NURS 6512 Exam 4 V1 | NURS 6512
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 4) |
Walden University
1. A 45-year-old patient presents with numbness and tingling in the thumb, index, and middle
fingers. The clinician performs the Phalen test. Which of the following describes a positive
finding?
A. Pain upon percussion of the median nerve at the wrist.
B. Weakness of the abductor pollicis brevis muscle.
C. Numbness or tingling in the median nerve distribution after 60 seconds of wrist flexion.
D. Inability to maintain the wrist in an extended position against resistance.
Answer: C
Rationale: The Phalen test is used to assess for Carpal Tunnel Syndrome by compressing
the median nerve. The patient is asked to hold the backs of their hands together with wrists
flexed at 90 degrees for one minute. A positive test is indicated by the reproduction of
paresthesia in the thumb and first two fingers.
2. During a neurological examination, the clinician asks the patient to identify a common
object, such as a key, placed in their hand while their eyes are closed. This test evaluates:
A. Two-point discrimination
,B. Graphesthesia
C. Stereognosis
D. Extinction phenomenon
Answer: C
Rationale: Stereognosis is the ability to perceive and recognize the form of an object in the
absence of visual and auditory information. This test specifically evaluates the cortical
sensory function of the parietal lobe. Impairment suggests a lesion in the sensory cortex or
posterior columns of the spinal cord.
3. When assessing the deep tendon reflexes of a patient, the clinician notes a reflex that is
brisk and hyperactive with intermittent clonus. How should this be graded?
A. 1+
B. 2+
C. 3+
D. 4+
Answer: D
Rationale: Reflexes are graded on a scale from 0 to 4+. A grade of 4+ indicates a very brisk,
hyperactive response often associated with clonus, which is indicative of upper motor
neuron disease. Grade 2+ is considered normal or average, while 0 is absent.
, 4. A 22-year-old male presents with a sudden onset of severe scrotal pain and swelling. On
examination, the clinician notes the absence of the cremasteric reflex on the affected side.
This is most suggestive of:
A. Epididymitis
B. Varicocele
C. Hydrocele
D. Testicular torsion
Answer: D
Rationale: Testicular torsion is a surgical emergency characterized by the twisting of the
spermatic cord, which cuts off blood supply. The absence of the cremasteric reflex is a
hallmark physical finding in many cases of torsion. Immediate intervention is required to
prevent necrosis and loss of the testicle.
5. The Lachman test is used to evaluate the integrity of which of the following structures?
A. Medial collateral ligament
B. Anterior cruciate ligament
C. Posterior cruciate ligament
D. Lateral meniscus
Answer: B
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 4) |
Walden University
1. A 45-year-old patient presents with numbness and tingling in the thumb, index, and middle
fingers. The clinician performs the Phalen test. Which of the following describes a positive
finding?
A. Pain upon percussion of the median nerve at the wrist.
B. Weakness of the abductor pollicis brevis muscle.
C. Numbness or tingling in the median nerve distribution after 60 seconds of wrist flexion.
D. Inability to maintain the wrist in an extended position against resistance.
Answer: C
Rationale: The Phalen test is used to assess for Carpal Tunnel Syndrome by compressing
the median nerve. The patient is asked to hold the backs of their hands together with wrists
flexed at 90 degrees for one minute. A positive test is indicated by the reproduction of
paresthesia in the thumb and first two fingers.
2. During a neurological examination, the clinician asks the patient to identify a common
object, such as a key, placed in their hand while their eyes are closed. This test evaluates:
A. Two-point discrimination
,B. Graphesthesia
C. Stereognosis
D. Extinction phenomenon
Answer: C
Rationale: Stereognosis is the ability to perceive and recognize the form of an object in the
absence of visual and auditory information. This test specifically evaluates the cortical
sensory function of the parietal lobe. Impairment suggests a lesion in the sensory cortex or
posterior columns of the spinal cord.
3. When assessing the deep tendon reflexes of a patient, the clinician notes a reflex that is
brisk and hyperactive with intermittent clonus. How should this be graded?
A. 1+
B. 2+
C. 3+
D. 4+
Answer: D
Rationale: Reflexes are graded on a scale from 0 to 4+. A grade of 4+ indicates a very brisk,
hyperactive response often associated with clonus, which is indicative of upper motor
neuron disease. Grade 2+ is considered normal or average, while 0 is absent.
, 4. A 22-year-old male presents with a sudden onset of severe scrotal pain and swelling. On
examination, the clinician notes the absence of the cremasteric reflex on the affected side.
This is most suggestive of:
A. Epididymitis
B. Varicocele
C. Hydrocele
D. Testicular torsion
Answer: D
Rationale: Testicular torsion is a surgical emergency characterized by the twisting of the
spermatic cord, which cuts off blood supply. The absence of the cremasteric reflex is a
hallmark physical finding in many cases of torsion. Immediate intervention is required to
prevent necrosis and loss of the testicle.
5. The Lachman test is used to evaluate the integrity of which of the following structures?
A. Medial collateral ligament
B. Anterior cruciate ligament
C. Posterior cruciate ligament
D. Lateral meniscus
Answer: B
