NSG3160 Health Assessment | Exam 2 | Galen College of Nursing 2026/2027
NSG3160 / NSG 3160
Health Assessment
Exam 2
100% Correct Questions & Answers
Comprehensive Physical Assessment & Clinical Judgment
Institution: Galen College of Nursing
Course: NSG3160 - Health Assessment
Exam: Exam 2 (Latest )
Total Questions: 100 Multiple Choice (A-D)
Passing Score: 70%
Cognitive Levels: 30% Recall, 50% Application, 20% Analysis
NSG3160 Exam 2 - Comprehensive Health Assessment Page 1
,NSG3160 Health Assessment | Exam 2 | Galen College of Nursing 2026/2027
Section 1
Ears, Nose, Mouth, and Throat Assessment (Q1-Q15)
Q1: A nurse is performing an otoscopic examination of a client's tympanic membrane. Which finding indicates a normal
tympanic membrane according to the 2026 NSG3160 assessment standards?
A. Red, bulging membrane with absent light reflex
B. Pearly gray, translucent membrane with cone of light at the 5 o'clock position in the right ear [CORRECT]
C. Thickened, opaque membrane with retraction pocket
D. Yellowish membrane with visible air bubbles behind it
Correct Answer: B
Rationale: A normal tympanic membrane should appear pearly gray and translucent with a visible cone of light reflection. In the right
ear, the light reflex typically appears at the 5 o'clock position, and at the 7 o'clock position in the left ear. A red, bulging membrane
with absent light reflex suggests otitis media. A thickened, opaque membrane with retraction indicates chronic otitis media. Yellowish
discoloration with air bubbles behind the membrane suggests otitis media with effusion.
Q2: A nurse performs the Rinne test on a client and notes that bone conduction is heard longer than air conduction in the
left ear. How should the nurse interpret this finding?
A. Normal hearing in the left ear
B. Sensorineural hearing loss in the left ear
C. Conductive hearing loss in the left ear [CORRECT]
D. Mixed hearing loss in the left ear
Correct Answer: C
Rationale: The Rinne test compares air conduction (AC) to bone conduction (BC). In a normal ear, air conduction is heard longer than
bone conduction (AC > BC). When bone conduction is heard longer than or equal to air conduction (BC > AC or BC = AC), this indicates
conductive hearing loss, which may result from conditions such as otitis media, cerumen impaction, or otosclerosis. Sensorineural
hearing loss would still show AC > BC, but both would be decreased. The Weber test is needed to differentiate mixed from purely
conductive loss.
Q3: During a Weber test, a client reports that the sound lateralizes to the right ear. Which condition would produce this
finding if the client has right-sided hearing loss?
A. Right-sided sensorineural hearing loss
B. Right-sided conductive hearing loss [CORRECT]
C. Bilateral normal hearing
D. Left-sided sensorineural hearing loss
Correct Answer: B
Rationale: In the Weber test, sound lateralizes to the affected ear in conductive hearing loss because bone conduction bypasses the
external and middle ear pathology, making the tuning fork sound louder on the side with the conductive defect. In sensorineural
hearing loss, sound lateralizes to the unaffected (better) ear. If the client reports lateralization to the right ear and has right-sided
hearing loss, the loss must be conductive. If the right ear were normal and the left ear had sensorineural loss, sound would also
lateralize to the right, but the question specifies right-sided hearing loss.
Q4: A nurse inspects a client's external nose and notes a deviated nasal septum with bilateral mucosal swelling and clear
discharge. Which assessment technique should the nurse perform next?
A. Transillumination of the frontal and maxillary sinuses
B. Palpation of the frontal and maxillary sinuses for tenderness [CORRECT]
C. Otoscopy of the tympanic membrane
NSG3160 Exam 2 - Comprehensive Health Assessment Page 2
,NSG3160 Health Assessment | Exam 2 | Galen College of Nursing 2026/2027
D. Inspection of the oral cavity for tonsillar enlargement
Correct Answer: B
Rationale: When a client presents with nasal discharge and mucosal swelling, the nurse should assess for sinusitis by palpating the
frontal and maxillary sinuses for tenderness. The frontal sinuses are palpated by pressing upward beneath the supraorbital ridges,
and the maxillary sinuses by pressing on the cheek bones below the eyes. Tenderness on palpation is a hallmark sign of sinusitis.
Transillumination can also be performed but is less reliable. Otoscopy and oral cavity inspection are not the next priority assessments
for nasal symptoms.
Q5: A nurse assesses a client's tonsils and documents them as "3+." What does this grading indicate according to the
standardized tonsil grading scale?
