse practitioner performs tests to assess
for hip dislocation. Which tests are appropriate for this purpose?
A. Thomas test and Trendelenburg test
B. Barlow and Ortolani tests
, C. Patrick's test and FABER test
D. Ober test and Ely test
Correct Answer: B
Rationale: The Barlow and Ortolani tests are used in infants to detect developmental
dysplasia of the hip (DDH) and hip dislocation. The Barlow test attempts to dislocate an
unstable hip, while the Ortolani test reduces a dislocated hip with a characteristic "clunk."
These tests are common causes of leg length discrepancy in children. Thomas (A) and
Trendelenburg (A) assess hip flexion contractures and abductor weakness respectively.
Patrick/FABER (C) assesses sacroiliac joint pathology. Ober and Ely (D) assess iliotibial
band tightness and rectus femoris contracture.
17. A 60-year-old patient reports lower back pain that worsens when walking and
standing upright but improves when sitting or bending forward. Which test would
help confirm the suspected diagnosis?
A. Straight leg raise test
B. FABER test
C. Slump test
D. Kemp's test
Correct Answer: A
Rationale: The clinical presentation (pain with walking and upright posture, relief with
forward flexion) is characteristic of spinal stenosis. The straight leg raise test (also used for
herniated disc and lumbar radiculopathy) can help confirm the diagnosis by reproducing
radicular symptoms. Pain with walking that is relieved by sitting or bending forward is
classic neurogenic claudication from lumbar spinal stenosis. The FABER test (B) assesses
hip and sacroiliac pathology. The slump test (C) and Kemp's test (D) are also used for nerve
root tension but are not the primary test for spinal stenosis.
18. Select All That Apply: A patient with spinal stenosis typically presents with which
findings? (Select all that apply.)
A. Pain with movement
B. Pain specifically in the upright position
C. Pain with walking
D. Pain that improves with lumbar extension
E. Relief with sitting or bending forward
EXAM 3
Advanced Health Assessment
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
➢150 Exam Questions w/ Answers
➢Expert Rationales included
➢Exam 3 Comprehensive Study Guide
,Table of Contents
NSG 500 Exam 3 ............................................................................. 2
NSG 500 Exam 3 ........................................................................... 35
NSG 500 Exam 3 Study Guide .................................................... 67
NSG 500 Exam 3
1. A 68-year-old male presents for his annual physical examination. The nurse
practitioner is preparing to perform a digital rectal exam (DRE) and prostate
assessment. Which positioning is most appropriate for this examination?
A. Lithotomy position with hips abducted
B. Supine with knees extended
C. Side-lying with hips and knees flexed
D. Prone with a pillow under the abdomen
Correct Answer: C
Rationale: The side-lying position with hips and knees flexed (Sims' position) is the
preferred positioning for rectal and prostate examination. This position allows for optimal
visualization and palpation of the rectum and prostate gland while maintaining patient
comfort and dignity. The lithotomy position (A) is used for pelvic examinations in females.
Supine (B) and prone (D) positions do not provide adequate access for DRE.
2. During a digital rectal examination of a 55-year-old male, the nurse practitioner
palpates the posterior prostate. Which finding would be considered NORMAL?
A. Hard, irregular, and nodular
B. Smooth, rubbery, and round
C. Tender, boggy, and enlarged
D. Fixed and asymmetrical
Correct Answer: B
,Rationale: Normal prostate examination findings include a smooth, rubbery, and round
consistency. As males age, the prostate typically becomes more rubbery due to benign
prostatic hyperplasia. A hard, irregular, nodular prostate (A) is suggestive of prostate
malignancy. A tender, boggy prostate (C) indicates prostatitis. A fixed, asymmetrical
prostate (D) is abnormal and warrants further investigation.
3. A 72-year-old female reports that during bowel movements, she notices a red,
fleshy mass protruding from her rectum that slides back inside when she stands up.
Which condition does this describe?
A. Internal hemorrhoids
B. External hemorrhoids
C. Rectal prolapse
D. Anal fissure
Correct Answer: C
Rationale: Rectal prolapse is characterized by the sliding of rectal tissue through the anus,
often appearing as a red mass during defecation that may reduce spontaneously when
standing. Internal hemorrhoids (A) are smooth, round masses palpated digitally and
typically do not protrude unless severely prolapsed. External hemorrhoids (B) appear as
purple/dark lesions around the anal verge. Anal fissures (D) present as linear tears with
sharp pain during defecation.
4. During a digital rectal examination, the nurse practitioner palpates smooth, round
masses within the anal canal. These findings are most consistent with:
A. External thrombosed hemorrhoids
B. Internal hemorrhoids
C. Rectal polyps
D. Anal carcinoma
Correct Answer: B
Rationale: Internal hemorrhoids are palpated as smooth, round masses during digital
rectal examination. They originate above the dentate line and are covered by mucosa.
External thrombosed hemorrhoids (A) appear as purple/dark, painful nodules at the anal
verge. Rectal polyps (C) may be palpable but are less common and require colonoscopic
evaluation. Anal carcinoma (D) presents as irregular, ulcerated, or firm masses.
