NURS6540 ADVANCED HEALTH
ASSESSMENT - EXAM 2
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. When assessing for the presence of a S3 heart sound, which positioning and technique is
most effective?
A. Patient supine, using the diaphragm of the stethoscope at the base.
B. Patient standing, using the bell at the lower left sternal border.
C. Patient leaning forward, using the diaphragm at the 2nd intercostal space.
D. Patient in left lateral decubitus, using the bell of the stethoscope at the apex.
Answer: D
Conceptual Explanation: S3 is a low-frequency sound best heard with the bell at the apex
while the patient is in the left lateral decubitus position, which brings the left ventricle
closer to the chest wall.
,2. A 65-year-old male presents with a sudden onset of ‘the worst headache of my life.’ Which
physical exam finding would most strongly suggest a subarachnoid hemorrhage?
A. Unilateral ptosis
B. Nystagmus on lateral gaze
C. Positive Brudzinski sign
D. Bilateral papilledema
Answer: C
Conceptual Explanation: Sudden onset ‘thunderclap’ headache often indicates
subarachnoid hemorrhage. Nuchal rigidity signs, such as a positive Brudzinski or Kernig
sign, occur due to meningeal irritation from blood in the subarachnoid space.
3. Which cranial nerve is primarily responsible for the sensory component of the corneal
reflex?
A. Cranial Nerve III (Oculomotor)
B. Cranial Nerve VII (Facial)
C. Cranial Nerve V (Trigeminal)
D. Cranial Nerve VI (Abducens)
Answer: C
, Conceptual Explanation: The Trigeminal nerve (CN V) provides the sensory (afferent)
limb of the corneal reflex, while the Facial nerve (CN VII) provides the motor (efferent)
limb for blinking.
4. When performing the McMurray test, a palpable click or pop along the medial joint line
suggests an injury to which structure?
A. Medial meniscus
B. Anterior cruciate ligament (ACL)
C. Lateral collateral ligament (LCL)
D. Posterior cruciate ligament (PCL)
Answer: A
Conceptual Explanation: The McMurray test involves internal and external rotation of the
knee to detect meniscus tears; a click or pain at the medial joint line indicates a medial
meniscus injury.
5. A patient exhibits ‘A-V nicking’ during a fundoscopic examination. This finding is most
commonly associated with which chronic condition?
A. Diabetic retinopathy
B. Glaucoma
C. Hypertensive retinopathy
D. Macular degeneration
ASSESSMENT - EXAM 2
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. When assessing for the presence of a S3 heart sound, which positioning and technique is
most effective?
A. Patient supine, using the diaphragm of the stethoscope at the base.
B. Patient standing, using the bell at the lower left sternal border.
C. Patient leaning forward, using the diaphragm at the 2nd intercostal space.
D. Patient in left lateral decubitus, using the bell of the stethoscope at the apex.
Answer: D
Conceptual Explanation: S3 is a low-frequency sound best heard with the bell at the apex
while the patient is in the left lateral decubitus position, which brings the left ventricle
closer to the chest wall.
,2. A 65-year-old male presents with a sudden onset of ‘the worst headache of my life.’ Which
physical exam finding would most strongly suggest a subarachnoid hemorrhage?
A. Unilateral ptosis
B. Nystagmus on lateral gaze
C. Positive Brudzinski sign
D. Bilateral papilledema
Answer: C
Conceptual Explanation: Sudden onset ‘thunderclap’ headache often indicates
subarachnoid hemorrhage. Nuchal rigidity signs, such as a positive Brudzinski or Kernig
sign, occur due to meningeal irritation from blood in the subarachnoid space.
3. Which cranial nerve is primarily responsible for the sensory component of the corneal
reflex?
A. Cranial Nerve III (Oculomotor)
B. Cranial Nerve VII (Facial)
C. Cranial Nerve V (Trigeminal)
D. Cranial Nerve VI (Abducens)
Answer: C
, Conceptual Explanation: The Trigeminal nerve (CN V) provides the sensory (afferent)
limb of the corneal reflex, while the Facial nerve (CN VII) provides the motor (efferent)
limb for blinking.
4. When performing the McMurray test, a palpable click or pop along the medial joint line
suggests an injury to which structure?
A. Medial meniscus
B. Anterior cruciate ligament (ACL)
C. Lateral collateral ligament (LCL)
D. Posterior cruciate ligament (PCL)
Answer: A
Conceptual Explanation: The McMurray test involves internal and external rotation of the
knee to detect meniscus tears; a click or pain at the medial joint line indicates a medial
meniscus injury.
5. A patient exhibits ‘A-V nicking’ during a fundoscopic examination. This finding is most
commonly associated with which chronic condition?
A. Diabetic retinopathy
B. Glaucoma
C. Hypertensive retinopathy
D. Macular degeneration
