,NSG500/NSG 500 Exam 2 Advanced Health
Assessment | Wilkes | Latest 2026/2027 Update
1. During a comprehensive health history, the advanced practice nurse is assessing a 72-year-old
patient. Which of the following findings are consistent with normal age-related changes? (Select all
that apply)
A) Decreased taste sensation
B) Thinning skin with wrinkles
C) Difficulty swallowing (dysphagia)
D) Dry eyes
E) Thicker, coarse hair on eyebrows, nose, and ears
F) Muscle atrophy and gait abnormalities
Correct Answer: Decreased taste sensation, Thinning skin with wrinkles, Dry eyes, Thicker, coarse hair
on eyebrows, nose, and ears
Rationale: Normal aging findings include sensory deficits such as decreased taste and smell, thinning
skin with wrinkles, dry eyes, and changes in hair distribution like thicker/coarse hair on the face.
Difficulty swallowing and motor deficits such as muscle atrophy are abnormal findings requiring
further evaluation, not normal age-related changes.
2. A 45-year-old patient reports a "band-like" pressure sensation around the entire head that is
bilateral and non-throbbing. The advanced practice nurse recognizes this as most consistent with
which type of headache?
A) Tension headache
B) Migraine headache
C) Cluster headache
D) Sinus headache
Correct Answer: Tension headache
,Rationale: A tension headache is typically described as a bilateral, band-like pressure or tightness
around the head without throbbing. Migraines are usually unilateral and throbbing. Cluster headaches
are severe, unilateral, and periorbital. Sinus headaches are associated with facial pain and nasal
congestion.
3. The advanced practice nurse is percussing the seventh right intercostal space at the midclavicular
line over the liver. Which sound should the nurse expect to hear?
A) Dullness
B) Tympany
C) Resonance
D) Hyperresonance
Correct Answer: Dullness
Rationale: The liver is a solid organ located in the right upper quadrant, and percussion over solid
tissue produces a dull note. Tympany is heard over air-filled structures like the stomach. Resonance is
heard over normal lung tissue. Hyperresonance is heard with air trapping, such as in COPD or
pneumothorax.
4. A 24-year-old patient presents with sudden onset of left-sided scrotal pain. He reports having
intermittent unilateral testicular pain in the past but not as severe as the current episode.
Confirmation of testicular torsion would include all of the following findings except:
A) Unilateral loss of the cremasteric reflex
B) The affected testicle held higher in the scrotum
C) Testicular swelling
D) Relief of pain with scrotal elevation
Correct Answer: Relief of pain with scrotal elevation
Rationale: Testicular torsion typically presents with sudden, severe scrotal pain, loss of the
cremasteric reflex, a high-riding testicle, and swelling. Relief of pain with scrotal elevation (Prehn sign)
is more consistent with epididymitis, not torsion. Torsion is a surgical emergency requiring prompt
intervention.
, 5. A 45-year-old man is in the clinic for a physical examination. During the abdominal assessment, the
advanced practice nurse percusses the abdomen and notices an area of dullness above the right costal
margin of approximately 11 cm. The nurse should:
A) Document the presence of hepatomegaly
B) Ask additional health history questions regarding his alcohol intake
C) Describe this dullness as indicative of an enlarged liver and refer him to a physician
D) Consider this finding as normal and proceed with the examination
Correct Answer: Consider this finding as normal and proceed with the examination
Rationale: A liver span of 10.5 cm is the mean for males and 7 cm for females. Men and taller
individuals are at the upper end of this range. A liver span of 11 cm is within normal limits for this
individual. Documenting hepatomegaly or referring to a physician would be incorrect based on this
normal finding.
6. A 60-year-old man has just been told he has benign prostatic hypertrophy. He has a friend who just
died from cancer of the prostate, and he is concerned this will happen to him. How should the
advanced practice nurse respond?
A) "The swelling in your prostate is only temporary and will go away."
B) "We will treat you with chemotherapy so we can control the cancer."
C) "It would be very unusual for a man your age to have cancer of the prostate."
D) "The enlargement of your prostate is caused by hormone changes and not cancer."
Correct Answer: "The enlargement of your prostate is caused by hormone changes and not cancer."
Rationale: Benign prostatic hypertrophy is caused by hormonal imbalances that lead to the
proliferation of benign adenomas. It is not cancer, and the patient's concern should be addressed with
accurate information. The other responses are either inaccurate or do not directly address the
patient's fear of cancer.
