WEST COAST UNIVERSITY
NURS 190: PHYSICAL ASSESSMENT
FINAL EXAMINATION
100 QUESTIONS WITH CORRECT ANSWERS &
RATIONALES
LATEST VERSION 2026/2027
1. The nurse is caring for a client who was admitted to the medical unit. The
nurse notes in the physical exam done by the physician that the client has a
positive Romberg. When meeting elimination needs for this client, the nurse
would perform which of the following interventions?
A. obtain an order for a catheter
B. limit fluid intake
C. obtain a bedside commode
D. allow the client to walk independently
Correct Answer: C. obtain a bedside commode
Rationale: A positive Romberg test indicates that the client has difficulty
maintaining balance with eyes closed, suggesting proprioception or vestibular
impairment. This puts the client at risk for falls. A bedside commode is the
safest option to meet elimination needs while preventing falls. Allowing
independent walking would be unsafe, catheterization is invasive and not
indicated, and limiting fluids is inappropriate.
2. The nurse observes drainage from a client's ears after a head injury, and
suspects a cerebral spinal fluid (CSF) leak. The nurse would document which
of the following descriptions of the drainage?
,A. blood-tinged without sediment
B. pink without sediment
C. yellow without sediment
D. clear, colourless
Correct Answer: D. clear, colourless
Rationale: CSF drainage from the ears (otorrhea) after head injury is clear and
colourless, resembling water. It may also test positive for glucose. Blood-tinged,
pink, or yellow drainage would suggest other types of fluid such as blood or
purulent drainage.
3. The nurse is performing a neurological assessment on a client and needs to
use stereognosis. Which of the following instructions would the nurse
provide for the client?
A. "Identify the number being traced in your hand with your eyes closed."
B. "Identify the object in your hand with your eyes closed."
C. "Tell me if you feel one or two objects touching you with your eyes closed."
D. "Open and close your hand each time I tell you to."
Correct Answer: B. "Identify the object in your hand with your eyes closed."
Rationale: Stereognosis is the ability to recognize objects by touch alone. The
nurse places a familiar object (like a key or coin) in the client's hand and asks
them to identify it with their eyes closed. Option A describes graphesthesia,
option C describes two-point discrimination, and option D tests motor function.
4. The nurse notes fanning of the toes when the sole of the foot is stimulated
during assessment of the plantar reflex. The nurse would correctly chart
which of the following?
A. Brudzinski sign
B. nuchal rigidity
C. hyperreflexia
D. Babinski response
,Correct Answer: D. Babinski response
Rationale: A Babinski response is characterized by dorsiflexion of the great toe
and fanning of the other toes when the sole of the foot is stroked. This is an
abnormal finding in adults and indicates upper motor neuron dysfunction.
Brudzinski sign and nuchal rigidity are associated with meningitis.
5. The nurse is assessing a female client and notes facial hirsutism. The client
asks the nurse why this has happened to her. The nurse would correctly
respond with which of the following statements?
A. "Your diet is not nutritionally balanced."
B. "You need to take vitamins."
C. "There is not a known cause for this condition."
D. "You may have some hormone imbalances."
Correct Answer: D. "You may have some hormone imbalances."
Rationale: Hirsutism (excessive hair growth in a male pattern) in women is
often related to hormonal imbalances, particularly excess androgens. It can be
associated with conditions such as polycystic ovary syndrome (PCOS), adrenal
disorders, or certain medications.
6. The nurse is assessing the patellar reflex on a client and obtains no reflex
activity. The client is alert and oriented. The nurse should do which of the
following in this situation?
A. look at the medication records for central nervous system depressants
B. retest the reflex after having the client use distraction during the exam
C. notify the physician immediately
D. document the findings as normal
Correct Answer: B. retest the reflex after having the client use distraction
during the exam
Rationale: Absent reflexes (areflexia) may be due to the client being overly
anxious or tense, which can inhibit the reflex response. Using distraction
, techniques (such as having the client clench their teeth or squeeze their hands
together) can help elicit the reflex. If still absent after retesting, further
evaluation would be needed.
7. The nurse is caring for a client that insists on having their food very hot and
very cold at each meal. The nurse correctly recognizes this as a health belief
in which of the following cultural groups?
A. Chinese Americans
B. Native Americans
C. Cuban Americans
D. Jewish Americans
Correct Answer: A. Chinese Americans
Rationale: In traditional Chinese culture, food is classified as "hot" or "cold"
based on its perceived effect on the body's balance, not its temperature. This
belief is part of the traditional Chinese medicine concept of yin and yang
balance, where illness is thought to result from imbalance.
8. The nurse is caring for a client who is a long-time smoker and notes
clubbing of the fingers. The nurse utilizes which of the following techniques
to validate this assessment?
A. place two of the same fingers from each hand together
B. place the hands out straight with the palm sides down
C. place two index fingers together tip to tip
D. place two thumbs touching side by side
Correct Answer: C. place two index fingers together tip to tip
Rationale: The Schroth’s window test is used to assess for clubbing. The client
places the nails of their two index fingers together, back-to-back. Normally, a
diamond-shaped window of light is visible between the nail beds. In clubbing,
this window disappears due to increased nail bed angle.
