NURS 314 LATEST 2026 EXAM QUESTIONS AND
SOLUTIONS SCORED A+
✔✔Functions of skin - ✔✔Protection- primary function to prevent infection
Barrier- prevents organisms from entering body
Temperature regulation- if hot the skin sweats and chills itself
Absorption- Vitamin D (sun) & medications
Excretion- H2O, toxins, oils
Perception- what we feel (proprioception)
Production- oils, melatonin, melanin
Self repair- scars (ability to heal itself)
Most wounds heal from bottom up
Communication- nerve impulses, pain (1st/2nd degree burns)
Identification- fingerprints
✔✔Changes of skin in older adults - ✔✔Older Adults
Atrophy, thinning and flattening of epidermis and dermis
Loss of elasticity, subcutaneous fat, collagen
Increased fragility, risk for shearing, breakdown
Decreased number and function of sebaceous, eccrine and apocrine glands
Dryness (xerosis)
Decreased thermoregulation, increased risk of heat stroke
Capillary fragility (easy bruising)
Senile purpura
Speckling, uneven pigmentation, leathery texture
UV exposure
Slowed growth of hair, nails
Changes in distribution of hair
Delayed cell replacement, wound healing
✔✔Causes of pallor, cyanosis, jaundice, erythema - ✔✔Pallor: When the red-pink tones
from the oxygenated hemoglobin in the blood are lost, the skin takes on the color of
connective tissue (collagen), which is mostly white (can result from high stress, fear,
anxiety, cold, cigarette smoking, and edema)
Cyanosis: blueness around mouth/nails indicates poor oxigenation (hypoxia); signifies
decreased perfusion
Jaundice: A yellowish skin color indicates rising amounts of bilirubin in the blood; Liver
dysfunction, red blood cell destruction
Erythema: Erythema is an intense redness of the skin from excess blood (hyperemia) in
the dilated superficial capillaries. This sign is expected with fever, with local
inflammation, or with emotional reactions such as blushing in vascular flush areas
(cheeks, neck, and upper chest)
,✔✔Cause and grading of pitting edema - ✔✔Bilateral, dependent pitting edema occurs
with heart failure, diabetic neuropathy, and hepatic cirrhosis
Grading:
1+ Mild pitting, slight indentation, no perceptible swelling of the leg
2+ Moderate pitting, indentation subsides rapidly
3+ Deep pitting, indentation remains for a short time, leg looks swollen
4+ Very deep pitting, indentation lasts a long time, leg is grossly swollen and distorted
✔✔How to assess skin turgor - ✔✔Pinch up a large fold of skin on the anterior chest
under the clavicle (Fig. 12-5). Mobility is the skin's ease of rising, and turgor is its ability
to return to place promptly when released. This reflects the elasticity of the skin.
Poor turgor is evident in severe dehydration or extreme weight loss; the pinched skin
recedes slowly or "tents" and stands by itself.
✔✔The meaning and use of ABCDE - ✔✔Use the following mnemonic when assessing
skin lesions:
A- Asymmetry
B- Border
C- Color
D- Diameter (use small ruler; mm)
E- Elevation/Enlargement
✔✔Lung & Thorax Anatomy: Landmarks, reference lines - ✔✔5 lobes on anterior
-3 on right side
-2 on left side
Anterior Landmarks:
Suprasternal Notch: Hollow U-shaped depression just above the sternum, in between
the clavicles.
Sternum: The "breastbone" has three parts—the manubrium, the body, and the xiphoid
process.
Sternal Angle (Angle of Louis): Often called the "angle of Louis," is a useful place to
start counting ribs, which helps localize a respiratory finding horizontally. Also marks the
site of tracheal bifurcation into the right and left main bronchi; it corresponds with the
upper border of the atria of the heart, and it lies above the fourth thoracic vertebra on
the back.
