1 | Page
NSG500 ADVANCED HEALTH ASSESSMENT FINAL EXAM (2026) | 140
VERIFIED QUESTIONS & ANSWERS | WILKES UNIVERSITY,
ALREADY GRADED A+
1. Which cranial nerve is tested when assessing extraocular eye movements?
A. Cranial nerve II, optic
B. Cranial nerve III, oculomotor
C. Cranial nerve VII, facial
D. Cranial nerve IX, glossopharyngeal
Answer: Cranial nerve III, oculomotor
Rationale: Extraocular eye movements involve cranial nerves III (oculomotor), IV
(trochlear), and VI (abducens). However, CN III controls the majority of
extraocular muscles and pupil constriction.
2. A 58-year-old man presents with jugular venous distension, hepatomegaly,
and peripheral edema. These findings suggest:
A. Left-sided heart failure
B. Right-sided heart failure
C. Myocardial infarction
D. Aortic stenosis
Answer: Right-sided heart failure
Rationale: Right-sided heart failure results in systemic congestion, causing JVD,
hepatomegaly, and peripheral edema, unlike left-sided failure, which primarily
causes pulmonary congestion.
3. Which sound is best heard with the diaphragm of the stethoscope?
A. Low-pitched heart murmurs
B. S3 and S4 heart sounds
,2 | Page
C. High-pitched sounds like S1, S2, and lung sounds
D. Bruits with low-frequency
Answer: High-pitched sounds like S1, S2, and lung sounds
Rationale: The diaphragm detects high-pitched sounds such as breath sounds,
bowel sounds, normal heart sounds, and high-pitched murmurs.
4. Which physical exam technique is most important when assessing for
appendicitis?
A. Rebound tenderness in RLQ
B. Percussion of the epigastric area
C. Palpation of LUQ
D. Auscultation of bowel sounds
Answer: Rebound tenderness in RLQ
Rationale: Rebound tenderness at McBurney’s point in the right lower quadrant is
a classic finding in acute appendicitis due to peritoneal irritation.
5. A 70-year-old smoker presents with hematuria. Which is the most likely
diagnosis to rule out?
A. UTI
B. Renal stone
C. Bladder cancer
D. Glomerulonephritis
Answer: Bladder cancer
Rationale: Painless gross hematuria in an older smoker is highly suspicious for
bladder cancer and must be ruled out first.
6. The presence of a positive Romberg test indicates:
A. Cerebellar dysfunction
B. Vestibular or proprioceptive dysfunction
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C. Upper motor neuron lesion
D. Lower motor neuron lesion
Answer: Vestibular or proprioceptive dysfunction
Rationale: A positive Romberg test (swaying/falling with eyes closed) indicates
impaired proprioception or vestibular function, not cerebellar dysfunction (where
imbalance occurs even with eyes open).
7. Which heart murmur is described as a “harsh systolic ejection murmur”
radiating to the carotids?
A. Mitral regurgitation
B. Aortic stenosis
C. Aortic regurgitation
D. Mitral stenosis
Answer: Aortic stenosis
Rationale: Aortic stenosis produces a crescendo-decrescendo systolic murmur best
heard at the right second intercostal space, often radiating to the carotids.
8. Which lung sound is commonly heard in asthma?
A. Crackles
B. Rhonchi
C. Wheezes
D. Pleural rub
Answer: Wheezes
Rationale: Wheezes are high-pitched, musical sounds caused by narrowed
airways, often heard in asthma and COPD exacerbations.
9. Which abdominal finding is most consistent with ascites?
A. Positive Murphy’s sign
B. Shifting dullness
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C. Rebound tenderness
D. Pulsatile mass
Answer: Shifting dullness
Rationale: Ascites (fluid accumulation) is detected by shifting dullness on
percussion when the patient changes position.
10. Which cranial nerve is assessed by asking a patient to shrug shoulders
against resistance?
A. Cranial nerve X
B. Cranial nerve XI
C. Cranial nerve VII
D. Cranial nerve VI
Answer: Cranial nerve XI
Rationale: The spinal accessory nerve (CN XI) controls the trapezius and
sternocleidomastoid, tested by shoulder shrug and head rotation against resistance.
11. A positive Phalen’s and Tinel’s test is indicative of:
A. Ulnar nerve entrapment
B. Radial nerve palsy
C. Carpal tunnel syndrome
D. Tennis elbow
Answer: Carpal tunnel syndrome
Rationale: Phalen’s test (wrist flexion) and Tinel’s sign (tapping the median nerve)
reproduce paresthesias in carpal tunnel syndrome.
