NURS 6512 Exam 2 V2 | NURS 6512
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 2) |
Walden University
1. When conducting a visual acuity test using the Snellen chart, a patient is determined to
have 20/40 vision. How should the examiner interpret this finding?
A. The patient can read at 40 feet what a person with normal vision reads at 20 feet.
B. The patient has perfect vision in the right eye but limited vision in the left.
C. The patient’s vision is twice as sharp as the average person.
D. The patient can read at 20 feet what a person with normal vision reads at 40 feet.
Answer: D
Rationale: The Snellen fraction’s numerator indicates the distance the patient is from the
chart, while the denominator indicates the distance at which a normal eye can read that
line. A result of 20/40 suggests that the patient’s vision is less acute than the standard
reference. This assessment is a fundamental component of the cranial nerve II examination.
2. During the assessment of the neck, the nurse practitioner notes a soft, rushing sound heard
with the bell of the stethoscope over the thyroid gland. This finding is most consistent with:
A. Hyperthyroidism causing a thyroid bruit.
B. A normal thyroid gland functioning.
,C. Hypothyroidism with nodular development.
D. The presence of a carotid artery stenosis.
Answer: A
Rationale: A thyroid bruit is a vascular murmur heard over the thyroid gland due to
increased blood flow. This clinical sign is frequently associated with hypermetabolic states
such as Graves’ disease or hyperthyroidism. Proper auscultation with the bell is required to
distinguish this sound from other vascular noises.
3. When assessing for tactile fremitus on the posterior chest, the examiner notes increased
vibrations over the right lower lobe. This finding most likely indicates:
A. A large pneumothorax on the right side.
B. Pneumonia with lung consolidation.
C. Chronic obstructive pulmonary disease (COPD).
D. Pleural effusion in the lower lung base.
Answer: B
Rationale: Tactile fremitus is the vibration felt by the hands through the chest wall when a
patient speaks. Increased fremitus occurs when the lung tissue becomes solid or
consolidated, as seen in pneumonia. Conversely, air or fluid in the pleural space would
decrease these vibrations.
, 4. The nurse practitioner is performing the Rinne test on a patient. If the patient reports that
the sound is heard longer via bone conduction than by air conduction (BC > AC), the finding
suggests:
A. Normal hearing in both ears.
B. Sensorineural hearing loss in the affected ear.
C. A benign growth on the eighth cranial nerve.
D. Conductive hearing loss in the affected ear.
Answer: D
Rationale: In a healthy ear, air conduction (AC) should be twice as long as bone conduction
(BC). When BC is equal to or greater than AC, it indicates a conductive hearing loss, often
caused by wax or fluid. This test helps differentiate between external/middle ear issues
and inner ear damage.
5. While examining the eyes, the practitioner observes a rhythmic, oscillating movement of
the eyes. This condition is documented as:
A. Strabismus.
B. Nystagmus.
C. Exophthalmos.
D. Ptosis.
Answer: B
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 2) |
Walden University
1. When conducting a visual acuity test using the Snellen chart, a patient is determined to
have 20/40 vision. How should the examiner interpret this finding?
A. The patient can read at 40 feet what a person with normal vision reads at 20 feet.
B. The patient has perfect vision in the right eye but limited vision in the left.
C. The patient’s vision is twice as sharp as the average person.
D. The patient can read at 20 feet what a person with normal vision reads at 40 feet.
Answer: D
Rationale: The Snellen fraction’s numerator indicates the distance the patient is from the
chart, while the denominator indicates the distance at which a normal eye can read that
line. A result of 20/40 suggests that the patient’s vision is less acute than the standard
reference. This assessment is a fundamental component of the cranial nerve II examination.
2. During the assessment of the neck, the nurse practitioner notes a soft, rushing sound heard
with the bell of the stethoscope over the thyroid gland. This finding is most consistent with:
A. Hyperthyroidism causing a thyroid bruit.
B. A normal thyroid gland functioning.
,C. Hypothyroidism with nodular development.
D. The presence of a carotid artery stenosis.
Answer: A
Rationale: A thyroid bruit is a vascular murmur heard over the thyroid gland due to
increased blood flow. This clinical sign is frequently associated with hypermetabolic states
such as Graves’ disease or hyperthyroidism. Proper auscultation with the bell is required to
distinguish this sound from other vascular noises.
3. When assessing for tactile fremitus on the posterior chest, the examiner notes increased
vibrations over the right lower lobe. This finding most likely indicates:
A. A large pneumothorax on the right side.
B. Pneumonia with lung consolidation.
C. Chronic obstructive pulmonary disease (COPD).
D. Pleural effusion in the lower lung base.
Answer: B
Rationale: Tactile fremitus is the vibration felt by the hands through the chest wall when a
patient speaks. Increased fremitus occurs when the lung tissue becomes solid or
consolidated, as seen in pneumonia. Conversely, air or fluid in the pleural space would
decrease these vibrations.
, 4. The nurse practitioner is performing the Rinne test on a patient. If the patient reports that
the sound is heard longer via bone conduction than by air conduction (BC > AC), the finding
suggests:
A. Normal hearing in both ears.
B. Sensorineural hearing loss in the affected ear.
C. A benign growth on the eighth cranial nerve.
D. Conductive hearing loss in the affected ear.
Answer: D
Rationale: In a healthy ear, air conduction (AC) should be twice as long as bone conduction
(BC). When BC is equal to or greater than AC, it indicates a conductive hearing loss, often
caused by wax or fluid. This test helps differentiate between external/middle ear issues
and inner ear damage.
5. While examining the eyes, the practitioner observes a rhythmic, oscillating movement of
the eyes. This condition is documented as:
A. Strabismus.
B. Nystagmus.
C. Exophthalmos.
D. Ptosis.
Answer: B