Costal Angle: The right and left costal margins form an angle where they meet at the
xiphoid process. Usually 90 degrees or less
, Reference Lines:
MCL: Midclavicular Line
MSL: Midsternal Line
ALL: Anterior Axilary Line
PAL: Posterior Axillary Line
MAL: Midaxillary Line
✔✔General position of the lobes of the lung - ✔✔On the anterior chest, the oblique (the
major or diagonal) fissure crosses the fifth rib in the midaxillary line and terminates at
the sixth rib in the midclavicular line. The right lung also contains the horizontal (minor)
fissure, which divides the right upper and middle lobes. This fissure extends from the
fifth rib in the right midaxillary line to the third intercostal space or fourth rib at the right
sternal border
✔✔Pathway of air through the respiratory system, site of oxygen and C02 exchange -
✔✔ACINUS= Upside down part of the bronchiole tree
CO2 and O2 are exchanged at the alveoli
Intercostal muscles take more oxygen for us to breath than the diaphragm does
People with lung disease / lung problems should breath with their diaphragms instead of
their ribs (intercostal muscles)
✔✔Appropriate assessment techniques for anterior and posterior chest and what you
are assessing with each technique - ✔✔For smooth choreography in a complete
examination, begin the respiratory examination just after palpating thyroid gland when
you are standing behind person
Perform inspection, palpation, percussion, and auscultation on posterior and lateral
thorax
Then move to face person and repeat four maneuvers on anterior chest
Palpate: Symmetric expansion, tactile fremitus (say 99),
✔✔Definitions of adventious sounds: fine and coarse crackles, wheezing, stridor -
✔✔These are added sounds that are not normally heard in the lungs. If present, they
are heard as being superimposed on the breath sounds. They are caused by moving air
colliding with secretions in the tracheobronchial passageways or by the popping open of
previously deflated airways
Fine Crackles: Discontinuous, high-pitched, short crackling, popping sounds heard
during inspiration that are not cleared by coughing
Coarse Crackles: Loud, low-pitched, bubbling and gurgling sounds that start in early
inspiration and may be present in expiration
SOLUTIONS SCORED A+
✔✔Functions of skin - ✔✔Protection- primary function to prevent infection
Barrier- prevents organisms from entering body
Temperature regulation- if hot the skin sweats and chills itself
Absorption- Vitamin D (sun) & medications
Excretion- H2O, toxins, oils
Perception- what we feel (proprioception)
Production- oils, melatonin, melanin
Self repair- scars (ability to heal itself)
Most wounds heal from bottom up
Communication- nerve impulses, pain (1st/2nd degree burns)
Identification- fingerprints
✔✔Changes of skin in older adults - ✔✔Older Adults
Atrophy, thinning and flattening of epidermis and dermis
Loss of elasticity, subcutaneous fat, collagen
Increased fragility, risk for shearing, breakdown
Decreased number and function of sebaceous, eccrine and apocrine glands
Dryness (xerosis)
Decreased thermoregulation, increased risk of heat stroke
Capillary fragility (easy bruising)
Senile purpura
Speckling, uneven pigmentation, leathery texture
UV exposure
Slowed growth of hair, nails
Changes in distribution of hair
Delayed cell replacement, wound healing
✔✔Causes of pallor, cyanosis, jaundice, erythema - ✔✔Pallor: When the red-pink tones
from the oxygenated hemoglobin in the blood are lost, the skin takes on the color of
connective tissue (collagen), which is mostly white (can result from high stress, fear,
anxiety, cold, cigarette smoking, and edema)
Cyanosis: blueness around mouth/nails indicates poor oxigenation (hypoxia); signifies
decreased perfusion
Jaundice: A yellowish skin color indicates rising amounts of bilirubin in the blood; Liver
dysfunction, red blood cell destruction
Erythema: Erythema is an intense redness of the skin from excess blood (hyperemia) in
the dilated superficial capillaries. This sign is expected with fever, with local
inflammation, or with emotional reactions such as blushing in vascular flush areas
(cheeks, neck, and upper chest)
,✔✔Cause and grading of pitting edema - ✔✔Bilateral, dependent pitting edema occurs
with heart failure, diabetic neuropathy, and hepatic cirrhosis
Grading:
1+ Mild pitting, slight indentation, no perceptible swelling of the leg
2+ Moderate pitting, indentation subsides rapidly
3+ Deep pitting, indentation remains for a short time, leg looks swollen
4+ Very deep pitting, indentation lasts a long time, leg is grossly swollen and distorted
✔✔How to assess skin turgor - ✔✔Pinch up a large fold of skin on the anterior chest
under the clavicle (Fig. 12-5). Mobility is the skin's ease of rising, and turgor is its ability
to return to place promptly when released. This reflects the elasticity of the skin.
