Galen NSG 3160 Health Assessment: Final Exam
(Comprehensive) - Questions with Correct Answers
100 questions
1. Signs of opioid intoxication include:
A. Dilated pupils and agitation
B. Pinpoint pupils, drowsiness and slowed respirations
C. Tremors and sweating
D. Rapid breathing and hyperthermia
Correct Answer: B. Pinpoint pupils, drowsiness and slowed respirations
Rationale: Opioids depress the central nervous system and constrict pupils, and respiratory depression is
the main danger. Dilated pupils with agitation suggest stimulants, and tremors and sweating suggest
withdrawal from alcohol or opioids.
2. A patient with dementia becomes more confused and agitated in the late afternoon and
evening. This is known as:
A. Catatonia
B. Mania
C. Sundowning
D. Narcolepsy
Correct Answer: C. Sundowning
Rationale: Sundowning is increased confusion and agitation later in the day, often worsened by fatigue,
low light and unfamiliar surroundings. Catatonia involves abnormal motor behavior, mania elevated mood
and narcolepsy sudden sleep.
3. A vesicle is:
A. A solid nodule
B. A flat discoloration
C. An elevated, fluid-filled lesion less than 1 cm, as in herpes simplex or varicella
D. A crack in the skin
Correct Answer: C. An elevated, fluid-filled lesion less than 1 cm, as in herpes simplex or
varicella
Rationale: Vesicles contain clear serous fluid. Larger fluid-filled lesions are bullae, solid deeper lesions
are nodules, flat lesions are macules and cracks are fissures.
,4. Splinter hemorrhages in the nail beds may indicate:
A. Infective endocarditis or minor trauma
B. Normal aging
C. Iron overload
D. Vitamin A excess
Correct Answer: A. Infective endocarditis or minor trauma
Rationale: These thin, dark red-brown lines under the nails can be caused by emboli in endocarditis,
though trauma is a common benign cause. They are not a normal aging change or linked to iron or vitamin
A.
5. Lymph nodes that are enlarged, warm, tender and mobile most likely indicate:
A. Acute infection or inflammation
B. Metastatic cancer
C. Normal finding
D. Lymphoma in all cases
Correct Answer: A. Acute infection or inflammation
Rationale: Reactive nodes from infection are typically tender and movable and resolve as the infection
clears. Malignant nodes are more often hard, fixed and painless.
6. A patient with a migraine headache typically describes:
A. A tight band around the head without nausea
B. Brief stabbing pain behind one eye with tearing
C. Throbbing, often one-sided pain with nausea and sensitivity to light and sound
D. Sudden 'worst headache of my life'
Correct Answer: C. Throbbing, often one-sided pain with nausea and sensitivity to light and
sound
Rationale: Migraines often last hours and may be preceded by an aura. Band-like pain suggests tension
headache, one-sided eye pain with tearing suggests cluster headache and a sudden severe headache
suggests subarachnoid hemorrhage.
,7. Color vision is tested with the:
A. Ishihara chart
B. Snellen chart
C. Amsler grid
D. Tonometer
Correct Answer: A. Ishihara chart
Rationale: Ishihara plates contain numbers made of colored dots that people with red-green deficiencies
cannot see. The Snellen chart tests acuity, the Amsler grid tests macular function and the tonometer
measures eye pressure.
8. Hypertensive retinopathy may show:
A. Microaneurysms only
B. Arteriovenous nicking, narrowed arterioles and flame hemorrhages
C. Normal vessels
D. A swollen lens
Correct Answer: B. Arteriovenous nicking, narrowed arterioles and flame hemorrhages
Rationale: Long-standing high blood pressure thickens arterioles, which indent veins where they cross,
and severe hypertension causes hemorrhages and papilledema. Microaneurysms are more typical of
diabetes.
9. Tonsils graded 3+ are:
A. Touching the uvula
B. Visible behind the pillars
C. Touching each other in the midline
D. Not visible
Correct Answer: A. Touching the uvula
Rationale: Tonsils are graded 1+ (visible), 2+ (between pillars and uvula), 3+ (touching the uvula) and 4+
(touching each other). Grading helps track swelling and airway risk.
, 10. Normal oral mucosa is:
A. Dry and cracked
B. Pink, moist and smooth
C. White and patchy
D. Blue-tinged
Correct Answer: B. Pink, moist and smooth
Rationale: Moist pink mucosa indicates good hydration and perfusion, though some patients with dark
skin have normal patchy pigmentation. Dryness suggests dehydration, white patches suggest candidiasis
or leukoplakia and blue suggests cyanosis.
11. An enlarged, hard, fixed axillary node in a woman with a breast mass suggests:
A. Normal finding
B. Recent vaccination only
C. Possible metastasis of breast cancer to the lymph nodes
D. Allergic reaction
Correct Answer: C. Possible metastasis of breast cancer to the lymph nodes
Rationale: Hard, fixed nodes raise concern for spread of cancer and influence staging. Reactive nodes
after vaccination are usually tender and mobile.
12. Signs suggesting breast cancer on palpation include a mass that is:
A. Hard, irregular, nontender and fixed
B. Soft, round, mobile and tender
C. Smooth and rubbery
D. Changes with the menstrual cycle
Correct Answer: A. Hard, irregular, nontender and fixed
Rationale: Malignant lumps are often painless, poorly defined and attached to surrounding tissue. Soft,
mobile, tender or cyclical lumps are more typical of benign conditions, though any new lump needs
evaluation.
