NSG 500 ADVANCED HEALTH
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS 2027
1. A 65-year-old patient presents with a mid-systolic crescendo-decrescendo murmur heard
best at the 2nd right intercostal space, which radiates to the carotid arteries. Which condition
is most likely?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: A
Conceptual Explanation: Aortic stenosis is characterized by a mid-systolic ejection
murmur at the right upper sternal border that often radiates to the neck.
2. When performing the Weber test, a patient with conductive hearing loss in the right ear
will experience which of the following?
A. Sound lateralizes to the left ear
B. Sound is heard equally in both ears
,C. Sound lateralizes to the right ear
D. Sound is not heard at all
Answer: C
Conceptual Explanation: In conductive hearing loss, the sound lateralizes to the impaired
ear because the impaired ear is not distracted by background room noise.
3. During a respiratory assessment, the nurse practitioner notes increased tactile fremitus
over the right lower lobe. This finding is most consistent with:
A. Pneumothorax
B. Pleural Effusion
C. Emphysema
D. Lobar Pneumonia
Answer: D
Conceptual Explanation: Tactile fremitus is increased in conditions where lung tissue is
consolidated, such as pneumonia, because sound travels better through solid/liquid media
than air.
4. Which cranial nerve is being tested when the clinician asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN XI (Spinal Accessory)
, C. CN X (Vagus)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: Cranial nerve XI innervates the trapezius and
sternocleidomastoid muscles; shrugging tests the trapezius.
5. A positive Murphy’s sign is indicative of which inflammatory process?
A. Acute Appendicitis
B. Acute Cholecystitis
C. Acute Pancreatitis
D. Diverticulitis
Answer: B
Conceptual Explanation: Murphy’s sign involves sharp pain and inspiratory arrest upon
palpation of the gallbladder area, indicating cholecystitis.
6. While assessing the eyes, the clinician notes a rhythmic, involuntary oscillation of the eyes.
This is documented as:
A. Strabismus
B. Ptosis
C. Exophthalmos
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS 2027
1. A 65-year-old patient presents with a mid-systolic crescendo-decrescendo murmur heard
best at the 2nd right intercostal space, which radiates to the carotid arteries. Which condition
is most likely?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: A
Conceptual Explanation: Aortic stenosis is characterized by a mid-systolic ejection
murmur at the right upper sternal border that often radiates to the neck.
2. When performing the Weber test, a patient with conductive hearing loss in the right ear
will experience which of the following?
A. Sound lateralizes to the left ear
B. Sound is heard equally in both ears
,C. Sound lateralizes to the right ear
D. Sound is not heard at all
Answer: C
Conceptual Explanation: In conductive hearing loss, the sound lateralizes to the impaired
ear because the impaired ear is not distracted by background room noise.
3. During a respiratory assessment, the nurse practitioner notes increased tactile fremitus
over the right lower lobe. This finding is most consistent with:
A. Pneumothorax
B. Pleural Effusion
C. Emphysema
D. Lobar Pneumonia
Answer: D
Conceptual Explanation: Tactile fremitus is increased in conditions where lung tissue is
consolidated, such as pneumonia, because sound travels better through solid/liquid media
than air.
4. Which cranial nerve is being tested when the clinician asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN XI (Spinal Accessory)
, C. CN X (Vagus)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: Cranial nerve XI innervates the trapezius and
sternocleidomastoid muscles; shrugging tests the trapezius.
5. A positive Murphy’s sign is indicative of which inflammatory process?
A. Acute Appendicitis
B. Acute Cholecystitis
C. Acute Pancreatitis
D. Diverticulitis
Answer: B
Conceptual Explanation: Murphy’s sign involves sharp pain and inspiratory arrest upon
palpation of the gallbladder area, indicating cholecystitis.
6. While assessing the eyes, the clinician notes a rhythmic, involuntary oscillation of the eyes.
This is documented as:
A. Strabismus
B. Ptosis
C. Exophthalmos
