NURS 5220 ADVANCED HEALTH ASSESSMENT Exam 1 MODULE 2: CHAPTER 9,
10, 11, 12, 14, 15, 16 NEWEST ACTUAL EXAM QUESTIONS AND DESCRIPTIVE
CORRECT ANSWERS ALREADY GRADED A+
In which age group are milia an expected finding?
A. Newborns
B. Young children
C. Adolescents
D. Older adults
A: Milia are small, whitish, discrete papules on the face; they are commonly found during the
first 2 to 3 months of life. The sebaceous glands function in an immature fashion at this age and
are easily plugged by sebum. Answers b, c, and d are incorrect.
Mr. Babson is a 74-year-old man who presents to your office with a complaint of a "spot" on his
chin and wants to know whether it is cancerous. Which of the following signs or symptoms
indicates a need for further medical investigation?
A. The "spot" is a reddish-brown color.
B. The "spot" has been on his chin for 20 years.
C. The "spot" bleeds easily when it is touched.
D. The "spot" is slightly raised and circumscribed.
C: A "spot" that bleeds easily when it is touched may be indicative of a more serious condition
like basal cell carcinoma, the most common form of skin cancer.
A 6-year-old girl has freckles over her nose and cheeks. The examiner will recall that freckles
are a type of:
A. macule.
B. papule.
C. nodule.
D. patch.
A: A macule is a flat, circumscribed area that is a change in the color of the skin usually less than
1 cm in diameter. Freckles, flat moles, petechiae, and measles are examples of macules.
Which two muscles allow movement and provide support to the head and neck?
A. Pectoralis and coracobrachial
B. Trapezius and pectoralis
C. Sternocleidomastoid and coracobrachial
D. Trapezius and sternocleidomastoid
,D: The neck is formed by the cervical vertebrae, ligaments, and sternocleidomastoid and
trapezius muscles, which give it support and movement.
The anterior triangle is located:
A. under the mandible, medial to the sternocleidomastoid muscle.
B. between the trapezius and sternocleidomastoid muscle.
C. at the base of the clavicle.
D. between the cricoid and thyroid cartilages.
A: The anterior triangle is formed by the medial border of the sternocleidomastoid muscles, the
mandible, and the midline. The posterior triangle is formed by the trapezius and
sternocleidomastoid muscles and the clavicle and contains the posterior cervical lymph nodes.
On meeting a new patient, you observe a nodding movement of the patient's head. Based on this
observation, what assessment should you include as part of your examination of the patient?
A. Auscultation of the parietal region of the skull for a bruit
B. Percussion of the frontal bone for dullness
C. Check for synchronization of the nod and the pulse
D. Determination of arc of the nod
C; The patient's head should be upright and still. A horizontal jerking or bobbing motion may be
associated with a tremor; a nodding movement may be associated with aortic insufficiency,
especially if the nodding is synchronized with the pulse.
Mr. Anthony is a 46-year-old patient who presents to your office with a history of thyroid
dysfunction. Which maneuver will you ask him to perform while palpating his thyroid gland?
A. Stick out the tongue.
B. Cough deeply.
C. Swallow.
D. Say "ah."
C: The patient is asked to swallow when the thyroid gland is being palpated because the thyroid
gland moves with swallowing, whereas the subcutaneous fat that mimics a goiter does not.
A 45-year-old man tells you that he often has headaches in the evening that feel like a band is
being tightened around his head. These characteristics are indicative of which type of headache?
A. Classic migraine
B. Cluster
C. Tension
D. Hypertensive
C; Muscular tension headaches can occur at any time but usually present in the afternoon or
evening. Patients often report bandlike constriction with stress, anger, or bruxism.
,A 22-year-old college student presents for a routine physical examination. Which finding would
you expect on examination of the student's thyroid gland?
A. The gland decreases when the student swallows.
B. The right lobe is about a quarter larger than the left.
C. A soft rushing sound is heard on auscultation of the gland.
D. The glandular tissue feels gritty but free of nodules.
B; The thyroid at its broadest dimension is approximately 4 cm, and the right lobe is often 25%
larger than the left.
Mrs. Jones is a 34-year-old pregnant patient. For what benign effect of pregnancy are you
assessing when you inspect her face hyperpigmentation?
A. Chloasma
B. Vitiligo
C. Cloaca
D. Hyperpigmentosa
A: Beginning after 16 weeks of gestation, many pregnant women develop blotchy, brownish
hyperpigmentation of the face, particularly over the malar prominences and the forehead. This
chloasma, also called "mask of pregnancy," may further darken with sun exposure, but generally
it fades after delivery.
