NUR 3065 Questions (Exam 2)
Questions and All Actual Answers.
What auscultating a client's heart sounds, the nurse hears a louder s2 when listening at the 2nd
intercostal space right sternal border. The nurse determines that is finding is consistent with the
closure of which heart valves? - Answer Aortic and pulmonic
The second heart sound, "dub" or S2, is caused by the closure of the aortic and pulmonic valves,
marking the end of systole.
A nurse provides prevention strategies to a group of clients who are identified as at risk for
hypertension. Which strategies should the nurse include? - Answer Walk briskly 30 minutes
per day.
Choose foods like bananas and sweet potatoes. Use a low sodium seasoning to flavor food.
Which nursing assessment finding supports the diagnosis of chronic arterial insufficiency? -
Answer Cool foot temperature and ulceration on the client's great toe
Pigmentation, medial ankle ulceration, and thickened, scarred skin are associated with venous
insufficiency, while low temperature and toe ulceration are more commonly found in cases of
arterial insufficiency.
When a patient is obese or has a thick chest wall, what is difficult to palpate? - Answer Apical
Pulse
First attempt to palpate the apical pulse should be in supine position. If unable to feel it, place
the patient in the left lateral position.
What is the correct sequence of the cardiac examination? - Answer Inspect the pericardium,
palpate pulses, then auscultation ( listen at the 2nd intercostal space.
A nurse is palpating a patient's leg bilaterally with the back of her hands and notes that one leg
is colder than the other. The nurse knows that this may indicate which of the following? -
Answer Inadequate arterial circulation
The nurse is assessing the jugular venous pressure (JVP) on a patient and notices that it
measures at 9cm from the sternal angle. The nurse knows that this may indicate which of the
following? - Answer Right ventricular failure
, RVF occurs when the right ventricle fails to maintain enough blood flow to the pulmonary
circulation, and blood begins backing up into the periphery. This would cause a bounding, or
elevated JVP.
When a nurse is assessing the carotid pulse of a patient, the patient's head of bed should be
elevated at 30 degrees - Answer True
The nurse knows to listen for the S1 and S2 heart sounds in the supine position. However, if a
nurse suspects mitral stenosis, he/she should position the patient in which position to
emphasize extra heart sounds? - Answer Left lateral position
(Place the bell of your stethoscope lightly on the apical impulse)
The nurse is performing the Allen test on a patient to compare the patency of the ulnar and
radial arteries. After compressing both arteries and releasing pressure over the ulnar artery, the
nurse notes continued pallor of the hand. The nurse knows that this indicates which of the
following? - Answer Occlusion of the ulnar artery
(Remember that the radial artery continues to be compressed by the nurse.)
The nurse is preparing to percuss a patient's anterior chest area. Which approach will the nurse
use for this assessment? - Answer Begin above the right clavicle and percuss each section
comparing the right chest with the left chest.
The nurse is preparing to auscultate the lung sounds of a young adult. Which soft, low pitched
sound will the nurse expect to har over most of the patient's lungs? - Answer Vesicular
The nurse obtains a flat sound when percussing the right lower lobe of a patient. What does this
assessment finding indicates to the nurse? - Answer Pleural Effusion
(Percussion produces dullness with pleural effusion. Dullness occurs when fluid replaces
normally air-filled lungs.)
The nurse is determining the number of annual influenza vaccinations that will need to be
provided to a group of community members. Which members would benefit the most from
receiving this vaccinations? - Answer Adult patient caring for a children under age 5, Older
adult attending adult day care, and Adult patient with chronic obstructive pulmonary disease.
Which terms are used to identify the lobes of the right lungs? - Answer Lower Lobe, Middle
Lobe, and Upper Lobe
Questions and All Actual Answers.
What auscultating a client's heart sounds, the nurse hears a louder s2 when listening at the 2nd
intercostal space right sternal border. The nurse determines that is finding is consistent with the
closure of which heart valves? - Answer Aortic and pulmonic
The second heart sound, "dub" or S2, is caused by the closure of the aortic and pulmonic valves,
marking the end of systole.
A nurse provides prevention strategies to a group of clients who are identified as at risk for
hypertension. Which strategies should the nurse include? - Answer Walk briskly 30 minutes
per day.
Choose foods like bananas and sweet potatoes. Use a low sodium seasoning to flavor food.
Which nursing assessment finding supports the diagnosis of chronic arterial insufficiency? -
Answer Cool foot temperature and ulceration on the client's great toe
Pigmentation, medial ankle ulceration, and thickened, scarred skin are associated with venous
insufficiency, while low temperature and toe ulceration are more commonly found in cases of
arterial insufficiency.
When a patient is obese or has a thick chest wall, what is difficult to palpate? - Answer Apical
Pulse
First attempt to palpate the apical pulse should be in supine position. If unable to feel it, place
the patient in the left lateral position.
What is the correct sequence of the cardiac examination? - Answer Inspect the pericardium,
palpate pulses, then auscultation ( listen at the 2nd intercostal space.
A nurse is palpating a patient's leg bilaterally with the back of her hands and notes that one leg
is colder than the other. The nurse knows that this may indicate which of the following? -
Answer Inadequate arterial circulation
The nurse is assessing the jugular venous pressure (JVP) on a patient and notices that it
measures at 9cm from the sternal angle. The nurse knows that this may indicate which of the
following? - Answer Right ventricular failure
, RVF occurs when the right ventricle fails to maintain enough blood flow to the pulmonary
circulation, and blood begins backing up into the periphery. This would cause a bounding, or
elevated JVP.
When a nurse is assessing the carotid pulse of a patient, the patient's head of bed should be
elevated at 30 degrees - Answer True
The nurse knows to listen for the S1 and S2 heart sounds in the supine position. However, if a
nurse suspects mitral stenosis, he/she should position the patient in which position to
emphasize extra heart sounds? - Answer Left lateral position
(Place the bell of your stethoscope lightly on the apical impulse)
The nurse is performing the Allen test on a patient to compare the patency of the ulnar and
radial arteries. After compressing both arteries and releasing pressure over the ulnar artery, the
nurse notes continued pallor of the hand. The nurse knows that this indicates which of the
following? - Answer Occlusion of the ulnar artery
(Remember that the radial artery continues to be compressed by the nurse.)
The nurse is preparing to percuss a patient's anterior chest area. Which approach will the nurse
use for this assessment? - Answer Begin above the right clavicle and percuss each section
comparing the right chest with the left chest.
The nurse is preparing to auscultate the lung sounds of a young adult. Which soft, low pitched
sound will the nurse expect to har over most of the patient's lungs? - Answer Vesicular
The nurse obtains a flat sound when percussing the right lower lobe of a patient. What does this
assessment finding indicates to the nurse? - Answer Pleural Effusion
(Percussion produces dullness with pleural effusion. Dullness occurs when fluid replaces
normally air-filled lungs.)
The nurse is determining the number of annual influenza vaccinations that will need to be
provided to a group of community members. Which members would benefit the most from
receiving this vaccinations? - Answer Adult patient caring for a children under age 5, Older
adult attending adult day care, and Adult patient with chronic obstructive pulmonary disease.
Which terms are used to identify the lobes of the right lungs? - Answer Lower Lobe, Middle
Lobe, and Upper Lobe
