NURS 190 | NURS190 Final Exam: Physical
Assessment - WCU Updated and Latest Questions
and Correct Answers with Rationale
1. When performing a physical assessment on the abdomen, what is the correct sequence of
examination techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Percussion, Auscultation, Inspection, Palpation
C. Auscultation, Inspection, Palpation, Percussion
D. Inspection, Auscultation, Percussion, Palpation
Correct Answer: D
Rationale: The correct order for abdominal assessment is inspection followed by
auscultation to ensure bowel sounds are not altered. Percussion and palpation are
performed last because they can stimulate peristalsis and create false bowel sounds. This
specific order is unique compared to other body system assessments. Accurate sequence is
vital for valid clinical findings in the gastrointestinal system. Skipping or reordering these
steps could lead to an incorrect interpretation of the patient’s condition.
2. A nurse is assessing a patient’s pupillary light reflex. Which cranial nerve is primarily
responsible for the sensory component of this reflex?
A. Cranial Nerve IV (Trochlear)
B. Cranial Nerve III (Oculomotor)
C. Cranial Nerve II (Optic)
D. Cranial Nerve VI (Abducens)
Correct Answer: C
Rationale: Cranial Nerve II, the optic nerve, carries the sensory message of light to the
brain. Once the brain receives the signal, Cranial Nerve III provides the motor response to
constrict the pupil. The trochlear and abducens nerves are involved in extraocular eye
movements rather than light reflexes. Testing the pupillary reflex evaluates the integrity of
the brainstem and these specific nerves. Understanding this pathway allows the nurse to
pinpoint potential neurological deficits.
3. Which heart sound is often associated with heart failure and is referred to as a ventricular
gallop?
A. S3
B. S2
,C. S1
D. S4
Correct Answer: A
Rationale: The S3 heart sound occurs early in diastole during the rapid ventricular filling
phase. It is commonly heard in conditions where there is fluid volume overload, such as
congestive heart failure. While S1 and S2 are normal closing sounds of valves, S3 indicates a
potential pathological state in adults. S4 is typically heard in patients with stiffened
ventricles or hypertension. Differentiating these sounds is critical for identifying early signs
of cardiac deterioration.
4. A patient presents with a ‘barrel chest’ appearance. This finding is most commonly
associated with which chronic condition?
A. Pneumonia
B. Pulmonary Embolism
C. Chronic Obstructive Pulmonary Disease (COPD)
D. Heart Failure
Correct Answer: C
Rationale: A barrel chest occurs when the anteroposterior diameter of the chest equals the
transverse diameter. This condition is caused by hyperinflation of the lungs, which is a
hallmark sign of emphysema or COPD. Patients with COPD often develop this structural
change due to chronic air trapping in the alveoli. This finding reflects long-term respiratory
strain rather than an acute infection like pneumonia. Recognizing this physical marker
helps the nurse assess the severity of a patient’s chronic lung disease.
5. To assess for jaundice in a dark-skinned patient, where should the nurse look for changes
in pigmentation?
A. The palms of the hands
B. The sclera and hard palate
C. The nail beds
D. The skin of the abdomen
Correct Answer: B
Rationale: In patients with darker skin tones, skin color changes can be difficult to observe
directly. The sclera and the mucous membranes of the hard palate are the most reliable
sites to detect yellow discoloration. Jaundice indicates elevated bilirubin levels and
potential liver or gallbladder dysfunction. The palms and nail beds are better suited for
assessing cyanosis or pallor. Consistently checking these specific areas ensures that a nurse
provides equitable and accurate physical assessments for all patients.
, 6. When assessing a patient’s respiratory system, the nurse hears high-pitched, musical
sounds primarily during expiration. How should this be documented?
A. Fine crackles
B. Coarse crackles
C. Pleural friction rub
D. Wheezes
Correct Answer: D
Rationale: Wheezes are adventitious breath sounds caused by air flowing through
narrowed or obstructed airways. They are characteristically musical and high-pitched,
frequently heard in patients with asthma or bronchitis. Crackles, on the other hand, are
non-musical popping sounds caused by the opening of collapsed small airways. A pleural
friction rub sounds like leather rubbing together and occurs with inflammation. Accurate
documentation of these sounds is essential for choosing the correct respiratory
intervention.
7. During a musculoskeletal assessment, the nurse asks the patient to move their arm away
from the midline of the body. This movement is called:
A. Abduction
B. Adduction
C. Flexion
D. Extension
Correct Answer: A
Rationale: Abduction refers to the movement of a limb or appendage away from the
median plane of the body. Adduction is the opposite movement, where the limb is brought
toward the midline. Flexion involves bending a joint to decrease the angle, while extension
increases the angle. Using precise anatomical terminology is required for clear
communication among healthcare providers. This knowledge helps in documenting a
patient’s range of motion accurately during physical therapy or recovery.
8. Which of the following describes the correct technique for auscultating the carotid
arteries?
