NSG 500 ADVANCED HEALTH
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. During the physical examination of a patient reporting chronic vertigo, the clinician
performs the Dix-Hallpike maneuver. A positive finding of nystagmus during this test most
likely indicates which of the following?
A. Meniere’s disease
B. Acoustic neuroma
C. Benign Paroxysmal Positional Vertigo (BPPV)
D. Vestibular neuritis
Answer: C
Conceptual Explanation: The Dix-Hallpike maneuver is the gold standard for diagnosing
BPPV, characterized by brief periods of vertigo and nystagmus triggered by specific
changes in head position.
2. A 65-year-old male presents with a complaint of sudden, painless loss of vision in his right
eye. Funduscopic examination reveals a ‘cherry-red spot’ at the fovea and a pale, edematous
retina. What is the most probable diagnosis?
A. Central Retinal Vein Occlusion
,B. Central Retinal Artery Occlusion
C. Retinal Detachment
D. Acute Angle-Closure Glaucoma
Answer: B
Conceptual Explanation: A cherry-red spot at the fovea surrounded by a pale retina is a
classic hallmark of Central Retinal Artery Occlusion (CRAO), an ophthalmic emergency.
3. When assessing the carotid arteries, the clinician hears a blowing, swishing sound (bruit)
during auscultation. This finding is most likely indicative of:
A. Increased cardiac output
B. Normal blood flow in an elderly patient
C. Turbulent blood flow due to narrowing or stenosis
D. Venous hum from the jugular vein
Answer: C
Conceptual Explanation: A bruit indicates turbulent blood flow, usually resulting from
atherosclerotic narrowing of the vessel lumen.
4. During a cardiac assessment, the NP identifies a mid-systolic click followed by a late
systolic murmur at the apex. This is most characteristic of:
A. Mitral Valve Prolapse
B. Aortic Regurgitation
, C. Mitral Stenosis
D. Tricuspid Regurgitation
Answer: A
Conceptual Explanation: Mitral Valve Prolapse typically presents with a mid-systolic
click, often followed by a murmur if mitral regurgitation is present.
5. A clinician is assessing a patient with suspected appendicitis. The clinician applies deep
pressure to the left lower quadrant and the patient reports pain in the right lower quadrant.
This is a positive:
A. Murphy’s Sign
B. McBurney’s Sign
C. Psoas Sign
D. Rovsing’s Sign
Answer: D
Conceptual Explanation: Rovsing’s Sign is positive when pressure on the LLQ causes pain
in the RLQ, suggesting peritoneal irritation associated with appendicitis.
6. Which finding on a breast examination is the most concerning for malignancy?
A. A mobile, rubbery, well-circumscribed mass
B. Cyclical tenderness and lumpiness before menses
C. A fixed, hard, non-tender mass with irregular borders
ASSESSMENT COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. During the physical examination of a patient reporting chronic vertigo, the clinician
performs the Dix-Hallpike maneuver. A positive finding of nystagmus during this test most
likely indicates which of the following?
A. Meniere’s disease
B. Acoustic neuroma
C. Benign Paroxysmal Positional Vertigo (BPPV)
D. Vestibular neuritis
Answer: C
Conceptual Explanation: The Dix-Hallpike maneuver is the gold standard for diagnosing
BPPV, characterized by brief periods of vertigo and nystagmus triggered by specific
changes in head position.
2. A 65-year-old male presents with a complaint of sudden, painless loss of vision in his right
eye. Funduscopic examination reveals a ‘cherry-red spot’ at the fovea and a pale, edematous
retina. What is the most probable diagnosis?
A. Central Retinal Vein Occlusion
,B. Central Retinal Artery Occlusion
C. Retinal Detachment
D. Acute Angle-Closure Glaucoma
Answer: B
Conceptual Explanation: A cherry-red spot at the fovea surrounded by a pale retina is a
classic hallmark of Central Retinal Artery Occlusion (CRAO), an ophthalmic emergency.
3. When assessing the carotid arteries, the clinician hears a blowing, swishing sound (bruit)
during auscultation. This finding is most likely indicative of:
A. Increased cardiac output
B. Normal blood flow in an elderly patient
C. Turbulent blood flow due to narrowing or stenosis
D. Venous hum from the jugular vein
Answer: C
Conceptual Explanation: A bruit indicates turbulent blood flow, usually resulting from
atherosclerotic narrowing of the vessel lumen.
4. During a cardiac assessment, the NP identifies a mid-systolic click followed by a late
systolic murmur at the apex. This is most characteristic of:
A. Mitral Valve Prolapse
B. Aortic Regurgitation
, C. Mitral Stenosis
D. Tricuspid Regurgitation
Answer: A
Conceptual Explanation: Mitral Valve Prolapse typically presents with a mid-systolic
click, often followed by a murmur if mitral regurgitation is present.
5. A clinician is assessing a patient with suspected appendicitis. The clinician applies deep
pressure to the left lower quadrant and the patient reports pain in the right lower quadrant.
This is a positive:
A. Murphy’s Sign
B. McBurney’s Sign
C. Psoas Sign
D. Rovsing’s Sign
Answer: D
Conceptual Explanation: Rovsing’s Sign is positive when pressure on the LLQ causes pain
in the RLQ, suggesting peritoneal irritation associated with appendicitis.
6. Which finding on a breast examination is the most concerning for malignancy?
A. A mobile, rubbery, well-circumscribed mass
B. Cyclical tenderness and lumpiness before menses
C. A fixed, hard, non-tender mass with irregular borders
