NUR 6001 Exam 3 Actual Exam V3 | NUR 6001 Advanced Health
Assessment (NUR6001 Exam 3) | William Paterson University
1. A 55-year-old patient presents with difficulty maintaining balance when their eyes are
closed. During the physical exam, the patient stands with feet together and arms at their side,
then loses balance only when closing their eyes. Which test is being described, and what does
it suggest?
A. Positive Romberg test, suggesting sensory ataxia or vestibular dysfunction.
B. Positive Romberg test, suggesting cerebellar ataxia.
C. Negative Romberg test, suggesting normal motor function.
D. Positive Pronator Drift, suggesting upper motor neuron lesion.
Answer: A
Rationale: The Romberg test assesses for sensory ataxia by removing visual compensation
for balance. A positive result occurs when the patient can maintain balance with eyes open
but loses it with eyes closed. This finding typically points to an issue with proprioception or
the vestibular system rather than the cerebellum.
2. During a musculoskeletal assessment, the Nurse Practitioner (NP) performs the Lachman
test on a patient with knee pain after a sports injury. The NP notes significant forward
excursion of the tibia. What is the most likely diagnosis?
A. Medial collateral ligament (MCL) tear
B. Anterior cruciate ligament (ACL) rupture
C. Meniscal tear
D. Posterior cruciate ligament (PCL) injury
Answer: B
Rationale: The Lachman test is widely regarded as the most sensitive clinical maneuver for
detecting an ACL tear. It is performed with the knee flexed at 20-30 degrees while the
examiner stabilizes the femur and pulls the tibia anteriorly. Significant laxity or the lack of
a firm endpoint indicates a positive result for an ACL injury.
3. A 42-year-old female patient reports sharp right upper quadrant pain that radiates to her
right shoulder. Upon deep palpation under the right costal margin during inspiration, the
patient abruptly stops breathing due to pain. How should the NP document this finding?
A. Positive McBurney sign
B. Positive Rovsing sign
,C. Positive Murphy sign
D. Positive Psoas sign
Answer: C
Rationale: Murphy sign is a clinical indicator used to assess for acute cholecystitis. The test
is positive when pain and inspiratory arrest occur as the NP palpates the gallbladder area
while the patient breathes in. This finding is highly suggestive of gallbladder inflammation.
4. While assessing the neurological system of a patient, the NP strokes the lateral aspect of
the sole of the foot from the heel to the ball. The great toe dorsiflexes and the other toes fan
out. In an adult, how is this finding interpreted?
A. Normal plantar reflex
B. Positive Babinski sign, indicating upper motor neuron lesion
C. Negative Babinski sign
D. Positive Babinski sign, indicating lower motor neuron lesion
Answer: B
Rationale: The Babinski sign is an abnormal plantar reflex in adults and children older
than two years. Dorsiflexion of the big toe and fanning of the other toes indicates central
nervous system damage. This finding specifically points to an upper motor neuron lesion
within the corticospinal tract.
5. A patient presents with a mid-diastolic low-pitched rumbling murmur heard best at the
apex with the bell of the stethoscope while in the left lateral decubitus position. This finding
is most consistent with:
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: B
Rationale: Mitral stenosis typically produces a low-pitched diastolic rumble best heard at
the apex. Using the bell of the stethoscope and positioning the patient on their left side
enhances the sound of this murmur. It is often preceded by an opening snap in patients
with rheumatic heart disease.
6. When performing a respiratory exam on a patient with suspected lobar pneumonia, the NP
asks the patient to say ‘E’ while auscultating the lungs. The ‘E’ sounds like ‘A’ over the right
lower lobe. This is known as:
A. Egophony
, B. Whispered Pectoriloquy
C. Bronchophony
D. Tactile Fremitus
Answer: A
Rationale: Egophony is a physical exam finding where the spoken letter ‘E’ is heard as a
nasal ‘A’ through the stethoscope. This occurs because sound travels better through
consolidated lung tissue than through air-filled lung. It is a classic sign used to identify
areas of pulmonary consolidation, such as in pneumonia.
7. An NP asks a patient to identify a common object, such as a key or paperclip, placed in
their hand while their eyes are closed. The patient is unable to identify the object. This
finding is called:
A. Agraphesthesia
B. Astereognosis
C. Anesthesia
D. Apraxia
Answer: B
Rationale: Stereognosis is the ability to perceive the form and nature of objects through
touch. Astereognosis is the inability to do so, which may indicate a lesion in the sensory
cortex or posterior columns. This test requires both intact primary sensation and higher-
level cortical processing.
8. A 35-year-old office worker presents with numbness and tingling in the thumb, index, and
middle fingers. The NP asks the patient to hold the backs of their hands together with wrists
flexed at 90 degrees for 60 seconds. What is this test called?
A. Tinel’s sign
B. Finkelstein’s test
C. Phalen’s test
D. Allen’s test
Answer: C
Rationale: Phalen’s test is a diagnostic maneuver used to assess for carpal tunnel
syndrome. By flexing the wrists for 60 seconds, the median nerve is compressed within the
carpal tunnel. Numbness or tingling in the median nerve distribution indicates a positive
result.