Mrs. Tamber presents to your office with her 3-month-old infant son. On examination, your
findings include nuchal rigidity or resistance to flexion of the neck. Because of this finding you
suspect:
A. brain tumor.
B. meningeal irritation.
C. intracerebral aneurysm.
D. hydrocephalus.
B: Movement should be smooth and painless and should not cause dizziness. Nuchal rigidity,
resistance to flexion of the neck, may be associated with meningeal irritation.
You note asymmetry affecting the lower right side of a patient's face. You would suspect a
problem with which nerve?
A. Trigeminal
B. Facial
C. Hypoglossal
D. Trochlear
B: Suspect facial nerve paralysis when the entire side of the face is affected, and suspect facial
nerve weakness when the lower face is affected.
, Which examination technique would you use when checking for Chvostek sign?
A. Inspection
B. Auscultation
C. Palpation
D. Percussion
D: Percussion of the head and neck is not routinely performed. One exception is when evaluating
for hypercalcemia; percussion on the masseter muscle may produce a hyperactive masseteric
reflex, Chvostek sign.
Before instilling a mydriatic eyedrop into a patient's eye for examination, the examiner should:
A. assess the corneal reflex.
B. check for a shallow anterior chamber.
C. assess intraocular pressure.
D. observe the eye for vascular changes.
B: Before instillation of a mydriatic, inspect the patient's anterior chamber by shining a focused
light tangentially at the limbus (the union of the conjunctiva and the sclera). Note the
illumination of the iris nasally. This portion of the iris is not lighted when the patient has a
shallow anterior chamber, indicating a risk of acute-angle glaucoma. Mydriatics should be
avoided in these patients.
Mr. Black is a 66-year-old patient with a history of herpes simplex. He presents to your office
with a concern of visual disturbances. Which of the following would explain why this individual
may be unaware of an infection or injury to an eye?
A. Decreased corneal sensitivity
B. Diminished tearing
C. Reduced visual acuity
D. Increased density of the lens
A: Decreased corneal sensation is often associated with diabetes and herpes simplex and herpes
zoster viral infections and after trigeminal neuralgia surgery.
Mrs. Jones brings her 5-year-old son in for a well visit. As part of the child's examination, you
check for nystagmus. How do you do this?
A. Assess visual acuity.
B. Inspect the macula of the eye with an ophthalmoscope.
C. Inspect movement of the eyes to the six cardinal fields of gaze.
D. Palpate the globe while the child holds eyelids closed.
C: Nystagmus refers to horizontal, vertical or circular eye movements which are rapid, rhythmic,
repetitious, and involuntary. Full movement of the eyes is controlled by the integrated function
10, 11, 12, 14, 15, 16 NEWEST ACTUAL EXAM QUESTIONS AND DESCRIPTIVE
CORRECT ANSWERS ALREADY GRADED A+
In which age group are milia an expected finding?
A. Newborns
B. Young children
C. Adolescents
D. Older adults
A: Milia are small, whitish, discrete papules on the face; they are commonly found during the
first 2 to 3 months of life. The sebaceous glands function in an immature fashion at this age and
are easily plugged by sebum. Answers b, c, and d are incorrect.
Mr. Babson is a 74-year-old man who presents to your office with a complaint of a "spot" on his
chin and wants to know whether it is cancerous. Which of the following signs or symptoms
indicates a need for further medical investigation?
A. The "spot" is a reddish-brown color.
B. The "spot" has been on his chin for 20 years.
C. The "spot" bleeds easily when it is touched.
D. The "spot" is slightly raised and circumscribed.
C: A "spot" that bleeds easily when it is touched may be indicative of a more serious condition
like basal cell carcinoma, the most common form of skin cancer.
A 6-year-old girl has freckles over her nose and cheeks. The examiner will recall that freckles
are a type of:
A. macule.
B. papule.
C. nodule.
D. patch.
A: A macule is a flat, circumscribed area that is a change in the color of the skin usually less than
1 cm in diameter. Freckles, flat moles, petechiae, and measles are examples of macules.
Which two muscles allow movement and provide support to the head and neck?
A. Pectoralis and coracobrachial
B. Trapezius and pectoralis
C. Sternocleidomastoid and coracobrachial
D. Trapezius and sternocleidomastoid
,D: The neck is formed by the cervical vertebrae, ligaments, and sternocleidomastoid and
trapezius muscles, which give it support and movement.
The anterior triangle is located:
A. under the mandible, medial to the sternocleidomastoid muscle.
B. between the trapezius and sternocleidomastoid muscle.
C. at the base of the clavicle.
D. between the cricoid and thyroid cartilages.
A: The anterior triangle is formed by the medial border of the sternocleidomastoid muscles, the
mandible, and the midline. The posterior triangle is formed by the trapezius and
sternocleidomastoid muscles and the clavicle and contains the posterior cervical lymph nodes.
On meeting a new patient, you observe a nodding movement of the patient's head. Based on this
observation, what assessment should you include as part of your examination of the patient?
