NR 509 ADVANCED ASSESSMENT
NR 509 Total Mastery Blueprint: The Complete
A+ Guide to Advanced Physical Assessment,
Clinical Reasoning & Diagnostic Excellence
Weber test in conductive hearing loss - Answer- In conductive hearing loss, tone is louder
on affected side, because compensatory neural mechanisms or mechanical factors increase
the perceived volume on the side of conduction problem
Rinne test - Answer- hearing test using a tuning fork; checks for differences in bone
conduction and air conduction
Rinne test - Answer- hearing acuity test performed with a vibrating tuning fork that is first
placed on the mastoid process and then in front of the external auditory canal to test bone
and air conduction
Weber test - Answer- Test done by placing the stem of a vibrating tuning fork on the
midline of the head and having the patient indicate in which ear the tone can be heard.
Dysarthria definition - Answer- Is a group of neurologic speech disorders that reflect
abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements
required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of
speech production
vestibular - Answer- the sense of body movement and position, including the sense of
balance
Snellen test - Answer- a distance visual acuity test which determines the smallest letters
that can be read on a chart from a distance of 20 feet away
pg. 1
, NR 509 ADVANCED ASSESSMENT
Snellen eye - Answer- OFirst indicates the distance of the patient from the chart (20 feet),
OSecond, the distance at which a normal eye can read the line of lettersOThe larger the
second number, the worse the vision.
O"20/40 corrected" means the patient could read the 20/40 line with glasses (a correction
rotator cuff tear - Answer- The Apley scratch test is another useful maneuver to assess
shoulder range of motion (Figure 2). In this test, abduction and external rotation are
measured by having the patient reach behind the head and touch the superior aspect of the
opposite scapula
Empty can test
Cross body test
Cross Body Adduction Test - Answer- Flex shoulder to 90 degrees, pull arm across body;
Pain at AC indicates AC pathology/arthritis
condylar joint - Answer- egg-shaped articular surface of one bone fits into an oval
concavity in another
Empty Can Test - Answer- flexion and internal rotation of the shoulder followed by
resistance to observe for weakening of the supraspinatus muscle
Drop Arm Test - Answer- abduction of the arm followed by controlled lowering to assess
the possibility of injury to the rotator cuff
Presentation of Acute Rheumatoid Arthritis - Answer- OTender, painful, stiff joints in RA,
usually with symmetric involvement on both sides of the body.
OThe distal interphalangeal (DIP), metacarpophalangeal (MCP)
Owrist joints are the most frequently affected
ONote the fusiform or spindle-shaped swelling of the PIP joints in acute disease
pg. 2
, NR 509 ADVANCED ASSESSMENT
Presentation of chronic rheumatoid arthritis - Answer- OIn chronic disease, note the
swelling and thickening of the MCP and PIP joints.
ORange of motion becomes limited, and fingers may deviate toward the ulnar side.
Rheumatoid nodules are seen in the acute or the chronic stage - Answer-
risk factors of melanoma - Answer- Risk Factors for Melanoma
• Personal or family history of previous melanoma4.7-9
• 250 common moles
• Atypical or large moles, especially if dysplastic
• Red or light hair
• Solar lentigines (acquired brown macules on sun-exposed areas)
• Freckles (inherited brown macules)
• Ultraviolet radiation from heavy sun exposure, sunlamps, or tanning booths
• Light eye or skin color, especially skin that freckles or burns easily
• Severe blistering sunburns in childhood
• Immunosuppression from human immunodeficiency virus (HIV) or from
chemotherapy
• Personal history of nonmelanoma skin cancer
ABCDE rule of melanoma - Answer- OAsymmetry: (compare one side to the other)
OBorder irregularity: look for ragged, notched or blurred
OColor variations: more than 2 colors(blue black) (brown red), loss of pigment, or redness
ODiameter >6 mm: size of pencil eraser
OEvolving: changing rapidly in size, symptoms, or morphology (usually asymmetrical)
OAlso look for elevation, firmness to palpate, growing progressively over several weeks.
