Page |1
NR509 – ADVANCED HEALTH ASSESSMENT Final Exam Study Guide | HEENT,
Cardiac, Respiratory, Abdominal Questions with Detailed Rationales |
Chamberlain University | Latest 2026/2027 Update
SECTION 1
Question 1
A nurse practitioner is assessing a patient's visual acuity using a
Snellen chart. The patient reads the 20/30 line at 20 feet. Which
statement is correct?
A. The patient can see at 30 feet what a normal eye can see at
20 feet.
B. The patient can see at 20 feet what a normal eye can see at
30 feet.
C. The patient has normal visual acuity.
D. The patient is legally blind.
Answer: B
Rationale: Snellen notation: first number = testing distance (20
ft), second = distance at which a normal eye can read that line.
20/30 means the patient sees at 20 feet what a normal person
sees at 30 feet—slightly reduced acuity.
Question 2
, Page |2
Which cranial nerve is tested by asking the patient to raise their
eyebrows, squeeze their eyes shut, and smile?
A. CN V
B. CN VII
C. CN IX
D. CN X
Answer: B
Rationale: CN VII (facial) controls muscles of facial expression,
tested by eyebrow raise, eye closure, and smile. CN V is
trigeminal (sensation/mastication).
Question 3
A patient presents with a painless, non-tender eyelid lump that
has been present for several weeks. What is the most likely
diagnosis?
A. Hordeolum
B. Chalazion
C. Blepharitis
D. Dacryocystitis
Answer: B
Rationale: A chalazion is a chronic, painless lipogranulomatous
inflammation of a meibomian gland. A hordeolum (stye) is
acute and painful.
, Page |3
Question 4
Which finding on otoscopic examination suggests acute otitis
media?
A. Pearly gray, translucent tympanic membrane
B. Red, bulging tympanic membrane with decreased mobility
C. Retracted tympanic membrane with visible landmarks
D. Amber fluid level behind the tympanic membrane
Answer: B
Rationale: Acute otitis media shows a red, bulging TM with
reduced mobility on pneumatic otoscopy. Serous effusion
appears amber with decreased mobility but not red.
Question 5
A patient reports hearing loss in the left ear. The Weber test
lateralizes to the left ear. The Rinne test shows bone conduction
greater than air conduction in the left ear. What is the
diagnosis?
A. Sensorineural hearing loss in the left ear
B. Conductive hearing loss in the left ear
C. Sensorineural hearing loss in the right ear
D. Normal hearing
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Answer: B
Rationale: Weber lateralizes to the ear with conductive loss.
Rinne: BC > AC indicates conductive hearing loss. Combined,
these findings indicate left conductive hearing loss.
Question 6
Which of the following is a normal finding on fundoscopic
examination?
A. Blurred optic disc margins
B. Optic disc with sharp margins and cup-to-disc ratio 0.4
C. Flame hemorrhages
D. Papilledema
Answer: B
Rationale: A normal optic disc has sharp margins and a cup-to-
disc ratio ≤0.5. Blurred margins (papilledema) and hemorrhages
are abnormal.
Question 7
A patient has a fixed, dilated pupil. Which cranial nerve is most
likely affected?
A. CN II
B. CN III
NR509 – ADVANCED HEALTH ASSESSMENT Final Exam Study Guide | HEENT,
Cardiac, Respiratory, Abdominal Questions with Detailed Rationales |
Chamberlain University | Latest 2026/2027 Update
SECTION 1
Question 1
A nurse practitioner is assessing a patient's visual acuity using a
Snellen chart. The patient reads the 20/30 line at 20 feet. Which
statement is correct?
A. The patient can see at 30 feet what a normal eye can see at
20 feet.
B. The patient can see at 20 feet what a normal eye can see at
30 feet.
C. The patient has normal visual acuity.
D. The patient is legally blind.
Answer: B
Rationale: Snellen notation: first number = testing distance (20
ft), second = distance at which a normal eye can read that line.
20/30 means the patient sees at 20 feet what a normal person
sees at 30 feet—slightly reduced acuity.
Question 2
, Page |2
Which cranial nerve is tested by asking the patient to raise their
eyebrows, squeeze their eyes shut, and smile?
A. CN V
B. CN VII
C. CN IX
D. CN X
Answer: B
Rationale: CN VII (facial) controls muscles of facial expression,
tested by eyebrow raise, eye closure, and smile. CN V is
trigeminal (sensation/mastication).
Question 3
A patient presents with a painless, non-tender eyelid lump that
has been present for several weeks. What is the most likely
diagnosis?
A. Hordeolum
B. Chalazion
C. Blepharitis
D. Dacryocystitis
Answer: B
Rationale: A chalazion is a chronic, painless lipogranulomatous
inflammation of a meibomian gland. A hordeolum (stye) is
acute and painful.
, Page |3
Question 4
Which finding on otoscopic examination suggests acute otitis
media?
A. Pearly gray, translucent tympanic membrane
B. Red, bulging tympanic membrane with decreased mobility
C. Retracted tympanic membrane with visible landmarks
D. Amber fluid level behind the tympanic membrane
Answer: B
Rationale: Acute otitis media shows a red, bulging TM with
reduced mobility on pneumatic otoscopy. Serous effusion
appears amber with decreased mobility but not red.
Question 5
A patient reports hearing loss in the left ear. The Weber test
lateralizes to the left ear. The Rinne test shows bone conduction
greater than air conduction in the left ear. What is the
diagnosis?
A. Sensorineural hearing loss in the left ear
B. Conductive hearing loss in the left ear
C. Sensorineural hearing loss in the right ear
D. Normal hearing
, Page |4
Answer: B
Rationale: Weber lateralizes to the ear with conductive loss.
Rinne: BC > AC indicates conductive hearing loss. Combined,
these findings indicate left conductive hearing loss.
Question 6
Which of the following is a normal finding on fundoscopic
examination?
A. Blurred optic disc margins
B. Optic disc with sharp margins and cup-to-disc ratio 0.4
C. Flame hemorrhages
D. Papilledema
Answer: B
Rationale: A normal optic disc has sharp margins and a cup-to-
disc ratio ≤0.5. Blurred margins (papilledema) and hemorrhages
are abnormal.
Question 7
A patient has a fixed, dilated pupil. Which cranial nerve is most
likely affected?
A. CN II
B. CN III