7. A 70-year-old man is visiting the clinic for difficulty in passing urine. In the history he indicates he
has to urinate frequently, especially at night. He has burning when he urinates and has noticed pain in
Assessment | Wilkes | Latest 2026/2027 Update
1. During a comprehensive health history, the advanced practice nurse is assessing a 72-year-old
patient. Which of the following findings are consistent with normal age-related changes? (Select all
that apply)
A) Decreased taste sensation
B) Thinning skin with wrinkles
C) Difficulty swallowing (dysphagia)
D) Dry eyes
E) Thicker, coarse hair on eyebrows, nose, and ears
F) Muscle atrophy and gait abnormalities
Correct Answer: Decreased taste sensation, Thinning skin with wrinkles, Dry eyes, Thicker, coarse hair
on eyebrows, nose, and ears
Rationale: Normal aging findings include sensory deficits such as decreased taste and smell, thinning
skin with wrinkles, dry eyes, and changes in hair distribution like thicker/coarse hair on the face.
Difficulty swallowing and motor deficits such as muscle atrophy are abnormal findings requiring
further evaluation, not normal age-related changes.
2. A 45-year-old patient reports a "band-like" pressure sensation around the entire head that is
bilateral and non-throbbing. The advanced practice nurse recognizes this as most consistent with
which type of headache?
A) Tension headache
B) Migraine headache
C) Cluster headache
D) Sinus headache
Correct Answer: Tension headache
,Rationale: A tension headache is typically described as a bilateral, band-like pressure or tightness
around the head without throbbing. Migraines are usually unilateral and throbbing. Cluster headaches
are severe, unilateral, and periorbital. Sinus headaches are associated with facial pain and nasal
congestion.
3. The advanced practice nurse is percussing the seventh right intercostal space at the midclavicular
line over the liver. Which sound should the nurse expect to hear?
A) Dullness
B) Tympany
C) Resonance
D) Hyperresonance
Correct Answer: Dullness
Rationale: The liver is a solid organ located in the right upper quadrant, and percussion over solid
tissue produces a dull note. Tympany is heard over air-filled structures like the stomach. Resonance is
heard over normal lung tissue. Hyperresonance is heard with air trapping, such as in COPD or
pneumothorax.
4. A 24-year-old patient presents with sudden onset of left-sided scrotal pain. He reports having
intermittent unilateral testicular pain in the past but not as severe as the current episode.
Confirmation of testicular torsion would include all of the following findings except:
A) Unilateral loss of the cremasteric reflex
B) The affected testicle held higher in the scrotum
C) Testicular swelling
D) Relief of pain with scrotal elevation
Correct Answer: Relief of pain with scrotal elevation
Rationale: Testicular torsion typically presents with sudden, severe scrotal pain, loss of the
cremasteric reflex, a high-riding testicle, and swelling. Relief of pain with scrotal elevation (Prehn sign)
is more consistent with epididymitis, not torsion. Torsion is a surgical emergency requiring prompt
intervention.
, 5. A 45-year-old man is in the clinic for a physical examination. During the abdominal assessment, the
advanced practice nurse percusses the abdomen and notices an area of dullness above the right costal
margin of approximately 11 cm. The nurse should:
A) Document the presence of hepatomegaly
B) Ask additional health history questions regarding his alcohol intake
C) Describe this dullness as indicative of an enlarged liver and refer him to a physician
D) Consider this finding as normal and proceed with the examination
Correct Answer: Consider this finding as normal and proceed with the examination
Rationale: A liver span of 10.5 cm is the mean for males and 7 cm for females. Men and taller
individuals are at the upper end of this range. A liver span of 11 cm is within normal limits for this
individual. Documenting hepatomegaly or referring to a physician would be incorrect based on this
normal finding.
6. A 60-year-old man has just been told he has benign prostatic hypertrophy. He has a friend who just
died from cancer of the prostate, and he is concerned this will happen to him. How should the
advanced practice nurse respond?
A) "The swelling in your prostate is only temporary and will go away."
B) "We will treat you with chemotherapy so we can control the cancer."
C) "It would be very unusual for a man your age to have cancer of the prostate."
D) "The enlargement of your prostate is caused by hormone changes and not cancer."
Correct Answer: "The enlargement of your prostate is caused by hormone changes and not cancer."
Rationale: Benign prostatic hypertrophy is caused by hormonal imbalances that lead to the
proliferation of benign adenomas. It is not cancer, and the patient's concern should be addressed with
accurate information. The other responses are either inaccurate or do not directly address the
patient's fear of cancer.
7. A 70-year-old man is visiting the clinic for difficulty in passing urine. In the history he indicates he
has to urinate frequently, especially at night. He has burning when he urinates and has noticed pain in