Poor turgor is evident in severe dehydration or extreme weight loss; the pinched skin
recedes slowly or "tents" and stands by itself.
✔✔The meaning and use of ABCDE - ✔✔Use the following mnemonic when assessing
skin lesions:
A- Asymmetry
B- Border
C- Color
D- Diameter (use small ruler; mm)
E- Elevation/Enlargement
✔✔Lung & Thorax Anatomy: Landmarks, reference lines - ✔✔5 lobes on anterior
-3 on right side
-2 on left side
Anterior Landmarks:
Suprasternal Notch: Hollow U-shaped depression just above the sternum, in between
the clavicles.
Sternum: The "breastbone" has three parts—the manubrium, the body, and the xiphoid
process.
Sternal Angle (Angle of Louis): Often called the "angle of Louis," is a useful place to
start counting ribs, which helps localize a respiratory finding horizontally. Also marks the
site of tracheal bifurcation into the right and left main bronchi; it corresponds with the
upper border of the atria of the heart, and it lies above the fourth thoracic vertebra on
the back.
Costal Angle: The right and left costal margins form an angle where they meet at the
xiphoid process. Usually 90 degrees or less
, Reference Lines:
MCL: Midclavicular Line
MSL: Midsternal Line
ALL: Anterior Axilary Line
PAL: Posterior Axillary Line
MAL: Midaxillary Line
✔✔General position of the lobes of the lung - ✔✔On the anterior chest, the oblique (the
major or diagonal) fissure crosses the fifth rib in the midaxillary line and terminates at
the sixth rib in the midclavicular line. The right lung also contains the horizontal (minor)
fissure, which divides the right upper and middle lobes. This fissure extends from the
fifth rib in the right midaxillary line to the third intercostal space or fourth rib at the right
sternal border
✔✔Pathway of air through the respiratory system, site of oxygen and C02 exchange -
✔✔ACINUS= Upside down part of the bronchiole tree
CO2 and O2 are exchanged at the alveoli
Intercostal muscles take more oxygen for us to breath than the diaphragm does
People with lung disease / lung problems should breath with their diaphragms instead of
their ribs (intercostal muscles)
✔✔Appropriate assessment techniques for anterior and posterior chest and what you
are assessing with each technique - ✔✔For smooth choreography in a complete
examination, begin the respiratory examination just after palpating thyroid gland when
you are standing behind person
Perform inspection, palpation, percussion, and auscultation on posterior and lateral
thorax
Then move to face person and repeat four maneuvers on anterior chest
Palpate: Symmetric expansion, tactile fremitus (say 99),
✔✔Definitions of adventious sounds: fine and coarse crackles, wheezing, stridor -
✔✔These are added sounds that are not normally heard in the lungs. If present, they
are heard as being superimposed on the breath sounds. They are caused by moving air
colliding with secretions in the tracheobronchial passageways or by the popping open of
previously deflated airways
Fine Crackles: Discontinuous, high-pitched, short crackling, popping sounds heard
during inspiration that are not cleared by coughing
Coarse Crackles: Loud, low-pitched, bubbling and gurgling sounds that start in early
inspiration and may be present in expiration
