NUR612/NUR 612 Exam 3 V2 | Advanced
Nursing II Q&A with Rationale | William
Paterson University
1. When auscultating the heart, the nurse practitioner knows that the S1 sound is produced
by which of the following?
A. Closure of the aortic and pulmonic valves
B. Opening of the mitral and tricuspid valves
C. Closure of the mitral and tricuspid valves
D. Opening of the aortic and pulmonic valves
Correct Answer: C
Expert Explanation: The S1 heart sound corresponds to the closure of the atrioventricular
valves at the beginning of systole. This sound is typically loudest at the apex of the heart
where the mitral and tricuspid components are best heard. Understanding the cardiac cycle
is essential for differentiating normal sounds from pathologic murmurs.
2. A 55-year-old patient presents with shortness of breath. During percussion of the lungs,
the nurse practitioner notes a dull sound over the right lower lobe. This finding most likely
indicates:
A. Normal lung tissue
B. Pneumonia or pleural effusion
,C. Emphysema
D. Pneumothorax
Correct Answer: B
Expert Explanation: Dullness on percussion suggests that the air-filled lung tissue has
been replaced by fluid or solid tissue. This is a common finding in conditions such as lobar
pneumonia, pleural effusion, or a tumor. Normal lung tissue should produce a resonant
sound during percussion.
3. The nurse practitioner is performing an abdominal assessment and notes a positive
Murphy’s sign. This finding is highly suggestive of:
A. Acute appendicitis
B. Acute cholecystitis
C. Splenomegaly
D. Peritonitis
Correct Answer: B
Expert Explanation: Murphy’s sign is elicited by palpating the right upper quadrant while
the patient takes a deep breath. If the patient experiences sharp pain and stops breathing
mid-inspiration, the sign is considered positive. This physical exam finding is specific for
gallbladder inflammation or cholecystitis.
, 4. While examining a patient’s breasts, the nurse practitioner notices an area of skin that
resembles an orange peel (peau d’orange). This is a clinical sign of:
A. Benign fibrocystic changes
B. Lymphatic obstruction from underlying malignancy
C. A normal variation in older adults
D. Acute mastitis
Correct Answer: B
Expert Explanation: Peau d’orange is characterized by skin edema that causes the hair
follicles to appear prominent and recessed. This appearance is often a result of lymphatic
obstruction, which can be caused by inflammatory breast cancer. It is a critical finding that
requires immediate further diagnostic evaluation.
5. When assessing the peripheral vascular system, the nurse practitioner performs the Allen
test. What is the primary purpose of this test?
A. To evaluate for deep vein thrombosis
B. To assess for peripheral artery disease in the lower extremities
C. To measure the ankle-brachial index
D. To check the patency of the radial and ulnar arteries
Correct Answer: D
Nursing II Q&A with Rationale | William
Paterson University
1. When auscultating the heart, the nurse practitioner knows that the S1 sound is produced
by which of the following?
A. Closure of the aortic and pulmonic valves
B. Opening of the mitral and tricuspid valves
C. Closure of the mitral and tricuspid valves
D. Opening of the aortic and pulmonic valves
Correct Answer: C
Expert Explanation: The S1 heart sound corresponds to the closure of the atrioventricular
valves at the beginning of systole. This sound is typically loudest at the apex of the heart
where the mitral and tricuspid components are best heard. Understanding the cardiac cycle
is essential for differentiating normal sounds from pathologic murmurs.
2. A 55-year-old patient presents with shortness of breath. During percussion of the lungs,
the nurse practitioner notes a dull sound over the right lower lobe. This finding most likely
indicates:
A. Normal lung tissue
B. Pneumonia or pleural effusion
,C. Emphysema
D. Pneumothorax
Correct Answer: B
Expert Explanation: Dullness on percussion suggests that the air-filled lung tissue has
been replaced by fluid or solid tissue. This is a common finding in conditions such as lobar
pneumonia, pleural effusion, or a tumor. Normal lung tissue should produce a resonant
sound during percussion.
3. The nurse practitioner is performing an abdominal assessment and notes a positive
Murphy’s sign. This finding is highly suggestive of:
A. Acute appendicitis
B. Acute cholecystitis
C. Splenomegaly
D. Peritonitis
Correct Answer: B
Expert Explanation: Murphy’s sign is elicited by palpating the right upper quadrant while
the patient takes a deep breath. If the patient experiences sharp pain and stops breathing
mid-inspiration, the sign is considered positive. This physical exam finding is specific for
gallbladder inflammation or cholecystitis.
, 4. While examining a patient’s breasts, the nurse practitioner notices an area of skin that
resembles an orange peel (peau d’orange). This is a clinical sign of:
A. Benign fibrocystic changes
B. Lymphatic obstruction from underlying malignancy
C. A normal variation in older adults
D. Acute mastitis
Correct Answer: B
Expert Explanation: Peau d’orange is characterized by skin edema that causes the hair
follicles to appear prominent and recessed. This appearance is often a result of lymphatic
obstruction, which can be caused by inflammatory breast cancer. It is a critical finding that
requires immediate further diagnostic evaluation.
5. When assessing the peripheral vascular system, the nurse practitioner performs the Allen
test. What is the primary purpose of this test?
A. To evaluate for deep vein thrombosis
B. To assess for peripheral artery disease in the lower extremities
C. To measure the ankle-brachial index
D. To check the patency of the radial and ulnar arteries
Correct Answer: D
