NURS 6512 ADVANCED HEALTH ASSESSMENT
MIDTERM EXAM BANK | 184 Q&AS WITH
RATIONALES | LATEST VERFIED VERSION
, Question 1
During a comprehensive physical examination of a 48-year-old patient, you
notice a flat, vascular skin lesion that blanches completely when light pressure
is applied with a glass slide. When the pressure is released, the lesion refills
symmetrically from the central arteriole outward. How should you document
this finding?
A) Cherry angioma
B) Spider angioma
C) Petechiae
D) Purpura
Correct Answer: B) Spider angioma
Explanation: A spider angioma is a vascular lesion characterized by a fiery
red central clearing arteriole surrounded by erythema and radiating capillary
legs. It is highly sensitive to pressure and blanches fully because you are
temporarily occluding the feeding arteriole. Cherry angiomas do not typically
blanch completely, while petechiae and purpura represent extravasated blood
outside the vessels and never blanch.
Question 2
When performing a cranial nerve assessment on an adult patient, you ask the
patient to tightly close their eyes against resistance, smile broadly, and puff out
, their cheeks. Which cranial nerve are you directly evaluating?
A) Cranial Nerve V (Trigeminal)
B) Cranial Nerve VII (Facial)
C) Cranial Nerve XI (Spinal Accessory)
D) Cranial Nerve XII (Hypoglossal)
Correct Answer: B) Cranial Nerve VII (Facial)
Explanation: Cranial Nerve VII (the facial nerve) is responsible for
controlling the muscles of facial expression. Actions such as smiling,
frowning, puffing cheeks, and tightly closing the eyelids test the motor branch
of this nerve. Cranial nerve V tests facial sensation and mastication muscles,
while CN XI controls neck movement and CN XII controls tongue deviation.
Question 3
An advanced practice nurse is conducting a physical assessment on a 4-year-old
child presenting with a suspected upper respiratory tract infection. When
attempting to palpate the paranasal sinuses, which sinuses are physically
developed enough to be clinically examined in a child of this age?
A) Frontal and ethmoid sinuses
B) Maxillary and frontal sinuses
C) Maxillary and ethmoid sinuses
D) Sphenoid and frontal sinuses
Correct Answer: C) Maxillary and ethmoid sinuses
Explanation: Only the maxillary and ethmoid sinuses are present and
clinically significant at birth or early childhood. The frontal sinuses do not
begin developing significantly until around age 5 to 7 and are not fully
, developed until adolescence. Therefore, palpating for frontal sinus tenderness
in a 4-year-old is clinically inaccurate.
Question 4
A 68-year-old patient presents with acute neck pain and stiffness. During the
examination, you attempt to flex the patient's neck forward toward the chest.
The patient experiences severe resistance and pain, and you observe involuntary
flexion of the patient's hips and knees. How should this positive reflex sign be
documented?
A) Positive Kernig sign
B) Positive Babinski sign
C) Positive Brudzinski sign
D) Positive Romberg sign
Correct Answer: C) Positive Brudzinski sign
Explanation: The Brudzinski sign is a classic clinical indicator of meningeal
irritation or nuchal rigidity. It occurs when passive flexion of the neck
induces involuntary flexion of the hips and knees. A positive Kernig sign
involves pain or resistance when extending the knee from a flexed hip
position. Romberg tests proprioception/balance.
Question 5
MIDTERM EXAM BANK | 184 Q&AS WITH
RATIONALES | LATEST VERFIED VERSION
, Question 1
During a comprehensive physical examination of a 48-year-old patient, you
notice a flat, vascular skin lesion that blanches completely when light pressure
is applied with a glass slide. When the pressure is released, the lesion refills
symmetrically from the central arteriole outward. How should you document
this finding?
A) Cherry angioma
B) Spider angioma
C) Petechiae
D) Purpura
Correct Answer: B) Spider angioma
Explanation: A spider angioma is a vascular lesion characterized by a fiery
red central clearing arteriole surrounded by erythema and radiating capillary
legs. It is highly sensitive to pressure and blanches fully because you are
temporarily occluding the feeding arteriole. Cherry angiomas do not typically
blanch completely, while petechiae and purpura represent extravasated blood
outside the vessels and never blanch.
Question 2
When performing a cranial nerve assessment on an adult patient, you ask the
patient to tightly close their eyes against resistance, smile broadly, and puff out
, their cheeks. Which cranial nerve are you directly evaluating?
A) Cranial Nerve V (Trigeminal)
B) Cranial Nerve VII (Facial)
C) Cranial Nerve XI (Spinal Accessory)
D) Cranial Nerve XII (Hypoglossal)
Correct Answer: B) Cranial Nerve VII (Facial)
Explanation: Cranial Nerve VII (the facial nerve) is responsible for
controlling the muscles of facial expression. Actions such as smiling,
frowning, puffing cheeks, and tightly closing the eyelids test the motor branch
of this nerve. Cranial nerve V tests facial sensation and mastication muscles,
while CN XI controls neck movement and CN XII controls tongue deviation.
Question 3
An advanced practice nurse is conducting a physical assessment on a 4-year-old
child presenting with a suspected upper respiratory tract infection. When
attempting to palpate the paranasal sinuses, which sinuses are physically
developed enough to be clinically examined in a child of this age?
A) Frontal and ethmoid sinuses
B) Maxillary and frontal sinuses
C) Maxillary and ethmoid sinuses
D) Sphenoid and frontal sinuses
Correct Answer: C) Maxillary and ethmoid sinuses
Explanation: Only the maxillary and ethmoid sinuses are present and
clinically significant at birth or early childhood. The frontal sinuses do not
begin developing significantly until around age 5 to 7 and are not fully
, developed until adolescence. Therefore, palpating for frontal sinus tenderness
in a 4-year-old is clinically inaccurate.
Question 4
A 68-year-old patient presents with acute neck pain and stiffness. During the
examination, you attempt to flex the patient's neck forward toward the chest.
The patient experiences severe resistance and pain, and you observe involuntary
flexion of the patient's hips and knees. How should this positive reflex sign be
documented?
A) Positive Kernig sign
B) Positive Babinski sign
C) Positive Brudzinski sign
D) Positive Romberg sign
Correct Answer: C) Positive Brudzinski sign
Explanation: The Brudzinski sign is a classic clinical indicator of meningeal
irritation or nuchal rigidity. It occurs when passive flexion of the neck
induces involuntary flexion of the hips and knees. A positive Kernig sign
involves pain or resistance when extending the knee from a flexed hip
position. Romberg tests proprioception/balance.
Question 5
