NSG 500 WILKES ADVANCED HEALTH
ASSESSMENT FINAL EXAM QUESTIONS
AND ANSWERS
1. When assessing for increased tactile fremitus, which clinical condition is most likely
associated with this finding?
A. Pneumothorax
B. Pleural effusion
C. Chronic obstructive pulmonary disease
D. Lobar pneumonia
Answer: D
Conceptual Explanation: Tactile fremitus is increased in conditions where there is
consolidation of lung tissue, such as lobar pneumonia, because sound travels better
through solid or fluid-filled media than through air.
2. A 65-year-old patient presents with sudden onset of ‘the worst headache of my life.’ Which
physical exam finding is most critical to assess for?
A. Nuchal rigidity
,B. Tonsillar hypertrophy
C. Bilateral papilledema
D. Temporal artery tenderness
Answer: A
Conceptual Explanation: The description suggests a subarachnoid hemorrhage. Nuchal
rigidity (meningeal irritation) is a key assessment finding in this emergency.
3. During a cardiac assessment, a clinician hears a high-pitched, scratchy sound at the left
lower sternal border that is louder when the patient leans forward. This is most likely:
A. Pericardial friction rub
B. Aortic regurgitation murmur
C. Mitral valve prolapse
D. S3 gallop
Answer: A
Conceptual Explanation: A pericardial friction rub is typically high-pitched and scratchy,
heard best at the left lower sternal border with the patient leaning forward in expiration.
4. Which of the following tests is most specific for diagnosing a suspected ACL (Anterior
Cruciate Ligament) tear?
A. McMurray test
B. Valgus stress test
, C. Bulge sign
D. Lachman test
Answer: D
Conceptual Explanation: The Lachman test is considered the most sensitive and specific
clinical maneuver for detecting ACL insufficiency.
5. A patient exhibits a positive Murphy’s sign. Which condition does this specifically indicate?
A. Acute Appendicitis
B. Acute Cholecystitis
C. Acute Pancreatitis
D. Renal Colic
Answer: B
Conceptual Explanation: Murphy’s sign is positive when a patient stops breathing mid-
inspiration during deep palpation of the RUQ due to pain from an inflamed gallbladder.
6. In a patient with suspected carpal tunnel syndrome, which maneuver involves holding the
wrists in acute flexion for 60 seconds to elicit paresthesia?
A. Phalen’s test
B. Tinel’s sign
C. Finkelstein’s test
ASSESSMENT FINAL EXAM QUESTIONS
AND ANSWERS
1. When assessing for increased tactile fremitus, which clinical condition is most likely
associated with this finding?
A. Pneumothorax
B. Pleural effusion
C. Chronic obstructive pulmonary disease
D. Lobar pneumonia
Answer: D
Conceptual Explanation: Tactile fremitus is increased in conditions where there is
consolidation of lung tissue, such as lobar pneumonia, because sound travels better
through solid or fluid-filled media than through air.
2. A 65-year-old patient presents with sudden onset of ‘the worst headache of my life.’ Which
physical exam finding is most critical to assess for?
A. Nuchal rigidity
,B. Tonsillar hypertrophy
C. Bilateral papilledema
D. Temporal artery tenderness
Answer: A
Conceptual Explanation: The description suggests a subarachnoid hemorrhage. Nuchal
rigidity (meningeal irritation) is a key assessment finding in this emergency.
3. During a cardiac assessment, a clinician hears a high-pitched, scratchy sound at the left
lower sternal border that is louder when the patient leans forward. This is most likely:
A. Pericardial friction rub
B. Aortic regurgitation murmur
C. Mitral valve prolapse
D. S3 gallop
Answer: A
Conceptual Explanation: A pericardial friction rub is typically high-pitched and scratchy,
heard best at the left lower sternal border with the patient leaning forward in expiration.
4. Which of the following tests is most specific for diagnosing a suspected ACL (Anterior
Cruciate Ligament) tear?
A. McMurray test
B. Valgus stress test
, C. Bulge sign
D. Lachman test
Answer: D
Conceptual Explanation: The Lachman test is considered the most sensitive and specific
clinical maneuver for detecting ACL insufficiency.
5. A patient exhibits a positive Murphy’s sign. Which condition does this specifically indicate?
A. Acute Appendicitis
B. Acute Cholecystitis
C. Acute Pancreatitis
D. Renal Colic
Answer: B
Conceptual Explanation: Murphy’s sign is positive when a patient stops breathing mid-
inspiration during deep palpation of the RUQ due to pain from an inflamed gallbladder.
6. In a patient with suspected carpal tunnel syndrome, which maneuver involves holding the
wrists in acute flexion for 60 seconds to elicit paresthesia?
A. Phalen’s test
B. Tinel’s sign
C. Finkelstein’s test
