NU 650 MIDTERM EXAM – ADVANCED
HEALTH ASSESSMENT (2027)
QUESTIONS AND ANSWERS
1. When assessing a patient for a suspected tension pneumothorax, which clinical finding is
most specific to this life-threatening condition?
A. Tracheal deviation toward the affected side
B. Hyperresonance on percussion of the affected side
C. Dullness on percussion of the affected side
D. Tracheal deviation toward the unaffected side
Answer: D
Conceptual Explanation: A tension pneumothorax causes a shift of mediastinal structures,
including the trachea, toward the opposite (unaffected) side due to increased intrapleural
pressure.
,2. A 68-year-old male presents with a history of hypertension and sudden onset of ‘ripping’
chest pain radiating to his back. During physical exam, you note a significant blood pressure
discrepancy between the right and left arms. What is the most likely diagnosis?
A. Myocardial Infarction
B. Pulmonary Embolism
C. Aortic Dissection
D. Esophageal Rupture
Answer: C
Conceptual Explanation: Ripping or tearing chest pain radiating to the back combined
with a blood pressure differential between arms is classic for an acute aortic dissection.
3. During the funduscopic examination, the presence of ‘cotton wool spots’ on the retina is
most indicative of:
A. Micro-infarcts causing nerve fiber layer damage
B. Macular degeneration
C. Acute glaucoma
D. Benign aging changes
Answer: A
Conceptual Explanation: Cotton wool spots represent micro-infarcts of the retinal nerve
fiber layer, often seen in hypertension or diabetes mellitus.
, 4. While performing a musculoskeletal exam, the NP uses the McMurray test. A palpable click
or pop along the joint line is a positive sign for:
A. Medial or lateral meniscus tear
B. Anterior cruciate ligament (ACL) tear
C. Patellar tendonitis
D. Baker’s cyst
Answer: A
Conceptual Explanation: The McMurray test involves rotation of the knee with flexion
and extension; a click or pain indicates a meniscal injury.
5. In a patient with suspected bacterial meningitis, the NP flexes the patient’s neck and
observes involuntary flexion of the hips and knees. This is known as:
A. Kernig’s sign
B. Babinski’s sign
C. Hoffman’s sign
D. Brudzinski’s sign
Answer: D
Conceptual Explanation: Brudzinski’s sign is a clinical sign of meningeal irritation where
passive neck flexion causes reflex hip and knee flexion.
HEALTH ASSESSMENT (2027)
QUESTIONS AND ANSWERS
1. When assessing a patient for a suspected tension pneumothorax, which clinical finding is
most specific to this life-threatening condition?
A. Tracheal deviation toward the affected side
B. Hyperresonance on percussion of the affected side
C. Dullness on percussion of the affected side
D. Tracheal deviation toward the unaffected side
Answer: D
Conceptual Explanation: A tension pneumothorax causes a shift of mediastinal structures,
including the trachea, toward the opposite (unaffected) side due to increased intrapleural
pressure.
,2. A 68-year-old male presents with a history of hypertension and sudden onset of ‘ripping’
chest pain radiating to his back. During physical exam, you note a significant blood pressure
discrepancy between the right and left arms. What is the most likely diagnosis?
A. Myocardial Infarction
B. Pulmonary Embolism
C. Aortic Dissection
D. Esophageal Rupture
Answer: C
Conceptual Explanation: Ripping or tearing chest pain radiating to the back combined
with a blood pressure differential between arms is classic for an acute aortic dissection.
3. During the funduscopic examination, the presence of ‘cotton wool spots’ on the retina is
most indicative of:
A. Micro-infarcts causing nerve fiber layer damage
B. Macular degeneration
C. Acute glaucoma
D. Benign aging changes
Answer: A
Conceptual Explanation: Cotton wool spots represent micro-infarcts of the retinal nerve
fiber layer, often seen in hypertension or diabetes mellitus.
, 4. While performing a musculoskeletal exam, the NP uses the McMurray test. A palpable click
or pop along the joint line is a positive sign for:
A. Medial or lateral meniscus tear
B. Anterior cruciate ligament (ACL) tear
C. Patellar tendonitis
D. Baker’s cyst
Answer: A
Conceptual Explanation: The McMurray test involves rotation of the knee with flexion
and extension; a click or pain indicates a meniscal injury.
5. In a patient with suspected bacterial meningitis, the NP flexes the patient’s neck and
observes involuntary flexion of the hips and knees. This is known as:
A. Kernig’s sign
B. Babinski’s sign
C. Hoffman’s sign
D. Brudzinski’s sign
Answer: D
Conceptual Explanation: Brudzinski’s sign is a clinical sign of meningeal irritation where
passive neck flexion causes reflex hip and knee flexion.