(Comprehensive) - Questions with Correct Answers
100 questions
1. Signs of opioid intoxication include:
A. Dilated pupils and agitation
B. Pinpoint pupils, drowsiness and slowed respirations
C. Tremors and sweating
D. Rapid breathing and hyperthermia
Correct Answer: B. Pinpoint pupils, drowsiness and slowed respirations
Rationale: Opioids depress the central nervous system and constrict pupils, and respiratory depression is
the main danger. Dilated pupils with agitation suggest stimulants, and tremors and sweating suggest
withdrawal from alcohol or opioids.
2. A patient with dementia becomes more confused and agitated in the late afternoon and
evening. This is known as:
A. Catatonia
B. Mania
C. Sundowning
D. Narcolepsy
Correct Answer: C. Sundowning
Rationale: Sundowning is increased confusion and agitation later in the day, often worsened by fatigue,
low light and unfamiliar surroundings. Catatonia involves abnormal motor behavior, mania elevated mood
and narcolepsy sudden sleep.
3. A vesicle is:
A. A solid nodule
B. A flat discoloration
C. An elevated, fluid-filled lesion less than 1 cm, as in herpes simplex or varicella
D. A crack in the skin
Correct Answer: C. An elevated, fluid-filled lesion less than 1 cm, as in herpes simplex or
varicella
Rationale: Vesicles contain clear serous fluid. Larger fluid-filled lesions are bullae, solid deeper lesions
are nodules, flat lesions are macules and cracks are fissures.
,4. Splinter hemorrhages in the nail beds may indicate:
A. Infective endocarditis or minor trauma
B. Normal aging
C. Iron overload
D. Vitamin A excess
Correct Answer: A. Infective endocarditis or minor trauma
Rationale: These thin, dark red-brown lines under the nails can be caused by emboli in endocarditis,
though trauma is a common benign cause. They are not a normal aging change or linked to iron or vitamin
A.
5. Lymph nodes that are enlarged, warm, tender and mobile most likely indicate:
A. Acute infection or inflammation
B. Metastatic cancer
C. Normal finding
D. Lymphoma in all cases
Correct Answer: A. Acute infection or inflammation
Rationale: Reactive nodes from infection are typically tender and movable and resolve as the infection
clears. Malignant nodes are more often hard, fixed and painless.
6. A patient with a migraine headache typically describes:
A. A tight band around the head without nausea
B. Brief stabbing pain behind one eye with tearing
C. Throbbing, often one-sided pain with nausea and sensitivity to light and sound
D. Sudden 'worst headache of my life'
Correct Answer: C. Throbbing, often one-sided pain with nausea and sensitivity to light and
sound
Rationale: Migraines often last hours and may be preceded by an aura. Band-like pain suggests tension
headache, one-sided eye pain with tearing suggests cluster headache and a sudden severe headache
suggests subarachnoid hemorrhage.
,7. Color vision is tested with the:
A. Ishihara chart
B. Snellen chart
C. Amsler grid
D. Tonometer
Correct Answer: A. Ishihara chart
Rationale: Ishihara plates contain numbers made of colored dots that people with red-green deficiencies
cannot see. The Snellen chart tests acuity, the Amsler grid tests macular function and the tonometer
measures eye pressure.
8. Hypertensive retinopathy may show:
A. Microaneurysms only
B. Arteriovenous nicking, narrowed arterioles and flame hemorrhages
C. Normal vessels
D. A swollen lens
Correct Answer: B. Arteriovenous nicking, narrowed arterioles and flame hemorrhages
Rationale: Long-standing high blood pressure thickens arterioles, which indent veins where they cross,
and severe hypertension causes hemorrhages and papilledema. Microaneurysms are more typical of
diabetes.
9. Tonsils graded 3+ are:
A. Touching the uvula
B. Visible behind the pillars
C. Touching each other in the midline
D. Not visible
Correct Answer: A. Touching the uvula
Rationale: Tonsils are graded 1+ (visible), 2+ (between pillars and uvula), 3+ (touching the uvula) and 4+
(touching each other). Grading helps track swelling and airway risk.
, 10. Normal oral mucosa is:
A. Dry and cracked
B. Pink, moist and smooth
C. White and patchy
D. Blue-tinged
Correct Answer: B. Pink, moist and smooth
Rationale: Moist pink mucosa indicates good hydration and perfusion, though some patients with dark
skin have normal patchy pigmentation. Dryness suggests dehydration, white patches suggest candidiasis
or leukoplakia and blue suggests cyanosis.
11. An enlarged, hard, fixed axillary node in a woman with a breast mass suggests:
A. Normal finding
B. Recent vaccination only
C. Possible metastasis of breast cancer to the lymph nodes
D. Allergic reaction
Correct Answer: C. Possible metastasis of breast cancer to the lymph nodes
Rationale: Hard, fixed nodes raise concern for spread of cancer and influence staging. Reactive nodes
after vaccination are usually tender and mobile.
12. Signs suggesting breast cancer on palpation include a mass that is:
A. Hard, irregular, nontender and fixed
B. Soft, round, mobile and tender
C. Smooth and rubbery
D. Changes with the menstrual cycle
Correct Answer: A. Hard, irregular, nontender and fixed
Rationale: Malignant lumps are often painless, poorly defined and attached to surrounding tissue. Soft,
mobile, tender or cyclical lumps are more typical of benign conditions, though any new lump needs
evaluation.
