NUR 6001 Exam 3 Actual Exam V2 | NUR 6001 Advanced Health
Assessment (NUR6001 Exam 3) | William Paterson University
1. A 68-year-old patient presents with heart failure. During auscultation, you hear a low-
pitched sound early in diastole, following S2. What is the most likely interpretation of this
finding?
A. An S4 gallop indicating decreased ventricular compliance.
B. An S3 gallop indicating rapid ventricular filling into a dilated ventricle.
C. An opening snap associated with mitral stenosis.
D. A mid-systolic click related to mitral valve prolapse.
Answer: B
Rationale: The S3 heart sound, or ventricular gallop, occurs during the rapid filling phase
of diastole and is often a sign of volume overload in adults with heart failure. It is best
heard with the bell of the stethoscope at the apex while the patient is in the left lateral
decubitus position. This finding reflects clinical deterioration and requires immediate
assessment of fluid status and cardiac output.
2. When performing a respiratory assessment on a patient with suspected lobar pneumonia,
which finding is most consistent with consolidation?
A. Hyperresonance on percussion and decreased tactile fremitus.
B. Increased tactile fremitus and dullness to percussion.
C. Vesicular breath sounds and resonant percussion.
D. Stridor and tracheal deviation to the affected side.
Answer: B
Rationale: Consolidation in the lung tissue, such as in pneumonia, increases the density of
the medium through which sound travels, leading to increased tactile fremitus. Percussion
over consolidated tissue produces a dull note rather than the normal resonant sound of air-
filled lungs. Additionally, auscultation may reveal bronchial breath sounds or late
inspiratory crackles over the affected lobe.
3. A 45-year-old female presents with acute right upper quadrant pain that radiates to the
right scapula. On inspiration, while palpating the gallbladder area, the patient stops breathing
due to pain. What is this sign called?
A. Rovsing’s sign
B. Murphy’s sign
,C. Psoas sign
D. McBurney’s sign
Answer: B
Rationale: Murphy’s sign is a classic clinical finding for acute cholecystitis where the
patient experiences a sudden cessation of inspiration during deep palpation of the right
upper quadrant. This occurs because the inflamed gallbladder comes into contact with the
examiner’s hand as the diaphragm descends. It is highly specific for gallbladder
inflammation and necessitates further imaging like an ultrasound.
4. During a neurological examination, the clinician asks the patient to puff out their cheeks
and show their teeth. Which cranial nerve is being evaluated?
A. Cranial Nerve VII (Facial)
B. Cranial Nerve V (Trigeminal)
C. Cranial Nerve IX (Glossopharyngeal)
D. Cranial Nerve XII (Hypoglossal)
Answer: A
Rationale: Cranial Nerve VII, the facial nerve, controls the muscles of facial expression.
Asking the patient to puff out their cheeks, smile, and close their eyes tightly assesses the
motor function of this nerve. Weakness or asymmetry in these movements could indicate a
peripheral lesion like Bell’s Palsy or a central nervous system issue such as a stroke.
5. A patient reports ‘clicking’ and ‘locking’ of the knee after a twisting injury. The clinician
performs the McMurray test, resulting in a palpable click. What does this suggest?
A. Anterior cruciate ligament (ACL) tear
B. Meniscal tear
C. Medial collateral ligament (MCL) sprain
D. Patellar subluxation
Answer: B
Rationale: The McMurray test is used to evaluate the integrity of the meniscus within the
knee joint. By rotating the lower leg while extending the knee from a flexed position, the
examiner traps a torn meniscus between the femoral condyle and the tibial plateau. A
positive result is indicated by a palpable or audible click accompanied by pain.
6. A 30-year-old male presents with a red, painful eye and photophobia. Examination reveals
a constricted pupil and cloudiness of the anterior chamber. What is the most likely diagnosis?
A. Acute angle-closure glaucoma
, B. Bacterial conjunctivitis
C. Acute iritis (uveitis)
D. Corneal abrasion
Answer: C
Rationale: Acute iritis presents with deep aching pain, photophobia, and a small, irregular
pupil due to inflammation of the iris. Unlike conjunctivitis, it involves deeper structures of
the eye and requires urgent referral to an ophthalmologist. The ciliary injection (redness
around the limbus) is a hallmark sign that distinguishes it from superficial conjunctival
infections.
7. When assessing the thyroid gland of a patient with suspected Graves’ disease, which
finding is most common?
A. A small, hard, fixed nodule.
B. Multiple irregular, tender nodules.
C. A diffuse, soft enlargement with a possible bruit.
D. Atrophy and inability to palpate the gland.
Answer: C
Rationale: In Graves’ disease, the thyroid gland typically undergoes diffuse, symmetrical
enlargement and is often soft to palpation. Because of the increased vascularity in
hyperthyroidism, a systolic bruit may be heard upon auscultation over the gland. This
finding, combined with systemic symptoms like exophthalmos and tachycardia, points
strongly toward hyperthyroidism.
8. A clinician is assessing a 75-year-old patient’s risk for falls. Which evidence-based tool is
most appropriate for this assessment?
A. The PHQ-9
B. The Get Up and Go Test
C. The CAGE questionnaire
D. The Braden Scale
Answer: B
Rationale: The Get Up and Go Test (or Timed Up and Go) is a validated clinical tool used to
assess mobility, balance, and fall risk in older adults. The patient is timed as they rise from
a chair, walk three meters, turn, and sit back down. Scores greater than 12-14 seconds are
generally associated with an increased risk of falling in the geriatric population.
