NU 650 Advanced Health Assessment ACTUAL
EXAM 2026/2027: 100% Verified Questions &
Correct Answers
Question 1: A 68-year-old woman presents with 3 weeks of progressive morning headaches and
“blurry” vision when looking at distant objects. On exam, you note a relative afferent pupillary
defect (RAPD) OS and optic disc pallor. Visual-field testing by confrontation shows a
superior-temporal defect OD and an inferior-nasal defect OS. Which targeted physical-exam
maneuver best confirms the expected optic-nerve pathology?
A. Direct ophthalmoscopy with undilated 4× lens
B. swinging-flashlight test comparing both eyes
C. Fundus photography with red-free filter
D. Pupil dilation and slit-lamp biomicroscopy
Correct Answer: B
Rationale: The swinging-flashlight test directly demonstrates RAPD by revealing paradoxical
pupillary dilation when light swings to the affected eye, confirming optic-nerve dysfunction
consistent with optic neuritis or anterior ischemic optic neuropathy.
,Question 2: A 4-year-old boy is brought in after a febrile illness with new “winking” of the left eye
and intermittent upward deviation of the right eye. Exam shows a left facial droop that worsens
when the child smiles. Otoscopy reveals a normal tympanic membrane. Which cranial-nerve
assessment best localizes the lesion?
A. Corneal reflex testing of CN V1
B. Taste sensation on the anterior two-thirds of the tongue
C. Scleral elevation test for Bell phenomenon
D. Whispered-voice test at 60 cm
Correct Answer: B
Rationale: Loss of taste on the ipsilateral anterior tongue confirms involvement of the chorda
tympani branch of facial nerve (CN VII), supporting a lower-motor-neuron facial palsy—common in
pediatric Lyme disease or post-viral neuritis.
Question 3: A 54-year-old man with longstanding hypertension is unable to heel-walk. Strength is
5/5 plantar-flexion but 4/5 dorsiflexion. Light-touch is absent over the lateral malleolus and dorsal
foot. Which peripheral-nerve lesion best accounts for these findings?
A. Common peroneal (fibular) neuropathy at the fibular head
B. Tibial nerve entrapment in the tarsal tunnel
C. L5 radiculopathy
,D. S1–S2 radiculopathy
Correct Answer: A
Rationale: Weak dorsiflexion/eversion plus sensory loss over the dorsal foot is the classic pattern
of common peroneal compression—often from crossing legs or prolonged squatting—sparing
plantar-flexion (tibial nerve).
Question 4: A 77-year-old man with CHF reports new right-hand weakness lasting 10 min this
morning. Carotid auscultation reveals a faint, high-pitched systolic bruit just beneath the angle of
the jaw. Which auscultatory technique best distinguishes critical internal-carotid stenosis from
external-carotid turbulence?
A. Have the patient hold breath in expiration and listen over the thyroid cartilage
B. Auscultate while the patient performs a Valsalva maneuver
C. Listen with the bell during slow neck extension while patient turns head away
D. Compress the ipsilateral temporal artery while listening
Correct Answer: C
Rationale: Using the bell with the neck extended and rotated lengthens the carotid bulb, allowing
clearer localization of a soft, high-frequency bruit of ≥ 70 % ICA stenosis; breath-holding eliminates
transmitted cardiac murmurs.
, Question 5: A 29-year-old woman 8 weeks postpartum describes “can’t catch my breath” and sharp
chest pain when nursing. Vitals: HR 105, BP 118/78, RR 22, SpO₂ 97 % RA. Inspection shows mild
jugular venous distension to the angle of the jaw at 30° elevation. Which bedside maneuver best
differentiates deconditioning from peripartum cardiomyopathy?
A. Pulsus paradoxus by manual sphygmomanometer
B. Hepatojugular (abdominojugular) reflux test
C. Passive straight-leg raise at 45° for 2 min
D. Orthostatic vital signs
Correct Answer: B
Rationale: Sustained JVP rise > 4 cm for ≥ 15 s during right-upper-quadrant pressure indicates
right-heart inability to handle increased venous return—supporting early heart failure rather than
simple deconditioning.
Question 6: A 6-year-old girl has a 2-day limp and refuses to weight-bear on the left leg. Hip flexion
to 90° produces pain and limited internal rotation. Which special test best confirms irritable hip
versus septic arthritis?
