,UTA NURS 5220 Final Exam | Advanced Health Assessment & Diagnostic
Reasoning (2026) Q&A
1. During a comprehensive abdominal examination, in what order should the nurse
practitioner perform assessment techniques?
A) Inspection, Auscultation, Percussion, Palpation
B) Inspection, Palpation, Percussion, Auscultation
C) Auscultation, Inspection, Palpation, Percussion
D) Percussion, Auscultation, Inspection, Palpation
Correct Answer: Inspection, Auscultation, Percussion, Palpation
Rationale: The standard order for abdominal assessment is inspection, auscultation,
percussion, and palpation. Auscultation precedes percussion and palpation because physical
manipulation can alter bowel sound frequency and intensity. Following this sequence ensures
the most accurate assessment of gastrointestinal status.
2. When auscultating the heart, an S3 gallop is detected in an older adult. This finding is most
commonly associated with which condition?
A) Aortic stenosis
B) Mitral valve prolapse
C) Heart failure
D) Chronic hypertension
Correct Answer: Heart failure
Rationale: An S3 heart sound, or ventricular gallop, occurs early in diastole during rapid
ventricular filling. In older adults, it frequently signifies ventricular non-compliance often
seen in heart failure or fluid volume overload. This sound is considered pathological in older
populations and requires further diagnostic investigation.
,3. A patient presents with a herald patch followed by a Christmas tree pattern of smaller
lesions on the trunk. Which diagnosis is most likely?
A) Tinea corporis
B) Pityriasis rosea
C) Psoriasis
D) Atopic dermatitis
Correct Answer: Pityriasis rosea
Rationale: Pityriasis rosea typically begins with a single, large herald patch that precedes a
generalized eruption. The subsequent lesions often follow the skin's cleavage lines, creating a
characteristic Christmas tree distribution on the back. The condition is self-limiting, and
diagnosis relies on these specific morphological patterns.
4. The practitioner notes a positive Murphy sign during the abdominal exam. This indicates
inflammation of which organ?
A) Appendix
B) Gallbladder
C) Liver
D) Pancreas
Correct Answer: Gallbladder
Rationale: Murphy sign is performed by palpating the right upper quadrant while the patient
takes a deep breath. Sharp pain and a sudden halt in inspiration as the gallbladder touches the
examiner's hand indicate cholecystitis. This maneuver is highly specific for gallbladder
inflammation.
5. When evaluating deep tendon reflexes, which grade indicates a normal response?
, A) 0
B) 1+
C) 2+
D) 4+
Correct Answer: 2+
Rationale: Deep tendon reflexes are graded on a scale from 0 to 4. A grade of 2+ indicates a
normal, expected reflex response. Grade 0 is absent, 1+ is diminished, and 4+ is hyperactive
with clonus. Accurate grading is essential for identifying neurologic abnormalities.
6. Which cranial nerve is assessed by testing the corneal reflex?
A) Cranial nerve III
B) Cranial nerve V
C) Cranial nerve VII
D) Cranial nerve IX
Correct Answer: Cranial nerve V
Rationale: The corneal reflex is mediated by the trigeminal nerve (cranial nerve V) for the
sensory component and the facial nerve (cranial nerve VII) for the motor component. Testing
this reflex assesses both nerves. Cranial nerve III controls eye movement, and cranial nerve
IX is involved in the gag reflex.
7. What is the primary purpose of the Rinne test?
A) To assess lateralization of sound
B) To compare air conduction and bone conduction
C) To evaluate balance function
Reasoning (2026) Q&A
1. During a comprehensive abdominal examination, in what order should the nurse
practitioner perform assessment techniques?
A) Inspection, Auscultation, Percussion, Palpation
B) Inspection, Palpation, Percussion, Auscultation
C) Auscultation, Inspection, Palpation, Percussion
D) Percussion, Auscultation, Inspection, Palpation
Correct Answer: Inspection, Auscultation, Percussion, Palpation
Rationale: The standard order for abdominal assessment is inspection, auscultation,
percussion, and palpation. Auscultation precedes percussion and palpation because physical
manipulation can alter bowel sound frequency and intensity. Following this sequence ensures
the most accurate assessment of gastrointestinal status.
2. When auscultating the heart, an S3 gallop is detected in an older adult. This finding is most
commonly associated with which condition?
A) Aortic stenosis
B) Mitral valve prolapse
C) Heart failure
D) Chronic hypertension
Correct Answer: Heart failure
Rationale: An S3 heart sound, or ventricular gallop, occurs early in diastole during rapid
ventricular filling. In older adults, it frequently signifies ventricular non-compliance often
seen in heart failure or fluid volume overload. This sound is considered pathological in older
populations and requires further diagnostic investigation.
,3. A patient presents with a herald patch followed by a Christmas tree pattern of smaller
lesions on the trunk. Which diagnosis is most likely?
A) Tinea corporis
B) Pityriasis rosea
C) Psoriasis
D) Atopic dermatitis
Correct Answer: Pityriasis rosea
Rationale: Pityriasis rosea typically begins with a single, large herald patch that precedes a
generalized eruption. The subsequent lesions often follow the skin's cleavage lines, creating a
characteristic Christmas tree distribution on the back. The condition is self-limiting, and
diagnosis relies on these specific morphological patterns.
4. The practitioner notes a positive Murphy sign during the abdominal exam. This indicates
inflammation of which organ?
A) Appendix
B) Gallbladder
C) Liver
D) Pancreas
Correct Answer: Gallbladder
Rationale: Murphy sign is performed by palpating the right upper quadrant while the patient
takes a deep breath. Sharp pain and a sudden halt in inspiration as the gallbladder touches the
examiner's hand indicate cholecystitis. This maneuver is highly specific for gallbladder
inflammation.
5. When evaluating deep tendon reflexes, which grade indicates a normal response?
, A) 0
B) 1+
C) 2+
D) 4+
Correct Answer: 2+
Rationale: Deep tendon reflexes are graded on a scale from 0 to 4. A grade of 2+ indicates a
normal, expected reflex response. Grade 0 is absent, 1+ is diminished, and 4+ is hyperactive
with clonus. Accurate grading is essential for identifying neurologic abnormalities.
6. Which cranial nerve is assessed by testing the corneal reflex?
A) Cranial nerve III
B) Cranial nerve V
C) Cranial nerve VII
D) Cranial nerve IX
Correct Answer: Cranial nerve V
Rationale: The corneal reflex is mediated by the trigeminal nerve (cranial nerve V) for the
sensory component and the facial nerve (cranial nerve VII) for the motor component. Testing
this reflex assesses both nerves. Cranial nerve III controls eye movement, and cranial nerve
IX is involved in the gag reflex.
7. What is the primary purpose of the Rinne test?
A) To assess lateralization of sound
B) To compare air conduction and bone conduction
C) To evaluate balance function
