NUR612/NUR 612 Final Exam V2 |
Advanced Nursing II Q&A with Rationale |
William Paterson University
1. When auscultating heart sounds, an S3 gallop is most commonly associated with which
condition in older adults?
A. Aortic stenosis
B. Mitral valve prolapse
C. Chronic hypertension
D. Heart failure
Answer: D
Rationale: The S3 heart sound is often referred to as a ventricular gallop occurring in early
diastole. In older populations, this finding is a classic sign of ventricular wall vibration
caused by fluid overload. It specifically suggests decreased ventricular compliance or heart
failure.
2. Which cranial nerve is primarily responsible for the motor function of facial expressions?
A. Cranial Nerve V
B. Cranial Nerve VII
C. Cranial Nerve X
D. Cranial Nerve XII
,Answer: B
Rationale: Cranial Nerve VII, the facial nerve, controls the muscles used for facial
expressions like smiling or frowning. Assessment involves asking the patient to puff out
their cheeks or raise their eyebrows. Damage to this nerve can result in conditions such as
Bell’s palsy.
3. A positive Murphy sign is most indicative of which inflammatory process?
A. Acute appendicitis
B. Acute pancreatitis
C. Acute cholecystitis
D. Acute pyelonephritis
Answer: C
Rationale: A Murphy sign is elicited by palpating the right upper quadrant while the
patient takes a deep breath. A positive result occurs when the patient catches their breath
due to pain as the gallbladder descends. This maneuver is highly specific for diagnosing
inflammation of the gallbladder.
4. The ‘A’ in the ABCDE rule for evaluating skin lesions for potential melanoma stands for:
A. Actinic
B. Atypical
C. Asymmetry
, D. Adherent
Answer: C
Rationale: Asymmetry refers to a lesion where one half does not match the other half in
shape. This is the first step in the visual screening process for malignant melanoma.
Recognizing asymmetrical growth is critical for early detection and referral.
5. During a physical exam, increased tactile fremitus is typically found in which of the
following conditions?
A. Pneumothorax
B. Lobar pneumonia
C. Pleural effusion
D. Emphysema
Answer: B
Rationale: Tactile fremitus is the vibration felt on the chest wall when the patient speaks.
It increases when there is consolidation in the lung tissue, such as in pneumonia, because
sound travels better through solid or liquid than air. Conversely, conditions that trap air or
separate the lung from the chest wall will decrease fremitus.
6. Which of the following is considered an Instrumental Activity of Daily Living (IADL)?
A. Bathing
B. Dressing
Advanced Nursing II Q&A with Rationale |
William Paterson University
1. When auscultating heart sounds, an S3 gallop is most commonly associated with which
condition in older adults?
A. Aortic stenosis
B. Mitral valve prolapse
C. Chronic hypertension
D. Heart failure
Answer: D
Rationale: The S3 heart sound is often referred to as a ventricular gallop occurring in early
diastole. In older populations, this finding is a classic sign of ventricular wall vibration
caused by fluid overload. It specifically suggests decreased ventricular compliance or heart
failure.
2. Which cranial nerve is primarily responsible for the motor function of facial expressions?
A. Cranial Nerve V
B. Cranial Nerve VII
C. Cranial Nerve X
D. Cranial Nerve XII
,Answer: B
Rationale: Cranial Nerve VII, the facial nerve, controls the muscles used for facial
expressions like smiling or frowning. Assessment involves asking the patient to puff out
their cheeks or raise their eyebrows. Damage to this nerve can result in conditions such as
Bell’s palsy.
3. A positive Murphy sign is most indicative of which inflammatory process?
A. Acute appendicitis
B. Acute pancreatitis
C. Acute cholecystitis
D. Acute pyelonephritis
Answer: C
Rationale: A Murphy sign is elicited by palpating the right upper quadrant while the
patient takes a deep breath. A positive result occurs when the patient catches their breath
due to pain as the gallbladder descends. This maneuver is highly specific for diagnosing
inflammation of the gallbladder.
4. The ‘A’ in the ABCDE rule for evaluating skin lesions for potential melanoma stands for:
A. Actinic
B. Atypical
C. Asymmetry
, D. Adherent
Answer: C
Rationale: Asymmetry refers to a lesion where one half does not match the other half in
shape. This is the first step in the visual screening process for malignant melanoma.
Recognizing asymmetrical growth is critical for early detection and referral.
5. During a physical exam, increased tactile fremitus is typically found in which of the
following conditions?
A. Pneumothorax
B. Lobar pneumonia
C. Pleural effusion
D. Emphysema
Answer: B
Rationale: Tactile fremitus is the vibration felt on the chest wall when the patient speaks.
It increases when there is consolidation in the lung tissue, such as in pneumonia, because
sound travels better through solid or liquid than air. Conversely, conditions that trap air or
separate the lung from the chest wall will decrease fremitus.
6. Which of the following is considered an Instrumental Activity of Daily Living (IADL)?
A. Bathing
B. Dressing
