NURS6540 ADVANCED HEALTH
ASSESSMENT FINAL EXAM STUDY
GUIDE
1. A 65-year-old male presents with a mid-systolic click followed by a late systolic murmur at
the apex. This is most characteristic of which condition?
A. Mitral Stenosis
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Valve Prolapse
Answer: D
Conceptual Explanation: Mitral valve prolapse (MVP) typically presents with a mid-
systolic click often followed by a late systolic murmur as the leaflets bulge into the left
atrium.
2. When performing the Rinne test, a patient reports that bone conduction lasts longer than
air conduction in the right ear. What does this finding indicate?
A. Conductive hearing loss in the right ear
,B. Sensorineural hearing loss in the right ear
C. Normal hearing in the right ear
D. Vestibular dysfunction
Answer: A
Conceptual Explanation: In conductive hearing loss, bone conduction (BC) is greater than
or equal to air conduction (AC). In normal hearing and sensorineural loss, AC is greater
than BC.
3. A positive Murphy’s sign is best described as which of the following?
A. Pain upon release of deep pressure in the right lower quadrant
B. Bruising around the umbilicus indicating pancreatitis
C. Pain in the right lower quadrant when the left lower quadrant is palpated
D. Sharp tenderness and sudden halt in inspiration when the gallbladder is palpated
Answer: D
Conceptual Explanation: Murphy’s sign is specific for acute cholecystitis. It occurs when
the patient experiences sharp pain and stops breathing in during deep palpation of the
right upper quadrant.
4. Testing the corneal reflex involves which two cranial nerves?
A. CN V and CN VII
B. CN III and CN IV
, C. CN II and CN III
D. CN V and CN VIII
Answer: A
Conceptual Explanation: The trigeminal nerve (CN V) provides the sensory limb (feeling
the touch), and the facial nerve (CN VII) provides the motor limb (blinking the eye).
5. The Lachman test is considered the most sensitive clinical test for evaluating the integrity
of which structure?
A. Posterior Cruciate Ligament (PCL)
B. Anterior Cruciate Ligament (ACL)
C. Medial Collateral Ligament (MCL)
D. Lateral Meniscus
Answer: B
Conceptual Explanation: The Lachman test, performed with the knee at 20-30 degrees of
flexion, is the most reliable physical exam maneuver to diagnose an ACL tear.
6. A 72-year-old patient presents with sudden onset of ‘curtain-like’ vision loss in one eye.
This is a hallmark symptom of:
A. Macular Degeneration
B. Acute Angle-Closure Glaucoma
C. Cataracts
ASSESSMENT FINAL EXAM STUDY
GUIDE
1. A 65-year-old male presents with a mid-systolic click followed by a late systolic murmur at
the apex. This is most characteristic of which condition?
A. Mitral Stenosis
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Valve Prolapse
Answer: D
Conceptual Explanation: Mitral valve prolapse (MVP) typically presents with a mid-
systolic click often followed by a late systolic murmur as the leaflets bulge into the left
atrium.
2. When performing the Rinne test, a patient reports that bone conduction lasts longer than
air conduction in the right ear. What does this finding indicate?
A. Conductive hearing loss in the right ear
,B. Sensorineural hearing loss in the right ear
C. Normal hearing in the right ear
D. Vestibular dysfunction
Answer: A
Conceptual Explanation: In conductive hearing loss, bone conduction (BC) is greater than
or equal to air conduction (AC). In normal hearing and sensorineural loss, AC is greater
than BC.
3. A positive Murphy’s sign is best described as which of the following?
A. Pain upon release of deep pressure in the right lower quadrant
B. Bruising around the umbilicus indicating pancreatitis
C. Pain in the right lower quadrant when the left lower quadrant is palpated
D. Sharp tenderness and sudden halt in inspiration when the gallbladder is palpated
Answer: D
Conceptual Explanation: Murphy’s sign is specific for acute cholecystitis. It occurs when
the patient experiences sharp pain and stops breathing in during deep palpation of the
right upper quadrant.
4. Testing the corneal reflex involves which two cranial nerves?
A. CN V and CN VII
B. CN III and CN IV
, C. CN II and CN III
D. CN V and CN VIII
Answer: A
Conceptual Explanation: The trigeminal nerve (CN V) provides the sensory limb (feeling
the touch), and the facial nerve (CN VII) provides the motor limb (blinking the eye).
5. The Lachman test is considered the most sensitive clinical test for evaluating the integrity
of which structure?
A. Posterior Cruciate Ligament (PCL)
B. Anterior Cruciate Ligament (ACL)
C. Medial Collateral Ligament (MCL)
D. Lateral Meniscus
Answer: B
Conceptual Explanation: The Lachman test, performed with the knee at 20-30 degrees of
flexion, is the most reliable physical exam maneuver to diagnose an ACL tear.
6. A 72-year-old patient presents with sudden onset of ‘curtain-like’ vision loss in one eye.
This is a hallmark symptom of:
A. Macular Degeneration
B. Acute Angle-Closure Glaucoma
C. Cataracts
