NURS 5220 Advanced Health Assessment Exam 2
UTA 2026/2027 – Questions and Answers |
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• 1. A 65-year-old patient presents with a sudden, painless loss of vision in
the right eye that lasted for 10 minutes and has now resolved. What is the
most critical differential diagnosis to consider?
o A. Cataract
o B. Open-angle glaucoma
o C. Amaurosis fugax
o D. Macular degeneration
o Correct Answer: C
o Rationale: Amaurosis fugax is a temporary loss of vision in one
eye, often described as a "curtain coming down." It is caused by a
transient ischemic attack (TIA) of the ophthalmic artery and is a
critical warning sign for an impending stroke. It requires immediate
medical evaluation. A cataract causes a gradual, painless blurring.
Open-angle glaucoma is typically asymptomatic until late stages,
causing gradual peripheral vision loss. Macular degeneration causes
central vision loss, not typically a full, transient blackout.
• 2. During an eye exam, you note that the patient's pupil constricts when a
light is shone into the opposite eye. This is a positive finding for which
reflex?
o A. Direct light reflex
o B. Accommodation
, o C. Consensual light reflex
o D. Corneal light reflex
o Correct Answer: C
o Rationale: The consensual light reflex is the constriction of a pupil
in response to light shone in the other eye. This indicates an intact
optic nerve (CN II) and oculomotor nerve (CN III) pathway on both
sides. The direct light reflex is constriction of the same eye.
Accommodation is the pupillary constriction and convergence that
occurs when looking at a near object. The corneal light reflex assesses
for strabismus.
• 3. A patient complains of a "floater" and "flashes of light" in their left eye.
What is the most urgent concern?
o A. Conjunctivitis
o B. Retinal detachment
o C. Cataract
o D. Blepharitis
o Correct Answer: B
o Rationale: The sudden onset of floaters and flashes of light are
classic symptoms of a retinal tear or detachment. This is a medical
emergency that requires immediate ophthalmological evaluation to
prevent permanent vision loss. Conjunctivitis and blepharitis are
inflammatory conditions of the eye surface. A cataract is a gradual
clouding of the lens.
• 4. Which cranial nerve is primarily responsible for the motor function of the
tongue?
o A. CN IX (Glossopharyngeal)
o B. CN X (Vagus)
, o C. CN XI (Accessory)
o D. CN XII (Hypoglossal)
o Correct Answer: D
o Rationale: The hypoglossal nerve (CN XII) provides motor
innervation to the muscles of the tongue. Assessment involves asking
the patient to protrude their tongue; it should be midline. Deviation
to one side indicates a lesion on the same side as the deviation. CN IX
and X are involved in taste and gag reflex. CN XI controls the
sternocleidomastoid and trapezius muscles.
• 5. A patient presents with a "bull's-eye" rash that has expanded over several
days. What is the most likely diagnosis?
o A. Rocky Mountain Spotted Fever
o B. Lyme disease
o C. Cellulitis
o D. Tinea corporis
o Correct Answer: B
o Rationale: The "bull's-eye" rash, known as erythema migrans, is
the hallmark sign of early localized Lyme disease, caused by the
bacterium Borrelia burgdorferi. Rocky Mountain Spotted Fever
presents with a rash that starts on the wrists and ankles and spreads
centrally. Cellulitis is a red, swollen, tender area without a bull's-eye
pattern. Tinea corporis (ringworm) is a circular, scaly rash with central
clearing, but it lacks the distinct concentric rings of erythema
migrans.
• 6. When assessing the cranial nerves, which test assesses both CN IX and
CN X?
o A. Asking the patient to say "ahh"
, o B. Testing the sense of smell
o C. Checking the visual fields
o D. Assessing shoulder shrug
o Correct Answer: A
o Rationale: Asking the patient to say "ahh" assesses the elevation
of the soft palate and uvula, which is mediated by the
glossopharyngeal (CN IX) and vagus (CN X) nerves. The uvula should
rise symmetrically in the midline. Smell is CN I. Visual fields are CN II.
Shoulder shrug is CN XI.
• 7. A patient has a lesion on CN VII (Facial). Which of the following findings
would you expect?
o A. Inability to shrug the shoulders
o B. Inability to taste on the anterior two-thirds of the tongue
o C. Deviation of the tongue to the left
o D. Inability to hear a whisper
o Correct Answer: B
o Rationale: The facial nerve (CN VII) is responsible for motor
control of facial expressions, taste on the anterior two-thirds of the
tongue, and lacrimal/salivary gland secretion. A lesion would cause
ipsilateral facial paralysis (Bell's Palsy). Shoulder shrug is CN XI.
Tongue deviation is CN XII. Hearing is CN VIII.
