NUR 6001/NUR6001 Exam 2 V2 | Advanced
Health Assessment Q&A with Rationale |
William Paterson University
1. During the cardiac assessment, the nurse practitioner identifies the first heart sound (S1).
Which physiological event is responsible for this sound?
A. Closure of the aortic and pulmonic valves.
B. Opening of the atrioventricular valves.
C. Closure of the mitral and tricuspid valves.
D. The rush of blood into the ventricles during early diastole.
Correct Answer: C
Expert Explanation: The first heart sound, S1, signals the beginning of systole. It is
primarily caused by the closure of the atrioventricular valves, which are the mitral and
tricuspid valves. This occurs when ventricular pressure rises above atrial pressure during
contraction.
2. When performing a respiratory exam on a patient with suspected lobar pneumonia, what
finding would the nurse practitioner expect during tactile fremitus?
A. Decreased tactile fremitus over the affected area.
B. Absent tactile fremitus throughout the lung fields.
C. Increased tactile fremitus over the affected area.
,D. Fremitus that shifts with changes in position.
Correct Answer: C
Expert Explanation: Tactile fremitus refers to the palpable vibrations transmitted through
the bronchopulmonary system. In lobar pneumonia, the lung tissue becomes consolidated
with fluid or cellular debris. Since sound travels better through solid or fluid-filled media
than through air, the vibrations are increased.
3. A patient presents with sharp right upper quadrant pain that radiates to the right scapula.
The clinician performs a Murphy’s sign test. Which of the following indicates a positive
result?
A. Pain triggered by deep palpation of the left lower quadrant.
B. A sharp increase in pain and sudden stop in inspiratory effort during palpation.
C. Radiating pain when the patient is asked to cough.
D. Rebound tenderness noted at McBurney’s point.
Correct Answer: B
Expert Explanation: Murphy’s sign is used to assess for acute cholecystitis or gallbladder
inflammation. The clinician palpates the right upper quadrant at the liver border while the
patient takes a deep breath. A positive sign is defined as the patient halting inspiration due
to sharp pain when the gallbladder contacts the examiner’s fingers.
, 4. A 65-year-old patient with a history of heart failure presents with an extra heart sound
heard early in diastole. This sound is best described as:
A. An S4 heart sound, indicating a stiff ventricle.
B. A physiologic split S2.
C. An ejection click heard at the base.
D. An S3 heart sound, often called a ventricular gallop.
Correct Answer: D
Expert Explanation: The S3 heart sound occurs during the rapid filling phase of diastole
right after S2. In older adults or those with heart failure, it often indicates volume overload
or decreased ventricular compliance. It is frequently referred to as a ventricular gallop
because of its cadence.
5. To assess the function of Cranial Nerve II (Optic), which of the following tools should the
nurse practitioner use?
A. An otoscope to visualize the tympanic membrane.
B. A cotton wisp to test the corneal reflex.
C. A Snellen chart to measure visual acuity.
D. A tuning fork for the Weber test.
Correct Answer: C
Health Assessment Q&A with Rationale |
William Paterson University
1. During the cardiac assessment, the nurse practitioner identifies the first heart sound (S1).
Which physiological event is responsible for this sound?
A. Closure of the aortic and pulmonic valves.
B. Opening of the atrioventricular valves.
C. Closure of the mitral and tricuspid valves.
D. The rush of blood into the ventricles during early diastole.
Correct Answer: C
Expert Explanation: The first heart sound, S1, signals the beginning of systole. It is
primarily caused by the closure of the atrioventricular valves, which are the mitral and
tricuspid valves. This occurs when ventricular pressure rises above atrial pressure during
contraction.
2. When performing a respiratory exam on a patient with suspected lobar pneumonia, what
finding would the nurse practitioner expect during tactile fremitus?
A. Decreased tactile fremitus over the affected area.
B. Absent tactile fremitus throughout the lung fields.
C. Increased tactile fremitus over the affected area.
,D. Fremitus that shifts with changes in position.
Correct Answer: C
Expert Explanation: Tactile fremitus refers to the palpable vibrations transmitted through
the bronchopulmonary system. In lobar pneumonia, the lung tissue becomes consolidated
with fluid or cellular debris. Since sound travels better through solid or fluid-filled media
than through air, the vibrations are increased.
3. A patient presents with sharp right upper quadrant pain that radiates to the right scapula.
The clinician performs a Murphy’s sign test. Which of the following indicates a positive
result?
A. Pain triggered by deep palpation of the left lower quadrant.
B. A sharp increase in pain and sudden stop in inspiratory effort during palpation.
C. Radiating pain when the patient is asked to cough.
D. Rebound tenderness noted at McBurney’s point.
Correct Answer: B
Expert Explanation: Murphy’s sign is used to assess for acute cholecystitis or gallbladder
inflammation. The clinician palpates the right upper quadrant at the liver border while the
patient takes a deep breath. A positive sign is defined as the patient halting inspiration due
to sharp pain when the gallbladder contacts the examiner’s fingers.
, 4. A 65-year-old patient with a history of heart failure presents with an extra heart sound
heard early in diastole. This sound is best described as:
A. An S4 heart sound, indicating a stiff ventricle.
B. A physiologic split S2.
C. An ejection click heard at the base.
D. An S3 heart sound, often called a ventricular gallop.
Correct Answer: D
Expert Explanation: The S3 heart sound occurs during the rapid filling phase of diastole
right after S2. In older adults or those with heart failure, it often indicates volume overload
or decreased ventricular compliance. It is frequently referred to as a ventricular gallop
because of its cadence.
5. To assess the function of Cranial Nerve II (Optic), which of the following tools should the
nurse practitioner use?
A. An otoscope to visualize the tympanic membrane.
B. A cotton wisp to test the corneal reflex.
C. A Snellen chart to measure visual acuity.
D. A tuning fork for the Weber test.
Correct Answer: C