,5. A patient presents with dark purple, painful nodules at the anal verge. The nurse
practitioner recognizes these as external hemorrhoids. Which finding would be most
concerning and indicate the need for surgical intervention?
A. Mild itching with no discoloration
B. Bleeding during defecation
C. Purple/dark color indicating thrombus with compromised blood supply
D. Soft, reducible mass
Correct Answer: C
Rationale: External hemorrhoids that appear purple or dark indicate thrombosis with
compromised blood supply, which can lead to tissue necrosis. This is a surgical emergency
requiring intervention. Mild itching (A) and bleeding (B) are common symptoms of
hemorrhoids but do not indicate necrosis. A soft, reducible mass (D) is consistent with
uncomplicated hemorrhoids.
6. Select All That Apply: A 45-year-old patient presents with complaints of rectal
discomfort. Which symptoms are commonly associated with hemorrhoids? (Select all
that apply.)
A. Bleeding
B. Pain
C. Itching
D. Fever
E. Weight loss
Correct Answers: A, B, C
Rationale: The common signs and symptoms of hemorrhoids include bleeding (typically
bright red blood on toilet paper or in the stool), pain (especially with thrombosed external
hemorrhoids), and itching (due to mucus secretion and perianal moisture). Fever (D) and
weight loss (E) are not associated with uncomplicated hemorrhoids and would suggest
infection, malignancy, or inflammatory bowel disease requiring further evaluation.
7. A 50-year-old patient reports bright red blood in the stool. The nurse practitioner
notes no evidence of hemorrhoids on examination and learns the patient has a family
history of colon cancer. What is the most appropriate clinical action?
A. Reassure the patient and recommend increased fiber intake
B. Order a colonoscopy for further evaluation
,C. Prescribe hemorrhoid cream and schedule follow-up in 6 months
D. Recommend a fecal occult blood test only
Correct Answer: B
Rationale: Rectal bleeding in the absence of hemorrhoids, particularly with a family history
of colon cancer, warrants immediate further evaluation with colonoscopy. This is a red flag
symptom that requires ruling out malignancy, inflammatory bowel disease, or polyps.
Reassurance (A) or topical treatment (C) would be inappropriate without identifying the
source of bleeding. While fecal occult blood testing (D) has screening value, direct
visualization via colonoscopy is indicated given the clinical presentation.
8. Select All That Apply: Which of the following are potential causes of rectal
bleeding? (Select all that apply.)
A. Hemorrhoids
B. NSAID use
C. Inflammatory bowel disease
D. Crohn's disease
E. Ulcerative colitis
F. Anal fissures
G. Anticoagulant therapy
H. Upper and lower GI bleeding
I. Constipation with straining
J. Excessive alcohol consumption
Correct Answers: A, B, C, D, E, F, G, H, I, J
Rationale: Rectal bleeding has multiple etiologies. Hemorrhoids (A) and anal fissures (F)
are common anorectal causes. NSAIDs (B) and anticoagulants (G) can cause or exacerbate
bleeding by impairing clotting or causing mucosal injury. Inflammatory bowel diseases
including Crohn's disease (D) and ulcerative colitis (E) cause mucosal inflammation and
bleeding. Both upper and lower GI bleeding (H) can present as rectal bleeding. Constipation
with straining (I) can precipitate hemorrhoidal bleeding or fissures. Excessive alcohol
consumption (J) is associated with GI bleeding through multiple mechanisms including
gastritis, liver disease, and coagulopathy.
9. A nurse practitioner is conducting a musculoskeletal examination on a 35-year-old
athlete. What is the correct sequence for this assessment?
,A. Inspect → Palpate → ROM (active and passive) → Joint stability
B. Palpate → Inspect → Joint stability → ROM
C. ROM → Inspect → Palpate → Joint stability
D. Joint stability → Inspect → Palpate → ROM
Correct Answer: A
Rationale: The standard sequence for musculoskeletal examination is: Inspection (observe
for deformity, swelling, asymmetry, skin changes), Palpation (assess for tenderness,
warmth, crepitus, effusions), Range of Motion (active first, then passive if limited), and Joint
Stability (special tests). This sequence follows the general physical examination principle of
least invasive to most invasive, beginning with visual observation before touching or
manipulating the joint.
10. A 65-year-old postmenopausal female is concerned about bone health. The nurse
practitioner explains that weakening bones in aging females are primarily due to:
A. Decreased physical activity
B. Increased bone resorption due to decreased estrogen and calcium demands
C. Excessive calcium supplementation
D. Increased osteoblastic activity
Correct Answer: B
Rationale: Postmenopausal females experience increased bone resorption due to
decreased estrogen levels, which normally suppresses osteoclast activity. The body also has
ongoing calcium demands for metabolic processes. A DEXA scan is the gold standard for
assessing bone mineral density and diagnosing osteoporosis. While decreased activity (A)
contributes to bone loss, the primary mechanism is hormonal. Excessive calcium (C) does
not cause weakening bones, and decreased—not increased—osteoblastic activity (D)
occurs with aging.
11. During a musculoskeletal examination, the nurse practitioner is assessing joint
symmetry. Which technique is most appropriate?