A. Tonsils are visible but within the tonsillar pillars
B. Tonsils extend halfway between the tonsillar pillars and the uvula
C. Tonsils are touching the uvula [CORRECT]
D. Tonsils are touching each other
Correct Answer: C
Rationale: The standardized tonsil grading scale is: 1+ (tonsils visible within tonsillar pillars), 2+ (tonsils extend halfway between
tonsillar pillars and the uvula), 3+ (tonsils touching the uvula), and 4+ (tonsils touching each other, also known as "kissing tonsils"). A
3+ grading indicates significant tonsillar hypertrophy that may cause airway obstruction, difficulty swallowing, or sleep-disordered
breathing. This finding warrants further evaluation for conditions such as recurrent tonsillitis or obstructive sleep apnea.
Q6: A nurse performs a whisper test during a hearing screening. The client correctly repeats the whispered words at 1
foot from each ear. What conclusion should the nurse draw from this finding?
A. The client has significant sensorineural hearing loss
B. The client has conductive hearing loss requiring referral
C. The client demonstrates adequate hearing for a screening test [CORRECT]
D. The client needs audiometric testing for precise thresholds
Correct Answer: C
Rationale: The whisper test is a screening tool for hearing loss, not a diagnostic test. The nurse whispers softly at approximately 1 to 2
feet from the client's ear while occluding the opposite ear canal. If the client can correctly repeat the whispered words, the screening
result is considered normal and no further evaluation is routine. However, the whisper test cannot quantify the degree or type of
hearing loss, distinguish between conductive and sensorineural loss, or replace formal audiometry. It serves as a quick bedside
screening to identify clients who may need comprehensive audiological evaluation.
Q7: A nurse examines a client's oral cavity and observes white, raised, plaque-like lesions on the lateral border of the
tongue that cannot be scraped off. Which condition should the nurse suspect, and what is the most appropriate action?
A. Oral candidiasis; prescribe antifungal medication
B. Leukoplakia; refer for biopsy to rule out malignancy [CORRECT]
C. Aphthous ulcer; recommend topical corticosteroids
D. Herpes simplex; obtain viral culture
Correct Answer: B
Rationale: Leukoplakia presents as white, raised, plaque-like lesions on the oral mucosa that cannot be scraped off, distinguishing it
from candidiasis (thrush), which can be scraped away revealing a bleeding surface. Leukoplakia is considered a precancerous lesion
with potential for malignant transformation to squamous cell carcinoma. The lateral border of the tongue is the most common site
for oral cancer. The nurse should refer the client for biopsy and further evaluation. Aphthous ulcers present as painful, shallow
ulcerations with erythematous halos, and herpes simplex presents as vesicular lesions that rupture to form shallow ulcers.
Q8: A client presents with complaints of vertigo, tinnitus, and a feeling of fullness in the left ear. The nurse observes
horizontal nystagmus when the client is asked to look to the left. Which cranial nerve is primarily responsible for the
NSG3160 Exam 2 - Comprehensive Health Assessment Page 3
, NSG3160 Health Assessment | Exam 2 | Galen College of Nursing 2026/2027
vestibular component of these symptoms?
A. Cranial Nerve V (Trigeminal)
B. Cranial Nerve VII (Facial)
C. Cranial Nerve VIII (Acoustic/Vestibulocochlear) [CORRECT]
D. Cranial Nerve X (Vagus)
Correct Answer: C
Rationale: Cranial Nerve VIII (Vestibulocochlear) has two divisions: the cochlear division, which is responsible for hearing, and the
vestibular division, which is responsible for balance and equilibrium. The client's symptoms of vertigo, tinnitus, ear fullness, and
nystagmus are consistent with Meniere's disease, which affects the vestibular portion of CN VIII. CN V (Trigeminal) provides facial
sensation and jaw movement. CN VII (Facial) controls facial expression and taste on the anterior two-thirds of the tongue. CN X
(Vagus) controls the gag reflex, palatal elevation, and swallowing.
Q9: A nurse assesses the oral cavity of an older adult client and notes the uvula deviates to the left when the client says
"Ahh." Which cranial nerve dysfunction should the nurse suspect?
A. Right CN IX (Glossopharyngeal) and CN X (Vagus) weakness [CORRECT]
B. Left CN IX and CN X weakness
C. Right CN XII (Hypoglossal) weakness
D. Left CN XII weakness
Correct Answer: A
Rationale: The uvula should remain midline when the client says "Ahh." If the uvula deviates to one side, it deviates away from the
affected side due to unopposed pull by the intact muscle. Uvula deviation to the left indicates right-sided weakness of CN IX
(Glossopharyngeal) and CN X (Vagus), which innervate the palatal muscles. CN XII (Hypoglossal) innervates the tongue muscles, and
its dysfunction would cause tongue deviation toward the affected side, not uvula deviation. This is a critical assessment for brainstem
function and may indicate conditions such as stroke or brainstem tumor.
