NU 650 MIDTERM EXAM – ADVANCED
HEALTH ASSESSMENT QUESTIONS
AND ANSWERS
1. When performing a physical examination on a patient with suspected aortic stenosis,
which of the following findings is most characteristic of this condition?
A. A high-pitched decrescendo diastolic murmur heard best at the left sternal border.
B. A harsh systolic crescendo-decrescendo murmur radiating to the carotids.
C. A mid-systolic click followed by a late systolic murmur.
D. A holosystolic murmur that increases in intensity with inspiration.
Answer: B
Conceptual Explanation: Aortic stenosis typically presents as a harsh systolic crescendo-
decrescendo murmur heard best at the right second intercostal space, often radiating to the
carotid arteries.
,2. During a neurological exam, you ask the patient to perform the Romberg test. The patient
stands with feet together and eyes closed, then begins to sway significantly and loses
balance. This result is documented as:
A. A positive Romberg test, suggesting sensory ataxia or vestibular dysfunction.
B. A negative Romberg test, indicating normal cerebellar function.
C. Dysmetria, indicating a lesion in the motor cortex.
D. Dysdiadochokinesia, suggesting a basal ganglia disorder.
Answer: A
Conceptual Explanation: The Romberg test assesses proprioception and vestibular
function; loss of balance with eyes closed is a positive sign, indicating sensory ataxia.
3. Which of the following clinical signs is specifically used to assess for acute cholecystitis
during the abdominal examination?
A. Rovsing’s sign
B. Grey Turner’s sign
C. Psoas sign
D. Murphy’s sign
Answer: D
Conceptual Explanation: Murphy’s sign is a sharp increase in tenderness with inspiratory
effort during palpation of the gallbladder area, highly specific for acute cholecystitis.
, 4. When assessing the thyroid gland, the examiner should ask the patient to swallow a sip of
water. The primary purpose of this maneuver is to:
A. Relieve patient anxiety during a sensitive part of the exam.
B. Facilitate the movement of the thyroid and cricoid cartilage upward.
C. Observe for the presence of a carotid bruit.
D. Check for the integrity of Cranial Nerve XII.
Answer: B
Conceptual Explanation: The thyroid gland is attached to the trachea and moves upward
during swallowing, which helps the examiner differentiate the thyroid from other neck
masses.
5. A 65-year-old male presents with sudden, painless loss of vision in one eye, described as a
‘curtain’ coming down. This most likely indicates:
A. Acute angle-closure glaucoma
B. Macular degeneration
C. Retinal detachment
D. Central retinal artery occlusion
Answer: C
Conceptual Explanation: Retinal detachment often presents with the classic description
of a shadow or curtain falling across the field of vision, usually without pain.
HEALTH ASSESSMENT QUESTIONS
AND ANSWERS
1. When performing a physical examination on a patient with suspected aortic stenosis,
which of the following findings is most characteristic of this condition?
A. A high-pitched decrescendo diastolic murmur heard best at the left sternal border.
B. A harsh systolic crescendo-decrescendo murmur radiating to the carotids.
C. A mid-systolic click followed by a late systolic murmur.
D. A holosystolic murmur that increases in intensity with inspiration.
Answer: B
Conceptual Explanation: Aortic stenosis typically presents as a harsh systolic crescendo-
decrescendo murmur heard best at the right second intercostal space, often radiating to the
carotid arteries.
,2. During a neurological exam, you ask the patient to perform the Romberg test. The patient
stands with feet together and eyes closed, then begins to sway significantly and loses
balance. This result is documented as:
A. A positive Romberg test, suggesting sensory ataxia or vestibular dysfunction.
B. A negative Romberg test, indicating normal cerebellar function.
C. Dysmetria, indicating a lesion in the motor cortex.
D. Dysdiadochokinesia, suggesting a basal ganglia disorder.
Answer: A
Conceptual Explanation: The Romberg test assesses proprioception and vestibular
function; loss of balance with eyes closed is a positive sign, indicating sensory ataxia.
3. Which of the following clinical signs is specifically used to assess for acute cholecystitis
during the abdominal examination?
A. Rovsing’s sign
B. Grey Turner’s sign
C. Psoas sign
D. Murphy’s sign
Answer: D
Conceptual Explanation: Murphy’s sign is a sharp increase in tenderness with inspiratory
effort during palpation of the gallbladder area, highly specific for acute cholecystitis.
, 4. When assessing the thyroid gland, the examiner should ask the patient to swallow a sip of
water. The primary purpose of this maneuver is to:
A. Relieve patient anxiety during a sensitive part of the exam.
B. Facilitate the movement of the thyroid and cricoid cartilage upward.
C. Observe for the presence of a carotid bruit.
D. Check for the integrity of Cranial Nerve XII.
Answer: B
Conceptual Explanation: The thyroid gland is attached to the trachea and moves upward
during swallowing, which helps the examiner differentiate the thyroid from other neck
masses.
5. A 65-year-old male presents with sudden, painless loss of vision in one eye, described as a
‘curtain’ coming down. This most likely indicates:
A. Acute angle-closure glaucoma
B. Macular degeneration
C. Retinal detachment
D. Central retinal artery occlusion
Answer: C
Conceptual Explanation: Retinal detachment often presents with the classic description
of a shadow or curtain falling across the field of vision, usually without pain.
