ADVANCED HEALTH ASSESSMENT
FINAL EXAM (NSG 5140) QUESTIONS
AND ANSWERS
1. When assessing Jugular Venous Pressure (JVP), the clinician observes the vertical distance
between the sternal angle and the highest point of pulsation. What is considered the upper
limit of normal for this measurement?
A. 2 cm
B. 5 cm
C. 3 cm
D. 8 cm
Answer: C
Conceptual Explanation: A JVP measurement of more than 3 cm above the sternal angle
(or more than 8 cm total distance from the right atrium) is considered elevated and
suggests right-sided heart failure or fluid overload.
,2. A 65-year-old patient presents with a mid-systolic crescendo-decrescendo murmur at the
second right intercostal space that radiates to the carotid arteries. This most likely indicates:
A. Mitral Regurgitation
B. Mitral Valve Prolapse
C. Pulmonic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis typically presents with a harsh systolic
crescendo-decrescendo murmur at the right second intercostal space, often radiating to the
carotids.
3. During a respiratory assessment, the clinician notes increased tactile fremitus over the
right lower lobe. This finding is most consistent with:
A. Pneumothorax
B. Lobar Pneumonia
C. Pleural Effusion
D. COPD
Answer: B
, Conceptual Explanation: Tactile fremitus increases with lung consolidation, such as in
pneumonia, because solid or fluid-filled tissue conducts vibrations more efficiently than
air-filled tissue.
4. Which physical examination maneuver is specifically used to assess for a torn anterior
cruciate ligament (ACL)?
A. McMurray Test
B. Bulge Sign
C. Phalen’s Sign
D. Lachman Test
Answer: D
Conceptual Explanation: The Lachman test is highly sensitive for ACL injury. McMurray is
for meniscal tears, Phalen’s is for carpal tunnel, and the Bulge sign is for minor knee
effusions.
5. A patient exhibits a positive Murphy’s sign. This finding is pathognomonic for:
A. Acute Appendicitis
B. Acute Cholecystitis
C. Acute Pancreatitis
D. Splenic Rupture
Answer: B
FINAL EXAM (NSG 5140) QUESTIONS
AND ANSWERS
1. When assessing Jugular Venous Pressure (JVP), the clinician observes the vertical distance
between the sternal angle and the highest point of pulsation. What is considered the upper
limit of normal for this measurement?
A. 2 cm
B. 5 cm
C. 3 cm
D. 8 cm
Answer: C
Conceptual Explanation: A JVP measurement of more than 3 cm above the sternal angle
(or more than 8 cm total distance from the right atrium) is considered elevated and
suggests right-sided heart failure or fluid overload.
,2. A 65-year-old patient presents with a mid-systolic crescendo-decrescendo murmur at the
second right intercostal space that radiates to the carotid arteries. This most likely indicates:
A. Mitral Regurgitation
B. Mitral Valve Prolapse
C. Pulmonic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis typically presents with a harsh systolic
crescendo-decrescendo murmur at the right second intercostal space, often radiating to the
carotids.
3. During a respiratory assessment, the clinician notes increased tactile fremitus over the
right lower lobe. This finding is most consistent with:
A. Pneumothorax
B. Lobar Pneumonia
C. Pleural Effusion
D. COPD
Answer: B
, Conceptual Explanation: Tactile fremitus increases with lung consolidation, such as in
pneumonia, because solid or fluid-filled tissue conducts vibrations more efficiently than
air-filled tissue.
4. Which physical examination maneuver is specifically used to assess for a torn anterior
cruciate ligament (ACL)?
A. McMurray Test
B. Bulge Sign
C. Phalen’s Sign
D. Lachman Test
Answer: D
Conceptual Explanation: The Lachman test is highly sensitive for ACL injury. McMurray is
for meniscal tears, Phalen’s is for carpal tunnel, and the Bulge sign is for minor knee
effusions.
5. A patient exhibits a positive Murphy’s sign. This finding is pathognomonic for:
A. Acute Appendicitis
B. Acute Cholecystitis
C. Acute Pancreatitis
D. Splenic Rupture
Answer: B