A. Use the bell of the stethoscope and ask the patient to take a deep breath
B. Use the diaphragm of the stethoscope while the patient talks
C. Use the bell of the stethoscope and ask the patient to hold their breath
D. Use the diaphragm and apply heavy pressure over the artery
Correct Answer: C
Assessment - WCU Updated and Latest Questions
and Correct Answers with Rationale
1. When performing a physical assessment on the abdomen, what is the correct sequence of
examination techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Percussion, Auscultation, Inspection, Palpation
C. Auscultation, Inspection, Palpation, Percussion
D. Inspection, Auscultation, Percussion, Palpation
Correct Answer: D
Rationale: The correct order for abdominal assessment is inspection followed by
auscultation to ensure bowel sounds are not altered. Percussion and palpation are
performed last because they can stimulate peristalsis and create false bowel sounds. This
specific order is unique compared to other body system assessments. Accurate sequence is
vital for valid clinical findings in the gastrointestinal system. Skipping or reordering these
steps could lead to an incorrect interpretation of the patient’s condition.
2. A nurse is assessing a patient’s pupillary light reflex. Which cranial nerve is primarily
responsible for the sensory component of this reflex?
A. Cranial Nerve IV (Trochlear)
B. Cranial Nerve III (Oculomotor)
C. Cranial Nerve II (Optic)
D. Cranial Nerve VI (Abducens)
Correct Answer: C
Rationale: Cranial Nerve II, the optic nerve, carries the sensory message of light to the
brain. Once the brain receives the signal, Cranial Nerve III provides the motor response to
constrict the pupil. The trochlear and abducens nerves are involved in extraocular eye
movements rather than light reflexes. Testing the pupillary reflex evaluates the integrity of
the brainstem and these specific nerves. Understanding this pathway allows the nurse to
pinpoint potential neurological deficits.
3. Which heart sound is often associated with heart failure and is referred to as a ventricular
gallop?
A. S3
B. S2
,C. S1
D. S4
Correct Answer: A
Rationale: The S3 heart sound occurs early in diastole during the rapid ventricular filling
phase. It is commonly heard in conditions where there is fluid volume overload, such as
congestive heart failure. While S1 and S2 are normal closing sounds of valves, S3 indicates a
potential pathological state in adults. S4 is typically heard in patients with stiffened
ventricles or hypertension. Differentiating these sounds is critical for identifying early signs
of cardiac deterioration.
4. A patient presents with a ‘barrel chest’ appearance. This finding is most commonly
associated with which chronic condition?
A. Pneumonia
B. Pulmonary Embolism
C. Chronic Obstructive Pulmonary Disease (COPD)
D. Heart Failure
Correct Answer: C
Rationale: A barrel chest occurs when the anteroposterior diameter of the chest equals the
transverse diameter. This condition is caused by hyperinflation of the lungs, which is a
hallmark sign of emphysema or COPD. Patients with COPD often develop this structural
change due to chronic air trapping in the alveoli. This finding reflects long-term respiratory
strain rather than an acute infection like pneumonia. Recognizing this physical marker
helps the nurse assess the severity of a patient’s chronic lung disease.
5. To assess for jaundice in a dark-skinned patient, where should the nurse look for changes
in pigmentation?
A. The palms of the hands
B. The sclera and hard palate
C. The nail beds
D. The skin of the abdomen
Correct Answer: B
Rationale: In patients with darker skin tones, skin color changes can be difficult to observe
directly. The sclera and the mucous membranes of the hard palate are the most reliable
sites to detect yellow discoloration. Jaundice indicates elevated bilirubin levels and
potential liver or gallbladder dysfunction. The palms and nail beds are better suited for
assessing cyanosis or pallor. Consistently checking these specific areas ensures that a nurse
provides equitable and accurate physical assessments for all patients.
, 6. When assessing a patient’s respiratory system, the nurse hears high-pitched, musical
sounds primarily during expiration. How should this be documented?
A. Fine crackles
B. Coarse crackles
C. Pleural friction rub
D. Wheezes
Correct Answer: D
Rationale: Wheezes are adventitious breath sounds caused by air flowing through
narrowed or obstructed airways. They are characteristically musical and high-pitched,
frequently heard in patients with asthma or bronchitis. Crackles, on the other hand, are
non-musical popping sounds caused by the opening of collapsed small airways. A pleural
friction rub sounds like leather rubbing together and occurs with inflammation. Accurate
documentation of these sounds is essential for choosing the correct respiratory
intervention.
7. During a musculoskeletal assessment, the nurse asks the patient to move their arm away
from the midline of the body. This movement is called:
A. Abduction
B. Adduction
C. Flexion
D. Extension
Correct Answer: A
Rationale: Abduction refers to the movement of a limb or appendage away from the
median plane of the body. Adduction is the opposite movement, where the limb is brought
toward the midline. Flexion involves bending a joint to decrease the angle, while extension
increases the angle. Using precise anatomical terminology is required for clear
communication among healthcare providers. This knowledge helps in documenting a
patient’s range of motion accurately during physical therapy or recovery.
8. Which of the following describes the correct technique for auscultating the carotid
arteries?
A. Use the bell of the stethoscope and ask the patient to take a deep breath
B. Use the diaphragm of the stethoscope while the patient talks
C. Use the bell of the stethoscope and ask the patient to hold their breath
D. Use the diaphragm and apply heavy pressure over the artery
Correct Answer: C
