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NUR 209 Exam 3 Med Surg II 2026/2027
Questions with Verified Answers and
Detailed Rationales Grade A
1. A nurse in a provider's office is preparing to auscultate and percuss a
client's thorax as part of a comprehensive physical examination. Which
of the following findings should the nurse expect?
Correct Answer: Resonance and bronchovesicular sounds
Rationale:
1. Resonance is the normal percussion sound over healthy lung tissue.
2. Bronchovesicular breath sounds are normal over the main bronchi (1st-
2nd intercostal spaces anteriorly and between the scapulae posteriorly).
3. These findings indicate normal lung structure and function.
4. Abnormal findings include dullness (consolidation/effusion) or
hyperresonance (COPD/pneumothorax).
2. During an abdominal examination, a nurse in a provider's office
determines that a client has abdominal distention. The protrusion is at
midline, the skin over the area is taut, and the nurse notes no
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involvement of the flanks. Which of the following possible causes of
distention should the nurse suspect?
Correct Answer: Flatus
Rationale:
1. Midline distention without flank involvement suggests gas (flatus) in the
intestines.
2. Taut skin indicates pressure from within the abdomen.
3. Flatus distention is generalized, not localized to one side.
4. Other causes: ascites (flank bulging, shifting dullness), obesity (fat
distribution), pregnancy, or tumor.
3. During a cardiovascular examination, a nurse in a provider's office
places the diaphragm of the stethoscope on the left midclavicular line at
the fifth intercostal space. Which of the following data is the nurse
attempting to auscultate?
Correct Answer: Closure of the mitral valve; Apical heart rate
Rationale:
1. The left midclavicular line at the fifth intercostal space is the mitral (apical)
area.
2. The nurse auscultates the closure of the mitral (and tricuspid) valve (S1
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sound).
3. The apical heart rate is counted at this location (most accurate for rate and
rhythm).
4. This is the point of maximum impulse (PMI).
4. A nurse in a provider's office is preparing to auscultate and percuss a
client's abdomen as part of a comprehensive physical examination.
Which of the following findings should the nurse expect?
Correct Answer: Tympany; High pitched clicks
Rationale:
1. Tympany is the normal percussion sound over air-filled stomach and
intestines.
2. High-pitched clicks and gurgles are normal bowel sounds.
3. Dullness over solid organs (liver, spleen) is also normal in specific locations.
4. Absent bowel sounds or hyperresonance would be abnormal.
5. A nurse in a provider's office is preparing to assess a client's skin as
part of a comprehensive physical examination. Which of the following
findings should the nurse expect?
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Correct Answer: Capillary refill less than 3 seconds; Thick skin on the
soles of the feet; Numerous macules on the face darker than the
surrounding skin color
Rationale:
1. Capillary refill less than 3 seconds indicates normal peripheral perfusion.
2. Thick skin on the soles of the feet is normal due to weight-bearing and
friction.
3. Numerous macules (freckles) on the face darker than surrounding skin are
normal (lentigines, ephelides).
4. Any capillary refill greater than 3 seconds indicates poor perfusion.
6. A nurse is assessing an older adult client who has significant tenting of
the skin over the forearm. Which of the following factors should the
nurse consider as a cause for this finding?
Correct Answer: Loss of adipose tissue; Dehydration; Diminished skin
elasticity
Rationale:
1. Loss of adipose tissue (subcutaneous fat) reduces skin support.
2. Dehydration decreases skin turgor, causing tenting.
3. Diminished skin elasticity is an age-related change (loss of collagen and
NUR 209 Exam 3 Med Surg II 2026/2027
Questions with Verified Answers and
Detailed Rationales Grade A
1. A nurse in a provider's office is preparing to auscultate and percuss a
client's thorax as part of a comprehensive physical examination. Which
of the following findings should the nurse expect?
Correct Answer: Resonance and bronchovesicular sounds
Rationale:
1. Resonance is the normal percussion sound over healthy lung tissue.
2. Bronchovesicular breath sounds are normal over the main bronchi (1st-
2nd intercostal spaces anteriorly and between the scapulae posteriorly).
3. These findings indicate normal lung structure and function.
4. Abnormal findings include dullness (consolidation/effusion) or
hyperresonance (COPD/pneumothorax).
2. During an abdominal examination, a nurse in a provider's office
determines that a client has abdominal distention. The protrusion is at
midline, the skin over the area is taut, and the nurse notes no
,2|Page
involvement of the flanks. Which of the following possible causes of
distention should the nurse suspect?
Correct Answer: Flatus
Rationale:
1. Midline distention without flank involvement suggests gas (flatus) in the
intestines.
2. Taut skin indicates pressure from within the abdomen.
3. Flatus distention is generalized, not localized to one side.
4. Other causes: ascites (flank bulging, shifting dullness), obesity (fat
distribution), pregnancy, or tumor.
3. During a cardiovascular examination, a nurse in a provider's office
places the diaphragm of the stethoscope on the left midclavicular line at
the fifth intercostal space. Which of the following data is the nurse
attempting to auscultate?
Correct Answer: Closure of the mitral valve; Apical heart rate
Rationale:
1. The left midclavicular line at the fifth intercostal space is the mitral (apical)
area.
2. The nurse auscultates the closure of the mitral (and tricuspid) valve (S1
,3|Page
sound).
3. The apical heart rate is counted at this location (most accurate for rate and
rhythm).
4. This is the point of maximum impulse (PMI).
4. A nurse in a provider's office is preparing to auscultate and percuss a
client's abdomen as part of a comprehensive physical examination.
Which of the following findings should the nurse expect?
Correct Answer: Tympany; High pitched clicks
Rationale:
1. Tympany is the normal percussion sound over air-filled stomach and
intestines.
2. High-pitched clicks and gurgles are normal bowel sounds.
3. Dullness over solid organs (liver, spleen) is also normal in specific locations.
4. Absent bowel sounds or hyperresonance would be abnormal.
5. A nurse in a provider's office is preparing to assess a client's skin as
part of a comprehensive physical examination. Which of the following
findings should the nurse expect?
, 4|Page
Correct Answer: Capillary refill less than 3 seconds; Thick skin on the
soles of the feet; Numerous macules on the face darker than the
surrounding skin color
Rationale:
1. Capillary refill less than 3 seconds indicates normal peripheral perfusion.
2. Thick skin on the soles of the feet is normal due to weight-bearing and
friction.
3. Numerous macules (freckles) on the face darker than surrounding skin are
normal (lentigines, ephelides).
4. Any capillary refill greater than 3 seconds indicates poor perfusion.
6. A nurse is assessing an older adult client who has significant tenting of
the skin over the forearm. Which of the following factors should the
nurse consider as a cause for this finding?
Correct Answer: Loss of adipose tissue; Dehydration; Diminished skin
elasticity
Rationale:
1. Loss of adipose tissue (subcutaneous fat) reduces skin support.
2. Dehydration decreases skin turgor, causing tenting.
3. Diminished skin elasticity is an age-related change (loss of collagen and