Q10: A nurse is teaching a student about ear assessment. Which statement by the student indicates the need for further
instruction regarding otoscopic examination?
A. I should pull the pinna up and back for an adult client to straighten the ear canal
B. The tympanic membrane landmarks include the umbo, handle of malleus, pars flaccida, and pars tensa
C. I should brace my hand against the client's head to prevent injury if the client moves suddenly
D. I should insert the otoscope speculum deeply into the ear canal before turning on the light [CORRECT]
Correct Answer: D
Rationale: The otoscope light should be turned on before insertion so the nurse can visualize the ear canal throughout the procedure
and avoid trauma to the tympanic membrane or canal wall. The nurse should insert the speculum slowly while visualizing the canal,
bracing the examining hand against the client's head for stability. For an adult, the pinna is pulled up and back to straighten the ear
canal; for a child under 3, it is pulled down and back. Key TM landmarks include the umbo, handle (manubrium) of the malleus, pars
flaccida (superior), and pars tensa (inferior). Inserting blindly is incorrect and dangerous.
Q11: A nurse inspects a client's mouth and identifies angular cheilitis. Which clinical description best characterizes this
finding?
A. Painful, shallow ulcerations with erythematous halos on the buccal mucosa
B. Cracking, fissuring, or inflammation at the corners of the mouth [CORRECT]
C. White, curd-like patches on the tongue that scrape off leaving a bleeding surface
D. A red, smooth, glossy appearance of the tongue with loss of papillae
Correct Answer: B
Rationale: Angular cheilitis presents as cracking, fissuring, or inflammation at the corners (commissures) of the mouth. It is associated
with nutritional deficiencies (riboflavin, iron, B vitamins), ill-fitting dentures, saliva pooling, or candidal infection. Painful shallow
ulcerations with erythematous halos describe aphthous ulcers (canker sores). White, curd-like patches that scrape off describe oral
NSG3160 Exam 2 - Comprehensive Health Assessment Page 4
NSG3160 / NSG 3160
Health Assessment
Exam 2
100% Correct Questions & Answers
Comprehensive Physical Assessment & Clinical Judgment
Institution: Galen College of Nursing
Course: NSG3160 - Health Assessment
Exam: Exam 2 (Latest )
Total Questions: 100 Multiple Choice (A-D)
Passing Score: 70%
Cognitive Levels: 30% Recall, 50% Application, 20% Analysis
NSG3160 Exam 2 - Comprehensive Health Assessment Page 1
,NSG3160 Health Assessment | Exam 2 | Galen College of Nursing 2026/2027
Section 1
Ears, Nose, Mouth, and Throat Assessment (Q1-Q15)
Q1: A nurse is performing an otoscopic examination of a client's tympanic membrane. Which finding indicates a normal
tympanic membrane according to the 2026 NSG3160 assessment standards?
A. Red, bulging membrane with absent light reflex
B. Pearly gray, translucent membrane with cone of light at the 5 o'clock position in the right ear [CORRECT]
C. Thickened, opaque membrane with retraction pocket
D. Yellowish membrane with visible air bubbles behind it
Correct Answer: B
Rationale: A normal tympanic membrane should appear pearly gray and translucent with a visible cone of light reflection. In the right
ear, the light reflex typically appears at the 5 o'clock position, and at the 7 o'clock position in the left ear. A red, bulging membrane
with absent light reflex suggests otitis media. A thickened, opaque membrane with retraction indicates chronic otitis media. Yellowish
discoloration with air bubbles behind the membrane suggests otitis media with effusion.
Q2: A nurse performs the Rinne test on a client and notes that bone conduction is heard longer than air conduction in the
left ear. How should the nurse interpret this finding?
A. Normal hearing in the left ear
B. Sensorineural hearing loss in the left ear
C. Conductive hearing loss in the left ear [CORRECT]
D. Mixed hearing loss in the left ear
Correct Answer: C
Rationale: The Rinne test compares air conduction (AC) to bone conduction (BC). In a normal ear, air conduction is heard longer than
bone conduction (AC > BC). When bone conduction is heard longer than or equal to air conduction (BC > AC or BC = AC), this indicates
conductive hearing loss, which may result from conditions such as otitis media, cerumen impaction, or otosclerosis. Sensorineural
hearing loss would still show AC > BC, but both would be decreased. The Weber test is needed to differentiate mixed from purely
conductive loss.
