NUR2180 Physical Assessment
Midterm Exam Review
(Questions & Solutions)
2025
©2025
, Question 1:
A 64-year-old female with a history of myocardial infarction and heart
failure presents with increasing dyspnea on exertion. During the cardiac
examination, which of the following auscultatory findings most strongly
supports the presence of systolic dysfunction?
A. Split S1
B. S2 with wide splitting
C. S3 gallop
D. Ejection click
Correct ANS: C. S3 gallop
Rationale: An S3 heart sound is produced during rapid ventricular filling
and is typically associated with volume overload and a reduced ejection
fraction, marking it as a key finding in systolic dysfunction.
---
Question 2:
A 52-year-old male presents with fever, productive cough, and pleuritic
chest pain. Upon respiratory examination, which set of lung sound
findings is most characteristic of lobar pneumonia?
A. Vesicular breath sounds with prolonged expiration
B. Bronchial breath sounds with increased tactile fremitus
C. Fine crackles with diminished vocal resonance
D. Inspiratory wheezes with prolonged inspiratory phase
Correct ANS: B. Bronchial breath sounds with increased tactile
fremitus
Rationale: In lobar pneumonia, lung consolidation enables sound to
travel more effectively, yielding bronchial breath sounds and elevated
tactile fremitus due to denser, fluid-filled tissue.
©2025
,---
Question 3:
A 38-year-old female experiences right upper quadrant discomfort.
Which physical examination technique is most reliable in detecting
hepatomegaly during an abdominal exam?
A. Inspection for distended abdominal walls
B. Auscultation for a hepatic bruit
C. Percussion to detect a dull, enlarged liver margin
D. Palpation of abdominal tenderness
Correct ANS: C. Percussion to detect a dull, enlarged liver margin
Rationale: Percussion is critical in delineating organs. A dull sound with
an upward shift of the liver margin provides strong evidence for
hepatomegaly.
---
Question 4:
A 28-year-old athlete sustains a knee injury. To evaluate a suspected
anterior cruciate ligament (ACL) tear, which physical test is considered
most specific?
A. McMurray test
B. Lachman test
C. Apley's compression test
D. Posterior drawer test
Correct ANS: B. Lachman test
Rationale: The Lachman test is highly sensitive and specific for
detecting ACL injuries, as it measures anterior tibial translation with
minimal interference from other structures.
---
Question 5:
©2025
, A 70-year-old male undergoing neurological evaluation following a
suspected stroke is found to have hyperreflexia. Which additional finding
would most strongly indicate an upper motor neuron lesion?
A. Flaccid paralysis
B. Positive Babinski sign
C. Hemisensory loss
D. Ataxia
Correct ANS: B. Positive Babinski sign
Rationale: The presence of a positive Babinski sign—upgoing great toe
upon stimulation—is a classic indicator of upper motor neuron damage.
---
Question 6:
A 60-year-old diabetic patient with intermittent claudication is examined
for peripheral arterial disease. Which advanced physical assessment
technique is most valuable in this evaluation?
A. Auscultation for vascular bruits
B. Palpation of peripheral pulses
C. Inspection of capillary refill
D. Percussion of muscle tone
Correct ANS: B. Palpation of peripheral pulses
Rationale: Careful palpation of peripheral pulses (e.g., dorsalis pedis,
posterior tibial) is essential in determining arterial integrity and
identifying peripheral arterial disease.
---
Question 7:
A 45-year-old female is evaluated for lower extremity edema. Which
physical assessment finding is most indicative of pitting edema?
A. Diffuse, non-pitting firmness
B. Persistent indentation following pressure
©2025
Midterm Exam Review
(Questions & Solutions)
2025
©2025
, Question 1:
A 64-year-old female with a history of myocardial infarction and heart
failure presents with increasing dyspnea on exertion. During the cardiac
examination, which of the following auscultatory findings most strongly
supports the presence of systolic dysfunction?
A. Split S1
B. S2 with wide splitting
C. S3 gallop
D. Ejection click
Correct ANS: C. S3 gallop
Rationale: An S3 heart sound is produced during rapid ventricular filling
and is typically associated with volume overload and a reduced ejection
fraction, marking it as a key finding in systolic dysfunction.
---
Question 2:
A 52-year-old male presents with fever, productive cough, and pleuritic
chest pain. Upon respiratory examination, which set of lung sound
findings is most characteristic of lobar pneumonia?
A. Vesicular breath sounds with prolonged expiration
B. Bronchial breath sounds with increased tactile fremitus
C. Fine crackles with diminished vocal resonance
D. Inspiratory wheezes with prolonged inspiratory phase
Correct ANS: B. Bronchial breath sounds with increased tactile
fremitus
Rationale: In lobar pneumonia, lung consolidation enables sound to
travel more effectively, yielding bronchial breath sounds and elevated
tactile fremitus due to denser, fluid-filled tissue.
©2025
,---
Question 3:
A 38-year-old female experiences right upper quadrant discomfort.
Which physical examination technique is most reliable in detecting
hepatomegaly during an abdominal exam?
A. Inspection for distended abdominal walls
B. Auscultation for a hepatic bruit
C. Percussion to detect a dull, enlarged liver margin
D. Palpation of abdominal tenderness
Correct ANS: C. Percussion to detect a dull, enlarged liver margin
Rationale: Percussion is critical in delineating organs. A dull sound with
an upward shift of the liver margin provides strong evidence for
hepatomegaly.
---
Question 4:
A 28-year-old athlete sustains a knee injury. To evaluate a suspected
anterior cruciate ligament (ACL) tear, which physical test is considered
most specific?
A. McMurray test
B. Lachman test
C. Apley's compression test
D. Posterior drawer test
Correct ANS: B. Lachman test
Rationale: The Lachman test is highly sensitive and specific for
detecting ACL injuries, as it measures anterior tibial translation with
minimal interference from other structures.
---
Question 5:
©2025
, A 70-year-old male undergoing neurological evaluation following a
suspected stroke is found to have hyperreflexia. Which additional finding
would most strongly indicate an upper motor neuron lesion?
A. Flaccid paralysis
B. Positive Babinski sign
C. Hemisensory loss
D. Ataxia
Correct ANS: B. Positive Babinski sign
Rationale: The presence of a positive Babinski sign—upgoing great toe
upon stimulation—is a classic indicator of upper motor neuron damage.
---
Question 6:
A 60-year-old diabetic patient with intermittent claudication is examined
for peripheral arterial disease. Which advanced physical assessment
technique is most valuable in this evaluation?
A. Auscultation for vascular bruits
B. Palpation of peripheral pulses
C. Inspection of capillary refill
D. Percussion of muscle tone
Correct ANS: B. Palpation of peripheral pulses
Rationale: Careful palpation of peripheral pulses (e.g., dorsalis pedis,
posterior tibial) is essential in determining arterial integrity and
identifying peripheral arterial disease.
---
Question 7:
A 45-year-old female is evaluated for lower extremity edema. Which
physical assessment finding is most indicative of pitting edema?
A. Diffuse, non-pitting firmness
B. Persistent indentation following pressure
©2025
