LPN to ADN Bridge Week 2: Advanced Assessment & Pathophysiology
2026/2027 Update
1. When auscultating the heart of a 70-year-old patient with heart failure, the
nurse hears an extra sound early in diastole. This sound is most likely:
A. S1
B. S2
C. S4
D. S3
Answer: D
Rationale: An S3 heart sound, or ventricular gallop, is often a sign of fluid overload and
ventricular dysfunction in older adults.
2. Which assessment finding is most characteristic of a patient with tension
pneumothorax?
A. Tracheal deviation to the affected side
B. Dullness on percussion
C. Increased tactile fremitus
D. Tracheal deviation to the unaffected side
Answer: D
Rationale: In a tension pneumothorax, air pressure builds up and shifts the mediastinum,
causing the trachea to deviate toward the healthy side.
,3. A patient’s ABG results are pH 7.32, PaCO2 52, and HCO3 24. How should the
nurse interpret these results?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: The low pH (<7.35) and high PaCO2 (>45) indicate respiratory acidosis, with a
normal bicarbonate level suggesting no compensation.
4. During an abdominal assessment, the nurse should perform the techniques in
which order?
A. Inspection, Palpation, Percussion, Auscultation
B. Inspection, Auscultation, Percussion, Palpation
C. Auscultation, Inspection, Palpation, Percussion
D. Palpation, Percussion, Auscultation, Inspection
Answer: B
Rationale: Auscultation is done before percussion and palpation to avoid altering bowel
sounds.
5. What is the hallmark pathophysiology of Type 1 Diabetes Mellitus?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Excessive glucagon production by alpha cells
D. Overproduction of insulin by the pancreas
Answer: A
Rationale: Type 1 Diabetes is characterized by an absolute insulin deficiency due to the
destruction of beta cells.
, 6. Which cranial nerve is being tested when the nurse asks the patient to smile,
frown, and puff out their cheeks?
A. CN V (Trigeminal)
B. CN XII (Hypoglossal)
C. CN IX (Glossopharyngeal)
D. CN VII (Facial)
E. CN II (Optic)
Answer: D
Rationale: The facial nerve (CN VII) controls the muscles of facial expression.
7. A positive Murphy’s sign during physical examination is most suggestive of:
A. Appendicitis
B. Splenomegaly
C. Nephrolithiasis
D. Cholecystitis
Answer: D
Rationale: Murphy’s sign is pain and a sudden stop in inspiration during palpation of the
right upper quadrant, indicating gallbladder inflammation.
8. Which electrolyte imbalance is most likely to cause the presence of U waves
on an ECG?
A. Hyperkalemia
B. Hypokalemia
C. Hypocalcemia
D. Hypernatremia
Answer: B
Rationale: Hypokalemia typically causes flattened T waves and the appearance of U waves
on an ECG.
2026/2027 Update
1. When auscultating the heart of a 70-year-old patient with heart failure, the
nurse hears an extra sound early in diastole. This sound is most likely:
A. S1
B. S2
C. S4
D. S3
Answer: D
Rationale: An S3 heart sound, or ventricular gallop, is often a sign of fluid overload and
ventricular dysfunction in older adults.
2. Which assessment finding is most characteristic of a patient with tension
pneumothorax?
A. Tracheal deviation to the affected side
B. Dullness on percussion
C. Increased tactile fremitus
D. Tracheal deviation to the unaffected side
Answer: D
Rationale: In a tension pneumothorax, air pressure builds up and shifts the mediastinum,
causing the trachea to deviate toward the healthy side.
,3. A patient’s ABG results are pH 7.32, PaCO2 52, and HCO3 24. How should the
nurse interpret these results?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: The low pH (<7.35) and high PaCO2 (>45) indicate respiratory acidosis, with a
normal bicarbonate level suggesting no compensation.
4. During an abdominal assessment, the nurse should perform the techniques in
which order?
A. Inspection, Palpation, Percussion, Auscultation
B. Inspection, Auscultation, Percussion, Palpation
C. Auscultation, Inspection, Palpation, Percussion
D. Palpation, Percussion, Auscultation, Inspection
Answer: B
Rationale: Auscultation is done before percussion and palpation to avoid altering bowel
sounds.
5. What is the hallmark pathophysiology of Type 1 Diabetes Mellitus?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Excessive glucagon production by alpha cells
D. Overproduction of insulin by the pancreas
Answer: A
Rationale: Type 1 Diabetes is characterized by an absolute insulin deficiency due to the
destruction of beta cells.
, 6. Which cranial nerve is being tested when the nurse asks the patient to smile,
frown, and puff out their cheeks?
A. CN V (Trigeminal)
B. CN XII (Hypoglossal)
C. CN IX (Glossopharyngeal)
D. CN VII (Facial)
E. CN II (Optic)
Answer: D
Rationale: The facial nerve (CN VII) controls the muscles of facial expression.
7. A positive Murphy’s sign during physical examination is most suggestive of:
A. Appendicitis
B. Splenomegaly
C. Nephrolithiasis
D. Cholecystitis
Answer: D
Rationale: Murphy’s sign is pain and a sudden stop in inspiration during palpation of the
right upper quadrant, indicating gallbladder inflammation.
8. Which electrolyte imbalance is most likely to cause the presence of U waves
on an ECG?
A. Hyperkalemia
B. Hypokalemia
C. Hypocalcemia
D. Hypernatremia
Answer: B
Rationale: Hypokalemia typically causes flattened T waves and the appearance of U waves
on an ECG.