• 8. Which of the following is a normal age-related change in the eye?
o A. Increased tear production
o B. Arcus senilis
o C. Miosis (pupillary constriction)
UTA 2026/2027 – Questions and Answers |
100% Verified | Detailed Rationales – Pass
Guaranteed – A+ Graded
• 1. A 65-year-old patient presents with a sudden, painless loss of vision in
the right eye that lasted for 10 minutes and has now resolved. What is the
most critical differential diagnosis to consider?
o A. Cataract
o B. Open-angle glaucoma
o C. Amaurosis fugax
o D. Macular degeneration
o Correct Answer: C
o Rationale: Amaurosis fugax is a temporary loss of vision in one
eye, often described as a "curtain coming down." It is caused by a
transient ischemic attack (TIA) of the ophthalmic artery and is a
critical warning sign for an impending stroke. It requires immediate
medical evaluation. A cataract causes a gradual, painless blurring.
Open-angle glaucoma is typically asymptomatic until late stages,
causing gradual peripheral vision loss. Macular degeneration causes
central vision loss, not typically a full, transient blackout.
• 2. During an eye exam, you note that the patient's pupil constricts when a
light is shone into the opposite eye. This is a positive finding for which
reflex?
o A. Direct light reflex
o B. Accommodation
, o C. Consensual light reflex
o D. Corneal light reflex
o Correct Answer: C
o Rationale: The consensual light reflex is the constriction of a pupil
in response to light shone in the other eye. This indicates an intact
optic nerve (CN II) and oculomotor nerve (CN III) pathway on both
sides. The direct light reflex is constriction of the same eye.
Accommodation is the pupillary constriction and convergence that
occurs when looking at a near object. The corneal light reflex assesses
for strabismus.
• 3. A patient complains of a "floater" and "flashes of light" in their left eye.
What is the most urgent concern?
o A. Conjunctivitis
o B. Retinal detachment
o C. Cataract
o D. Blepharitis
o Correct Answer: B
o Rationale: The sudden onset of floaters and flashes of light are
classic symptoms of a retinal tear or detachment. This is a medical
emergency that requires immediate ophthalmological evaluation to
prevent permanent vision loss. Conjunctivitis and blepharitis are
inflammatory conditions of the eye surface. A cataract is a gradual
clouding of the lens.
• 4. Which cranial nerve is primarily responsible for the motor function of the
tongue?
o A. CN IX (Glossopharyngeal)
o B. CN X (Vagus)
, o C. CN XI (Accessory)
o D. CN XII (Hypoglossal)
o Correct Answer: D
o Rationale: The hypoglossal nerve (CN XII) provides motor
innervation to the muscles of the tongue. Assessment involves asking
the patient to protrude their tongue; it should be midline. Deviation
to one side indicates a lesion on the same side as the deviation. CN IX
and X are involved in taste and gag reflex. CN XI controls the
sternocleidomastoid and trapezius muscles.
• 5. A patient presents with a "bull's-eye" rash that has expanded over several
days. What is the most likely diagnosis?
o A. Rocky Mountain Spotted Fever
o B. Lyme disease
o C. Cellulitis
o D. Tinea corporis
o Correct Answer: B
o Rationale: The "bull's-eye" rash, known as erythema migrans, is
the hallmark sign of early localized Lyme disease, caused by the
bacterium Borrelia burgdorferi. Rocky Mountain Spotted Fever
presents with a rash that starts on the wrists and ankles and spreads
centrally. Cellulitis is a red, swollen, tender area without a bull's-eye
pattern. Tinea corporis (ringworm) is a circular, scaly rash with central
clearing, but it lacks the distinct concentric rings of erythema
migrans.
• 6. When assessing the cranial nerves, which test assesses both CN IX and
CN X?
o A. Asking the patient to say "ahh"
, o B. Testing the sense of smell
o C. Checking the visual fields
o D. Assessing shoulder shrug
o Correct Answer: A
o Rationale: Asking the patient to say "ahh" assesses the elevation
of the soft palate and uvula, which is mediated by the
glossopharyngeal (CN IX) and vagus (CN X) nerves. The uvula should
rise symmetrically in the midline. Smell is CN I. Visual fields are CN II.
Shoulder shrug is CN XI.
• 7. A patient has a lesion on CN VII (Facial). Which of the following findings
would you expect?
o A. Inability to shrug the shoulders
o B. Inability to taste on the anterior two-thirds of the tongue
o C. Deviation of the tongue to the left
o D. Inability to hear a whisper
o Correct Answer: B
o Rationale: The facial nerve (CN VII) is responsible for motor
control of facial expressions, taste on the anterior two-thirds of the
tongue, and lacrimal/salivary gland secretion. A lesion would cause
ipsilateral facial paralysis (Bell's Palsy). Shoulder shrug is CN XI.
Tongue deviation is CN XII. Hearing is CN VIII.
• 8. Which of the following is a normal age-related change in the eye?
o A. Increased tear production
o B. Arcus senilis
o C. Miosis (pupillary constriction)