Q3: During a Weber test, a client reports that the sound lateralizes to the right ear. Which condition would produce this
finding if the client has right-sided hearing loss?
A. Right-sided sensorineural hearing loss
B. Right-sided conductive hearing loss [CORRECT]
C. Bilateral normal hearing
D. Left-sided sensorineural hearing loss
Correct Answer: B
Rationale: In the Weber test, sound lateralizes to the affected ear in conductive hearing loss because bone conduction bypasses the
external and middle ear pathology, making the tuning fork sound louder on the side with the conductive defect. In sensorineural
hearing loss, sound lateralizes to the unaffected (better) ear. If the client reports lateralization to the right ear and has right-sided
hearing loss, the loss must be conductive. If the right ear were normal and the left ear had sensorineural loss, sound would also
lateralize to the right, but the question specifies right-sided hearing loss.
Q4: A nurse inspects a client's external nose and notes a deviated nasal septum with bilateral mucosal swelling and clear
discharge. Which assessment technique should the nurse perform next?
A. Transillumination of the frontal and maxillary sinuses
B. Palpation of the frontal and maxillary sinuses for tenderness [CORRECT]
C. Otoscopy of the tympanic membrane
NSG3160 Exam 2 - Comprehensive Health Assessment Page 2
,NSG3160 Health Assessment | Exam 2 | Galen College of Nursing 2026/2027
D. Inspection of the oral cavity for tonsillar enlargement
Correct Answer: B
Rationale: When a client presents with nasal discharge and mucosal swelling, the nurse should assess for sinusitis by palpating the
frontal and maxillary sinuses for tenderness. The frontal sinuses are palpated by pressing upward beneath the supraorbital ridges,
and the maxillary sinuses by pressing on the cheek bones below the eyes. Tenderness on palpation is a hallmark sign of sinusitis.
Transillumination can also be performed but is less reliable. Otoscopy and oral cavity inspection are not the next priority assessments
for nasal symptoms.
Q5: A nurse assesses a client's tonsils and documents them as "3+." What does this grading indicate according to the
standardized tonsil grading scale?
A. Tonsils are visible but within the tonsillar pillars
B. Tonsils extend halfway between the tonsillar pillars and the uvula
C. Tonsils are touching the uvula [CORRECT]
D. Tonsils are touching each other
Correct Answer: C
Rationale: The standardized tonsil grading scale is: 1+ (tonsils visible within tonsillar pillars), 2+ (tonsils extend halfway between
tonsillar pillars and the uvula), 3+ (tonsils touching the uvula), and 4+ (tonsils touching each other, also known as "kissing tonsils"). A
3+ grading indicates significant tonsillar hypertrophy that may cause airway obstruction, difficulty swallowing, or sleep-disordered
breathing. This finding warrants further evaluation for conditions such as recurrent tonsillitis or obstructive sleep apnea.
Q6: A nurse performs a whisper test during a hearing screening. The client correctly repeats the whispered words at 1
foot from each ear. What conclusion should the nurse draw from this finding?
A. The client has significant sensorineural hearing loss
B. The client has conductive hearing loss requiring referral
C. The client demonstrates adequate hearing for a screening test [CORRECT]
D. The client needs audiometric testing for precise thresholds
Correct Answer: C
Rationale: The whisper test is a screening tool for hearing loss, not a diagnostic test. The nurse whispers softly at approximately 1 to 2
feet from the client's ear while occluding the opposite ear canal. If the client can correctly repeat the whispered words, the screening
result is considered normal and no further evaluation is routine. However, the whisper test cannot quantify the degree or type of
hearing loss, distinguish between conductive and sensorineural loss, or replace formal audiometry. It serves as a quick bedside
screening to identify clients who may need comprehensive audiological evaluation.
Q7: A nurse examines a client's oral cavity and observes white, raised, plaque-like lesions on the lateral border of the
tongue that cannot be scraped off. Which condition should the nurse suspect, and what is the most appropriate action?
A. Oral candidiasis; prescribe antifungal medication
B. Leukoplakia; refer for biopsy to rule out malignancy [CORRECT]
C. Aphthous ulcer; recommend topical corticosteroids
D. Herpes simplex; obtain viral culture
Correct Answer: B
Rationale: Leukoplakia presents as white, raised, plaque-like lesions on the oral mucosa that cannot be scraped off, distinguishing it
from candidiasis (thrush), which can be scraped away revealing a bleeding surface. Leukoplakia is considered a precancerous lesion
with potential for malignant transformation to squamous cell carcinoma. The lateral border of the tongue is the most common site
for oral cancer. The nurse should refer the client for biopsy and further evaluation. Aphthous ulcers present as painful, shallow
ulcerations with erythematous halos, and herpes simplex presents as vesicular lesions that rupture to form shallow ulcers.