Assessment (NUR6001 Exam 3) | William Paterson University
1. A 68-year-old patient presents with heart failure. During auscultation, you hear a low-
pitched sound early in diastole, following S2. What is the most likely interpretation of this
finding?
A. An S4 gallop indicating decreased ventricular compliance.
B. An S3 gallop indicating rapid ventricular filling into a dilated ventricle.
C. An opening snap associated with mitral stenosis.
D. A mid-systolic click related to mitral valve prolapse.
Answer: B
Rationale: The S3 heart sound, or ventricular gallop, occurs during the rapid filling phase
of diastole and is often a sign of volume overload in adults with heart failure. It is best
heard with the bell of the stethoscope at the apex while the patient is in the left lateral
decubitus position. This finding reflects clinical deterioration and requires immediate
assessment of fluid status and cardiac output.
2. When performing a respiratory assessment on a patient with suspected lobar pneumonia,
which finding is most consistent with consolidation?
A. Hyperresonance on percussion and decreased tactile fremitus.
B. Increased tactile fremitus and dullness to percussion.
C. Vesicular breath sounds and resonant percussion.
D. Stridor and tracheal deviation to the affected side.
Answer: B
Rationale: Consolidation in the lung tissue, such as in pneumonia, increases the density of
the medium through which sound travels, leading to increased tactile fremitus. Percussion
over consolidated tissue produces a dull note rather than the normal resonant sound of air-
filled lungs. Additionally, auscultation may reveal bronchial breath sounds or late
inspiratory crackles over the affected lobe.
3. A 45-year-old female presents with acute right upper quadrant pain that radiates to the
right scapula. On inspiration, while palpating the gallbladder area, the patient stops breathing
due to pain. What is this sign called?
A. Rovsing’s sign
B. Murphy’s sign
,C. Psoas sign
D. McBurney’s sign
Answer: B
Rationale: Murphy’s sign is a classic clinical finding for acute cholecystitis where the
patient experiences a sudden cessation of inspiration during deep palpation of the right
upper quadrant. This occurs because the inflamed gallbladder comes into contact with the
examiner’s hand as the diaphragm descends. It is highly specific for gallbladder
inflammation and necessitates further imaging like an ultrasound.
4. During a neurological examination, the clinician asks the patient to puff out their cheeks
and show their teeth. Which cranial nerve is being evaluated?
A. Cranial Nerve VII (Facial)
B. Cranial Nerve V (Trigeminal)
C. Cranial Nerve IX (Glossopharyngeal)
D. Cranial Nerve XII (Hypoglossal)
Answer: A
Rationale: Cranial Nerve VII, the facial nerve, controls the muscles of facial expression.
Asking the patient to puff out their cheeks, smile, and close their eyes tightly assesses the
motor function of this nerve. Weakness or asymmetry in these movements could indicate a
peripheral lesion like Bell’s Palsy or a central nervous system issue such as a stroke.
5. A patient reports ‘clicking’ and ‘locking’ of the knee after a twisting injury. The clinician
performs the McMurray test, resulting in a palpable click. What does this suggest?
A. Anterior cruciate ligament (ACL) tear
B. Meniscal tear
C. Medial collateral ligament (MCL) sprain
D. Patellar subluxation
Answer: B
Rationale: The McMurray test is used to evaluate the integrity of the meniscus within the
knee joint. By rotating the lower leg while extending the knee from a flexed position, the
examiner traps a torn meniscus between the femoral condyle and the tibial plateau. A
positive result is indicated by a palpable or audible click accompanied by pain.
6. A 30-year-old male presents with a red, painful eye and photophobia. Examination reveals
a constricted pupil and cloudiness of the anterior chamber. What is the most likely diagnosis?
A. Acute angle-closure glaucoma
, B. Bacterial conjunctivitis
C. Acute iritis (uveitis)
D. Corneal abrasion
Answer: C
Rationale: Acute iritis presents with deep aching pain, photophobia, and a small, irregular
pupil due to inflammation of the iris. Unlike conjunctivitis, it involves deeper structures of
the eye and requires urgent referral to an ophthalmologist. The ciliary injection (redness
around the limbus) is a hallmark sign that distinguishes it from superficial conjunctival
infections.
7. When assessing the thyroid gland of a patient with suspected Graves’ disease, which
finding is most common?
A. A small, hard, fixed nodule.
B. Multiple irregular, tender nodules.
C. A diffuse, soft enlargement with a possible bruit.
D. Atrophy and inability to palpate the gland.
Answer: C
Rationale: In Graves’ disease, the thyroid gland typically undergoes diffuse, symmetrical
enlargement and is often soft to palpation. Because of the increased vascularity in
hyperthyroidism, a systolic bruit may be heard upon auscultation over the gland. This
finding, combined with systemic symptoms like exophthalmos and tachycardia, points
strongly toward hyperthyroidism.
8. A clinician is assessing a 75-year-old patient’s risk for falls. Which evidence-based tool is
most appropriate for this assessment?
A. The PHQ-9
B. The Get Up and Go Test
C. The CAGE questionnaire
D. The Braden Scale
Answer: B
Rationale: The Get Up and Go Test (or Timed Up and Go) is a validated clinical tool used to
assess mobility, balance, and fall risk in older adults. The patient is timed as they rise from
a chair, walk three meters, turn, and sit back down. Scores greater than 12-14 seconds are
generally associated with an increased risk of falling in the geriatric population.