A. FABER (Patrick) test
B. Trendelenburg test
C. Log-roll test with passive hip rotation
EXAM 2026/2027: 100% Verified Questions &
Correct Answers
Question 1: A 68-year-old woman presents with 3 weeks of progressive morning headaches and
“blurry” vision when looking at distant objects. On exam, you note a relative afferent pupillary
defect (RAPD) OS and optic disc pallor. Visual-field testing by confrontation shows a
superior-temporal defect OD and an inferior-nasal defect OS. Which targeted physical-exam
maneuver best confirms the expected optic-nerve pathology?
A. Direct ophthalmoscopy with undilated 4× lens
B. swinging-flashlight test comparing both eyes
C. Fundus photography with red-free filter
D. Pupil dilation and slit-lamp biomicroscopy
Correct Answer: B
Rationale: The swinging-flashlight test directly demonstrates RAPD by revealing paradoxical
pupillary dilation when light swings to the affected eye, confirming optic-nerve dysfunction
consistent with optic neuritis or anterior ischemic optic neuropathy.
,Question 2: A 4-year-old boy is brought in after a febrile illness with new “winking” of the left eye
and intermittent upward deviation of the right eye. Exam shows a left facial droop that worsens
when the child smiles. Otoscopy reveals a normal tympanic membrane. Which cranial-nerve
assessment best localizes the lesion?
A. Corneal reflex testing of CN V1
B. Taste sensation on the anterior two-thirds of the tongue
C. Scleral elevation test for Bell phenomenon
D. Whispered-voice test at 60 cm
Correct Answer: B
Rationale: Loss of taste on the ipsilateral anterior tongue confirms involvement of the chorda
tympani branch of facial nerve (CN VII), supporting a lower-motor-neuron facial palsy—common in
pediatric Lyme disease or post-viral neuritis.
Question 3: A 54-year-old man with longstanding hypertension is unable to heel-walk. Strength is
5/5 plantar-flexion but 4/5 dorsiflexion. Light-touch is absent over the lateral malleolus and dorsal
foot. Which peripheral-nerve lesion best accounts for these findings?
A. Common peroneal (fibular) neuropathy at the fibular head
B. Tibial nerve entrapment in the tarsal tunnel
C. L5 radiculopathy
,D. S1–S2 radiculopathy
Correct Answer: A
Rationale: Weak dorsiflexion/eversion plus sensory loss over the dorsal foot is the classic pattern
of common peroneal compression—often from crossing legs or prolonged squatting—sparing
plantar-flexion (tibial nerve).
Question 4: A 77-year-old man with CHF reports new right-hand weakness lasting 10 min this
morning. Carotid auscultation reveals a faint, high-pitched systolic bruit just beneath the angle of
the jaw. Which auscultatory technique best distinguishes critical internal-carotid stenosis from
external-carotid turbulence?
A. Have the patient hold breath in expiration and listen over the thyroid cartilage
B. Auscultate while the patient performs a Valsalva maneuver
C. Listen with the bell during slow neck extension while patient turns head away
D. Compress the ipsilateral temporal artery while listening
Correct Answer: C
Rationale: Using the bell with the neck extended and rotated lengthens the carotid bulb, allowing
clearer localization of a soft, high-frequency bruit of ≥ 70 % ICA stenosis; breath-holding eliminates
transmitted cardiac murmurs.
, Question 5: A 29-year-old woman 8 weeks postpartum describes “can’t catch my breath” and sharp
chest pain when nursing. Vitals: HR 105, BP 118/78, RR 22, SpO₂ 97 % RA. Inspection shows mild
jugular venous distension to the angle of the jaw at 30° elevation. Which bedside maneuver best
differentiates deconditioning from peripartum cardiomyopathy?
A. Pulsus paradoxus by manual sphygmomanometer
B. Hepatojugular (abdominojugular) reflux test
C. Passive straight-leg raise at 45° for 2 min
D. Orthostatic vital signs
Correct Answer: B
Rationale: Sustained JVP rise > 4 cm for ≥ 15 s during right-upper-quadrant pressure indicates
right-heart inability to handle increased venous return—supporting early heart failure rather than
simple deconditioning.
Question 6: A 6-year-old girl has a 2-day limp and refuses to weight-bear on the left leg. Hip flexion
to 90° produces pain and limited internal rotation. Which special test best confirms irritable hip
versus septic arthritis?
A. FABER (Patrick) test
B. Trendelenburg test
C. Log-roll test with passive hip rotation