pg. 3
NR 509 Total Mastery Blueprint: The Complete
A+ Guide to Advanced Physical Assessment,
Clinical Reasoning & Diagnostic Excellence
Weber test in conductive hearing loss - Answer- In conductive hearing loss, tone is louder
on affected side, because compensatory neural mechanisms or mechanical factors increase
the perceived volume on the side of conduction problem
Rinne test - Answer- hearing test using a tuning fork; checks for differences in bone
conduction and air conduction
Rinne test - Answer- hearing acuity test performed with a vibrating tuning fork that is first
placed on the mastoid process and then in front of the external auditory canal to test bone
and air conduction
Weber test - Answer- Test done by placing the stem of a vibrating tuning fork on the
midline of the head and having the patient indicate in which ear the tone can be heard.
Dysarthria definition - Answer- Is a group of neurologic speech disorders that reflect
abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements
required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of
speech production
vestibular - Answer- the sense of body movement and position, including the sense of
balance
Snellen test - Answer- a distance visual acuity test which determines the smallest letters
that can be read on a chart from a distance of 20 feet away
pg. 1
, NR 509 ADVANCED ASSESSMENT
Snellen eye - Answer- OFirst indicates the distance of the patient from the chart (20 feet),
OSecond, the distance at which a normal eye can read the line of lettersOThe larger the
second number, the worse the vision.
O"20/40 corrected" means the patient could read the 20/40 line with glasses (a correction
rotator cuff tear - Answer- The Apley scratch test is another useful maneuver to assess
shoulder range of motion (Figure 2). In this test, abduction and external rotation are
measured by having the patient reach behind the head and touch the superior aspect of the
opposite scapula
Empty can test
Cross body test
Cross Body Adduction Test - Answer- Flex shoulder to 90 degrees, pull arm across body;
Pain at AC indicates AC pathology/arthritis
condylar joint - Answer- egg-shaped articular surface of one bone fits into an oval
concavity in another
Empty Can Test - Answer- flexion and internal rotation of the shoulder followed by
resistance to observe for weakening of the supraspinatus muscle
Drop Arm Test - Answer- abduction of the arm followed by controlled lowering to assess
the possibility of injury to the rotator cuff
Presentation of Acute Rheumatoid Arthritis - Answer- OTender, painful, stiff joints in RA,
usually with symmetric involvement on both sides of the body.
OThe distal interphalangeal (DIP), metacarpophalangeal (MCP)
Owrist joints are the most frequently affected
ONote the fusiform or spindle-shaped swelling of the PIP joints in acute disease
pg. 2
, NR 509 ADVANCED ASSESSMENT
Presentation of chronic rheumatoid arthritis - Answer- OIn chronic disease, note the
swelling and thickening of the MCP and PIP joints.
ORange of motion becomes limited, and fingers may deviate toward the ulnar side.
Rheumatoid nodules are seen in the acute or the chronic stage - Answer-
risk factors of melanoma - Answer- Risk Factors for Melanoma
• Personal or family history of previous melanoma4.7-9
• 250 common moles
• Atypical or large moles, especially if dysplastic
• Red or light hair
• Solar lentigines (acquired brown macules on sun-exposed areas)
• Freckles (inherited brown macules)
• Ultraviolet radiation from heavy sun exposure, sunlamps, or tanning booths
• Light eye or skin color, especially skin that freckles or burns easily
• Severe blistering sunburns in childhood
• Immunosuppression from human immunodeficiency virus (HIV) or from
chemotherapy
• Personal history of nonmelanoma skin cancer
ABCDE rule of melanoma - Answer- OAsymmetry: (compare one side to the other)
OBorder irregularity: look for ragged, notched or blurred
OColor variations: more than 2 colors(blue black) (brown red), loss of pigment, or redness
ODiameter >6 mm: size of pencil eraser
OEvolving: changing rapidly in size, symptoms, or morphology (usually asymmetrical)
OAlso look for elevation, firmness to palpate, growing progressively over several weeks.
pg. 3
