NSG 500 ADVANCED HEALTH
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a pearly, translucent papule on the forehead that has a
central depression and telangiectasia. What is the most likely diagnosis?
A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Malignant melanoma
D. Actinic keratosis
Answer: B
Conceptual Explanation: Basal cell carcinoma typically presents as a pearly, translucent
papule with telangiectasia and often a central ulceration or ‘umbilication’.
2. During a funduscopic examination, the nurse practitioner notes copper wiring and
arteriovenous (AV) nicking. These findings are most consistent with which condition?
A. Diabetic retinopathy
B. Hypertensive retinopathy
C. Glaucoma
,D. Macular degeneration
Answer: B
Conceptual Explanation: Chronic hypertension causes narrowing of the retinal arteries
(copper wiring) and compression of the veins at crossing points (AV nicking).
3. A patient complains of a sudden, severe ‘thunderclap’ headache. This symptom is a red flag
for which of the following?
A. Migraine with aura
B. Temporal arteritis
C. Subarachnoid hemorrhage
D. Cluster headache
Answer: C
Conceptual Explanation: A ‘thunderclap’ headache is a classic presentation of a
subarachnoid hemorrhage and requires immediate neuroimaging.
4. In the Rinne test, a patient with conductive hearing loss in the right ear will demonstrate
which result?
A. Air conduction is greater than bone conduction (AC > BC)
B. Lateralization to the unaffected ear
C. Bone conduction is greater than or equal to air conduction (BC >= AC)
D. Equal time for both AC and BC
, Answer: C
Conceptual Explanation: In conductive hearing loss, bone conduction is heard longer than
or equal to air conduction because sound bypasses the obstructed external/middle ear.
5. Which heart sound is considered a hallmark sign of heart failure in an older adult,
representing ventricular gallop during early diastole?
A. S1
B. S2
C. S4
D. S3
Answer: D
Conceptual Explanation: S3 occurs during the rapid filling phase of diastole and is often
an indicator of fluid overload or ventricular failure in adults.
6. A patient exhibits pain when pressure is applied to the Right Lower Quadrant (RLQ) and
then suddenly released. This finding is known as:
A. Murphy’s sign
B. Rebound tenderness
C. Rovsing’s sign
D. Psoas sign
Answer: B
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a pearly, translucent papule on the forehead that has a
central depression and telangiectasia. What is the most likely diagnosis?
A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Malignant melanoma
D. Actinic keratosis
Answer: B
Conceptual Explanation: Basal cell carcinoma typically presents as a pearly, translucent
papule with telangiectasia and often a central ulceration or ‘umbilication’.
2. During a funduscopic examination, the nurse practitioner notes copper wiring and
arteriovenous (AV) nicking. These findings are most consistent with which condition?
A. Diabetic retinopathy
B. Hypertensive retinopathy
C. Glaucoma
,D. Macular degeneration
Answer: B
Conceptual Explanation: Chronic hypertension causes narrowing of the retinal arteries
(copper wiring) and compression of the veins at crossing points (AV nicking).
3. A patient complains of a sudden, severe ‘thunderclap’ headache. This symptom is a red flag
for which of the following?
A. Migraine with aura
B. Temporal arteritis
C. Subarachnoid hemorrhage
D. Cluster headache
Answer: C
Conceptual Explanation: A ‘thunderclap’ headache is a classic presentation of a
subarachnoid hemorrhage and requires immediate neuroimaging.
4. In the Rinne test, a patient with conductive hearing loss in the right ear will demonstrate
which result?
A. Air conduction is greater than bone conduction (AC > BC)
B. Lateralization to the unaffected ear
C. Bone conduction is greater than or equal to air conduction (BC >= AC)
D. Equal time for both AC and BC
, Answer: C
Conceptual Explanation: In conductive hearing loss, bone conduction is heard longer than
or equal to air conduction because sound bypasses the obstructed external/middle ear.
5. Which heart sound is considered a hallmark sign of heart failure in an older adult,
representing ventricular gallop during early diastole?
A. S1
B. S2
C. S4
D. S3
Answer: D
Conceptual Explanation: S3 occurs during the rapid filling phase of diastole and is often
an indicator of fluid overload or ventricular failure in adults.
6. A patient exhibits pain when pressure is applied to the Right Lower Quadrant (RLQ) and
then suddenly released. This finding is known as:
A. Murphy’s sign
B. Rebound tenderness
C. Rovsing’s sign
D. Psoas sign
Answer: B
