NSG 500 ADVANCED HEALTH
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. During a comprehensive health history, a patient reports a ‘tearing’ sensation in the upper
abdomen radiating to the back. Which differential diagnosis should the provider prioritize?
A. Acute cholecystitis
B. Abdominal aortic aneurysm
C. Peptic ulcer disease
D. Acute pancreatitis
Answer: B
Conceptual Explanation: A tearing sensation radiating to the back is a classic clinical
indicator of an aortic dissection or expanding abdominal aortic aneurysm, requiring
immediate intervention.
2. When assessing the pupillary light reflex, the provider notes that the consensual response
is absent in the left eye when light is shone into the right eye. This indicates a lesion in which
cranial nerve?
A. Left Cranial Nerve III
,B. Right Cranial Nerve II
C. Right Cranial Nerve III
D. Left Cranial Nerve II
Answer: A
Conceptual Explanation: The consensual light reflex is mediated by the efferent pathway
of the oculomotor nerve (CN III). Absence in the left eye while the right eye constricts
suggest a left-sided CN III deficit.
3. Which of the following physical exam findings is most specific for a diagnosis of bacterial
meningitis in an adult?
A. Positive Brudzinski sign
B. Generalized headache
C. Nuchal rigidity
D. Positive Kernig sign
Answer: A
Conceptual Explanation: While all are seen in meningitis, the Brudzinski sign (flexion of
hips and knees in response to neck flexion) is highly specific for meningeal irritation.
, 4. A 65-year-old patient presents with a history of tobacco use and chronic cough. Upon
percussion of the chest, the provider notes hyperresonance. This finding is most consistent
with:
A. Lobar pneumonia
B. Emphysema
C. Pleural effusion
D. Atelectasis
Answer: B
Conceptual Explanation: Hyperresonance occurs when there is an increased amount of
air in the lungs or pleural space, common in COPD/emphysema.
5. In the evaluation of a cardiac murmur, the provider hears a mid-systolic click followed by a
late systolic murmur at the apex. This is most likely:
A. Mitral valve prolapse
B. Aortic regurgitation
C. Mitral stenosis
D. Ventricular septal defect
Answer: A
Conceptual Explanation: Mitral valve prolapse (MVP) is characteristically identified by a
mid-systolic click and a following systolic murmur.
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. During a comprehensive health history, a patient reports a ‘tearing’ sensation in the upper
abdomen radiating to the back. Which differential diagnosis should the provider prioritize?
A. Acute cholecystitis
B. Abdominal aortic aneurysm
C. Peptic ulcer disease
D. Acute pancreatitis
Answer: B
Conceptual Explanation: A tearing sensation radiating to the back is a classic clinical
indicator of an aortic dissection or expanding abdominal aortic aneurysm, requiring
immediate intervention.
2. When assessing the pupillary light reflex, the provider notes that the consensual response
is absent in the left eye when light is shone into the right eye. This indicates a lesion in which
cranial nerve?
A. Left Cranial Nerve III
,B. Right Cranial Nerve II
C. Right Cranial Nerve III
D. Left Cranial Nerve II
Answer: A
Conceptual Explanation: The consensual light reflex is mediated by the efferent pathway
of the oculomotor nerve (CN III). Absence in the left eye while the right eye constricts
suggest a left-sided CN III deficit.
3. Which of the following physical exam findings is most specific for a diagnosis of bacterial
meningitis in an adult?
A. Positive Brudzinski sign
B. Generalized headache
C. Nuchal rigidity
D. Positive Kernig sign
Answer: A
Conceptual Explanation: While all are seen in meningitis, the Brudzinski sign (flexion of
hips and knees in response to neck flexion) is highly specific for meningeal irritation.
, 4. A 65-year-old patient presents with a history of tobacco use and chronic cough. Upon
percussion of the chest, the provider notes hyperresonance. This finding is most consistent
with:
A. Lobar pneumonia
B. Emphysema
C. Pleural effusion
D. Atelectasis
Answer: B
Conceptual Explanation: Hyperresonance occurs when there is an increased amount of
air in the lungs or pleural space, common in COPD/emphysema.
5. In the evaluation of a cardiac murmur, the provider hears a mid-systolic click followed by a
late systolic murmur at the apex. This is most likely:
A. Mitral valve prolapse
B. Aortic regurgitation
C. Mitral stenosis
D. Ventricular septal defect
Answer: A
Conceptual Explanation: Mitral valve prolapse (MVP) is characteristically identified by a
mid-systolic click and a following systolic murmur.
