NSG 500: ADVANCED HEALTH
ASSESSMENT MIDTERM EXAM STUDY
GUIDE QUESTIONS AND VERIFIED
ANSWERS |GRADE A+| JUST RELEASED
1. A 45-year-old patient presents with a ‘stabbing’ pain in the right upper quadrant that
radiates to the right scapula, typically occurring after fatty meals. Which physical examination
sign is most likely to be positive?
A. Rovsing’s Sign
B. Murphy’s Sign
C. Psoas Sign
D. Grey Turner’s Sign
Answer: B
Conceptual Explanation: Murphy’s sign is associated with acute cholecystitis,
characterized by pain and inspiratory arrest upon deep palpation of the gallbladder area.
,2. During a cardiac assessment, the nurse practitioner notes a mid-systolic click followed by a
late systolic murmur at the apex. This finding is most consistent with:
A. Aortic Stenosis
B. Mitral Valve Prolapse
C. Mitral Stenosis
D. Tricuspid Regurgitation
Answer: B
Conceptual Explanation: Mitral Valve Prolapse (MVP) typically presents with a mid-
systolic click and a late systolic murmur as the valve leaflets bulge into the atrium.
3. Which of the following describes the correct technique for assessing the Cranial Nerve XI
(Spinal Accessory)?
A. Ask the patient to say ‘Ah’ and observe uvula deviation.
B. Assess the corneal reflex with a cotton wisp.
C. Test the patient’s ability to shrug shoulders against resistance.
D. Evaluate the patient’s ability to identify sharp versus dull sensations on the face.
Answer: C
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; shrugging and turning the head against resistance tests its function.
, 4. A patient presents with a localized, flat, non-palpable area of skin discoloration measuring
0.8 cm. The nurse practitioner correctly documents this as a:
A. Patch
B. Macule
C. Papule
D. Plaque
Answer: B
Conceptual Explanation: A macule is a flat, non-palpable lesion less than 1 cm. A patch is
flat but greater than 1 cm.
5. During a respiratory exam, the provider notes increased tactile fremitus over the right
lower lobe. This finding most likely indicates:
A. Pneumothorax
B. Pleural Effusion
C. Lobar Pneumonia
D. Chronic Obstructive Pulmonary Disease (COPD)
Answer: C
Conceptual Explanation: Tactile fremitus increases with lung consolidation (e.g.,
pneumonia) because sound travels better through solid/liquid media than air.
ASSESSMENT MIDTERM EXAM STUDY
GUIDE QUESTIONS AND VERIFIED
ANSWERS |GRADE A+| JUST RELEASED
1. A 45-year-old patient presents with a ‘stabbing’ pain in the right upper quadrant that
radiates to the right scapula, typically occurring after fatty meals. Which physical examination
sign is most likely to be positive?
A. Rovsing’s Sign
B. Murphy’s Sign
C. Psoas Sign
D. Grey Turner’s Sign
Answer: B
Conceptual Explanation: Murphy’s sign is associated with acute cholecystitis,
characterized by pain and inspiratory arrest upon deep palpation of the gallbladder area.
,2. During a cardiac assessment, the nurse practitioner notes a mid-systolic click followed by a
late systolic murmur at the apex. This finding is most consistent with:
A. Aortic Stenosis
B. Mitral Valve Prolapse
C. Mitral Stenosis
D. Tricuspid Regurgitation
Answer: B
Conceptual Explanation: Mitral Valve Prolapse (MVP) typically presents with a mid-
systolic click and a late systolic murmur as the valve leaflets bulge into the atrium.
3. Which of the following describes the correct technique for assessing the Cranial Nerve XI
(Spinal Accessory)?
A. Ask the patient to say ‘Ah’ and observe uvula deviation.
B. Assess the corneal reflex with a cotton wisp.
C. Test the patient’s ability to shrug shoulders against resistance.
D. Evaluate the patient’s ability to identify sharp versus dull sensations on the face.
Answer: C
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; shrugging and turning the head against resistance tests its function.
, 4. A patient presents with a localized, flat, non-palpable area of skin discoloration measuring
0.8 cm. The nurse practitioner correctly documents this as a:
A. Patch
B. Macule
C. Papule
D. Plaque
Answer: B
Conceptual Explanation: A macule is a flat, non-palpable lesion less than 1 cm. A patch is
flat but greater than 1 cm.
5. During a respiratory exam, the provider notes increased tactile fremitus over the right
lower lobe. This finding most likely indicates:
A. Pneumothorax
B. Pleural Effusion
C. Lobar Pneumonia
D. Chronic Obstructive Pulmonary Disease (COPD)
Answer: C
Conceptual Explanation: Tactile fremitus increases with lung consolidation (e.g.,
pneumonia) because sound travels better through solid/liquid media than air.