Assessment (NUR6001 Exam 3) | William Paterson University
1. A 55-year-old patient presents with difficulty maintaining balance when their eyes are
closed. During the physical exam, the patient stands with feet together and arms at their side,
then loses balance only when closing their eyes. Which test is being described, and what does
it suggest?
A. Positive Romberg test, suggesting sensory ataxia or vestibular dysfunction.
B. Positive Romberg test, suggesting cerebellar ataxia.
C. Negative Romberg test, suggesting normal motor function.
D. Positive Pronator Drift, suggesting upper motor neuron lesion.
Answer: A
Rationale: The Romberg test assesses for sensory ataxia by removing visual compensation
for balance. A positive result occurs when the patient can maintain balance with eyes open
but loses it with eyes closed. This finding typically points to an issue with proprioception or
the vestibular system rather than the cerebellum.
2. During a musculoskeletal assessment, the Nurse Practitioner (NP) performs the Lachman
test on a patient with knee pain after a sports injury. The NP notes significant forward
excursion of the tibia. What is the most likely diagnosis?
A. Medial collateral ligament (MCL) tear
B. Anterior cruciate ligament (ACL) rupture
C. Meniscal tear
D. Posterior cruciate ligament (PCL) injury
Answer: B
Rationale: The Lachman test is widely regarded as the most sensitive clinical maneuver for
detecting an ACL tear. It is performed with the knee flexed at 20-30 degrees while the
examiner stabilizes the femur and pulls the tibia anteriorly. Significant laxity or the lack of
a firm endpoint indicates a positive result for an ACL injury.
3. A 42-year-old female patient reports sharp right upper quadrant pain that radiates to her
right shoulder. Upon deep palpation under the right costal margin during inspiration, the
patient abruptly stops breathing due to pain. How should the NP document this finding?
A. Positive McBurney sign
B. Positive Rovsing sign
,C. Positive Murphy sign
D. Positive Psoas sign
Answer: C
Rationale: Murphy sign is a clinical indicator used to assess for acute cholecystitis. The test
is positive when pain and inspiratory arrest occur as the NP palpates the gallbladder area
while the patient breathes in. This finding is highly suggestive of gallbladder inflammation.
4. While assessing the neurological system of a patient, the NP strokes the lateral aspect of
the sole of the foot from the heel to the ball. The great toe dorsiflexes and the other toes fan
out. In an adult, how is this finding interpreted?
A. Normal plantar reflex
B. Positive Babinski sign, indicating upper motor neuron lesion
C. Negative Babinski sign
D. Positive Babinski sign, indicating lower motor neuron lesion
Answer: B
Rationale: The Babinski sign is an abnormal plantar reflex in adults and children older
than two years. Dorsiflexion of the big toe and fanning of the other toes indicates central
nervous system damage. This finding specifically points to an upper motor neuron lesion
within the corticospinal tract.
5. A patient presents with a mid-diastolic low-pitched rumbling murmur heard best at the
apex with the bell of the stethoscope while in the left lateral decubitus position. This finding
is most consistent with:
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: B
Rationale: Mitral stenosis typically produces a low-pitched diastolic rumble best heard at
the apex. Using the bell of the stethoscope and positioning the patient on their left side
enhances the sound of this murmur. It is often preceded by an opening snap in patients
with rheumatic heart disease.
6. When performing a respiratory exam on a patient with suspected lobar pneumonia, the NP
asks the patient to say ‘E’ while auscultating the lungs. The ‘E’ sounds like ‘A’ over the right
lower lobe. This is known as:
A. Egophony
, B. Whispered Pectoriloquy
C. Bronchophony
D. Tactile Fremitus
Answer: A
Rationale: Egophony is a physical exam finding where the spoken letter ‘E’ is heard as a
nasal ‘A’ through the stethoscope. This occurs because sound travels better through
consolidated lung tissue than through air-filled lung. It is a classic sign used to identify
areas of pulmonary consolidation, such as in pneumonia.
7. An NP asks a patient to identify a common object, such as a key or paperclip, placed in
their hand while their eyes are closed. The patient is unable to identify the object. This
finding is called:
A. Agraphesthesia
B. Astereognosis
C. Anesthesia
D. Apraxia
Answer: B
Rationale: Stereognosis is the ability to perceive the form and nature of objects through
touch. Astereognosis is the inability to do so, which may indicate a lesion in the sensory
cortex or posterior columns. This test requires both intact primary sensation and higher-
level cortical processing.
8. A 35-year-old office worker presents with numbness and tingling in the thumb, index, and
middle fingers. The NP asks the patient to hold the backs of their hands together with wrists
flexed at 90 degrees for 60 seconds. What is this test called?
A. Tinel’s sign
B. Finkelstein’s test
C. Phalen’s test
D. Allen’s test
Answer: C
Rationale: Phalen’s test is a diagnostic maneuver used to assess for carpal tunnel
syndrome. By flexing the wrists for 60 seconds, the median nerve is compressed within the
carpal tunnel. Numbness or tingling in the median nerve distribution indicates a positive
result.
