NUR600/NUR 600 Exam 3 V3 | Advanced
Health Assess Q&A with Rationale |
William Paterson University
1. When assessing a patient for a suspected carotid bruit, which is the correct technique for
auscultation?
A. Use the diaphragm of the stethoscope while the patient breathes deeply.
B. Apply firm pressure with the diaphragm over the carotid bulb.
C. Use the bell of the stethoscope while the patient holds their breath.
D. Auscultate with the bell while the patient speaks in a low voice.
Correct Answer: C
Expert Explanation: A carotid bruit is a blowing or swishing sound indicating turbulent
blood flow. Using the bell of the stethoscope is preferred because it is better at picking up
low-frequency sounds like bruits. The patient should hold their breath so that respiratory
sounds do not interfere with or mask the vascular sounds being assessed.
2. Which heart sound is most commonly associated with heart failure and is heard during the
early part of diastole?
A. S1 heart sound
B. S2 heart sound
C. S3 heart sound
,D. S4 heart sound
Correct Answer: C
Expert Explanation: The S3 heart sound, also known as a ventricular gallop, occurs in
early diastole during the rapid ventricular filling phase. In adults, it often signifies volume
overload or decreased ventricular compliance, which are hallmarks of heart failure. It is
best heard at the apex of the heart with the patient in the left lateral decubitus position.
3. During a physical examination, the clinician notes a ‘machinery-like’ murmur heard
throughout systole and diastole. This finding is classic for which condition?
A. Mitral Stenosis
B. Patent Ductus Arteriosus
C. Aortic Regurgitation
D. Ventricular Septal Defect
Correct Answer: B
Expert Explanation: A continuous ‘machinery’ murmur is the hallmark clinical sign of a
Patent Ductus Arteriosus (PDA). This murmur persists through both systole and diastole
because the pressure in the aorta is always higher than in the pulmonary artery. It is
typically loudest at the left upper sternal border in the second intercostal space.
4. To assess for costovertebral angle (CVA) tenderness, the clinician should perform which
maneuver?
A. Deep palpation in the right upper quadrant.
, B. Light percussion over the symphysis pubis.
C. Indirect percussion with the ulnar surface of the fist over the 12th rib.
D. Firm pressure applied to the epigastric region.
Correct Answer: C
Expert Explanation: CVA tenderness is assessed by placing one hand over the
costovertebral angle and striking it with the ulnar surface of the other fist. Pain during this
maneuver suggests inflammation of the kidney, such as pyelonephritis. This physical exam
finding is critical for differentiating renal issues from general back pain.
5. When performing the Romberg test, what is the clinician primarily assessing?
A. Strength of the lower extremities.
B. Cerebellar coordination and proprioception.
C. The function of the glossopharyngeal nerve.
D. Fine motor skills and finger dexterity.
Correct Answer: B
Expert Explanation: The Romberg test assesses the integrity of the sensory pathways for
subcortical balance and proprioception. A positive test occurs when a patient can maintain
balance with eyes open but loses it when eyes are closed. This indicates that the patient is
relying on visual cues to compensate for a lack of proprioceptive or vestibular input.
Health Assess Q&A with Rationale |
William Paterson University
1. When assessing a patient for a suspected carotid bruit, which is the correct technique for
auscultation?
A. Use the diaphragm of the stethoscope while the patient breathes deeply.
B. Apply firm pressure with the diaphragm over the carotid bulb.
C. Use the bell of the stethoscope while the patient holds their breath.
D. Auscultate with the bell while the patient speaks in a low voice.
Correct Answer: C
Expert Explanation: A carotid bruit is a blowing or swishing sound indicating turbulent
blood flow. Using the bell of the stethoscope is preferred because it is better at picking up
low-frequency sounds like bruits. The patient should hold their breath so that respiratory
sounds do not interfere with or mask the vascular sounds being assessed.
2. Which heart sound is most commonly associated with heart failure and is heard during the
early part of diastole?
A. S1 heart sound
B. S2 heart sound
C. S3 heart sound
,D. S4 heart sound
Correct Answer: C
Expert Explanation: The S3 heart sound, also known as a ventricular gallop, occurs in
early diastole during the rapid ventricular filling phase. In adults, it often signifies volume
overload or decreased ventricular compliance, which are hallmarks of heart failure. It is
best heard at the apex of the heart with the patient in the left lateral decubitus position.
3. During a physical examination, the clinician notes a ‘machinery-like’ murmur heard
throughout systole and diastole. This finding is classic for which condition?
A. Mitral Stenosis
B. Patent Ductus Arteriosus
C. Aortic Regurgitation
D. Ventricular Septal Defect
Correct Answer: B
Expert Explanation: A continuous ‘machinery’ murmur is the hallmark clinical sign of a
Patent Ductus Arteriosus (PDA). This murmur persists through both systole and diastole
because the pressure in the aorta is always higher than in the pulmonary artery. It is
typically loudest at the left upper sternal border in the second intercostal space.
4. To assess for costovertebral angle (CVA) tenderness, the clinician should perform which
maneuver?
A. Deep palpation in the right upper quadrant.
, B. Light percussion over the symphysis pubis.
C. Indirect percussion with the ulnar surface of the fist over the 12th rib.
D. Firm pressure applied to the epigastric region.
Correct Answer: C
Expert Explanation: CVA tenderness is assessed by placing one hand over the
costovertebral angle and striking it with the ulnar surface of the other fist. Pain during this
maneuver suggests inflammation of the kidney, such as pyelonephritis. This physical exam
finding is critical for differentiating renal issues from general back pain.
5. When performing the Romberg test, what is the clinician primarily assessing?
A. Strength of the lower extremities.
B. Cerebellar coordination and proprioception.
C. The function of the glossopharyngeal nerve.
D. Fine motor skills and finger dexterity.
Correct Answer: B
Expert Explanation: The Romberg test assesses the integrity of the sensory pathways for
subcortical balance and proprioception. A positive test occurs when a patient can maintain
balance with eyes open but loses it when eyes are closed. This indicates that the patient is
relying on visual cues to compensate for a lack of proprioceptive or vestibular input.