Q8: A client presents with complaints of vertigo, tinnitus, and a feeling of fullness in the left ear. The nurse observes
horizontal nystagmus when the client is asked to look to the left. Which cranial nerve is primarily responsible for the
NSG3160 Exam 2 - Comprehensive Health Assessment Page 3
, NSG3160 Health Assessment | Exam 2 | Galen College of Nursing 2026/2027
vestibular component of these symptoms?
A. Cranial Nerve V (Trigeminal)
B. Cranial Nerve VII (Facial)
C. Cranial Nerve VIII (Acoustic/Vestibulocochlear) [CORRECT]
D. Cranial Nerve X (Vagus)
Correct Answer: C
Rationale: Cranial Nerve VIII (Vestibulocochlear) has two divisions: the cochlear division, which is responsible for hearing, and the
vestibular division, which is responsible for balance and equilibrium. The client's symptoms of vertigo, tinnitus, ear fullness, and
nystagmus are consistent with Meniere's disease, which affects the vestibular portion of CN VIII. CN V (Trigeminal) provides facial
sensation and jaw movement. CN VII (Facial) controls facial expression and taste on the anterior two-thirds of the tongue. CN X
(Vagus) controls the gag reflex, palatal elevation, and swallowing.
Q9: A nurse assesses the oral cavity of an older adult client and notes the uvula deviates to the left when the client says
"Ahh." Which cranial nerve dysfunction should the nurse suspect?
A. Right CN IX (Glossopharyngeal) and CN X (Vagus) weakness [CORRECT]
B. Left CN IX and CN X weakness
C. Right CN XII (Hypoglossal) weakness
D. Left CN XII weakness
Correct Answer: A
Rationale: The uvula should remain midline when the client says "Ahh." If the uvula deviates to one side, it deviates away from the
affected side due to unopposed pull by the intact muscle. Uvula deviation to the left indicates right-sided weakness of CN IX
(Glossopharyngeal) and CN X (Vagus), which innervate the palatal muscles. CN XII (Hypoglossal) innervates the tongue muscles, and
its dysfunction would cause tongue deviation toward the affected side, not uvula deviation. This is a critical assessment for brainstem
function and may indicate conditions such as stroke or brainstem tumor.
Q10: A nurse is teaching a student about ear assessment. Which statement by the student indicates the need for further
instruction regarding otoscopic examination?
A. I should pull the pinna up and back for an adult client to straighten the ear canal
B. The tympanic membrane landmarks include the umbo, handle of malleus, pars flaccida, and pars tensa
C. I should brace my hand against the client's head to prevent injury if the client moves suddenly
D. I should insert the otoscope speculum deeply into the ear canal before turning on the light [CORRECT]
Correct Answer: D
Rationale: The otoscope light should be turned on before insertion so the nurse can visualize the ear canal throughout the procedure
and avoid trauma to the tympanic membrane or canal wall. The nurse should insert the speculum slowly while visualizing the canal,
bracing the examining hand against the client's head for stability. For an adult, the pinna is pulled up and back to straighten the ear
canal; for a child under 3, it is pulled down and back. Key TM landmarks include the umbo, handle (manubrium) of the malleus, pars
flaccida (superior), and pars tensa (inferior). Inserting blindly is incorrect and dangerous.
Q11: A nurse inspects a client's mouth and identifies angular cheilitis. Which clinical description best characterizes this
finding?
A. Painful, shallow ulcerations with erythematous halos on the buccal mucosa
B. Cracking, fissuring, or inflammation at the corners of the mouth [CORRECT]
C. White, curd-like patches on the tongue that scrape off leaving a bleeding surface
D. A red, smooth, glossy appearance of the tongue with loss of papillae
Correct Answer: B
Rationale: Angular cheilitis presents as cracking, fissuring, or inflammation at the corners (commissures) of the mouth. It is associated
with nutritional deficiencies (riboflavin, iron, B vitamins), ill-fitting dentures, saliva pooling, or candidal infection. Painful shallow
ulcerations with erythematous halos describe aphthous ulcers (canker sores). White, curd-like patches that scrape off describe oral
NSG3160 Exam 2 - Comprehensive Health Assessment Page 4
