NUR 3065
EXAM 3
Questions, Answers, and Rationales
Comprehensive Clinical Judgment Assessment
Instructions
Select the best answer for each question. Apply nursing assessment skills,
clinical reasoning, and patient safety principles.
1. A client has a BMI of 32. Which classification does this finding
represent?
A. Underweight
B. Normal weight
C. Overweight
D. Obesity
Correct Answer: D
Rationale: Obesity is classified as a BMI of 30 or greater in adults.
2. A nurse assessing an older adult identifies loss of muscle mass related
to aging. Which condition is present?
A. Cachexia
B. Sarcopenia
C. Kwashiorkor
D. Ascites
Correct Answer: B
Rationale: Sarcopenia refers to age-related loss of skeletal muscle mass.
3. Which assessment finding is expected during normal abdominal
auscultation?
A. Absent bowel sounds
B. High-pitched gurgling sounds
C. Continuous bruit
,D. No abdominal sounds
Correct Answer: B
Rationale: Normal bowel sounds are high-pitched gurgling sounds occurring
intermittently.
4. A patient with appendicitis commonly reports pain that moves from the
periumbilical area to which location?
A. Left upper quadrant
B. Right lower quadrant
C. Left lower quadrant
D. Epigastric region
Correct Answer: B
Rationale: Appendicitis pain commonly migrates to the right lower quadrant.
5. A positive Murphy sign is associated with which condition?
A. Appendicitis
B. Cholecystitis
C. Colon cancer
D. Gastritis
Correct Answer: B
Rationale: Murphy sign indicates gallbladder inflammation.
6. Which test is used to assess carpal tunnel syndrome?
A. Romberg test
B. Phalen test
C. Babinski test
D. Weber test
Correct Answer: B
,Rationale: Phalen test reproduces numbness and tingling in carpal tunnel
syndrome.
7. A patient has a Glasgow Coma Scale score of 15. How should this
finding be interpreted?
A. Severe impairment
B. Normal neurological status
C. Coma
D. Unresponsive state
Correct Answer: B
Rationale: A GCS score of 15 represents the best possible neurological
response.
8. Which cranial nerve is responsible for facial movement?
A. CN V
B. CN VII
C. CN VIII
D. CN XII
Correct Answer: B
Rationale: CN VII controls facial motor movements.
9. Which finding is expected in ischemic stroke?
A. Blood leaking into brain tissue
B. Weakness on one side of the body
C. Severe vomiting only
D. No neurological changes
Correct Answer: B
Rationale: Ischemic stroke results from blocked blood flow causing neurological
deficits.
10. Which action assesses cerebellar function?
, A. Testing pupil response
B. Finger-to-nose testing
C. Checking abdominal sounds
D. Testing bowel frequency
Correct Answer: B
Rationale: Cerebellar assessment includes coordination and balance testing.
11. A client has a BMI of 32. Which classification does this finding
represent?
A. Underweight
B. Normal weight
C. Overweight
D. Obesity
Correct Answer: D
Rationale: Obesity is classified as a BMI of 30 or greater in adults.
12. A nurse assessing an older adult identifies loss of muscle mass related
to aging. Which condition is present?
A. Cachexia
B. Sarcopenia
C. Kwashiorkor
D. Ascites
Correct Answer: B
Rationale: Sarcopenia refers to age-related loss of skeletal muscle mass.
13. Which assessment finding is expected during normal abdominal
auscultation?
A. Absent bowel sounds
B. High-pitched gurgling sounds
EXAM 3
Questions, Answers, and Rationales
Comprehensive Clinical Judgment Assessment
Instructions
Select the best answer for each question. Apply nursing assessment skills,
clinical reasoning, and patient safety principles.
1. A client has a BMI of 32. Which classification does this finding
represent?
A. Underweight
B. Normal weight
C. Overweight
D. Obesity
Correct Answer: D
Rationale: Obesity is classified as a BMI of 30 or greater in adults.
2. A nurse assessing an older adult identifies loss of muscle mass related
to aging. Which condition is present?
A. Cachexia
B. Sarcopenia
C. Kwashiorkor
D. Ascites
Correct Answer: B
Rationale: Sarcopenia refers to age-related loss of skeletal muscle mass.
3. Which assessment finding is expected during normal abdominal
auscultation?
A. Absent bowel sounds
B. High-pitched gurgling sounds
C. Continuous bruit
,D. No abdominal sounds
Correct Answer: B
Rationale: Normal bowel sounds are high-pitched gurgling sounds occurring
intermittently.
4. A patient with appendicitis commonly reports pain that moves from the
periumbilical area to which location?
A. Left upper quadrant
B. Right lower quadrant
C. Left lower quadrant
D. Epigastric region
Correct Answer: B
Rationale: Appendicitis pain commonly migrates to the right lower quadrant.
5. A positive Murphy sign is associated with which condition?
A. Appendicitis
B. Cholecystitis
C. Colon cancer
D. Gastritis
Correct Answer: B
Rationale: Murphy sign indicates gallbladder inflammation.
6. Which test is used to assess carpal tunnel syndrome?
A. Romberg test
B. Phalen test
C. Babinski test
D. Weber test
Correct Answer: B
,Rationale: Phalen test reproduces numbness and tingling in carpal tunnel
syndrome.
7. A patient has a Glasgow Coma Scale score of 15. How should this
finding be interpreted?
A. Severe impairment
B. Normal neurological status
C. Coma
D. Unresponsive state
Correct Answer: B
Rationale: A GCS score of 15 represents the best possible neurological
response.
8. Which cranial nerve is responsible for facial movement?
A. CN V
B. CN VII
C. CN VIII
D. CN XII
Correct Answer: B
Rationale: CN VII controls facial motor movements.
9. Which finding is expected in ischemic stroke?
A. Blood leaking into brain tissue
B. Weakness on one side of the body
C. Severe vomiting only
D. No neurological changes
Correct Answer: B
Rationale: Ischemic stroke results from blocked blood flow causing neurological
deficits.
10. Which action assesses cerebellar function?
, A. Testing pupil response
B. Finger-to-nose testing
C. Checking abdominal sounds
D. Testing bowel frequency
Correct Answer: B
Rationale: Cerebellar assessment includes coordination and balance testing.
11. A client has a BMI of 32. Which classification does this finding
represent?
A. Underweight
B. Normal weight
C. Overweight
D. Obesity
Correct Answer: D
Rationale: Obesity is classified as a BMI of 30 or greater in adults.
12. A nurse assessing an older adult identifies loss of muscle mass related
to aging. Which condition is present?
A. Cachexia
B. Sarcopenia
C. Kwashiorkor
D. Ascites
Correct Answer: B
Rationale: Sarcopenia refers to age-related loss of skeletal muscle mass.
13. Which assessment finding is expected during normal abdominal
auscultation?
A. Absent bowel sounds
B. High-pitched gurgling sounds
