NU 518 Exam 2 | Advanced Nursing Assessment (2026) |USA
1. When percussing over healthy lung tissue in an adult, which sound does the
nurse expect to hear?
A. Resonance
B. Tympany
C. Dullness
D. Hyperresonance
Answer: A
Rationale: Resonance is the low-pitched, clear, hollow sound that predominates in healthy
lung tissue in the adult.
2. The S2 heart sound is caused by the closure of which valves?
A. Mitral and tricuspid
B. Aortic and pulmonic
C. Mitral and aortic
D. Tricuspid and pulmonic
Answer: B
Rationale: S2 occurs with the closure of the semilunar valves (aortic and pulmonic) and
signals the end of systole.
3. In what sequence should the nurse perform an abdominal assessment?
A. Inspection, palpation, percussion, auscultation
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, percussion, palpation
D. Palpation, percussion, auscultation, inspection
Answer: B
,Rationale: Auscultation is done before percussion and palpation to avoid increasing
peristalsis, which would yield false bowel sounds.
4. When assessing for costovertebral angle (CVA) tenderness, the nurse is
checking for inflammation of which organ?
A. Kidney
B. Spleen
C. Liver
D. Appendix
Answer: A
Rationale: Sharp pain with percussion over the 12th rib at the costovertebral angle
indicates inflammation of the kidney.
5. Which cranial nerve is responsible for the movement of the tongue?
A. CN X (Vagus)
B. CN IX (Glossopharyngeal)
C. CN VII (Facial)
D. CN XII (Hypoglossal)
Answer: D
Rationale: Cranial nerve XII, the hypoglossal nerve, controls the muscles that move the
tongue.
6. A client presents with ‘the worst headache of my life.’ This description is most
characteristic of which condition?
A. Subarachnoid hemorrhage
B. Tension headache
C. Migraine headache
D. Cluster headache
Answer: A
, Rationale: A sudden, severe headache described as ‘the worst of my life’ is a red flag for a
subarachnoid hemorrhage.
7. Which heart sound is frequently associated with heart failure and is referred
to as a ventricular gallop?
A. S1
B. S2
C. S3
D. S4
Answer: C
Rationale: S3 is a ventricular filling sound occurs in early diastole and is common in
conditions of volume overload like heart failure.
8. Where is the point of maximal impulse (PMI) normally located in an adult?
A. Fifth left intercostal space, midclavicular line
B. Fourth left intercostal space, midclavicular line
C. Second left intercostal space, sternal border
D. Fifth right intercostal space, midaxillary line
Answer: A
Rationale: The apical impulse or PMI is normally at the fifth intercostal space at or inside
the left midclavicular line.
9. To assess the dorsal pedis pulse, where should the nurse palpate?
A. Behind the medial malleolus
B. In the popliteal fossa
C. Lateral to the extensor tendon of the great toe
D. In the groin area
Answer: C
Rationale: The dorsalis pedis pulse is located on the dorsum of the foot, lateral to and
parallel with the extensor tendon of the big toe.
1. When percussing over healthy lung tissue in an adult, which sound does the
nurse expect to hear?
A. Resonance
B. Tympany
C. Dullness
D. Hyperresonance
Answer: A
Rationale: Resonance is the low-pitched, clear, hollow sound that predominates in healthy
lung tissue in the adult.
2. The S2 heart sound is caused by the closure of which valves?
A. Mitral and tricuspid
B. Aortic and pulmonic
C. Mitral and aortic
D. Tricuspid and pulmonic
Answer: B
Rationale: S2 occurs with the closure of the semilunar valves (aortic and pulmonic) and
signals the end of systole.
3. In what sequence should the nurse perform an abdominal assessment?
A. Inspection, palpation, percussion, auscultation
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, percussion, palpation
D. Palpation, percussion, auscultation, inspection
Answer: B
,Rationale: Auscultation is done before percussion and palpation to avoid increasing
peristalsis, which would yield false bowel sounds.
4. When assessing for costovertebral angle (CVA) tenderness, the nurse is
checking for inflammation of which organ?
A. Kidney
B. Spleen
C. Liver
D. Appendix
Answer: A
Rationale: Sharp pain with percussion over the 12th rib at the costovertebral angle
indicates inflammation of the kidney.
5. Which cranial nerve is responsible for the movement of the tongue?
A. CN X (Vagus)
B. CN IX (Glossopharyngeal)
C. CN VII (Facial)
D. CN XII (Hypoglossal)
Answer: D
Rationale: Cranial nerve XII, the hypoglossal nerve, controls the muscles that move the
tongue.
6. A client presents with ‘the worst headache of my life.’ This description is most
characteristic of which condition?
A. Subarachnoid hemorrhage
B. Tension headache
C. Migraine headache
D. Cluster headache
Answer: A
, Rationale: A sudden, severe headache described as ‘the worst of my life’ is a red flag for a
subarachnoid hemorrhage.
7. Which heart sound is frequently associated with heart failure and is referred
to as a ventricular gallop?
A. S1
B. S2
C. S3
D. S4
Answer: C
Rationale: S3 is a ventricular filling sound occurs in early diastole and is common in
conditions of volume overload like heart failure.
8. Where is the point of maximal impulse (PMI) normally located in an adult?
A. Fifth left intercostal space, midclavicular line
B. Fourth left intercostal space, midclavicular line
C. Second left intercostal space, sternal border
D. Fifth right intercostal space, midaxillary line
Answer: A
Rationale: The apical impulse or PMI is normally at the fifth intercostal space at or inside
the left midclavicular line.
9. To assess the dorsal pedis pulse, where should the nurse palpate?
A. Behind the medial malleolus
B. In the popliteal fossa
C. Lateral to the extensor tendon of the great toe
D. In the groin area
Answer: C
Rationale: The dorsalis pedis pulse is located on the dorsum of the foot, lateral to and
parallel with the extensor tendon of the big toe.
