NSG 6020 MIDTERM EXAM - HEALTH
ASSESSMENT QUESTIONS AND
ANSWERS
1. When assessing a patient with suspected appendicitis, the clinician performs deep
palpation in the left lower quadrant, which results in pain in the right lower quadrant. This
finding is known as:
A. Murphy’s sign
B. Rovsing’s sign
C. Psoas sign
D. Obturator sign
Answer: B
Conceptual Explanation: Rovsing’s sign is pain felt in the right lower quadrant upon
palpation of the left lower quadrant, indicative of peritoneal irritation seen in appendicitis.
2. In a patient with a suspected pleural effusion, the clinician would expect to find which of
the following during the physical examination?
A. Hyperresonance on percussion
B. Increased tactile fremitus
,C. Decreased or absent breath sounds
D. Pectoriloquy
Answer: C
Conceptual Explanation: Pleural effusion involves fluid in the pleural space which
insulates the transmission of sound, leading to decreased breath sounds and decreased
tactile fremitus.
3. Which heart sound is most commonly associated with heart failure and fluid volume
overload in an older adult?
A. S4 (Atrial gallop)
B. S3 (Ventricular gallop)
C. S1 (Mitral/Tricuspid closure)
D. Opening snap
Answer: B
Conceptual Explanation: S3 is a low-frequency sound occurring in early diastole, often
representing a pathologically dilated ventricle or volume overload in older adults.
4. During the Weber test, a patient with conductive hearing loss in the right ear will
experience sound lateralization to which side?
A. The right ear
B. Both ears equally
, C. The left ear
D. Neither ear
E. N/A
Answer: A
Conceptual Explanation: In conductive hearing loss, the sound lateralizes to the impaired
ear because the ‘noisy’ background of the room is not heard, allowing the vibrations to be
perceived more clearly.
5. A 65-year-old male presents with a history of tobacco use and complaints of calf pain when
walking that is relieved by rest. On examination, the clinician notes thin, shiny skin and
diminished pedal pulses. This is most characteristic of:
A. Chronic Venous Insufficiency
B. Peripheral Arterial Disease (PAD)
C. Deep Vein Thrombosis
D. Raynaud’s Phenomenon
Answer: B
Conceptual Explanation: Intermittent claudication, thin/shiny skin, and diminished
pulses are classic markers of PAD due to arterial narrowing.
ASSESSMENT QUESTIONS AND
ANSWERS
1. When assessing a patient with suspected appendicitis, the clinician performs deep
palpation in the left lower quadrant, which results in pain in the right lower quadrant. This
finding is known as:
A. Murphy’s sign
B. Rovsing’s sign
C. Psoas sign
D. Obturator sign
Answer: B
Conceptual Explanation: Rovsing’s sign is pain felt in the right lower quadrant upon
palpation of the left lower quadrant, indicative of peritoneal irritation seen in appendicitis.
2. In a patient with a suspected pleural effusion, the clinician would expect to find which of
the following during the physical examination?
A. Hyperresonance on percussion
B. Increased tactile fremitus
,C. Decreased or absent breath sounds
D. Pectoriloquy
Answer: C
Conceptual Explanation: Pleural effusion involves fluid in the pleural space which
insulates the transmission of sound, leading to decreased breath sounds and decreased
tactile fremitus.
3. Which heart sound is most commonly associated with heart failure and fluid volume
overload in an older adult?
A. S4 (Atrial gallop)
B. S3 (Ventricular gallop)
C. S1 (Mitral/Tricuspid closure)
D. Opening snap
Answer: B
Conceptual Explanation: S3 is a low-frequency sound occurring in early diastole, often
representing a pathologically dilated ventricle or volume overload in older adults.
4. During the Weber test, a patient with conductive hearing loss in the right ear will
experience sound lateralization to which side?
A. The right ear
B. Both ears equally
, C. The left ear
D. Neither ear
E. N/A
Answer: A
Conceptual Explanation: In conductive hearing loss, the sound lateralizes to the impaired
ear because the ‘noisy’ background of the room is not heard, allowing the vibrations to be
perceived more clearly.
5. A 65-year-old male presents with a history of tobacco use and complaints of calf pain when
walking that is relieved by rest. On examination, the clinician notes thin, shiny skin and
diminished pedal pulses. This is most characteristic of:
A. Chronic Venous Insufficiency
B. Peripheral Arterial Disease (PAD)
C. Deep Vein Thrombosis
D. Raynaud’s Phenomenon
Answer: B
Conceptual Explanation: Intermittent claudication, thin/shiny skin, and diminished
pulses are classic markers of PAD due to arterial narrowing.