A. Auscultation of the parietal region of the skull for a bruit
B. Percussion of the frontal bone for dullness
C. Check for synchronization of the nod and the pulse
D. Determination of arc of the nod
C; The patient's head should be upright and still. A horizontal jerking or bobbing motion may be
associated with a tremor; a nodding movement may be associated with aortic insufficiency,
especially if the nodding is synchronized with the pulse.
Mr. Anthony is a 46-year-old patient who presents to your office with a history of thyroid
dysfunction. Which maneuver will you ask him to perform while palpating his thyroid gland?
A. Stick out the tongue.
B. Cough deeply.
C. Swallow.
D. Say "ah."
C: The patient is asked to swallow when the thyroid gland is being palpated because the thyroid
gland moves with swallowing, whereas the subcutaneous fat that mimics a goiter does not.
A 45-year-old man tells you that he often has headaches in the evening that feel like a band is
being tightened around his head. These characteristics are indicative of which type of headache?
A. Classic migraine
B. Cluster
C. Tension
D. Hypertensive
C; Muscular tension headaches can occur at any time but usually present in the afternoon or
evening. Patients often report bandlike constriction with stress, anger, or bruxism.
,A 22-year-old college student presents for a routine physical examination. Which finding would
you expect on examination of the student's thyroid gland?
A. The gland decreases when the student swallows.
B. The right lobe is about a quarter larger than the left.
C. A soft rushing sound is heard on auscultation of the gland.
D. The glandular tissue feels gritty but free of nodules.
B; The thyroid at its broadest dimension is approximately 4 cm, and the right lobe is often 25%
larger than the left.
Mrs. Jones is a 34-year-old pregnant patient. For what benign effect of pregnancy are you
assessing when you inspect her face hyperpigmentation?
A. Chloasma
B. Vitiligo
C. Cloaca
D. Hyperpigmentosa
A: Beginning after 16 weeks of gestation, many pregnant women develop blotchy, brownish
hyperpigmentation of the face, particularly over the malar prominences and the forehead. This
chloasma, also called "mask of pregnancy," may further darken with sun exposure, but generally
it fades after delivery.
Mrs. Tamber presents to your office with her 3-month-old infant son. On examination, your
findings include nuchal rigidity or resistance to flexion of the neck. Because of this finding you
suspect:
A. brain tumor.
B. meningeal irritation.
C. intracerebral aneurysm.
D. hydrocephalus.
B: Movement should be smooth and painless and should not cause dizziness. Nuchal rigidity,
resistance to flexion of the neck, may be associated with meningeal irritation.
You note asymmetry affecting the lower right side of a patient's face. You would suspect a
problem with which nerve?
A. Trigeminal
B. Facial
C. Hypoglossal
D. Trochlear
B: Suspect facial nerve paralysis when the entire side of the face is affected, and suspect facial
nerve weakness when the lower face is affected.
, Which examination technique would you use when checking for Chvostek sign?
A. Inspection
B. Auscultation
C. Palpation
D. Percussion
D: Percussion of the head and neck is not routinely performed. One exception is when evaluating
for hypercalcemia; percussion on the masseter muscle may produce a hyperactive masseteric
reflex, Chvostek sign.
Before instilling a mydriatic eyedrop into a patient's eye for examination, the examiner should:
A. assess the corneal reflex.
B. check for a shallow anterior chamber.
C. assess intraocular pressure.
D. observe the eye for vascular changes.
B: Before instillation of a mydriatic, inspect the patient's anterior chamber by shining a focused
light tangentially at the limbus (the union of the conjunctiva and the sclera). Note the
illumination of the iris nasally. This portion of the iris is not lighted when the patient has a
shallow anterior chamber, indicating a risk of acute-angle glaucoma. Mydriatics should be
avoided in these patients.
Mr. Black is a 66-year-old patient with a history of herpes simplex. He presents to your office
with a concern of visual disturbances. Which of the following would explain why this individual
may be unaware of an infection or injury to an eye?
A. Decreased corneal sensitivity
B. Diminished tearing
C. Reduced visual acuity
D. Increased density of the lens
A: Decreased corneal sensation is often associated with diabetes and herpes simplex and herpes
zoster viral infections and after trigeminal neuralgia surgery.
Mrs. Jones brings her 5-year-old son in for a well visit. As part of the child's examination, you
check for nystagmus. How do you do this?
A. Assess visual acuity.
B. Inspect the macula of the eye with an ophthalmoscope.
C. Inspect movement of the eyes to the six cardinal fields of gaze.
D. Palpate the globe while the child holds eyelids closed.
C: Nystagmus refers to horizontal, vertical or circular eye movements which are rapid, rhythmic,
repetitious, and involuntary. Full movement of the eyes is controlled by the integrated function
