Question 1 of 100 SKIN, HAIR & NAILS
NR509 Week 8 Final Exam
Which cranial nerve is tested by assessing shoulder shrug and head rotation against resistance?
Answer choices:
A. Spinal accessory (CN XI)
B. Glossopharyngeal (CN IX)
C. Vagus (CN X)
D. Hypoglossal (CN XII)
✅ Correct answer: A. Spinal accessory (CN XI)
Explanation:
The spinal accessory nerve (cranial nerve XI) innervates the trapezius and sternocleidomastoid
muscles. Testing shoulder shrug evaluates the trapezius, and testing head rotation against resistance
evaluates the sternocleidomastoid—both functions of CN XI.
, Question 2 of 100 SKIN, HAIR & NAILS
A patient reports abdominal pain that began in the periumbilical region and later migrated to the
right lower quadrant. Which diagnosis should be considered?
Answer choices:
A. Acute cholecystitis
B. Peptic ulcer disease
C. Irritable bowel syndrome
D. Acute appendicitis
✅ Correct answer: D. Acute appendicitis
Explanation:
A classic presentation of acute appendicitis is pain that starts around the umbilicus (periumbilical
pain) due to visceral nerve irritation, then moves to the right lower quadrant (RLQ) as inflammation
spreads to the parietal peritoneum near the appendix. Other common findings include fever,
nausea/vomiting, and tenderness at McBurney’s point.
, Question 3 of 100 SKIN, HAIR & NAILS
A patient presents to the nurse practitioner with a severe headache, fever, and a stiff, painful neck.
During the physical examination, the NP flexes the patient's neck forward and notes involuntary
flexion of the hips and knees. Which of the following physical examination findings is being
assessed?
A. Kernig sign
B. Brudzinski sign
C. Spurling test
D. Cervical lymphadenopathy
✅ Correct Answer: B. Brudzinski sign
Explanation:
The Brudzinski sign is a meningeal irritation test. When the examiner passively flexes the patient's
neck, involuntary flexion of the hips and knees suggests meningeal irritation, commonly associated
with meningitis.
, Question 4 of 100 SKIN, HAIR & NAILS
A 27-year-old female presents for a breast examination with a history of fibroadenomas. The nurse
practitioner notes a rubbery, mobile, nontender mass in the right breast. Which of the following
describes the proper documentation of this finding?
A. Rubbery, mobile, nontender mass located in the right breast, in the upper inner quadrant
B. Rubbery, mobile, nontender mass located in the right breast, upper outer quadrant
C. Rubbery, mobile, nontender mass located in the right breast, in the 1:30 position from the nipple
D. Rubbery, mobile, nontender mass located in the right breast, in the 10:30 position from the nipple
✅ Most likely correct answer: C. Rubbery, mobile, nontender mass located in the right breast, in
the 1:30 position from the nipple
NR509 Week 8 Final Exam
Which cranial nerve is tested by assessing shoulder shrug and head rotation against resistance?
Answer choices:
A. Spinal accessory (CN XI)
B. Glossopharyngeal (CN IX)
C. Vagus (CN X)
D. Hypoglossal (CN XII)
✅ Correct answer: A. Spinal accessory (CN XI)
Explanation:
The spinal accessory nerve (cranial nerve XI) innervates the trapezius and sternocleidomastoid
muscles. Testing shoulder shrug evaluates the trapezius, and testing head rotation against resistance
evaluates the sternocleidomastoid—both functions of CN XI.
, Question 2 of 100 SKIN, HAIR & NAILS
A patient reports abdominal pain that began in the periumbilical region and later migrated to the
right lower quadrant. Which diagnosis should be considered?
Answer choices:
A. Acute cholecystitis
B. Peptic ulcer disease
C. Irritable bowel syndrome
D. Acute appendicitis
✅ Correct answer: D. Acute appendicitis
Explanation:
A classic presentation of acute appendicitis is pain that starts around the umbilicus (periumbilical
pain) due to visceral nerve irritation, then moves to the right lower quadrant (RLQ) as inflammation
spreads to the parietal peritoneum near the appendix. Other common findings include fever,
nausea/vomiting, and tenderness at McBurney’s point.
, Question 3 of 100 SKIN, HAIR & NAILS
A patient presents to the nurse practitioner with a severe headache, fever, and a stiff, painful neck.
During the physical examination, the NP flexes the patient's neck forward and notes involuntary
flexion of the hips and knees. Which of the following physical examination findings is being
assessed?
A. Kernig sign
B. Brudzinski sign
C. Spurling test
D. Cervical lymphadenopathy
✅ Correct Answer: B. Brudzinski sign
Explanation:
The Brudzinski sign is a meningeal irritation test. When the examiner passively flexes the patient's
neck, involuntary flexion of the hips and knees suggests meningeal irritation, commonly associated
with meningitis.
, Question 4 of 100 SKIN, HAIR & NAILS
A 27-year-old female presents for a breast examination with a history of fibroadenomas. The nurse
practitioner notes a rubbery, mobile, nontender mass in the right breast. Which of the following
describes the proper documentation of this finding?
A. Rubbery, mobile, nontender mass located in the right breast, in the upper inner quadrant
B. Rubbery, mobile, nontender mass located in the right breast, upper outer quadrant
C. Rubbery, mobile, nontender mass located in the right breast, in the 1:30 position from the nipple
D. Rubbery, mobile, nontender mass located in the right breast, in the 10:30 position from the nipple
✅ Most likely correct answer: C. Rubbery, mobile, nontender mass located in the right breast, in
the 1:30 position from the nipple