A. Palpation of bilateral joints simultaneously
B. Inspection of bilateral joints for comparison
C. Active ROM testing of one joint at a time
D. Percussion over joint spaces
Correct Answer: B
,Rationale: Joint symmetry is assessed through inspection by visually comparing bilateral
joints for alignment, size, contour, and skin changes. Simultaneous palpation (A) is used for
temperature comparison. Active ROM (C) assesses function rather than symmetry.
Percussion (D) is not a standard musculoskeletal assessment technique.
12. The nurse practitioner palpates a patient's knee and notes a soft, spongy sensation
around the joint line. This finding is described as:
A. Crepitus
B. Boggy
C. Indurated
D. Fluctuant
Correct Answer: B
Rationale: A boggy sensation on palpation indicates joint effusion—soft and spongy due to
accumulated synovial fluid within the joint capsule. Crepitus (A) is a grating sensation or
sound. Indurated (C) describes hardened tissue. Fluctuant (D) describes a wave-like
sensation suggestive of fluid but is not the specific term used for joint effusion palpation.
13. Select All That Apply: Which factors increase the risk for developing
osteoarthritis? (Select all that apply.)
A. Advanced age
B. Obesity
C. Smoking
D. Excessive alcohol consumption
E. Family history
F. Female gender
G. Overuse injuries
H. Chronic pain conditions
Correct Answers: A, B, C, D, E, F, G
Rationale: Risk factors for osteoarthritis include advanced age (A), obesity (B) (increases
mechanical stress on weight-bearing joints), smoking (C), excessive alcohol consumption
(D), family history (E), female gender (F), and overuse injuries (G). Chronic pain conditions
(H) are not a recognized risk factor for OA development, though pain is a symptom of
established OA.
,14. A 70-year-old patient presents with bony enlargements at the distal
interphalangeal joints of the fingers. The nurse practitioner identifies these as
Heberden's nodes. What is the recommended treatment?
A. Joint replacement surgery
B. Immobilization and rest
C. Exercise
D. High-dose corticosteroids
Correct Answer: C
Rationale: Heberden's nodes are bony enlargements at the distal interphalangeal joints
characteristic of osteoarthritis. The recommended treatment is exercise to maintain joint
mobility, strengthen surrounding muscles, and improve function. Joint replacement (A) is
reserved for severe, debilitating cases. Immobilization (B) leads to further stiffness and
functional decline. Corticosteroids (D) may provide symptomatic relief but are not first-line
treatment and do not alter disease progression.
15. A 22-year-old soccer player reports a twisting injury to the knee with a popping
sensation. During the examination, the nurse practitioner performs a test that elicits
a clicking sound. Which test is being performed?
A. Lachman test
B. McMurray test
C. Anterior drawer test
D. Apley's compression test
Correct Answer: B
Rationale: The McMurray test is performed to assess for meniscus injury. A positive test is
indicated by a clicking or popping sensation when the knee is flexed, rotated, and then
extended. The Lachman test (A) assesses ACL integrity. The anterior drawer test (C) also
evaluates the ACL. Apley's compression test (D) is another meniscal test but involves
compression rather than the characteristic clicking of McMurray.
16. During a newborn examination, the nurse practitioner performs tests to assess
for hip dislocation. Which tests are appropriate for this purpose?
A. Thomas test and Trendelenburg test
B. Barlow and Ortolani tests
, C. Patrick's test and FABER test
D. Ober test and Ely test
Correct Answer: B
Rationale: The Barlow and Ortolani tests are used in infants to detect developmental
dysplasia of the hip (DDH) and hip dislocation. The Barlow test attempts to dislocate an
unstable hip, while the Ortolani test reduces a dislocated hip with a characteristic "clunk."
These tests are common causes of leg length discrepancy in children. Thomas (A) and
Trendelenburg (A) assess hip flexion contractures and abductor weakness respectively.
Patrick/FABER (C) assesses sacroiliac joint pathology. Ober and Ely (D) assess iliotibial
band tightness and rectus femoris contracture.
17. A 60-year-old patient reports lower back pain that worsens when walking and
standing upright but improves when sitting or bending forward. Which test would
help confirm the suspected diagnosis?
A. Straight leg raise test
B. FABER test
C. Slump test
D. Kemp's test
Correct Answer: A
Rationale: The clinical presentation (pain with walking and upright posture, relief with
forward flexion) is characteristic of spinal stenosis. The straight leg raise test (also used for
herniated disc and lumbar radiculopathy) can help confirm the diagnosis by reproducing
radicular symptoms. Pain with walking that is relieved by sitting or bending forward is
classic neurogenic claudication from lumbar spinal stenosis. The FABER test (B) assesses
hip and sacroiliac pathology. The slump test (C) and Kemp's test (D) are also used for nerve
root tension but are not the primary test for spinal stenosis.
18. Select All That Apply: A patient with spinal stenosis typically presents with which
findings? (Select all that apply.)
A. Pain with movement
B. Pain specifically in the upright position
C. Pain with walking
D. Pain that improves with lumbar extension
E. Relief with sitting or bending forward
