NURS 6512 Final Exam V1 | NURS 6512
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Final
Exam) | Walden University
1. A 55-year-old patient presents with sudden onset of ‘the worst headache of my life.’ Which
of the following is the most appropriate next step in assessment?
A. Assess for cranial nerve V function.
B. Perform a funduscopic examination for papilledema.
C. Evaluate for meningeal signs and immediate neurological imaging.
D. Administer an NSAID and reassess in one hour.
Answer: C
Rationale: A sudden, severe headache described as the ‘worst of life’ is a classic
presentation for a subarachnoid hemorrhage. The clinician must prioritize evaluating for
signs of intracranial pressure or meningeal irritation. Immediate referral for imaging such
as a CT scan is mandatory to rule out life-threatening conditions.
2. During the physical exam of a 72-year-old male, the clinician notes a rhythmic tremor that
is most prominent when the patient is at rest and disappears during purposeful movement.
This finding is most consistent with:
A. Cerebellar ataxia.
,B. Essential tremor.
C. Parkinson’s disease.
D. Hyperthyroidism.
Answer: C
Rationale: Resting tremors, often described as ‘pill-rolling,’ are hallmark signs of
Parkinson’s disease. Unlike essential tremors, which occur with activity, Parkinsonian
tremors diminish when the limb is engaged in voluntary motion. This condition is typically
associated with other motor symptoms like bradykinesia and postural instability.
3. When performing a respiratory assessment, the clinician notes increased tactile fremitus
over the right lower lobe. This finding suggests:
A. Pneumothorax.
B. Lobar pneumonia.
C. Chronic Obstructive Pulmonary Disease (COPD).
D. Pleural effusion.
Answer: B
Rationale: Tactile fremitus is the vibration felt on the chest wall when the patient speaks.
It is increased in conditions where lung tissue becomes consolidated, such as in lobar
pneumonia. Conversely, air or fluid in the pleural space, as seen in pneumothorax or
effusion, will decrease the transmission of vibrations.
, 4. In a patient with suspected acute appendicitis, the clinician performs a test by applying
pressure to the left lower quadrant and observes pain in the right lower quadrant. This is
known as:
A. Murphy sign.
B. Rovsing sign.
C. McBurney’s point tenderness.
D. Psoas sign.
Answer: B
Rationale: Rovsing sign is a clinical indicator used to identify peritoneal irritation in the
right lower quadrant. By compressing the left side of the abdomen, the clinician shifts gas
and increases pressure, which elicits pain on the inflamed side. This is one of several
maneuvers used to support a diagnosis of appendicitis.
5. A patient exhibits a ‘strawberry tongue’ and a fine, sandpaper-like rash during a physical
exam. These findings are most characteristic of:
A. Measles (Rubeola).
B. Mononucleosis.
C. Kawasaki disease.
D. Scarlet fever.
Answer: D
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Final
Exam) | Walden University
1. A 55-year-old patient presents with sudden onset of ‘the worst headache of my life.’ Which
of the following is the most appropriate next step in assessment?
A. Assess for cranial nerve V function.
B. Perform a funduscopic examination for papilledema.
C. Evaluate for meningeal signs and immediate neurological imaging.
D. Administer an NSAID and reassess in one hour.
Answer: C
Rationale: A sudden, severe headache described as the ‘worst of life’ is a classic
presentation for a subarachnoid hemorrhage. The clinician must prioritize evaluating for
signs of intracranial pressure or meningeal irritation. Immediate referral for imaging such
as a CT scan is mandatory to rule out life-threatening conditions.
2. During the physical exam of a 72-year-old male, the clinician notes a rhythmic tremor that
is most prominent when the patient is at rest and disappears during purposeful movement.
This finding is most consistent with:
A. Cerebellar ataxia.
,B. Essential tremor.
C. Parkinson’s disease.
D. Hyperthyroidism.
Answer: C
Rationale: Resting tremors, often described as ‘pill-rolling,’ are hallmark signs of
Parkinson’s disease. Unlike essential tremors, which occur with activity, Parkinsonian
tremors diminish when the limb is engaged in voluntary motion. This condition is typically
associated with other motor symptoms like bradykinesia and postural instability.
3. When performing a respiratory assessment, the clinician notes increased tactile fremitus
over the right lower lobe. This finding suggests:
A. Pneumothorax.
B. Lobar pneumonia.
C. Chronic Obstructive Pulmonary Disease (COPD).
D. Pleural effusion.
Answer: B
Rationale: Tactile fremitus is the vibration felt on the chest wall when the patient speaks.
It is increased in conditions where lung tissue becomes consolidated, such as in lobar
pneumonia. Conversely, air or fluid in the pleural space, as seen in pneumothorax or
effusion, will decrease the transmission of vibrations.
, 4. In a patient with suspected acute appendicitis, the clinician performs a test by applying
pressure to the left lower quadrant and observes pain in the right lower quadrant. This is
known as:
A. Murphy sign.
B. Rovsing sign.
C. McBurney’s point tenderness.
D. Psoas sign.
Answer: B
Rationale: Rovsing sign is a clinical indicator used to identify peritoneal irritation in the
right lower quadrant. By compressing the left side of the abdomen, the clinician shifts gas
and increases pressure, which elicits pain on the inflamed side. This is one of several
maneuvers used to support a diagnosis of appendicitis.
5. A patient exhibits a ‘strawberry tongue’ and a fine, sandpaper-like rash during a physical
exam. These findings are most characteristic of:
A. Measles (Rubeola).
B. Mononucleosis.
C. Kawasaki disease.
D. Scarlet fever.
Answer: D
