1
NUR 345 ESSENTIALS OF NURSING FINAL EXAM BLUEPRINT
QUESTIONS WITH COMPLETE SOLUTION 2026
Content/Topic
Module 1: Vital Signs (Chapter 25)
• What are vital signs— are indicators of physiologic functioning and
reflect the health status of a person.
o pulse, BP, respirations, temperature, O2 saturation
• Assessment of vital signs
o Breath sounds:
Vesicular = soft & low pitched with longer inspiration than
expiration
Adventitious = abnormal breath sounds, medium
pitched, medium intensity, blowing sounds with an equal
inspiration and expiration
Bronchial = high pitched with expiration longer than inspiration
Bronchovesicular = moderate blowing sounds with equal
inspiration and expiration
Wheezes = high pitched musical sounds through narrowed airway
Rhonchi – low pitched snoring or rumbling sounds from mucous in
large airways
Crackles (& “rales” though they don’t use that term as much
now) = crackling sounds that indicated atelectasis,
pulmonary edema, or pneumonia, and indicate opening of
small airways and alveoli. See p. 652, table 25-6
Stridor = squeezing, closed airway (e.g., croup or choking sounds)
• Equipment used for vital signs
o Temperature—thermometer (oral, axillary, or rectal probe; tympanic;
temporal)
o Pulse—measure by palpation and using clock with seconds
hand; auscultate with stethoscope and clock with seconds
hand
o Respirations—visually watch chest rise and fall, count and use clock with
seconds hand
o Blood Pressure—sphygmomanometer and stethoscope
, 2
o
• Heat loss
o The Skin is the primary site of heat loss; arteriovenous shunts open
or close to allow changes in the core body temperature from the
blood through the skin to the environment.
Radiation, convection, evaporation, and conduction
, 3
Evaporation or sweat, warming/humidifying inspired
air, and elimination of urine/feces
Vital signs changes in certain conditions (e.g., infection can increase HR,
pain can increase HR & BP, too large of BP cuff can cause a low reading)
Ear assessments and tympanic temperatures: infants & children under 3
years old – pull pinna down & back. Adults and older children – pull pinna
up & back.
Circadian rhythm
Module 2: Health Assessment (Chapter 26)
• Glasgow Coma Scale/scores
o Glasgow Coma Scale/scores – normal total is 15; pt is assessed in
functions of eye opening, motor response, and verbal response
o
COMPONENT SCORE RESPONSE
Eye opening 4 Spontaneous eye
3 opening Eyes open to
2 speech
1 Eyes open to pain
No eye opening
Motor response 6 Obeys commands fully
5 Localizes to noxious
4 stimuli Withdraws from
3 noxious stimuli
2 Abnormal flexion (i.e.,
1 decorticate posturing;
flexes elbows and
wrists while extending
lower legs to pain)
Abnormal extensor
response (i.e.,
decerebrate posturing;
extends upper and
lower extremities to
pain)
No motor response
Verbal response 5 Alert and oriented
4 Confused yet coherent
NUR 345 ESSENTIALS OF NURSING FINAL EXAM BLUEPRINT
QUESTIONS WITH COMPLETE SOLUTION 2026
Content/Topic
Module 1: Vital Signs (Chapter 25)
• What are vital signs— are indicators of physiologic functioning and
reflect the health status of a person.
o pulse, BP, respirations, temperature, O2 saturation
• Assessment of vital signs
o Breath sounds:
Vesicular = soft & low pitched with longer inspiration than
expiration
Adventitious = abnormal breath sounds, medium
pitched, medium intensity, blowing sounds with an equal
inspiration and expiration
Bronchial = high pitched with expiration longer than inspiration
Bronchovesicular = moderate blowing sounds with equal
inspiration and expiration
Wheezes = high pitched musical sounds through narrowed airway
Rhonchi – low pitched snoring or rumbling sounds from mucous in
large airways
Crackles (& “rales” though they don’t use that term as much
now) = crackling sounds that indicated atelectasis,
pulmonary edema, or pneumonia, and indicate opening of
small airways and alveoli. See p. 652, table 25-6
Stridor = squeezing, closed airway (e.g., croup or choking sounds)
• Equipment used for vital signs
o Temperature—thermometer (oral, axillary, or rectal probe; tympanic;
temporal)
o Pulse—measure by palpation and using clock with seconds
hand; auscultate with stethoscope and clock with seconds
hand
o Respirations—visually watch chest rise and fall, count and use clock with
seconds hand
o Blood Pressure—sphygmomanometer and stethoscope
, 2
o
• Heat loss
o The Skin is the primary site of heat loss; arteriovenous shunts open
or close to allow changes in the core body temperature from the
blood through the skin to the environment.
Radiation, convection, evaporation, and conduction
, 3
Evaporation or sweat, warming/humidifying inspired
air, and elimination of urine/feces
Vital signs changes in certain conditions (e.g., infection can increase HR,
pain can increase HR & BP, too large of BP cuff can cause a low reading)
Ear assessments and tympanic temperatures: infants & children under 3
years old – pull pinna down & back. Adults and older children – pull pinna
up & back.
Circadian rhythm
Module 2: Health Assessment (Chapter 26)
• Glasgow Coma Scale/scores
o Glasgow Coma Scale/scores – normal total is 15; pt is assessed in
functions of eye opening, motor response, and verbal response
o
COMPONENT SCORE RESPONSE
Eye opening 4 Spontaneous eye
3 opening Eyes open to
2 speech
1 Eyes open to pain
No eye opening
Motor response 6 Obeys commands fully
5 Localizes to noxious
4 stimuli Withdraws from
3 noxious stimuli
2 Abnormal flexion (i.e.,
1 decorticate posturing;
flexes elbows and
wrists while extending
lower legs to pain)
Abnormal extensor
response (i.e.,
decerebrate posturing;
extends upper and
lower extremities to
pain)
No motor response
Verbal response 5 Alert and oriented
4 Confused yet coherent
