MSN Advanced Health Assessment 1 — Questions and Answers
Question 1: When performing an abdominal assessment, which sequence of examination techniques is most appropriate?
- Inspection, palpation, percussion, auscultation
- Inspection, auscultation, percussion, palpation (Correct answer)
- Palpation, inspection, auscultation, percussion
- Auscultation, inspection, palpation, percussion
Correct answer: Inspection, auscultation, percussion, palpation
Auscultation precedes palpation and percussion in abdominal assessment to avoid artificially altering bowel sounds.
Question 2: Which cranial nerves are primarily assessed when testing the gag reflex?
- CN IX (Glossopharyngeal) and CN X (Vagus) (Correct answer)
- CN VII (Facial) and CN XII (Hypoglossal)
- CN V (Trigeminal) and CN VII (Facial)
- CN X (Vagus) and CN XI (Accessory)
Correct answer: CN IX (Glossopharyngeal) and CN X (Vagus)
The gag reflex tests CN IX (afferent/sensory limb) and CN X (efferent/motor limb).
Question 3: Dullness on percussion over a lung field most commonly indicates which condition?
- Emphysema
- Pneumothorax
- Consolidation or pleural effusion (Correct answer)
- Normal aeration
Correct answer: Consolidation or pleural effusion
Dull percussion notes result from fluid or solid tissue replacing air-filled lung, as occurs with consolidation or pleural effusion.
Question 4: The Allen test is performed prior to radial artery cannulation to assess:
- Ulnar and radial artery collateral circulation patency (Correct answer)
- Brachial artery pulse pressure
- Venous insufficiency in the forearm
- Carpal tunnel syndrome severity
Correct answer: Ulnar and radial artery collateral circulation patency
The Allen test confirms adequate ulnar collateral circulation before radial artery cannulation to prevent hand ischemia.
Question 5: A patient presents with a positive Phalen's test (wrist flexion for 60 seconds reproduces symptoms). This finding is most associated with:
- De Quervain's tenosynovitis
- Carpal tunnel syndrome (Correct answer)
- Ulnar nerve entrapment at the elbow
- Lateral epicondylitis
Correct answer: Carpal tunnel syndrome
Phalen's test increases pressure within the carpal tunnel, reproducing median nerve compression symptoms characteristic of carpal tunnel syndrome.
Question 6: During a comprehensive health history, information about a patient's cultural beliefs, occupation, and living situation is captured in which component?
- Past medical history
- Review of systems
- Social history (Correct answer)
- Family history
Correct answer: Social history
Social history encompasses lifestyle factors including occupation, cultural practices, living conditions, and health behaviors.
Question 7: The S4 heart sound (atrial gallop) occurs during which phase of the cardiac cycle and is most associated with which condition?
- Early diastole; mitral stenosis
- Late diastole (presystolic); decreased ventricular compliance (Correct answer)
- Early systole; aortic regurgitation
- Mid-systole; mitral valve prolapse
Correct answer: Late diastole (presystolic); decreased ventricular compliance
S4 occurs in late diastole as the atria contract forcefully to fill a stiff, non-compliant ventricle, commonly seen in hypertension or left ventricular hypertrophy.
MSN Advanced Health Assessment 1
When performing an abdominal assessment, which sequence of examination techniques is most appropriate?