Advanced Practice Nursing I | Q&A with
Rationale (NUR6111 Exam 1) | William
Paterson University
1. When conducting a comprehensive health history, the nurse practitioner notes the
patient’s report of ‘occasional chest pressure.’ Under which section of the SOAP note should
this be documented?
A. Subjective
B. Objective
C. Assessment
D. Plan
Answer: A
Rationale: Subjective data includes information provided by the patient that cannot be
directly observed by the examiner. This encompasses symptoms, personal feelings, and the
patient’s perspective on their health status. Accurate documentation in the subjective
section is crucial for establishing a differential diagnosis.
2. A 55-year-old patient presents with a new skin lesion. Which characteristic in the ABCDE
mnemonic for melanoma would be most concerning for malignancy?
A. Symmetric shape
,B. Uniform light brown color
C. Evolution in size or appearance
D. Diameter less than 6 millimeters
Answer: C
Rationale: The ‘E’ in the ABCDE mnemonic stands for evolution, which refers to any
change in a lesion over time. Rapid changes in size, shape, or color are significant clinical
indicators of potential malignancy. Regular monitoring of pigmented lesions is a standard
component of advanced dermatological assessment.
3. During a physical examination of the thorax, the nurse practitioner hears low-pitched,
snoring sounds that clear with coughing. How should these be documented?
A. Rhonchi
B. Wheezes
C. Stridor
D. Fine crackles
Answer: A
Rationale: Rhonchi are continuous, low-pitched, rattling lung sounds that often resemble
snoring. They are typically caused by secretions in the larger airways and may clear after
the patient coughs. Distinguishing rhonchi from other adventitious sounds is essential for
identifying underlying obstructive processes.
, 4. Which heart sound is considered a ‘ventricular gallop’ and is often associated with heart
failure in older adults?
A. S1
B. S2
C. S4
D. S3
Answer: D
Rationale: The S3 heart sound occurs early in diastole during the rapid ventricular filling
phase. While it can be normal in children and athletes, in older adults it often indicates
volume overload or ventricular dysfunction. Identifying an S3 gallop is a key finding in the
assessment of congestive heart failure.
5. To assess for Cranial Nerve VII (Facial Nerve) function, which action should the nurse
practitioner ask the patient to perform?
A. Shrug the shoulders against resistance
B. Protrude the tongue to the midline
C. Smile and puff out the cheeks
D. Follow a finger through the six cardinal fields of gaze
Answer: C