NURS 190: PHYSICAL ASSESSMENT
FINAL EXAMINATION
100 QUESTIONS WITH CORRECT ANSWERS &
RATIONALES
LATEST VERSION 2026/2027
1. The nurse is caring for a client who was admitted to the medical unit. The
nurse notes in the physical exam done by the physician that the client has a
positive Romberg. When meeting elimination needs for this client, the nurse
would perform which of the following interventions?
A. obtain an order for a catheter
B. limit fluid intake
C. obtain a bedside commode
D. allow the client to walk independently
Correct Answer: C. obtain a bedside commode
Rationale: A positive Romberg test indicates that the client has difficulty
maintaining balance with eyes closed, suggesting proprioception or vestibular
impairment. This puts the client at risk for falls. A bedside commode is the
safest option to meet elimination needs while preventing falls. Allowing
independent walking would be unsafe, catheterization is invasive and not
indicated, and limiting fluids is inappropriate.
2. The nurse observes drainage from a client's ears after a head injury, and
suspects a cerebral spinal fluid (CSF) leak. The nurse would document which
of the following descriptions of the drainage?
,A. blood-tinged without sediment
B. pink without sediment
C. yellow without sediment
D. clear, colourless
Correct Answer: D. clear, colourless
Rationale: CSF drainage from the ears (otorrhea) after head injury is clear and
colourless, resembling water. It may also test positive for glucose. Blood-tinged,
pink, or yellow drainage would suggest other types of fluid such as blood or
purulent drainage.
3. The nurse is performing a neurological assessment on a client and needs to
use stereognosis. Which of the following instructions would the nurse
provide for the client?
A. "Identify the number being traced in your hand with your eyes closed."
B. "Identify the object in your hand with your eyes closed."
C. "Tell me if you feel one or two objects touching you with your eyes closed."
D. "Open and close your hand each time I tell you to."
Correct Answer: B. "Identify the object in your hand with your eyes closed."
Rationale: Stereognosis is the ability to recognize objects by touch alone. The
nurse places a familiar object (like a key or coin) in the client's hand and asks
them to identify it with their eyes closed. Option A describes graphesthesia,
option C describes two-point discrimination, and option D tests motor function.
4. The nurse notes fanning of the toes when the sole of the foot is stimulated
during assessment of the plantar reflex. The nurse would correctly chart
which of the following?
A. Brudzinski sign
B. nuchal rigidity
C. hyperreflexia
D. Babinski response
,Correct Answer: D. Babinski response
Rationale: A Babinski response is characterized by dorsiflexion of the great toe
and fanning of the other toes when the sole of the foot is stroked. This is an
abnormal finding in adults and indicates upper motor neuron dysfunction.
Brudzinski sign and nuchal rigidity are associated with meningitis.
5. The nurse is assessing a female client and notes facial hirsutism. The client
asks the nurse why this has happened to her. The nurse would correctly
respond with which of the following statements?
A. "Your diet is not nutritionally balanced."
B. "You need to take vitamins."
C. "There is not a known cause for this condition."
D. "You may have some hormone imbalances."
Correct Answer: D. "You may have some hormone imbalances."
Rationale: Hirsutism (excessive hair growth in a male pattern) in women is
often related to hormonal imbalances, particularly excess androgens. It can be
associated with conditions such as polycystic ovary syndrome (PCOS), adrenal
disorders, or certain medications.
6. The nurse is assessing the patellar reflex on a client and obtains no reflex
activity. The client is alert and oriented. The nurse should do which of the
following in this situation?
A. look at the medication records for central nervous system depressants
B. retest the reflex after having the client use distraction during the exam
C. notify the physician immediately
D. document the findings as normal
Correct Answer: B. retest the reflex after having the client use distraction
during the exam
Rationale: Absent reflexes (areflexia) may be due to the client being overly
anxious or tense, which can inhibit the reflex response. Using distraction
, techniques (such as having the client clench their teeth or squeeze their hands
together) can help elicit the reflex. If still absent after retesting, further
evaluation would be needed.
7. The nurse is caring for a client that insists on having their food very hot and
very cold at each meal. The nurse correctly recognizes this as a health belief
in which of the following cultural groups?
A. Chinese Americans
B. Native Americans
C. Cuban Americans
D. Jewish Americans
Correct Answer: A. Chinese Americans
Rationale: In traditional Chinese culture, food is classified as "hot" or "cold"
based on its perceived effect on the body's balance, not its temperature. This
belief is part of the traditional Chinese medicine concept of yin and yang
balance, where illness is thought to result from imbalance.
8. The nurse is caring for a client who is a long-time smoker and notes
clubbing of the fingers. The nurse utilizes which of the following techniques
to validate this assessment?
A. place two of the same fingers from each hand together
B. place the hands out straight with the palm sides down
C. place two index fingers together tip to tip
D. place two thumbs touching side by side
Correct Answer: C. place two index fingers together tip to tip
Rationale: The Schroth’s window test is used to assess for clubbing. The client
places the nails of their two index fingers together, back-to-back. Normally, a
diamond-shaped window of light is visible between the nail beds. In clubbing,
this window disappears due to increased nail bed angle.