12. A patient with mitral stenosis is most likely to develop which complication?
A. Pulmonary hypertension
B. Aortic aneurysm
NSG500 ADVANCED HEALTH ASSESSMENT FINAL EXAM (2026) | 140
VERIFIED QUESTIONS & ANSWERS | WILKES UNIVERSITY,
ALREADY GRADED A+
1. Which cranial nerve is tested when assessing extraocular eye movements?
A. Cranial nerve II, optic
B. Cranial nerve III, oculomotor
C. Cranial nerve VII, facial
D. Cranial nerve IX, glossopharyngeal
Answer: Cranial nerve III, oculomotor
Rationale: Extraocular eye movements involve cranial nerves III (oculomotor), IV
(trochlear), and VI (abducens). However, CN III controls the majority of
extraocular muscles and pupil constriction.
2. A 58-year-old man presents with jugular venous distension, hepatomegaly,
and peripheral edema. These findings suggest:
A. Left-sided heart failure
B. Right-sided heart failure
C. Myocardial infarction
D. Aortic stenosis
Answer: Right-sided heart failure
Rationale: Right-sided heart failure results in systemic congestion, causing JVD,
hepatomegaly, and peripheral edema, unlike left-sided failure, which primarily
causes pulmonary congestion.
3. Which sound is best heard with the diaphragm of the stethoscope?
A. Low-pitched heart murmurs
B. S3 and S4 heart sounds
,2 | Page
C. High-pitched sounds like S1, S2, and lung sounds
D. Bruits with low-frequency
Answer: High-pitched sounds like S1, S2, and lung sounds
Rationale: The diaphragm detects high-pitched sounds such as breath sounds,
bowel sounds, normal heart sounds, and high-pitched murmurs.
4. Which physical exam technique is most important when assessing for
appendicitis?
A. Rebound tenderness in RLQ
B. Percussion of the epigastric area
C. Palpation of LUQ
D. Auscultation of bowel sounds
Answer: Rebound tenderness in RLQ
Rationale: Rebound tenderness at McBurney’s point in the right lower quadrant is
a classic finding in acute appendicitis due to peritoneal irritation.
5. A 70-year-old smoker presents with hematuria. Which is the most likely
diagnosis to rule out?
A. UTI
B. Renal stone
C. Bladder cancer
D. Glomerulonephritis
Answer: Bladder cancer
Rationale: Painless gross hematuria in an older smoker is highly suspicious for
bladder cancer and must be ruled out first.
6. The presence of a positive Romberg test indicates:
A. Cerebellar dysfunction
B. Vestibular or proprioceptive dysfunction
,3 | Page
C. Upper motor neuron lesion
D. Lower motor neuron lesion
Answer: Vestibular or proprioceptive dysfunction
Rationale: A positive Romberg test (swaying/falling with eyes closed) indicates
impaired proprioception or vestibular function, not cerebellar dysfunction (where
imbalance occurs even with eyes open).
7. Which heart murmur is described as a “harsh systolic ejection murmur”
radiating to the carotids?
A. Mitral regurgitation
B. Aortic stenosis
C. Aortic regurgitation
D. Mitral stenosis
Answer: Aortic stenosis
Rationale: Aortic stenosis produces a crescendo-decrescendo systolic murmur best
heard at the right second intercostal space, often radiating to the carotids.
8. Which lung sound is commonly heard in asthma?
A. Crackles
B. Rhonchi
C. Wheezes
D. Pleural rub
Answer: Wheezes
Rationale: Wheezes are high-pitched, musical sounds caused by narrowed
airways, often heard in asthma and COPD exacerbations.
9. Which abdominal finding is most consistent with ascites?
A. Positive Murphy’s sign
B. Shifting dullness
, 4 | Page
C. Rebound tenderness
D. Pulsatile mass
Answer: Shifting dullness
Rationale: Ascites (fluid accumulation) is detected by shifting dullness on
percussion when the patient changes position.
10. Which cranial nerve is assessed by asking a patient to shrug shoulders
against resistance?
A. Cranial nerve X
B. Cranial nerve XI
C. Cranial nerve VII
D. Cranial nerve VI
Answer: Cranial nerve XI
Rationale: The spinal accessory nerve (CN XI) controls the trapezius and
sternocleidomastoid, tested by shoulder shrug and head rotation against resistance.
11. A positive Phalen’s and Tinel’s test is indicative of:
A. Ulnar nerve entrapment
B. Radial nerve palsy
C. Carpal tunnel syndrome
D. Tennis elbow
Answer: Carpal tunnel syndrome
Rationale: Phalen’s test (wrist flexion) and Tinel’s sign (tapping the median nerve)
reproduce paresthesias in carpal tunnel syndrome.
12. A patient with mitral stenosis is most likely to develop which complication?
A. Pulmonary hypertension
B. Aortic aneurysm
