NUR612/NUR 612 Exam 1 V3 | Advanced
Nursing II Q&A with Rationale | William
Paterson University
1. Which of the following physical examination findings is most indicative of lobar pneumonia
during percussion of the chest?
A. Resonance
B. Hyperresonance
C. Dullness
D. Tympany
Correct Answer: C
Expert Explanation: Dullness is the expected percussion sound when lung tissue is
consolidated, which occurs in conditions like lobar pneumonia. Resonance is the normal
sound found over healthy, air-filled lung tissue. Hyperresonance typically suggests air
trapping, such as in COPD or pneumothorax.
2. During an abdominal assessment, a nurse practitioner elicits pain when pressure is applied
to the right lower quadrant and then quickly released. This is known as:
A. Murphy’s sign
B. Rovsing’s sign
C. Rebound tenderness
,D. Psoas sign
Correct Answer: C
Expert Explanation: Rebound tenderness is a classic sign of peritoneal irritation, often
associated with appendicitis. It is elicited by pressing firmly and slowly into the abdomen
and then withdrawing the hand quickly. This specific maneuver at McBurney’s point is a
key diagnostic indicator for acute appendicitis.
3. An S3 heart sound is most commonly associated with which of the following conditions in
an older adult?
A. Hypertension
B. Heart Failure
C. Aortic Stenosis
D. Mitral Valve Prolapse
Correct Answer: B
Expert Explanation: The S3 heart sound, also known as a ventricular gallop, occurs early
in diastole during the rapid ventricular filling phase. In older adults, it is often a sign of
ventricular overfilling or poor contractility, frequently seen in heart failure. While it can be
normal in children and athletes, its presence in seniors warrants further cardiac
investigation.
4. To assess Cranial Nerve VII (Facial), which action should the patient be asked to perform?
A. Stick out their tongue
, B. Shrug their shoulders
C. Smile and puff out cheeks
D. Follow a finger with their eyes
Correct Answer: C
Expert Explanation: Cranial Nerve VII, the facial nerve, is responsible for the muscles of
facial expression. Asking the patient to smile, puff out their cheeks, or wrinkle their
forehead tests the motor component of this nerve. Asymmetry in these movements may
indicate a peripheral or central nerve lesion.
5. The nurse practitioner is performing a Rinne test. If the patient reports that bone
conduction is longer than air conduction (BC > AC), this indicates:
A. Sensorineural hearing loss
B. Normal hearing
C. Conductive hearing loss
D. Presbycusis
Correct Answer: C
Expert Explanation: In a normal ear, air conduction (AC) should be twice as long as bone
conduction (BC). When BC is greater than or equal to AC, it signifies a conductive hearing
loss in that ear. This occurs because the sound bypasses the external and middle ear
obstructions via the bone.
Nursing II Q&A with Rationale | William
Paterson University
1. Which of the following physical examination findings is most indicative of lobar pneumonia
during percussion of the chest?
A. Resonance
B. Hyperresonance
C. Dullness
D. Tympany
Correct Answer: C
Expert Explanation: Dullness is the expected percussion sound when lung tissue is
consolidated, which occurs in conditions like lobar pneumonia. Resonance is the normal
sound found over healthy, air-filled lung tissue. Hyperresonance typically suggests air
trapping, such as in COPD or pneumothorax.
2. During an abdominal assessment, a nurse practitioner elicits pain when pressure is applied
to the right lower quadrant and then quickly released. This is known as:
A. Murphy’s sign
B. Rovsing’s sign
C. Rebound tenderness
,D. Psoas sign
Correct Answer: C
Expert Explanation: Rebound tenderness is a classic sign of peritoneal irritation, often
associated with appendicitis. It is elicited by pressing firmly and slowly into the abdomen
and then withdrawing the hand quickly. This specific maneuver at McBurney’s point is a
key diagnostic indicator for acute appendicitis.
3. An S3 heart sound is most commonly associated with which of the following conditions in
an older adult?
A. Hypertension
B. Heart Failure
C. Aortic Stenosis
D. Mitral Valve Prolapse
Correct Answer: B
Expert Explanation: The S3 heart sound, also known as a ventricular gallop, occurs early
in diastole during the rapid ventricular filling phase. In older adults, it is often a sign of
ventricular overfilling or poor contractility, frequently seen in heart failure. While it can be
normal in children and athletes, its presence in seniors warrants further cardiac
investigation.
4. To assess Cranial Nerve VII (Facial), which action should the patient be asked to perform?
A. Stick out their tongue
, B. Shrug their shoulders
C. Smile and puff out cheeks
D. Follow a finger with their eyes
Correct Answer: C
Expert Explanation: Cranial Nerve VII, the facial nerve, is responsible for the muscles of
facial expression. Asking the patient to smile, puff out their cheeks, or wrinkle their
forehead tests the motor component of this nerve. Asymmetry in these movements may
indicate a peripheral or central nerve lesion.
5. The nurse practitioner is performing a Rinne test. If the patient reports that bone
conduction is longer than air conduction (BC > AC), this indicates:
A. Sensorineural hearing loss
B. Normal hearing
C. Conductive hearing loss
D. Presbycusis
Correct Answer: C
Expert Explanation: In a normal ear, air conduction (AC) should be twice as long as bone
conduction (BC). When BC is greater than or equal to AC, it signifies a conductive hearing
loss in that ear. This occurs because the sound bypasses the external and middle ear
obstructions via the bone.
